Crazy patients!

SDN Members don't see this ad. (About Ads)

this is a take off of the "Crazy Pre-meds" thread.

how about crazy patients?

unfortunately there are crazy people everywhere, but you'll see more crazies as physicians than perhaps anywhere else. And I'm not talking just about psychiatrists - you all will see them on a daily basis!

they can either be very entertaining or they can ruin your day. It's hard to imagine work without them, though.

i just finished a blog post about crazy patients - if you've ever done clinical work then you'll be able to relate!

how about crazy patient stories? anyone out there have anything to share that will brighten my day?

enjoy the blog post.

Ranting about "crazy" patients? It saddens me that there are physicians who can be this condescending.

Originally Posted by saveourpens

Ranting about "crazy" patients? It saddens me that there are physicians who can be this condescending.

Naive

Originally Posted by saveourpens

Ranting about "crazy" patients? It saddens me that there are physicians who can be this condescending.

If you can tell me a way to deal with the craziness of your patients without talking about them to SOMEBODY, I would very much like to know. There are some nutters and some just plain mean people out there, the best way I've found to deal with them is to talk about the experience with someone else (confidentially, of course).

Originally Posted by saveourpens

Ranting about "crazy" patients? It saddens me that there are physicians who can be this condescending.

Very naive...

I scanned through your blog. Very enjoyable. Perhaps when I have more time in a few weeks I will read it. Thanks for sharing.

Call me naive (and I'm sure I'll be thoroughly desensitized to patient's suffering when I'm done with med school) but I do think medicine can be practiced without labeling patients as crazy.

Originally Posted by saveourpens

Call me naive (and I'm sure I'll be thoroughly desensitized to patient's suffering when I'm done with med school) but I do think medicine can be practiced without labeling patients as crazy.

You say that now... I was once wide-eyed and full of hope.

Turns out, I was stupid. People are non-compliant, ungrateful and just downright bat sh!t crazy.

"doctor, I can't stop smoking, my assuth-mah won't let me"

"I want a plastic surgeon to fix my childs face!" (2 cm laceration, simple, on the right side of the face, right in front of the ear)

*after heroin overdosing and being revived by Naloxone* "Omg, are my parents here...?"

Originally Posted by saveourpens

Call me naive (and I'm sure I'll be thoroughly desensitized to patient's suffering when I'm done with med school) but I do think medicine can be practiced without labeling patients as crazy.

Just from having worked as a CNA for two years and an EMT for two before that, I can say with confidence that a great number of my patients have been certifiably crazy.

Pfft... Try working acute psychiatry. You see all sorts of colors.

I share the same sentiments as saveourpens, I find this thread repugnant.

I've had my share of experience with lots of annoying patients sure, like the guy who just revived from a heroine overdose and is now screaming non-stop due to withdrawal in the ER. However, annoying is the end of it and it's extremely inappropriate to dehumanize anyone, especially a patient.

Ranting about "annoying" patients? It saddens me that there are non-physicians who can be this condescending.

Originally Posted by pkwraith

Ranting about "annoying" patients? It saddens me that there are non-physicians who can be this condescending.

Sorry to to dampen your day.

You can take comfort in the that that I'm not making a public blog to invite the entire world to parse the craziness of these damned crazy people at their expense if that means anything.

Originally Posted by larryboy

this is a take off of the "Crazy Pre-meds" thread.

how about crazy patients?

unfortunately there are crazy people everywhere, but you'll see more crazies as physicians than perhaps anywhere else. And I'm not talking just about psychiatrists - you all will see them on a daily basis!

they can either be very entertaining or they can ruin your day. It's hard to imagine work without them, though.

i just finished a blog post about crazy patients - if you've ever done clinical work then you'll be able to relate!

how about crazy patient stories? anyone out there have anything to share that will brighten my day?

enjoy the blog post.

That most recent entry on the crazy people was actually spot-on in so, so many ways. I understand why most premeds are quick to jump to the patients' defense, having never actually dealt with a significant number of patients in meaningful ways.

Here are just a few of my more memorable incidences with patients.

After placing a nine year old into seclusion in a psych hospital he informed me, repeatedly, that once he got out he would "ram [his] f#$%ing c&*k down my throat until [I] bled to death."

Also in psych, I was called to an adult unit to assist in potentially restraining an escalating patient. When I arrive on the unit I find and nurse and ask what's going on. She proceeds to inform me that a fight broke out between two patients over whether they would watch The Wizard of Oz or One Flew Over the Cuckoo's Nest.

In med/surg, one of the nurses realizes a patient is missing (not one of mine thank god). Shortly after realizing this we get a phone call from the police stating that the patient was found at a grocery store about two blocks away, still hooked to his IV, trying to by cigarettes. When he came back to the hospital he informed us that it was "okay" he was going to come back, "the nicotine patches just weren't enough." Mind you the patient was admitted with pneumonia and COPD exacerbation.

Originally Posted by saveourpens

Ranting about "crazy" patients? It saddens me that there are physicians who can be this condescending.

Its not really being condescending. Not venting about ridiculous patients is in essence acting as if they don't exist, and just results in the stress of dealing with them pile-up and get at you. Though I do think its of upmost importance to maintain composure and professionalism when dealing with them; not venting makes this harder. On several occasions I've found it very difficult for myself, colleagues, and yes even physicians to maintain composure/seriousness and be professional when dealing with ridiculous patients. You just have to accept that these patients exist, and have outlets for dealing with them.

I haven't seen anything outrageous during my limited shadowing, but if anyone wants to hear some interesting stories, you should check out the "Things I learned from my patients" thread in the EM forum..... HIL--ARIOUS.

And I dont think there's anything wrong with venting about your patients on a blog. We all have our ways of coping, and I think it could be a lot worse than blogging.

Originally Posted by CodeBlu

You say that now... I was once wide-eyed and full of hope.

Turns out, I was stupid. People are non-compliant, ungrateful and just downright bat sh!t crazy.

"doctor, I can't stop smoking, my assuth-mah won't let me"

"I want a plastic surgeon to fix my childs face!" (2 cm laceration, simple, on the right side of the face, right in front of the ear)

*after heroin overdosing and being revived by Naloxone* "Omg, are my parents here...?"

Originally Posted by WillburCobb

Here are just a few of my more memorable incidences with patients.

After placing a nine year old into seclusion in a psych hospital he informed me, repeatedly, that once he got out he would "ram [his] f#$%ing c&*k down my throat until [I] bled to death."

Also in psych, I was called to an adult unit to assist in potentially restraining an escalating patient. When I arrive on the unit I find and nurse and ask what's going on. She proceeds to inform me that a fight broke out between two patients over whether they would watch The Wizard of Oz or One Flew Over the Cuckoo's Nest.

In med/surg, one of the nurses realizes a patient is missing (not one of mine thank god). Shortly after realizing this we get a phone call from the police stating that the patient was found at a grocery store about two blocks away, still hooked to his IV, trying to by cigarettes. When he came back to the hospital he informed us that it was "okay" he was going to come back, "the nicotine patches just weren't enough." Mind you the patient was admitted with pneumonia and COPD exacerbation.



Its not really being condescending. Not venting about ridiculous patients is in essence acting as if they don't exist, and just results in the stress of dealing with them pile-up and get at you. Though I do think its of upmost importance to maintain composure and professionalism when dealing with them; not venting makes this harder. On several occasions I've found it very difficult for myself, colleagues, and yes even physicians to maintain composure/seriousness and be professional when dealing with ridiculous patients. You just have to accept that these patients exist, and have outlets for dealing with them.

EPIC

Since I dont have anything to contribute, Ive decided to post a few from the thread I mentioned above:


obese patient (400+ pounds) p/w left scrotal pain secondary to sitting on his own testicle.. further analysis shows the guy crushed his own twig and berries..*

african american pt (who needs surgery) tells me NPO really stands for "n*gger patient out"*

swallowing batteries gives you energy (is the bunny inside you?)


I, like UTH2003, have not started MS1 yet, but I have worked in an Emergency Dept for a year now. May I add that when stealing a Rx pad to fill it out correctly when turning it into the pharmacy the following day. They realize something is fishy when you write for "1.2 pounds of Mofin" (yeah, sound it out). Also, don't... decide that the medical equipment in your room is included in your stay; you really won't be able to use that chest tube that you try to stuff into your purse or the epistaxis clamp that you think would increase your sexual adventures. I totally stopped believing in "survival of the fittest" when I started working in the ED.......

When your 15yo daughter gives precipitous delivery to a bleating, underweight infant 30 minutes after presenting to triage c "gas pains", you should run around the department loudly yelling, "I don't know what y'all did or who that baby is, but my lil' girl warn't pregnant when she come in here"*

I had a patient come in the other day complaining that he had had Hepatitis B so long it had turned into Hepatitis C...


Pt came in w/ "contractions" q 5 min. When asked about the prominent scar on her belly she said it was from her hysterectomy



If this is your "cup of tea", there's 60+ more pages where that came from in the EM forum.

I was changing linen bags when I heard **** going down. There were like 6 police men surrounding this old lady who was going bat sh*t insane. She was yelling about how she was from the fbi to investigate us throwing away bodies and heads and stuff. She pointed to my bag and yelled at me to look in there. The police men then restrained her and she went even more bat **** insane and started screaming even louder. This actually happened today. It brought some much needed excitement to my boring volunteer shift.

"Crazy" is often a result of disease processes like addiction. These people need help, not criticism, imo, as the rational component of their mind is temporarily or permanently defective.

Originally Posted by saveourpens

Call me naive (and I'm sure I'll be thoroughly desensitized to patient's suffering when I'm done with med school) but I do think medicine can be practiced without labeling patients as crazy.

Would you prefer psychosis NOS; schizoprenia (of which there are 3 types); bipolar type I/II? I try not to use the "c" word but for all intents and purposes these patients are crazy.

Originally Posted by sliceofbread136

I was changing linen bags when I heard **** going down. There were like 6 police men surrounding this old lady who was going bat sh*t insane. She was yelling about how she was from the fbi to investigate us throwing away bodies and heads and stuff. She pointed to my bag and yelled at me to look in there. The police men then restrained her and she went even more bat **** insane and started screaming even louder. This actually happened today. It brought some much needed excitement to my boring volunteer shift.

Originally Posted by Bacchus

Would you prefer psychosis NOS; schizoprenia (of which there are 3 types); bipolar type I/II? I try not to use the "c" word but for all intents and purposes these patients are crazy.

+1

Originally Posted by Bacchus

Would you prefer psychosis NOS; schizoprenia (of which there are 3 types); bipolar type I/II? I try not to use the "c" word but for all intents and purposes these patients are crazy.

True dat.

I have had some pretty batsh*t insane patients, but sometimes it's the RELATIVES that are truly off their rocker....

Working with crazy people isn't as bad as working with idiots

hahaha. you guys are funny. good stories. i just got done working a night shift in the ED...that was fun.

we had a patient who thought that the contents of a colostomy bag would be suitable for shampoo....you can imagine how that went down...LOL

in our psych ED, we had a patient who made a hole in the ceiling tiles and tried to escape...but when that person came out of the ceiling...that person just happened to land right in front of the security office...

I gots others, but i'm getting sleepy. EM gets a wide variety of weird wackiness.

Crazy patients are the norm, not the exception. Get used to it.

Originally Posted by GuerreDePlume

Crazy patients are the norm, not the exception. Get used to it.

I'm not so sure about that, but it depends on what field you're in. If you're working psych, almost all of your patients will be crazy. If you're working in the ED, a good number will be. But if you're working in, like, outpatient family practice or derm, most of your patients will be very sane people who just want to keep themselves in good health.

I don't think crazy people are THAT overrepresented in medicine. My cousin has been a waitress for many years, and she has had to deal with at least as many crazy people as I have working in a hospital for years. Almost all of us on SDN are fairly sane, and we tend to surround ourselves with other sane people, so we sometimes don't realize that the number of crazy people in the entire population is pretty astounding. When you work in a career where you have to deal with a sampling of the general population (like medicine or waitressing), it might seem like there an abnormal number of crazy people, but they are actually just representative of the public at large.

Originally Posted by WDeagle

Naive

Uneducated, stubborn and ill-informed are better terms. Very few are crazy and I agree, ranting about "crazy" patients is rather misplaced in a future doctor forum. I say the people you work with are going to be just as bad.

It is my opinion that exposure to patient care settings and experience in customer service and dealing with the public is very beneficial for a career in health care.

Originally Posted by TheMightySmiter

I'm not so sure about that, but it depends on what field you're in. If you're working psych, almost all of your patients will be crazy.

It actually depends on what you mean by 'crazy'. It varies from population to population but if by 'crazy' you mean insufferable, annoying and outrageous in my experience I put it at ~25%. Again, that varies hugely with the population you're working with.

Obviously, the majority have behavioral issues where they do weird things such as talking to themselves, rocking back and forth in their room for hours with a blanket over their head, covering their head with mayonnaise or endlessly reciting bible verses but that doesn't automatically equate to inconsiderate, rude or obnoxious. Most, not all, of the people I work with are actually quite congenial and the ones that aren't, 9 times out of 10, have a monstrous backlog of psychosocial hangups which warrant ridicule in the same way a patient with ALS deserves ridicule for losing the ability to walk.

Originally Posted by saveourpens

Call me naive (and I'm sure I'll be thoroughly desensitized to patient's suffering when I'm done with med school) but I do think medicine can be practiced without labeling patients as crazy.

Have you worked in the ED?

Guys I still stand by the notion that medicine can be practiced without such labeling.

Just throwing it out there, but perhaps physicians find it easier to label patients with conditions like hypochondria and chronic illnesses, like fibromyalgia, as "crazy" because it's much easier to blame the patient than realize their own limits?

Originally Posted by saveourpens

Just throwing it out there, but perhaps physicians find it easier to label patients with conditions like hypochondria and chronic illnesses, like fibromyalgia, as "crazy" because it's much easier to blame the patient than realize their own limits?

Oh dear God no. I've worked with one guy who had the bolded disorder and it is very painfully real. Read the DSM description if you want a rough understanding of it.

Originally Posted by saveourpens

Guys I still stand by the notion that medicine can be practiced without such labeling.

Just throwing it out there, but perhaps physicians find it easier to label patients with conditions like hypochondria and chronic illnesses, like fibromyalgia, as "crazy" because it's much easier to blame the patient than realize their own limits?

I think crazy is quite an accurate description of many psych patients. I don't even see why crazy would be a derogatory label at all.

Originally Posted by sliceofbread136

I think crazy is quite an accurate description of many psych patients. I don't even see why crazy would be a derogatory label at all.

It's derogatory because it's dehumanizing and implies someone is 'lesser than'. There's a very long history as to why you don't hear mental health people loosely using the term 'crazy' to describe people with a mental illness.

Originally Posted by PhiPhenomenon

It's derogatory because it's dehumanizing and implies someone is 'lesser than'. There's a very long history as to why you don't hear mental health people loosely using the term 'crazy' to describe people with a mental illness.

I don't see why it implies someone is "lesser than"? I think it just implies they have a mental illness, which they do.

Originally Posted by sliceofbread136

I don't see why it implies someone is "lesser than"? I think it just implies they have a mental illness, which they do.

In the same way you can use other words in a different context in spite of the its past context, sure. In the context of this thread the term is used to describe someone who does embarrassing or outrageous things and to ultimately mock the individual which is dehumanizing.

Originally Posted by PhiPhenomenon

In the same way you can use other words in a different context in spite of the its past context, sure. In the context of this thread the term is used to describe someone who does embarrassing or outrageous things and to ultimately mock the individual which is dehumanizing.

I really don't think sharing outrageous stories of strange actions done by psych patients is individually mocking them or dehumanizing them. In many cases it is just an interesting story. Many of the things they do are indeed crazy, so why is it insulting to call them crazy? Now if the patient was made fun of or degraded, I would agree with you.

This is really just becoming an argument in semantics. Would "Patients whose behavior differs 2+ standard deviations from the mean of some operationalized assessment of normal behavior" or some other PC description be preferred?

Originally Posted by WillburCobb

This is really just becoming an argument in semantics. Would "Patients whose behavior differs 2+ standard deviations from the mean of some operationalized assessment of normal behavior" or some other PC description be preferred?

Agree with your point. Some people are overly sensitive about specific terminology.

Wanna change it to "Weird things patients say/do?"

Doesn't make any difference what you call it, the intent of the thread is clear.

And people are crazy, fwiw.

Not really crazy in a mental way but we had an old biker guy come in with a broken femur one day when I was following an ortho surg on call for trauma surgery. The guy's penis was tattooed up like a snake. We caught sight of it while trying to set the leg up and the gown opened up Was slightly ridiculous lol.

Originally Posted by tenndoc

Not really crazy in a mental way but we had an old biker guy come in with a broken femur one day when I was following an ortho surg on call for trauma surgery. The guy's penis was tattooed up like a snake. We caught sight of it while trying to set the leg up and the gown opened up Was slightly ridiculous lol.

Whatever you do, do NOT photograph it.

http://jonathanturley.org/2007/12/22...uring-surgery/

Originally Posted by GuyWhoDoesStuff

Whatever you do, do NOT photograph it.

http://jonathanturley.org/2007/12/22...uring-surgery/

Haha I'm fine without photographing it. I see one everyday when I get dressed lol

Originally Posted by WillburCobb

This is really just becoming an argument in semantics. Would "Patients whose behavior differs 2+ standard deviations from the mean of some operationalized assessment of normal behavior" or some other PC description be preferred?

Originally Posted by sliceofbread136

Agree with your point. Some people are overly sensitive about specific terminology.

Originally Posted by armybound

Wanna change it to "Weird things patients say/do?"

Doesn't make any difference what you call it, the intent of the thread is clear.

And people are crazy, fwiw.

+1 million

I understand political correctness and I believe it has its place, but some people really go overboard with it. I agree with these posts 100%.

Originally Posted by tenndoc

Not really crazy in a mental way but we had an old biker guy come in with a broken femur one day when I was following an ortho surg on call for trauma surgery. The guy's penis was tattooed up like a snake. We caught sight of it while trying to set the leg up and the gown opened up Was slightly ridiculous lol.

holy sh**! Now THAT's a badass. Although I dont know many women that would be turned on by that. Talk about nightmares!

Originally Posted by GuyWhoDoesStuff

Whatever you do, do NOT photograph it.

http://jonathanturley.org/2007/12/22...uring-surgery/

Seriously? 5th year? He was almost home-free! How stupid can you be? There goes his career.

On another note, I may be requesting a woman to do my surgeries fron now on. I feel violated just from reading that article.

While Drawing blood from an HIV positive patient, he was mumbling but I didn't mind him. All of the sudden he pulled the needle(butterfly) out and walked out the lab, making a mess everywhere. I thought he was gonna throw the needle at me... I was scared!!!!!

I've had my encounters with "crazy" patients from the most literal definition of paranoid schizophrenia to people who just completely don't care at all about their health.

There really isn't any point in complaining about it, although I'm not going to judge anyone who does. I can see where they're coming from, it's sort of like soldiers in war I suppose. Some people deal with it by talking about it, others keep it to themselves.

Originally Posted by PhiPhenomenon

Oh dear God no. I've worked with one guy who had the bolded disorder and it is very painfully real. Read the DSM description if you want a rough understanding of it.

meh the DSM, where "normal" grieving time is changed from 1 year to 2 months and homophobia is discarded because of political pressure. That thing reeks of pharma influence, a desire to create more patients, and chasing profit.