Comments on Scalpel or Sword?: Drama Signs

"I'm cool with that! If I say I'm a hard stick, I'...

2009-01-05T03:25:00.000-06:00

"I'm cool with that! If I say I'm a hard stick, I'm just trying to be helpful b/c it does make things go faster if they pull in their best nurse/phlebotomist/doc and lidocaine worked really well one time."

Do you really think I'm gonna say "oh gee you say youre a hard stick I had better not look or try let me go get the best nurse/phlebotomist/doc?" If you do you are sadly mistaken. Oh and BTW our docs don't start IV's they start central lines.

"if you hit a valve - (and have had a flash back) simply flush it in with normal saline, wait 10 mins, draw off 1 10cc syring of blood and discard, then take a second spec for your tests. simple."

Great advice minus the 10 minute wait. LOL who the hell has 10 minutes to spare in the ED and if I put in 5cc saline and draw out 10cc of waste it's not really a problem.

"Of course, there was the one nurse who stabbed me and then stood there digging around in my arm, causing even more pain than normal, just so she could brag she got me in a single stick."

Let me guess you are a "you only get one stick" person right. I dig on those people too if I need to. LOL after all might as well make the most of my one stick right.

"Actually, yes it DOES. For some people. I saw my uncle brought to tears in the hospital a time or two by needle sticks."

Sounds like he may be as much of a drama queen as you are.

Ahhhhh.... feels good to vent using stupidity of others.

Ooooh, I have another one. It's a bad sign when y...

2008-12-31T20:49:00.000-06:00

Ooooh, I have another one. It's a bad sign when you walk into the room and the patient has the sheet or blanket pulled up over their head. I guess it's a variation on the eyes closed thing.

GRANDOLDPARTYER, YOU SOUND LIKE A SWEET HEART, TAK...

2008-12-22T17:04:00.000-06:00

GRANDOLDPARTYER, YOU SOUND LIKE A SWEET HEART, TAKE CARE OF YOURSELF. SEEK MEDICAL ATTENTION IF YOU NEED IT, DON'T WORRY ABOUT CONCERNS OF ED STAFF. YOUR LIFE IS IMPORTANT, AND WORTHY OF SEEKING ASSISTANCE. TAKE CARE.

Janice - I was merely posting the definition from ...

2008-11-23T16:17:00.000-06:00

Janice - I was merely posting the definition from Urban Dictionary because I find the word rather humorous. My wife, on the other hand, thinks it's a terrible word, among many others for the va-jay-jay. There are actually some very hygienic individuals whose who-ha's aren't so positively aromatic beyond their control (I guess, I'm giving them the benefit of the doubt as they've appeared to be otherwise cleanly). I've been blessed to find my partner so tasty that I often can't get enough of that particular delight, but thank you for your concern.

I would have to add to that list, anyone who comes...

2008-11-23T11:58:00.000-06:00

I would have to add to that list, anyone who comes to the ER with their own bedding and is not in the end stages of a terminal illness automatically redlines my bullshit meter...

Sorry the above comment was for grandoldpartyer

2008-11-23T01:00:00.000-06:00

Sorry the above comment was for grandoldpartyer

Your girlfriend Lauren sounds nasty.You need to be...

2008-11-23T00:11:00.000-06:00

Your girlfriend Lauren sounds nasty.

You need to be a little bit pickier when choosing your next girlfriend.

Maybe one that freshens up now and again. :)

LOL

Resident hubby (orthopaedics) enjoys patients who ...

2008-11-21T17:46:00.000-06:00

Resident hubby (orthopaedics) enjoys patients who come into the clinic complaining of "severe left arm pain"......and then [nonchalantly] use their left arm to lift themselves off of their chair to introduce themselves to him and his attending... :o)

I'm not a hard stick at all. You could probably d...

2008-11-21T00:38:00.000-06:00

I'm not a hard stick at all. You could probably do me by braille. Which is why I can say for sure that there is a huge disparity in skills out there. Most times it's one shot but every once in a while I get someone apparenty trying to tenderize me.

Some docs and nurses (mostly docs) just don't have the knack or maybe they're just out of practice. Either way, I wouldn't expect a self-assessment of "hard stick" to be viewed as a negative. Rather sounds like a good indication that "pincushion Paul" might want to defer to the nurse for this one and save everybody some hassle.

Ha ha, you said cooter. This might get deleted, it...

2008-11-20T16:29:00.000-06:00

Ha ha, you said cooter. This might get deleted, it probably should, but nevertheless I'll post the 3rd definition of 'cooter' from the Urban Dictionary:

Cooter: N the holiest of holies, the place all men aspire to be. Often paired with large, flappy labia known as "Beef Curtains."

The appearance of the Cooter is usually heralded by the distinct reek of low tide.

Lauren's cooter smelled like an octopus and resembled a bearded axe wound.

]"How long does it take to put on a pair of pants ...

2008-11-20T14:55:00.000-06:00

]"How long does it take to put on a pair of pants and a T-shirt? "

I checked in a Migraine patient this week who came in wearing a shorty robe (barely hung below her butt cheeks) and no underwear. Dramatically flailing away in "pain" showing her cooter to everyone passing by in the hallway.

I just want to mention, as a bragging point of cou...

2008-11-19T21:04:00.000-06:00

I just want to mention, as a bragging point of course: I have awesome veins!

whitecap nurse says:Dear Walt,I agree with you abo...

2008-11-18T21:51:00.000-06:00

whitecap nurse says:
Dear Walt,
I agree with you about the lidocaine - it hurts worse than the IV start. I guess in theory it would keep the IV site from hurting over time. However, in my personal experience (on the receiving end), lido just spasms the veins making it harder to start the IV in the first place! Everytime I tried lidocaine, I ended up getting stuck more than once anyway.

I can understand people showing up to the ED in PJ...

2008-11-18T20:06:00.000-06:00

I can understand people showing up to the ED in PJ's- it being an emergency and all that. Well, sorta understand.

But I work in FP and I don't get people showing up in their Tweety PJ's to an appointment at three in the afternoon...

And really, c'mon, a silky nightie? Outdoors? How long does it take to put on a pair of pants and a T-shirt? Not as long as it takes the ambulance guys to get there and do their assessments.

we still have to do our thing, and we don't do it ...

2008-11-18T20:01:00.000-06:00

we still have to do our thing, and we don't do it any differently based on your self-report.

Actually, several times upon saying that--although not in the ER--the person with the big pointy thingie has gone to get someone who's a bit better at it.

Of course, there was the one nurse who stabbed me and then stood there digging around in my arm, causing even more pain than normal, just so she could brag she got me in a single stick.

I know it doesn't hurt THAT bad.

Actually, yes it DOES. For some people. I saw my uncle brought to tears in the hospital a time or two by needle sticks. And he wasn't by any means a malingerer--he was in fact a Type I diabetic who injected himself with insulin twice a day, and so was used to needles. Didn't make it an less excruciating to have a vein tapped, though.

I have to say if I felt I needed to be in the ER, ...

2008-11-18T19:07:00.000-06:00

I have to say if I felt I needed to be in the ER, say for broken bones or heart attack, the LAST thing on my mind is going to be changing out of my pajamas.

I usually just wish them luck!

2008-11-18T18:53:00.000-06:00

I usually just wish them luck!

What if you really are a really hard stick? Not t...

2008-11-18T18:52:00.000-06:00

What if you really are a really hard stick? Not that I complain about it. It's not the nurse's fault, and it don't hurt anyway.

if you hit a valve - (and have had a flash back) s...

2008-11-18T13:35:00.000-06:00

if you hit a valve - (and have had a flash back) simply flush it in with normal saline, wait 10 mins, draw off 1 10cc syring of blood and discard, then take a second spec for your tests. simple.

EJ lines are nice too.

If we need to get blood or obtain IV access, it do...

2008-11-18T08:36:00.000-06:00

If we need to get blood or obtain IV access, it doesn't matter if you're a "hard stick" or not....we still have to do our thing, and we don't do it any differently based on your self-report.

"You're a hard stick? OK, I'll try EXTRA hard to get your IV."

I'm cool with that! If I say I'm a hard stick, I'm just trying to be helpful b/c it does make things go faster if they pull in their best nurse/phlebotomist/doc and lidocaine worked really well one time.

Also if there is time to let me sit with my arm hanging, that really helps. I do that with lab draws with great success.

According to one nurse, my veins are small and crooked and she kept running into valves when she did get a stick.(I asked because I was trying to understand why this was a repetitive issue for me.)

I think that I'm just the one patient that looks like a big red flag of whacko, but proves not to be in the end. Thank goodness I rarely, rarely go to the ER and I have a great pulmonologist (who I am losing because our multi-billion dollar in sales employer "can't afford" good health care any more. :( )

M

I have a question, sort of related to this thread ...

2008-11-18T08:30:00.000-06:00

I have a question, sort of related to this thread but not entirely: what is the point of a Lidocaine wheal injected into an IV site?

When I was in Paramedic school we started them on each other to learn how - been stuck lots of times... But 6 weeks ago I had an Achilles tendon repair and the Anesthesiologist was who started my IV's - he needed two attempts because he hit a valve on the first one. He prepped the sites with Lido, something I have never had done before. I really didn't like it; I would rather he did it without Lido but he insisted that this was his preference.

As far as I'm concerned, it doesn't matter whether or not this is done as putting Lido into the site has just as much of a sting as an IV start without it. At least it did for me.

Any takers on this?

Eh, as an ER nurse, I don't mind people telling me...

2008-11-18T02:04:00.000-06:00

Eh, as an ER nurse, I don't mind people telling me, they're a hard stick as long as they're willing to be patient and work with me. Know where your good vein usually is? I don't mind you telling me, but don't expect me to restrict my looking to that one spot. Oh and none of this, "You get one try" bullshit. Oh man, nothing makes me angrier- and you don't want to make the person with the needle angry. Shit, they had to poke me 3 times for my glucose tolerance test and I'll let the new nurses practice on me, I know it doesn't hurt THAT bad.

In oncology we get these all the time- especially ...

2008-11-17T23:32:00.000-06:00

In oncology we get these all the time- especially the "tough stick" "veins roll" "special cart" and "you'll need me to use a baby needle on me."

Most of the time it's cause the stupid teenager at county missed on their 3rd day and they have to blame it on the pt. Which is why almost everyone thinks of themselves as a "tough one."

If we need to get blood or obtain IV access, it do...

2008-11-17T23:00:00.000-06:00

I am a hard stick. But it's my fault. I'm 400 lbs ...

2008-11-17T22:32:00.000-06:00

I am a hard stick. But it's my fault. I'm 400 lbs and morbidly obese. I also don't goto the ED complaining of the symptoms I attribute to the fact that I'm overweight. For instance, lower back pain (once it was so bad after a trauma I do go but not because of disc issues due to being overweight), issues relating to what I presume is sugar/insulin related, or instances of frequent heart palpitations and/or prolonged chest pain. Thus far I haven't had any real complications after the presentation of any of these symptoms which reinforces my generalization that they're simply due to my obesity. I won't waste ED staff time with these problems when all I need to do is restrict my calories and move around more. I realize that I am causing my poor health, truly sick people should benefit from the ED and I have no right to take away from their care just because I don't want to deal with my obesity. Also, should I find myself in the ED or otherwise needing it and I know that I am a hard stick I don't say anything. I figure nursing staff can learn from their attempts at an IV/blood draw on an obese patient and benefit someone who is in fact truly sick.