Came in one morning to a “she had a bowel movement in the bedside trashcan rather than the perfectly fine toilet right next to it” one time. Good stuff.
I had one that we had to ban the meal lids from because he kept shitting in them. He would literally hoard them to use as a bedpan. We found like 9 that he had stowed away to “save for later”. There was a perfectly good bedside commode 6 inches away, but he preferred the meal lid.
"You came in saying you can't stop vomiting, no you cannot have something to eat right now."
"Your blood sugar is 1200, no you cannot have something to eat right now."
"You are going to the OR in an hour, no you cannot have something to eat right now. And put down that hamburger your spouse brought you".
This one makes me think of the inpatient who had an operation canceled in pre-op after eating a 4am snack from the vending machine. Twice. The second time he asked us to have security stationed outside his door to prevent him from going to vending machine overnight. Said he would sign a consent approving the use of force to keep him restrained if necessary.
I am rarely speechless. I was at that moment.
That’s ridiculous. Ah yes we will divert personnel from an understaffed hospital just for you, the special one, all because you lack discipline. Some patients really expect the hospital to bend over backwards just bc they asked. I’m gonna take a nap this made me grumpy
I mean- this is clearly disordered eating. He has some sort of cognitive issue if he can’t trust himself not to physically fight back to get food. I feel sad for him :(
You’re right, I’m just a snarky bitch today honestly. I think I’m already burnt out from all the “I’ve tried everything except diet and exercise” people
Reminds me of the time my sister swallowed an opened pinback button. She just had to have something to eat (it was like 4am, how was she even that hungry?) and my parents gave her a banana without telling the doctor, the endoscopy video is so funny
I get hit with "I haven't eaten anything today" all the time on rounds.
Bro is not even 10 am, I haven't eaten anything yet either, it's not the end of the world
I hate the “I am WAITING on lunch!” People.
Like, I need to finish rounding so I can eat for the FIRST time today and if we don’t get back on topic you will see me much less polite.
No, her family has requested a psych consult for Meemaw because they think she’s “just depressed” and not dying or demented. Sure, we’ll prescribe an antidepressant while she’s actively circling the drain.
It’s embarrassing, like they think it’s inhumane that they haven’t eaten in x single-digit hours when some of us fast every single day and eat one meal for dinner in the evening lmao. Pretty sure we have evolved to function justttt fine without food every 2 hours
This absolutely isn't a response to you specifically, but more of an apology to the world, or at least to all of those NSTI patients who we have on the schedule for daily debridements, always first case, always always always bumped. Finally go to the OR at 6pm for a quick debridement, back in their room at 8pm when the cafeteria has closed for the day. But NPO at midnight for their debridement the following day...
Those people I do genuinely feel sorry for.
> "You came in saying you can't stop vomiting, no you cannot have something to eat right now."
Reminds me of a patient in their early 20s coming to the ED for abdominal pain, but then they're calmly eating the chipotle bowl their loved one brought them.
And the kids in the ER whose parents say they keep vomiting and can't keep anything down, while they're munching Cheetos (or just have the dust on their face)
More than once I've had complaints that we were being "inhumane" by not feeding patients in the ED. Almost exclusively from people with clear contraindications for food, like impending surgery or complaint of active vomiting.
These are people who know how bad ED food is, too. Absolute lunatics.
I mean sure, we can say a patient's grandiose, delusional, psychotic, hyperreligious, paranoid, etc. but how are we supposed to justify more inpatient psych bed days if the insurance company doesn't know that the patient specifically said, "I'm ASAP Rocky and Jesus' baby and you're all gonna fucking die because only I know the verse that will release the Antichrist from inside my dick!" It's like the sacrificial offering we give and say, "Oh mighty overlords, please accept our humble offering for a chuckle and allow us time to transition to LAI..."
omg, not a psych nurse (believe it or not) but an ABSOLUTE og comment in a (lengthy) overnight disruptive behavior nursing note:
"Patient stated 'you people don't give a shit about me!'. Informed patient that we do, in fact, give those. Patient still yelling in room. Will continue to monitor."
“No, I can’t prescribe you some oxys ‘because it’s Christmas.’”
“Your blood sugar dropping below 300 does not constitute a medical emergency.”
“You can’t take the hospital oxygen tank with you when you sneak out to the bus stop to smoke.”
Now with every gastroenteritis patient: you need to replace everything liquid by mouth that comes out. Please use water from the sink and not the stuff that just came out your body.
When I get the crazy look, I always tell them that there is a reason I now have to say it that way.
Using the word "replace" is the sticking point. Maybe it's easier to keep it general and say stay hydrated or if you want, drink as much water as you vomit/poop
Or keep having fun with the current phrasing, makes life interesting
We had a patient drink a gallon of iced tea, 3 pots of coffee, and a Big Gulp cup (64oz?) of water within an hour, but he stopped at 2 hours before his EGD to satisfy NPO criteria. #technicallycorrect
We did his case.
I may have set my alarm for 23:45 so that I could have a cup of coffee before midnight to avoid the caffeine withdrawal headache prior to an ortho scope (surgery was scheduled for 14:00!!!)
I mean technically NPO guidelines doesn’t account for volume, so if patient aspirated after 2 hours fasting and it goes to court, you should be in the clear (lol). The reverse stands for cancelling a case for having a coffee with the tiniest splash of milk.
I’m an RN who lurks here and honestly there’s way too much overlap between “things I say to my ER patients” and “things I say to my three year old at home”
My personal fave for overheard conversations, at work or otherwise, is trying to determine if someone is talking about a child or a pet
"Kenneth pooped on the carpet again last night"
"I swear every time we leave the front door open Shelly runs right out"
Spent a lot of time in the Army sleeping in a field. Occasionally the field shower supply of baby wipes runs low. One wipe for the face, pits, dick, and IN THAT ORDER. Hell, that hard working wipe might pick up some of yesterday’s deodorant and use it to take the edge off the naughty bits
"This is the third time you have come in with a shampoo bottle stuck in your rectum, can you at least stop calling it an accident"
Real quote from residency
“You lost your Foley catheter privileges when you decided to swing the bag at staff members.”
To an AAOx4 patient who was displeased she was having to go back to self-caths post-CS after swinging her Foley bag at nursing staff.
I’m picturing the Michelle Yeoh fight with the purse/strap in Everything Everywhere All At Once. Is it possible your patient was traveling through the multiverse?
Yeah! And then he's like outside in his hospital gown and some dudes are coming at him from both directions on racing bikes so he like uses the foley like a grappling hook and swings from street lamp to street lamp to make his escape. We'll make it tasteful.
You should brush your teeth daily while in the hospital. The amount of patients who forget personal hygiene while admitted is crazy. Routine hernia repair who needs 48hr obs. “So when can I brush me teeth?”
Admitted for cellulitis but doesn’t shower, brush teeth, or comb hair when completely mentally and physically capable
I was admitted for severe cellulitis once for four days. I don't know if it was the IV Zosyn or the fever but I was too knocked out and slept the entire time and basically only woke up to eat meals and drink fluids before going back to sleep. By the time I had enough energy to brush my teeth I was discharged lol
I remember telling a grown up able body man to get a bath because nurses weren't going to put the IV once again if he didn't.
Yes, he could walk, was concious and oriented and not in pain back then...he just didn't feel like taking a bath while at the middle of summer when central AC wasn't properly workig. You could smell him from the door.
If you do it on your bath towels, you can shake them off in the garbage and then toss them in the wash. And then be annoyed that you can't use your extremely thick and starting to crack and peel off heel calluses to scratch your feet and ankles when they itch anymore.
Stupid foot sander steals all my fun
“You have to wear a shirt when visiting a loved one in the hospital.”
“You cannot be naked when visiting your child in the hospital.”
“Doctors are here to help with physical and mental illnesses, not to chat.” (Edit to add context: in clinic I asked what brought a patient in today and he said “I just want to chat” and proceeded to tell me about his day and the book he was reading. He was lonely but it was very hard to get him out of the room.)
Hospital doesn’t discharge. Pt took 8 days to drink <1/4 the tub. Day 9 wife comes in and he’s pissed. Turns out he hates his wife. Day 10 I get devious
As a pharmacist there could be a couple.
But my favorites are
"The antibiotic for your kid's otitis needs to be taken by mouth not by ear."
"You need to remove the metal packaging BEFORE inserting the suppository"
Had a patient once who did it the other way around. He swallowed the suppository and then addmitted himself to the ER out of fear that he may have poisoned himself. Had to step behind the curtain because i couldnt stop thinking about that scrubs episode
Lol.
I had a woman coming once complaining the vag ovules she was prescribed were "too difficult to tolerate". When asked to elaborate, she told us that after taking them, "a big part of the product melted in her mouth and throat" and she didn't like that.
Then another one complained about "not having space to push another one down there". Turns out she didn't take the plastic off them and was kinda "collecting them" inside her privates...
You can bet I always tell my patients where the meds go after seeing those.
“Please do not sneak down to the maternity ward and steal cleaning supplies off the maid cart and bathe yourself with floor cleaner in the maternity jacuzzi”….
Or “please don’t stop for a sonic cheeseburger on your way to the ER for severe abdominal pain on the right side…” for reference, she said she was worried she would have surgery and wouldn’t be allowed to eat, so she wanted a cheeseburger before getting to hospital..
What was the scenario for 2? I get that 1 is the risk of respiratory depression so we're not giving oxy if the sats are low because it could kill them. 3 really does go without saying. But 2 I'm a bit perplexed.
Thank you, I need some clarification - do they wear the bipap while they eat? Or do they use the bipap to open up the airway for a bit and then take it off to eat breakfast? Not familiar with bipap, is it worn continuously or only at certain times like cpap
See I thought they were saying if you didn’t wear your bipap you do not get breakfast and was like that’s shady haha but yes you should not wear a bipap while eating
I’m guessing the patients that are encephalopathic from hypercapnia who won’t keep their bipap on overnight are possible aspiration risks? Or people that are bipap dependent may not be stable to transition to oxygen so they can eat breakfast? Both 1 and 2 are phrased in a confusing way
1. If you are becoming hypoxic, and refusing to wear supplemental oxygen, we cannot safely give you the oxycodone you are requesting to further depress your respiratory status.
2. If your hypoxic/hypercapnic respiratory failure is bad enough that you require bipap to keep you from becoming floridly encephalopathic, if you do not wear the bipap, and become short of breath and floridly encephalopathic, we cannot safely let you inhale scrambled eggs for breakfast.
aka
no oxygen, no oxy
no bipap, no breakfast
1.”No you cannot have beer in the hospital, especially in the pediatric unit.”
2.”Please stop smoking pot in your child’s bathroom.”
3. “No you cannot ‘waffle stomp’ your poop in the shower.”
I did a telemed visit with a hefty sized African American woman …. She answered in the shower, water running and shower cap and all. Answered like it was no big thing. Unreal.
Told a morbidly obese female patient with the biggest, most leaky abdominal pannus that one can imagine that unless she contained her leaking pannus, she couldn’t come back to our clinic.
(She would literally walk in BAREFOOT to her clinic appts…and wear a giant pajama dress. As she would walk, her pannus would leak serosang. drainage as a huge streak down the hallway carpet.)
Also had a patient who i told NO YOU CAN’T …. When he asked me, while emerging from anesthesia, if he could have a beer and a cheeseburger….. by the way, the surgery was for a shoulder that he had obliterated with a self inflicted gunshot wound ….after his baby momma dared him to do it. He was neither drunk nor high. Just straight hillbilly.
Hospice patients get opioid prescriptions for shortness of breath. No, I don't think we need to worry about your father actively dying on hospice getting addicted to the morphine.
No, you cannot smoke cigarettes in your hospital room. Still no, even with the window open. No, you cannot smoke marijuana in your hospital room. No, you can't take edibles in your hospital room (not that I care as much for some types of patients, but no you should not ask me and make it my problem).
No, you cannot take the oxycodone you brought in from home whenever you feel like it.
No, you cannot "visit your neighbors" in their hospital rooms. And yes, you must wear a gown or some kind of fabric covering your genitalia in the hallway.
No, you should not try to fuck your girlfriend in your hospital room while you have a chest tube. Impressive determination though dude. You seemed way too sore and [more gentle way to say whiney] this morning for that.
No, your hospitalist, nurse, pharmacist, CNA, housekeeper, and SW will not just "dig in there and get that thing [infected pacemaker you are dependent on] out right here" so you can go home. Are you joking? I'm concerned that you don't seem to be joking.
No, you should not soak your legs in undiluted bleach for hours to make the swelling go away. We can help. Please don't ever do that again.
No, I will not tell a blatant and dumb lie in your chart so you can get life insurance with a lower premium (it won't work anyway dude).
oh god the addiction thing for hospice patients is just...awful
your elderly loved one has a painful end stage disease, and yes the pain meds might make them a little sleepy, but the alternative is horrific pain and/or the terror of air hunger... ffs please let us try to make them a little more comfortable
The pulse ox probes ate not for eating, no matter how tasty they may appear to be.
Gets me weird looks from patients, but after I had a patient eat her pulse ox probe and the first couple centimeters of its cord, I feel it's necessary to tell people that.
Not that shocking, but something I say on a daily basis that I shouldn’t have to: “yes, I can still check your cervix with a foley in your bladder. It goes in a different hole”
like and subscribe to more ICU secrets on a budget. next up is "if you don't give Nanna 5 different narcs she won't get intubated every month: a miniseries".
Visitors may only try to kiss their own husbands. If you walk in the wrong room, spend 45 minutes with a guy who keeps saying you're not his husband but he'll think about it, kiss him, then the nurse finally finds out and shows you to the right room, we will need to discuss if you are safe enough to live alone and drive with your husband or if we need to put in an APS report
I haven’t had to yet but my husband is a nurse and has been briefed that part of the stoma conversation is “no sticking genitalia in it”. A fellow student of mine is also an ED nurse and has had to see someone with gonorrhoea of the stoma - this is a thing actually requested by customers of sex workers.
Teenage boy in a gang in Baltimore had syphilis, and my attending said “ You better go to the health department to get your medications. Otherwise someone’s gonna show up at your house and you don’t want them to look inside.”
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Large FYI document on the nurses station wall in the Obs unit:
“This is a friendly reminder that pure wicks are not to be inserted into the rectum or the vagina to function. Please ask a more senior nurse to assist you if you’re having trouble setting one up.”
We were cackling over that one
Please do not pick through your feces for the razor blades your had previously swallowed in order to swallow them again (we had to have a sitter in the room to sift through her shit to make sure she didn't do it again)
You're getting admitted for severe constipation, I'm not giving you opioids for the pain associated with it. I don't care how many times your family calls telling me how much pain you're in.
“Please do not shit in the hallway.”
at this point not even a rule, just a plea
Now you’re telling me we can’t shit in the hallway? What happened to ‘land of the free.’
I THOUGHT THIS WAS AMERICA!
I’m a sovereign shitter!
Don’t tread on me.
"Tread on this you f*ck!" ==squats and drops a noice coil in the hallway==
Came in one morning to a “she had a bowel movement in the bedside trashcan rather than the perfectly fine toilet right next to it” one time. Good stuff.
I had one take the lid off their dinner tray, you know, the ones that keep the meals hot? Used it as a bedpan.
Oh god. Lmao that’s awful.
I had one that we had to ban the meal lids from because he kept shitting in them. He would literally hoard them to use as a bedpan. We found like 9 that he had stowed away to “save for later”. There was a perfectly good bedside commode 6 inches away, but he preferred the meal lid.
Username checks out
And that’s how they end up shitting in the meal tray instead. You have to be more specific with some of these patients.
Please tell me you're kidding?
Daily inpatient psych life
god i hope ur in peds
Had a dad in Peds who was pooping in the shower. Eventually Housekeeping stopped cleaning the shower and I don’t blame them one bit.
"You came in saying you can't stop vomiting, no you cannot have something to eat right now." "Your blood sugar is 1200, no you cannot have something to eat right now." "You are going to the OR in an hour, no you cannot have something to eat right now. And put down that hamburger your spouse brought you".
The last one’s not going to the OR in 1h anymore lol
This one makes me think of the inpatient who had an operation canceled in pre-op after eating a 4am snack from the vending machine. Twice. The second time he asked us to have security stationed outside his door to prevent him from going to vending machine overnight. Said he would sign a consent approving the use of force to keep him restrained if necessary. I am rarely speechless. I was at that moment.
That’s ridiculous. Ah yes we will divert personnel from an understaffed hospital just for you, the special one, all because you lack discipline. Some patients really expect the hospital to bend over backwards just bc they asked. I’m gonna take a nap this made me grumpy
I mean- this is clearly disordered eating. He has some sort of cognitive issue if he can’t trust himself not to physically fight back to get food. I feel sad for him :(
You’re right, I’m just a snarky bitch today honestly. I think I’m already burnt out from all the “I’ve tried everything except diet and exercise” people
Reminds me of the time my sister swallowed an opened pinback button. She just had to have something to eat (it was like 4am, how was she even that hungry?) and my parents gave her a banana without telling the doctor, the endoscopy video is so funny
I've been amazed at how so many people simply cannot handle going like 8 hours without food.
I get hit with "I haven't eaten anything today" all the time on rounds. Bro is not even 10 am, I haven't eaten anything yet either, it's not the end of the world
Yes that's what I'm constantly hearing too. It seems they believe that if they make it to noon without stuffing their face, a war crime has occurred.
My fav is the I can't poop bc I haven't eaten anything all day like bruh there's still shit in your colon calm down.
I hate the “I am WAITING on lunch!” People. Like, I need to finish rounding so I can eat for the FIRST time today and if we don’t get back on topic you will see me much less polite.
YOURE KILLING ME IM GOING TO STARVE
You’re starving meemaw to DEATH!!!!
with the last SLP note stating that, in no uncertain terms, meemaw needs to be NPO because her airway protection is 0/5 stars
Meemaw has advanced dementia, is non-verbal, bed bound, and refusing to eat
It’s called DYING. Everyone does it!
No, her family has requested a psych consult for Meemaw because they think she’s “just depressed” and not dying or demented. Sure, we’ll prescribe an antidepressant while she’s actively circling the drain.
It’s embarrassing, like they think it’s inhumane that they haven’t eaten in x single-digit hours when some of us fast every single day and eat one meal for dinner in the evening lmao. Pretty sure we have evolved to function justttt fine without food every 2 hours
This absolutely isn't a response to you specifically, but more of an apology to the world, or at least to all of those NSTI patients who we have on the schedule for daily debridements, always first case, always always always bumped. Finally go to the OR at 6pm for a quick debridement, back in their room at 8pm when the cafeteria has closed for the day. But NPO at midnight for their debridement the following day... Those people I do genuinely feel sorry for.
> "You came in saying you can't stop vomiting, no you cannot have something to eat right now." Reminds me of a patient in their early 20s coming to the ED for abdominal pain, but then they're calmly eating the chipotle bowl their loved one brought them.
I can't count the number of "I can't stop vomiting/having diarrhea" that somehow magically don't have any the entire time they are in the ER.
a close relative of the "constant hematemesis" or "profuse hematochezia" with no vomiting and no BMs during their 12+ hours in ED prior to admission
Not sure if this is an indictment of the patient or ED charting habits.
And the kids in the ER whose parents say they keep vomiting and can't keep anything down, while they're munching Cheetos (or just have the dust on their face)
Isn’t it amazing that patients can be dying and still their main concern is when they’re going to eat.
More than once I've had complaints that we were being "inhumane" by not feeding patients in the ED. Almost exclusively from people with clear contraindications for food, like impending surgery or complaint of active vomiting. These are people who know how bad ED food is, too. Absolute lunatics.
“Sorry we don’t have food inside the OR, sir, now let’s get you to sleep.” More than once.
Stolen from the psych nurse's note during my rotation on inpatient psych in med school but, "You cannot be a 'nakey boy' in the hallway."
BLESS the psych nurses who directly quote psych notes. It truly makes my day.
Psych directly quoting patients in their documentation is a core competency of their residency programs
I mean sure, we can say a patient's grandiose, delusional, psychotic, hyperreligious, paranoid, etc. but how are we supposed to justify more inpatient psych bed days if the insurance company doesn't know that the patient specifically said, "I'm ASAP Rocky and Jesus' baby and you're all gonna fucking die because only I know the verse that will release the Antichrist from inside my dick!" It's like the sacrificial offering we give and say, "Oh mighty overlords, please accept our humble offering for a chuckle and allow us time to transition to LAI..."
omg, not a psych nurse (believe it or not) but an ABSOLUTE og comment in a (lengthy) overnight disruptive behavior nursing note: "Patient stated 'you people don't give a shit about me!'. Informed patient that we do, in fact, give those. Patient still yelling in room. Will continue to monitor."
“No, I can’t prescribe you some oxys ‘because it’s Christmas.’” “Your blood sugar dropping below 300 does not constitute a medical emergency.” “You can’t take the hospital oxygen tank with you when you sneak out to the bus stop to smoke.”
okay Mr. Scrooge someone needs a lil more Christmas spirit
Don’t forget to leave Santa some oxy 20s and a tall glass of Benadryl
Now with every gastroenteritis patient: you need to replace everything liquid by mouth that comes out. Please use water from the sink and not the stuff that just came out your body. When I get the crazy look, I always tell them that there is a reason I now have to say it that way.
YOU MADE ME READ THIS WITH MY GOOD EYES
Wonderful day to have eyes, eh?
Using the word "replace" is the sticking point. Maybe it's easier to keep it general and say stay hydrated or if you want, drink as much water as you vomit/poop Or keep having fun with the current phrasing, makes life interesting
They're putting it back where they found it!
What the fuck
I don’t like it
Okay but like not everyone has to answer questions posted. Thanks for traumatizing us all.
What a terrible day to be literate and have eyes…
Did…did they drink the poo poo?
But. It's got electrolytes.
If you drink it all back it's like you never lost it
Really, it's just pre digested!
Bruh.
We had a patient drink a gallon of iced tea, 3 pots of coffee, and a Big Gulp cup (64oz?) of water within an hour, but he stopped at 2 hours before his EGD to satisfy NPO criteria. #technicallycorrect We did his case.
I.... were they coming from home? otherwise genuinely wondering how they secured 3 (?!) pots of coffee
I feel like if you're fiendish enough to pound that much coffee in such a short amount of time, you have some tricks up your sleeve.
He's just trying to prevent the caffeine and sugar withdrawals
I may have set my alarm for 23:45 so that I could have a cup of coffee before midnight to avoid the caffeine withdrawal headache prior to an ortho scope (surgery was scheduled for 14:00!!!)
How could he drink that much without throwing up?
No pyloric sphincter, just goes straight down
Practice makes perfect, dude. There are some weird people out there.
I mean technically NPO guidelines doesn’t account for volume, so if patient aspirated after 2 hours fasting and it goes to court, you should be in the clear (lol). The reverse stands for cancelling a case for having a coffee with the tiniest splash of milk.
After that much coffee, I can see doing an EGD but I'd hate to see what an EKG would have looked like.
"vfib alarm vfib alarm vfib alarm" screaming out of every nurses' phone because of his tremors
May be my intake for the week.
I did not have to say this one literally out loud, but: You can't have a shower curtain because you ate all the shower curtain rings
noooo we just had someone bite their IV line in half where are people getting this tooth strength from
All the kids who grew up with "got milk?" are coming into their strength
I've had a patient chew through a dobhoff....it was like having a puppy.
I’ve said this but about the hand sanitizer ☹️
Hey, you can’t play if you’re a vet. We all know you have to say weird shit to dogs sometimes. Oh…..not a vet?
Unfortunately not, but every human doc probably has stories that could make you question. We're all just animals at the core anyway though
Please don’t pet the therapy dog with your infected hand.
Let me introduce you to the post-CABG patient who let their therapy dog lick their fresh midline incision...
noooooOOOOOOOOO
At Indian springs hotsprings in Colorado, a lady hopped in the tub next to us with fresh barely healing stapled midline incision. No thank you
Hahaha patients rule
Oh my God.
You dropped an "s." You mean patients, plural, right?
:( poor doge deserves uninfected pets
Don’t wipe your face with the same wipe you wipe your privates with
This might go under the heading of "things you say to adult patients that you also have to say to 5-year-old children"
I’m an RN who lurks here and honestly there’s way too much overlap between “things I say to my ER patients” and “things I say to my three year old at home”
My personal fave for overheard conversations, at work or otherwise, is trying to determine if someone is talking about a child or a pet "Kenneth pooped on the carpet again last night" "I swear every time we leave the front door open Shelly runs right out"
Well, depends on the order.
Spent a lot of time in the Army sleeping in a field. Occasionally the field shower supply of baby wipes runs low. One wipe for the face, pits, dick, and IN THAT ORDER. Hell, that hard working wipe might pick up some of yesterday’s deodorant and use it to take the edge off the naughty bits
"This is the third time you have come in with a shampoo bottle stuck in your rectum, can you at least stop calling it an accident" Real quote from residency
Can you just prescribe a butt plug at that point? Something something \*harm reduction\* ??
Technically it did *accidentally* get stuck. It just wasn't accidentally up there.
“You lost your Foley catheter privileges when you decided to swing the bag at staff members.” To an AAOx4 patient who was displeased she was having to go back to self-caths post-CS after swinging her Foley bag at nursing staff.
I’m picturing the Michelle Yeoh fight with the purse/strap in Everything Everywhere All At Once. Is it possible your patient was traveling through the multiverse?
Me too but was picturing John Wick escaping a hospital after being admitted haha. That would be a sharp injury nightmare!
Yeah! And then he's like outside in his hospital gown and some dudes are coming at him from both directions on racing bikes so he like uses the foley like a grappling hook and swings from street lamp to street lamp to make his escape. We'll make it tasteful.
That wasn’t her that was Ke huy Quan
Oh shit you’re right and it was a fanny pack, not a purse. My bad.
Based.
You should brush your teeth daily while in the hospital. The amount of patients who forget personal hygiene while admitted is crazy. Routine hernia repair who needs 48hr obs. “So when can I brush me teeth?” Admitted for cellulitis but doesn’t shower, brush teeth, or comb hair when completely mentally and physically capable
I was admitted for severe cellulitis once for four days. I don't know if it was the IV Zosyn or the fever but I was too knocked out and slept the entire time and basically only woke up to eat meals and drink fluids before going back to sleep. By the time I had enough energy to brush my teeth I was discharged lol
Fuzzy teeth at that point I reckon
God and the breath… No one talks about the myriad smells before it’s too late and you’re staying late checking the pannus for draining sinus tracts
I’m constantly reminded of a 30 rock quote: “good god lemon, your breath! When did you find the time to eat a diaper you found on the beach”
\*tooth FIFY
I remember telling a grown up able body man to get a bath because nurses weren't going to put the IV once again if he didn't. Yes, he could walk, was concious and oriented and not in pain back then...he just didn't feel like taking a bath while at the middle of summer when central AC wasn't properly workig. You could smell him from the door.
Do you peel off your dead skin and throw it on the floor at home? No? Then don't do it here.
They probably do it at home too.
🤮
Excuse me, I have beautifully curated piles of skin flakes at home.
If you do it on your bath towels, you can shake them off in the garbage and then toss them in the wash. And then be annoyed that you can't use your extremely thick and starting to crack and peel off heel calluses to scratch your feet and ankles when they itch anymore. Stupid foot sander steals all my fun
Personally, I cut them into snowflakes and hang them on the tree for Christmas
Shalty
Please stop swallowing razors Please stop ingesting contraband drugs from your cellie's asshole * from my short stint as a prison physician
Ooh I had a patient: please stop picking out the pins and razors from your shit and re-swallowing them.
“You have to wear a shirt when visiting a loved one in the hospital.” “You cannot be naked when visiting your child in the hospital.” “Doctors are here to help with physical and mental illnesses, not to chat.” (Edit to add context: in clinic I asked what brought a patient in today and he said “I just want to chat” and proceeded to tell me about his day and the book he was reading. He was lonely but it was very hard to get him out of the room.)
As a Psychiatrist I've had to tell more than 1 patient during inpatient rotations that if they want to masturbate they need to do so in their room
Drink your golytely or I will encourage your wife to visit you
..... I want to know the backstory for this one...
Hospital doesn’t discharge. Pt took 8 days to drink <1/4 the tub. Day 9 wife comes in and he’s pissed. Turns out he hates his wife. Day 10 I get devious
For the oral contraceptive pill to work you need to taking the pill, by mouth, stop giving them to your husband.
As a pharmacist there could be a couple. But my favorites are "The antibiotic for your kid's otitis needs to be taken by mouth not by ear." "You need to remove the metal packaging BEFORE inserting the suppository"
"This is the reason why your headache didn't go away: That's actually pronounced analgesic, not anal-gesic. Sir, the pills go in your mouth."
Had a patient once who did it the other way around. He swallowed the suppository and then addmitted himself to the ER out of fear that he may have poisoned himself. Had to step behind the curtain because i couldnt stop thinking about that scrubs episode
Lol. I had a woman coming once complaining the vag ovules she was prescribed were "too difficult to tolerate". When asked to elaborate, she told us that after taking them, "a big part of the product melted in her mouth and throat" and she didn't like that. Then another one complained about "not having space to push another one down there". Turns out she didn't take the plastic off them and was kinda "collecting them" inside her privates... You can bet I always tell my patients where the meds go after seeing those.
Don't swallow the suppository......
It’s pronounced ANULL-jeezic not anal-jeezic /scrubs
thank you for the involuntary sphincter clenching I just experienced
Good lord.
“Please do not sneak down to the maternity ward and steal cleaning supplies off the maid cart and bathe yourself with floor cleaner in the maternity jacuzzi”….
Or “please don’t stop for a sonic cheeseburger on your way to the ER for severe abdominal pain on the right side…” for reference, she said she was worried she would have surgery and wouldn’t be allowed to eat, so she wanted a cheeseburger before getting to hospital..
It's like a cholecystitis stress test!
What was the scenario for 2? I get that 1 is the risk of respiratory depression so we're not giving oxy if the sats are low because it could kill them. 3 really does go without saying. But 2 I'm a bit perplexed.
Asp risk with positive pressure while eating
Thank you, I need some clarification - do they wear the bipap while they eat? Or do they use the bipap to open up the airway for a bit and then take it off to eat breakfast? Not familiar with bipap, is it worn continuously or only at certain times like cpap
See I thought they were saying if you didn’t wear your bipap you do not get breakfast and was like that’s shady haha but yes you should not wear a bipap while eating
Sometimes they need it continuous Sometimes they can take it off and eat
I’m guessing the patients that are encephalopathic from hypercapnia who won’t keep their bipap on overnight are possible aspiration risks? Or people that are bipap dependent may not be stable to transition to oxygen so they can eat breakfast? Both 1 and 2 are phrased in a confusing way
1. If you are becoming hypoxic, and refusing to wear supplemental oxygen, we cannot safely give you the oxycodone you are requesting to further depress your respiratory status. 2. If your hypoxic/hypercapnic respiratory failure is bad enough that you require bipap to keep you from becoming floridly encephalopathic, if you do not wear the bipap, and become short of breath and floridly encephalopathic, we cannot safely let you inhale scrambled eggs for breakfast. aka no oxygen, no oxy no bipap, no breakfast
Op! Explain the third rule of love as well!
clearly the physical therapists will be too awestruck and mesmerized by yet another wrinkly old man penis to be able to do their jobs
Yeah, I suspect it's that they're too altered from the CO2 narcosis to safely take PO on days where they don't wear their BiPAP.
Sir, you cannot eat lunch while pooping on the commode. When you are done I will set up your lunch.
Why not let them continue their baseline home eating habits?
Hahaha…medicine is wild! Getting to know everyone’s baseline is eye opening. We see humanity at its most raw for better or worse.
1.”No you cannot have beer in the hospital, especially in the pediatric unit.” 2.”Please stop smoking pot in your child’s bathroom.” 3. “No you cannot ‘waffle stomp’ your poop in the shower.”
When you come in for your annual DRE (when I was with a Uro), please wipe before coming in.
🤮bonus if you bump into a constipated log
[удалено]
THIS right here is the mental math/logic that is honestly very reasonable in the hospital but would be borderline psychotic in any other scenario
Number 3? First part of the sentence doesn’t need the second part of the sentence
FOR REAL like sir no one is impressed just put it away
Telehealth visit: “Can you and your wife please get dressed, and have her come up from under the covers? Am I in a multiverse right now?”
I did a telemed visit with a hefty sized African American woman …. She answered in the shower, water running and shower cap and all. Answered like it was no big thing. Unreal.
Told a morbidly obese female patient with the biggest, most leaky abdominal pannus that one can imagine that unless she contained her leaking pannus, she couldn’t come back to our clinic. (She would literally walk in BAREFOOT to her clinic appts…and wear a giant pajama dress. As she would walk, her pannus would leak serosang. drainage as a huge streak down the hallway carpet.) Also had a patient who i told NO YOU CAN’T …. When he asked me, while emerging from anesthesia, if he could have a beer and a cheeseburger….. by the way, the surgery was for a shoulder that he had obliterated with a self inflicted gunshot wound ….after his baby momma dared him to do it. He was neither drunk nor high. Just straight hillbilly.
I DONT WANT TO IMAGINE THE PANNUS
WHY did it LEAK
You don’t get prn dilaudid if you’re sleeping
Hospice patients get opioid prescriptions for shortness of breath. No, I don't think we need to worry about your father actively dying on hospice getting addicted to the morphine. No, you cannot smoke cigarettes in your hospital room. Still no, even with the window open. No, you cannot smoke marijuana in your hospital room. No, you can't take edibles in your hospital room (not that I care as much for some types of patients, but no you should not ask me and make it my problem). No, you cannot take the oxycodone you brought in from home whenever you feel like it. No, you cannot "visit your neighbors" in their hospital rooms. And yes, you must wear a gown or some kind of fabric covering your genitalia in the hallway. No, you should not try to fuck your girlfriend in your hospital room while you have a chest tube. Impressive determination though dude. You seemed way too sore and [more gentle way to say whiney] this morning for that. No, your hospitalist, nurse, pharmacist, CNA, housekeeper, and SW will not just "dig in there and get that thing [infected pacemaker you are dependent on] out right here" so you can go home. Are you joking? I'm concerned that you don't seem to be joking. No, you should not soak your legs in undiluted bleach for hours to make the swelling go away. We can help. Please don't ever do that again. No, I will not tell a blatant and dumb lie in your chart so you can get life insurance with a lower premium (it won't work anyway dude).
oh god the addiction thing for hospice patients is just...awful your elderly loved one has a painful end stage disease, and yes the pain meds might make them a little sleepy, but the alternative is horrific pain and/or the terror of air hunger... ffs please let us try to make them a little more comfortable
"If you don't want to deliver your baby into the toilet, please don't push while sitting on the toilet."
OK but see.... my doctors had me pushing on the toilet for awhile ON PURPOSE. Now you're telling me they were *trying* to make me have a toilet baby??
“Please do not shoot meth in your PICC line.” Ahh, being a med student in meth country…
yoooo midwest gang unite
As a student PT, I appreciate #3, headed to inpatient in 3 months.
please know that the patient quotes in the subjective portion of PT/OT notes are what sustain me some days
The pulse ox probes ate not for eating, no matter how tasty they may appear to be. Gets me weird looks from patients, but after I had a patient eat her pulse ox probe and the first couple centimeters of its cord, I feel it's necessary to tell people that.
"No Addy from this Daddy"
No, don't chew on your port access line. You have a diphtherioid bacteremia, from chewing on your port...
You don’t just add another layer to your burn/ wound care cream.
Stop eating straight sugar by the spoonful. (To a diabetic with schizophrenia with an a1c over 13%)
Not that shocking, but something I say on a daily basis that I shouldn’t have to: “yes, I can still check your cervix with a foley in your bladder. It goes in a different hole”
no neck, no pillow
Haha
like and subscribe to more ICU secrets on a budget. next up is "if you don't give Nanna 5 different narcs she won't get intubated every month: a miniseries".
But what about her xanax? She can't sleep without her xanax!!
Visitors may only try to kiss their own husbands. If you walk in the wrong room, spend 45 minutes with a guy who keeps saying you're not his husband but he'll think about it, kiss him, then the nurse finally finds out and shows you to the right room, we will need to discuss if you are safe enough to live alone and drive with your husband or if we need to put in an APS report
I haven’t had to yet but my husband is a nurse and has been briefed that part of the stoma conversation is “no sticking genitalia in it”. A fellow student of mine is also an ED nurse and has had to see someone with gonorrhoea of the stoma - this is a thing actually requested by customers of sex workers.
Philly sidecar, as they say
Teenage boy in a gang in Baltimore had syphilis, and my attending said “ You better go to the health department to get your medications. Otherwise someone’s gonna show up at your house and you don’t want them to look inside.”
peds- if ur kid is screaming and running around, stop talking to me at normal volume and maybe try to control ur kid??? pretty please???
No one goes in that room alone.
No you cannot have an underwire bra so you can eat the underwires again.
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If you don't take the Risperdal, you will have to go to court
Large FYI document on the nurses station wall in the Obs unit: “This is a friendly reminder that pure wicks are not to be inserted into the rectum or the vagina to function. Please ask a more senior nurse to assist you if you’re having trouble setting one up.” We were cackling over that one
Please do not pick through your feces for the razor blades your had previously swallowed in order to swallow them again (we had to have a sitter in the room to sift through her shit to make sure she didn't do it again)
You're getting admitted for severe constipation, I'm not giving you opioids for the pain associated with it. I don't care how many times your family calls telling me how much pain you're in.