101 things you REALLY want to say!

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corpsmanUP

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The subject should have read "101 things you really want to say to patients, but don't" but that was a bit too long. So I'll start it out. Basically tell us your real pet peaves about things patients consistently do to annoy you :D

First... I'd like to have a picture of a stethescope on the wall of every ED bay with a sign in bold letters next to it that reads "If you see this in the doctor's ears, shut the hell up!!!" Ever notice how even the most quiet of patients develops verbal diarrhea when you put that sucker in your ears?

Second.... How come you weren't coughing for the 3 hours you were waiting to see me and now when I come in the room you can't stop? There are no "bonus points" or extra days off from work for coughs per minute!

Who's next? Its real slow at work today with the three pellets of sleet we got on the road.
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I'll bite...

I actually have pointed this out to patients parents, as a medical student working in an inner city peds clinic. I got really tired of all the kids coming in with asthma whose parents said they couldn't buy their medicine because it was 30 bucks a month, all the while reeking of tobacco. +pity+ I asked them if they, smoked and told them that if they would quit, the kids would have fewer exacerbations, as well as being able to afford a whole lot more than meds. They could actually pay for the doctor visit! *Gasp!*

I guess my sign would read: If you smoke, do drugs, have cable TV, lots of "bling" or any other lifestyle addition that is not absolutely a necessity, don't whine to us about being too poor to afford your or your children's meds. It will only make us hate you. :mad:
Steve
 
Next...."Ma'am, how the hell could you have taken this {little white pill} for 16 years, not know the name of it, and have the balls to show up wanting a refill of it as a new patient without a bottle of it, an old chart, or simply a clue??......Sure, let me just write for Sig: 1 little white pill Qday, #30 with 11 refills!!"
 
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corpsmanUP said:
Next...."Ma'am, how the hell could you have taken this {little white pill} for 16 years, not know the name of it, and have the balls to show up wanting a refill of it as a new patient without a bottle of it, an old chart, or simply a clue??......Sure, let me just write for Sig: 1 little white pill Qday, #30 with 11 refills!!"
Click to expand...


Awesome! Best one yet! :laugh: :laugh: :laugh:
 
If you're here for fibromyalgia... NEEEEEEXT!!!!
 
If your knowledge of NSAIDS and allergies to such run as deep as Feldene and Sulindac, you are a junkie!
 
Your knees hurt because you weigh close to one quarter of a ton and every time you stand up you squat a Volkswagon.

Is there anything else I can 'hep you with?
 
Here at St Elsewhere's we give compazine for migraines, toradol for kidney stones and the boot for drug seekers.
 
In Response to "oh, you're in medical school...so you're going to be a nurse?" My reply would be "no, if I was going to be a nurse, I would say I was a nursing student, now wouldn't I? Women can be doctors too, and men can be nurses."
 
Me: "So when exactly was the last time you bathed?"

As I look for the nearst N-95 resipirator due to the unforgettable stench of pannus smegma....
 
Cover Your Mouth When You Cough!!!!!!!!!!!!!!! Were You Raised In A Barn!
 
So, your 6 month old has had this diaper rash for 3 weeks and it hasn't changed. He has a pediatrician. Why in the blue hell did you feel the need to bring him to the ER at 3 am on a random Friday night?
 
Members don't see this ad :)
"Your pain for the last week was so bad that you walked to the ED and are eating a big mac and fries at 2 am on a Saturday but didn't take anything for it?"


"You really came in an ambulance because your boyfriend thought "your snatch" smelled bad even though you didn't want to come????"
 
"Do you really think she (the attractive female nurse) is going to go out with you because she is the only member of the staff you haven't spit at, cursed at or threatened to sue?" - to a lawyer coming in after punching out a plate glass front to a candy machine at a strip club during a drunken bachelor party. The second question - same patient "Do you really think she (the same nurse) will be impressed that the cops had to taser you three times?" Yes, he was quite proud of that.

:laugh:

- H
 
Let me get this straight, you came in tonight after 4 months of shortness of breath because........it lasted a little longer this time?

Oh, so you are also having left sided chest pain when you walk a block for the last month?
How come you didn't mention it to your MD when you saw him a week ago?


Finally,

Good thing you brought you infant son to the Emergency Department at 3 in the morning in 15 degree weather for a cough and nasal congestion when you have a doctor's appointment in the Morning. Good thinking!!!!
 
Sorry but we have no food here so I can't get you anything to eat.
 
How about the patients who come in with a list of allergies.. which include...

Plastic and the best one yet "NaCl".. WHAT? Salt?
 
This is my county pet peeve.. Pt comes to see me in the Asthma room.. Says hey doc (me being an m4, he doesnt know nor care) I just lied so I could get my Nicorette script filled.. bets part was he blew a 400+ on the peak flow and the guy who screens the asthma patients out front tells him, "hey man you better do "better" than that or you will be sitting out here all night"... Gotta love the county system..

Anyhow I made him sit and wait while i waited on the "real" sick patients, then I presented to the attending and he informed me that we dont wrtie for Nicorette in the ED, needless to say he wasnt happy when I told him.
 
Pt: I'm allergic to XY drug.

Me: What happens when you take it?

Pt: It makes my tummy all rumbly.

Me: THAT'S NOT AN ALLERGY! THAT IS A NORMAL SIDE EFFECT! Here- take two. :rolleyes:


... I swear, not a day goes by without this conversation...
 
When exactly IS the last time you considered brushing your teeth?
 
Patient: "I ain't talkin' to no damn medical student!"
Me: O.K., the doctor will be around in a few hours
Me: :cool:
 
Back34 said:
Patient: "I ain't talkin' to no damn medical student!"
Me: O.K., the doctor will be around in a few hours
Me: :cool:
Click to expand...

This was an actual conversation :cool:
 
:love: 1. NO. you cannot choose your induction date for like 3 days past sunday for good luck. in fact, you can just go with the flow for as long as your creatinine is like 500 and you keep getting hepatitis and lord knows what else from lord knows whom (or who?).

2. here, another baby that you are totally not ready to take care of. let me clean up your HIV blood that's like everywhere and i'll place an IUD while you're not looking because you didn't bother taking AZT for the last kiddo! (actually I said congrats, she's a beautiful baby and washed my hands like crazy)
 
This one needs to be a sticky so people can link to it and yell at us :) :p
 
This might be the next "things you learned from your patients" thread... :laugh:
 
I laughed through the interview season, and our boring transition to residency, by reading the "things i learned from my patients" thread... keep posting... LOL :laugh:
 
I'm a paramedic... While writing this I realized that we medics aren't really good at NOT saying the stuff we want to..Read on and laugh.

Scenario: 15 y.o. male patient complaining of penile bleed. We pull up on scene to see this male patient dancing around on the sideway kinda ansy like, with this young (~14 y.o. female) beside him.

Me: So what's wrong today?
Pt: Like, man, we were having..you know...sex and umm...there was suddenly all this blood....like not from HER, FROM ME!... (me = female, my partner = female, both trying to sustain from laughing)
Me: Ok, well lets get in the back here and we'll get going to the hospital
Pt: Well the bleeding wouldn't stop so I ... took a elastic...you know...like one of those hair elastics...and wrapped it around a couple of times...then the bleeding stopped.

:eek: :eek: (me and my partner)

Me: "YOU WHAT??"
Pt: :scared: why not??
Me: umm, that's got to come off...
At this point patient (still standing on the side of the road) now has his hand down his pants fiddling trying to get this elastic off..

Ok, well maybe I did say it: Not a good thing to do, if you leave that on, it will fall off! :laugh:

---------------------------------------------
Second one that just popped into my head..
16 y.o female, HBD (has been drinking)
Get there, patient is wet, and kneeling over the toilet dry heaving.
Ask what happened...yada yada yaha..
Me: Why are you wet?
Pt: Because I asked my friends to put me in the shower cuz I felt sick.
Me: uhh...ok.
Pt states having a bad week, decided to drink LOTS..

My partner: and did this make it better??...

------------------------------------------------------------
Third!
Approx 1800 - Pick up patient at a nursing home, decreased LOA, increasing confusion all day. While i'm doing my assessment the RN is giving me a bit of a report.
RN: Patient is on...blah blah blah... history of angina, htn, IDDM...Someone came in at 1400 took the patients CBG it was 3.6, gave her 10 units of novolin...
Me...wait wait wait..they checked her blood sugar at 1400, it was low and they gave her insulin??...
- Check CBG = 1.9...hmmm...Gave glucagon, and off we went..

Now I was lucky enough to return this poor patient to the incompetent nursing home later on that night. The hospital didn't send any discharge orders..While we were putting the patient back into bed the RN asked (same one as earlier) if there was any instructions from the hospital.
Me: :idea: Yeah, don't give her insulin if her blood sugar is LESS THAN 4mmol/L!

Ok, that's it for now.
 
want to say to patient....

"I'm sorry we don't have sandwhiches without mustard right now, and we are fresh out of french fries... perhaps next time you are hungry you should try McDonalds instead of our Emergency room"

want to say...

"I'm sorry we can't afford to purchase deluxe cable for the patient rooms in the Emergency department. I know it is an inconvience but you will have to survive with basic cable for a few more hours while we wait on the CAT scan to be read.... Yes, I know, you have been waiting for two hours. Those radiologists really should read those things faster for special people like you."

ARGHHH!
 
"Your baby is small and developmentally delayed because you are a terrible mother, smoked crack during every trimester, chased it with cheap gin, and forgot about your free prenatal care. I am not impressed that you and the babydaddy have both showed up today protesting your change of heart as your gentleman friend looks and smells like a crystal meth abuser, you have a pack of cigarette clearly visible in your purse, and are holding the baby like you'd stuff him into a dumpster if you were sure you wouldn't get caught."

Of course I whipped some Duke Family Medicine non-judgemental psycho-babble on 'em.
 
After the least provoked altercation I have ever witnessed between a family member and attending, family member involves me (who up to now hasn't said word one, and has been doing, may I say, a Herculean job of keeping a neutral facial expression) in the following exchange as we are leaving the room:

Angry Family Member:
"Whatchoo lookin' at? You never seen BLACK PEOPLE before?!"

Me:
(Dying to say something totally inappropriate such as: "So THAT's what you guys look like!")
er....


I mean, it's tough.... it seems that often people play the race card because it seems they feel they have no other cards to play, and there is evidence for race being a factor in care recieved and dispo etc... But man do I hate being called a racist by people I'm just trying to help. :( (Doesn't happen often, so I'm hoping it's not just that I'm not some colossally oblivious bigot, all unbeknownst to myself and such.)
 
You're allergic to Tylenol but not Percocet...^$(&^E$)&$)!!!!!

If you drive a better car or wear more jewelry than I do, you shouldn't be on welfare or bitch about medical bills. Period.

Yes, it takes 6 hours to get a CT and get it read. You want it faster, trying going somewhere they take patients with insurance.

Sure, you can request a private room. I just don't want to hear it.

If you wait until I'm giving you your discharge papers to tell me about your vaginal itch, your brand new chest pain, or say you're going to kill yourself unless I get you into detox, I'm going to pretend I didn't hear it.
 
When doing a r/o SBI workup on an under three month old -

No really I just do LP's for ****s and giggles. They totally don't enhance the work up at all.

And yes, it will paralyze your child. Cool, huh?

When putting a kiddo on terb for the fifth time in two months for chronic recurrent freaking status asthmaticus -

Ya know, if ya quit smoking, maybe you wouldn't need to complain that you don't like the step-down unit 'cause they don't have private rooms and the nurses get 'all up in yo bidness'.

And just in general -

No, I don't dislike you 'cause you're black. I dislike you 'cause you're an a**hole.
 
Weeble said:
After the least provoked altercation I have ever witnessed between a family member and attending, family member involves me (who up to now hasn't said word one, and has been doing, may I say, a Herculean job of keeping a neutral facial expression) in the following exchange as we are leaving the room:

Angry Family Member:
"Whatchoo lookin' at? You never seen BLACK PEOPLE before?!"

Me:
(Dying to say something totally inappropriate such as: "So THAT's what you guys look like!")
er....


I mean, it's tough.... it seems that often people play the race card because it seems they feel they have no other cards to play, and there is evidence for race being a factor in care recieved and dispo etc... But man do I hate being called a racist by people I'm just trying to help. :( (Doesn't happen often, so I'm hoping it's not just that I'm not some colossally oblivious bigot, all unbeknownst to myself and such.)
Click to expand...
Interesting papaer just got put out in JAMA that says EVERYONE gets bad care and there is no difference based on how much $$ u make or if you have insurance.. Just a little FYI.
 
From my attending:

Lady, you are a horror. There is a reason none of nurses have checked in on your husband during the past hour.

Oh... so your son is a doctor, too? And he's the head of his fancy group practice up north? Nope, I've never heard of him. I'm sorry that deflates your bubble.
 
"For the tenth time in the last five minutes, you are not dying.

Shut up a minute and look at my face. Look close. Do I look anxious to you? Rushed? Am I doing anything with my hands? No, I am not. I am looking bored, and somewhat irritated. Granted, you have lived too long already, you poor demented lunatic. Still, if you were dying, I would be moving. When I appear nervous, you have permission to be scared. Until then, shut up and let me chart."
 
overheard in the er:
"I bet if you sold some more crack or that fancy cadillac you could afford some tylenol for your child....."

"you're fat. that's why your knees always hurt. and no, it's not an emergency"

"you didn't fall on that, you were trying to get off. don't think you can convince me otherwise"

"it's 2 am on a friday and your teeth hurt, take some tylenol like a sensible person would and find a dentist who cares"

"it's not asthma, it's copd-that's from smoking...and no, it won't get you an off work note"
 
when you come in to the ED c/o 10/10 chest pain brought on by smoking and walking more than a block or 2, don't wonder why i don't give you permission to walk 2 blocks to go outside to smoke. well, i don't give that permission anyway, but especially not to YOU, mister.
 
If I have to wake you up to do a history and physical, your pain is automatically 3 or less regardless of the "15 out of 10" you tell me that it is.
 
I had a chest pain patient two days ago who adamantly refused doing cocaine for the past 2 weeks. Of course her urine tox was positive for cocaine.

So when I confronted her, she swore she hadn't used in 2 weeks. Her reply: "I was around people who were doing it. I guess I got second-hand cocaine exposure."

Before I realized what I had said, I said "or maybe you were just using Cocaine XR." Then it hit me that I just said that to her. I could hear three nurses and my attending bust out laughing in the background. The patient nearby busted out laughing (that patient was a medical student). The patient, however, had no clue what cocaine XR meant.

I need to learn to bite my tongue!
 
"Alot of people pay alot of taxes so that you can have these thirty minutes of my time seemingly at your whim. Unless you are waiting on a call from a potential employer to tell you whether or not you got that job you've been applying for, you can turn off or at least ignore that $250 razor phone that is more tricked out than the space shuttle while I finish your GC/Chlamydia screen."

and to these teenagers in general (though more of a problem in clinic):

"You don't need to answer that cell phone while I am in mid-conversation with you and your mother regarding your health. I don't need to hear your entire conversation about how badly school "bites". If I wanted to know your innermost thoughts and musings about the mundane aspects of life in high school, I'll read your "blog". Right now I am trying to convince your mother that we don't need to double your dose of Adderall."
 
McDoctor said:
Right now I am trying to convince your mother that we don't need to double your dose of Adderall."
Click to expand...

...and you are NOT helping my case...
 
McDoctor said:
You don't need to answer that cell phone while I am in mid-conversation with you and your mother regarding your health.
Click to expand...

I had a patient do this recently. I thought she would quickly end the conversation. Then she started asking questions to the caller. After the second question, I said "I'm sorry, I have other patients to see. I'll come back when you're off the phone." She said "I'll get off now." "No, no, continue your conversation, I'll be back later."

Since she was there for a bogus complaint (viral URI for 3 days), I didn't come back to her for nearly 90 minutes. It wasn't intentional. I had a couple traumas come in. Man was she ever pissed when I came in the room!
 
No really, I don't leave the freaking hospital for 30 hours in a row. And yes, I am expected to make medically sound decisions - even at the end. No, I don't have any scheduled breaks. No, no protected time to sleep. And no, I don't feel like re-hashing YOUR plan of care (that I don't know, btw) at 3 freaking AM.

***

And yes, I know this is the EM forum and the above is more of a peds/internal med kinda discussion, but ya'll are way way more fun! Besides, I'll be working in the ER as an attending next year (yikes!) while I apply for a pedi sub-board!
 
how do I change the channel on the tv?
 
southerndoc said:
I had a patient do this recently. I thought she would quickly end the conversation. Then she started asking questions to the caller. After the second question, I said "I'm sorry, I have other patients to see. I'll come back when you're off the phone." She said "I'll get off now." "No, no, continue your conversation, I'll be back later."

Since she was there for a bogus complaint (viral URI for 3 days), I didn't come back to her for nearly 90 minutes. It wasn't intentional. I had a couple traumas come in. Man was she ever pissed when I came in the room!
Click to expand...

I find this kind of annoying too. I really don't mind the call getting answered and the patient saying ' i'm in with the doctor let me call you back in a bit' because I understand families would be REALLY worried if they didnt answer (especially if it was chest pain, gi bleeding, something like that). But the ones that start a conversation not even related to health is just rude.

As a student, I kind of feel bad saying anything so just sit there and take it, but I think if I'm REALLY working as a resident/doctor, I would do the same, and just say I'll come back in a few (especially if it is a non-acute emergency). But if it was chest pain, or I was kind of worried, I'd tell the patient you need me to evaluate you.

I guess what would confuse me more is the headset phones, sometimes I don't even see them and I think the person is talking to me!
 
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