Incident....

[EctopicFetus]

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I am currently working in the ED in a Level I trauma center. So a few days ago a patient is brought in who did a little too much Heroin. Long story short after she perked up a little she was lucid enough to talk and told me how she felt bad and regretted what happened. She also stated that she had been clean for 50 days but she was depressed cause she had been raped one week ago and other things that werent going right. She was crying etc about things in her life. I told her the best thing to do was to quit again etc. She was doing ok, then a nurse who was from her hometown came in and made some nasty and inapproriate comments. She stated she wanted to leave and to make a long story short she ended up getting put in 4 pt restraints. I told the site director who also happened to be the attending and he seemed to brush me off.

This incident really bothered me because IMO getting restrained is a necessary evil that should be reserved for certain instances. However, someone who is instigated by the ED staff isnt a reason to restrain someone.

Anyhow, I am wondering if i should just drop this or report it to the clinical medicine director at my school. Thanks

 

[Seaglass]

It was the patient's behavior that made restraints necessary regardless of what brought it on. ED nurses have a pretty short fuse for this type of patient and aren't shy about letting their feelings show. I bet that your attending didn't think much of it because it happens almost daily. Is it poor form? Yes, but it's not going to change. I guaruntee that that is not the only nurse in your department who feels like that and you can't fire them all and i wouldn't want too.

Regardless, the patient wanted to leave although her life was in imminent danger. You could make the argument that she is not competent to make decisions because of her intoxication ergo the restraints. The patient decided to leave--the nurse didn't throw her out.

 

[MustafaMond]

$hit happens.
Get over it.

When an OD patient comes in, we don't allow them to walk out of the hospital AMA.
If they insist on leaving, their ass gets the restraints.
THey aren't considered the same as other patients, that's the law.

You probably spent a lot of time with the patient, getting a full "med student" social history etc. Meanwhile, I'll bet the residents on your team admitted 3 or 4 other patients.

Stop wasting your energy on loser drug addicts , and worry about the sick patients. What happened in the hospital sounds completely within the law. If you need to stick your nose into it, feel free to tell your medical director.

Sounds like you need to harden up a bit.

 

[delchrys]

i don't know...being jaded is something that will happen naturally, but i say keep your spirit as long as you can. realizing when you have to let something go and actually saying "screw her" are two different things...realize that this one might have to be let go, but i think your sympathy is a rare gem among those who want to practice medicine. that nurse was unprofessional, and just because it's common doesn't make it right.
with that logic (that it's okay because she sees that stuff all the time), cops can beat people just because they see trash "like that" all the time.

 

[cooldreams]

$hit happens.
Get over it.

When an OD patient comes in, we don't allow them to walk out of the hospital AMA.
If they insist on leaving, their ass gets the restraints.
THey aren't considered the same as other patients, that's the law.

You probably spent a lot of time with the patient, getting a full "med student" social history etc. Meanwhile, I'll bet the residents on your team admitted 3 or 4 other patients.

Stop wasting your energy on loser drug addicts , and worry about the sick patients. What happened in the hospital sounds completely within the law. If you need to stick your nose into it, feel free to tell your medical director.

Sounds like you need to harden up a bit.

thas pretty damn harsh dood....

 

[Jaded Soul]

I agree that holding the patient, even if it means 4-point restraints, was the correct thing to do. Sounded like she was clearly a danger to self and needed to be legally held for her own protection. That her behavior was provoked is unfortunate and reflects poorly on the professionalism of that nurse, but it is the end result has to be dealt with at that point in time. Complaining to the medical director wouldn't be productive at all in this case.

 

[EctopicFetus]

Thanks for the replies.. As far as hardening up... I dont think thats in issue for me.. LOL.. The point is I know why patients get restrained, I actually did research on it last summer and I understand the legal reasoning. I also think it is just fine (im not some hippy let everyone be) to restrain patients. My point is more that this behavior was not professional and I think it is crappy to do that to people who have no power. It isnt a matter of anything besides professionalism.

As a follow-up I saw that nurse yesterday and he told me that the pt left about 1.5 hours after me. He said (without my asking) that he did that so that she would not fall back asleep and have an apneic episode. Anyhow thats the end of the story. Thanks for your advice (well most of you).

The Ectopic One!

 

[Hawk22]

$hit happens.
Get over it.

When an OD patient comes in, we don't allow them to walk out of the hospital AMA.
If they insist on leaving, their ass gets the restraints.
THey aren't considered the same as other patients, that's the law.

You probably spent a lot of time with the patient, getting a full "med student" social history etc. Meanwhile, I'll bet the residents on your team admitted 3 or 4 other patients.

Stop wasting your energy on loser drug addicts , and worry about the sick patients. What happened in the hospital sounds completely within the law. If you need to stick your nose into it, feel free to tell your medical director.

Sounds like you need to harden up a bit.

Wow, I really hope you're never my doctor or care for anyone else I know. All patients deserve a certain baseline amount of respect, no matter what. 😡

 

[EctopicFetus]

Mustafa is making up for other inadequecies.. 'nuff said...

 

[MustafaMond]

Wow, I really hope you're never my doctor or care for anyone else I know. All patients deserve a certain baseline amount of respect, no matter what. 😡

Whatever..... 🙄
I was just keeping it real.

Get into a residency program and work the wards for 2 years, then get back to me.

I myself would have never used innapropriate language with a pt. (from the poorly told story it is still unclear as to what was said)

The fact is that many nurses, especially in the ER, are overworked, and make comments like that to patients sometimes, especially if they are beligerant (as I'm willing to bet was the case here).

Is it wrong- probably. Does it happen- yes. Do I care- No.

If you want to act hard-core, and make complaints to the directors every time something like that happened, you would have no time to perform actual medicine.

And BTW.
I personally don't give a $hit what you think about my skills as a physician, because you are just a troll on a message board.

 

[EctopicFetus]

too funny.... people on these boards make me laugh..

 

[EctopicFetus]

Mustafa, are you referring to the difficulty of getting into an IM residency? Are you being serious? or are you referring to 2 yrs on the wards (which I will admit would probably make me want to kill myself?)

Clarify please?

 

[MustafaMond]

Mustafa, are you referring to the difficulty of getting into an IM residency?)

Clarify please?

No ectopic, I was referring to the difficulty listening to your whining-a$$ thread.
Go save the world.
You are the one.

 

[MustafaMond]

http://forums.studentdoctor.net/showthread.php?t=143218

patients with a long history of addiction can be the most challenging patients you will encounter, and arguably the most rewarding *if* they make a recovery.

Are you people condoning give Class II meds to Addicts????

In my opinion this is liberal horse poop.

This is from one of your previous posts, ectopic.

So, when did you become Buddha-On-The-Hill? 🙄

 

[EctopicFetus]

Your posts reek of a small man.. Sorry to hear your problems. If I cared I would go into psych.. Since I cant deal with little whiners Ill stay away from that. Obviously you spent a lot of time looking for that thread that thing must be 3 months old. I believe the that was a discussion on Ritalin. Probably something you had to use just to get that oh so difficult residency you are in

Get a grip man. Obviously you are saddened by your career choice. What a pathetic existence. Im done playing games with little kids like yourself 😀

 

[MustafaMond]

Sorry to hear your problems. If I cared I would go into psych.. Since I cant deal with little whiners Ill stay away from that

Who is the whiner?
You are the douchebag who started this thread.

Are you still going to go complain to the hospital staff, you wuss?
LOL! 👎

 

[EctopicFetus]

Reading is FUNdamental man... You are the one who started bashing me. I understand that you are mad at everyone in the medical profession because your existence is so miserable. I am not going to pursue this further. That being said everyone deserves some respect. These actions are not acceptable to me.

 

[MustafaMond]

Whatever..... 🙄

And BTW.
I personally don't give a $hit what you think about my skills as a physician, because you are just a troll on a message board.

I will repeat this quote above for you, Ectopic_Anus.

I'm quite proud of my profession.
I hope getting Dermatology or CV surgery works out for you, tool.
Good luck with that 215.
👎

 

[EctopicFetus]

but surely even a 200 would get me to where you are

Since you have spent so much time researching my life.. Ill save you any extra time. I am thinking of G Surgery or ER 🙂

I think I would rather die than do IM 👎

Since READING is FUNdamental, like Tim Hardaway used to say.. Ill spell this out for you I dont question your skills as a physician since I dont know you. I question your skills as a human being. You seem utterly incompetent in dealing with others.

As far as calling me a wuss.. that is sure easy to do when we arent face-to-face. I would squish you like a bug. You are pathetic and thats what makes you such a funny miserable little man 😎

 

[MustafaMond]

I think I would rather die than do IM 👎

You seem utterly incompetent in dealing with others.

I would squish you like a bug. You are pathetic and thats what makes you such a funny miserable little man 😎

Threats of physical violence...
How becoming of a future physician...

WHat's wrong, Buddha-On-The-Hill...did I get to you?



How pathetic.

 

[EctopicFetus]

No your little words... i think they show what a little man you are since any ***** can say whatever on here. But that same little person might not have the courage to say those same things if they were face-to-face.

I am your Buddha...your idol.. How is IM going?

 

[MustafaMond]

I am your Buddha...your idol.. How is IM going?

IM is going great. Thank you for asking.
You should look into it, if you grow some nards one day.

 

[EctopicFetus]

I can only hope to be as miserable as you. Hence I will pass on your path. Of course if that was my only choice because I was a douche bag then... but since I have better options ill be following them. Thanks though..

 

[MustafaMond]

... but since I have better options ill be following them. Thanks though..

Good luck with that.

As for me, I chose medicine because I want to do pulmonary/cc. There is no shame in this, and to diss on IM as a profession of "douchebags" exposes the depth of your ignorance.

 

[EctopicFetus]

No you obviously English must be your 2nd language because your reading comprehension is terrible.

I can only hope to be as miserable as you. Hence I will pass on your path. Of course if that was my only choice because I was a douche bag then... but since I have better options ill be following them. Thanks though..

I was referring to you being a douchebag and doing IM cause no one else would want you. I doubt with your crappy attitude you could get a fellowship. Actually based on your post you obviously missed out on a fellowship this yr. That would go a long way in explaining your angry state.

 

[MustafaMond]

No you obviously English must be your 2nd language because your reading comprehension is terrible.

I was referring to you being a douchebag and doing IM cause no one else would want you. I doubt with your crappy attitude you could get a fellowship. Actually based on your post you obviously missed out on a fellowship this yr. That would go a long way in explaining your angry state.

Your first line demonstrates a brilliant grasp of English.
Actually, I'm American, and I haven't applied for fellowship yet. Nice try dick.

I'd love to stay and chat, but I've got to go.

 

[EctopicFetus]

Actually I didnt apply for fellowship yet, nice try dick.

I'd love to stay and chat, but I've got to go.

Mustafa, that one must have stung.. ouch..thats quite a reaction from you.. Why didnt you apply yet? Must have known your chances were crappy. Of course thats likely due to your malignant personality. 😱

 

[EctopicFetus]

Im shocked you are american, perhaps you "skipped" some grades in elementary school your your comprehension skills suck.

 

[cooldreams]

ok.. this is a dumb pissing match now... anyone care to be the bigger person and quit this mind numbbing chatter?

 

[Trisomy13]

Stop wasting your energy on loser drug addicts, and worry about the sick patients.

there's a difference between hardening up and just being an a$s to someone with an illness that you perhaps don't fully understand.

just sayin'

 

[EctopicFetus]

I think this is just out of his realm of expertise. He is better off changing dosing of anti-hypertensives. When his attending says: "Mustafa, Mrs. Jones' BP is 150/91 and she takes enalapril 20 mg BID. What should we do?" Mustafa responds "I would raise it to 30 mg BID, that should do the trick."

Thats his future and he is proud of it. Anything outside of that is way too complex.