The reason I hate hospitals and don't trust doctors, part I

[MaggieTheCat]

* Bring a plush toy. My dentist is so used to me bringing in my plushie that when I forgot him, he asked about him - and was particularly gentle and careful that day.
No medical professional worth their licence should worry about you using a plushie to help you get past a procedure you find stressful. (IMO, anyway.)

I brought a plushy cat with me when I had the surgery to have my gall bladder removed. He was the stand-in for my husband, since my husband couldn't be there (this was before we were married and before we had moved in together.)

[Seshat]

The FIRST time they messed up with the IV is when I would have high-tailed it out of there & gone someplace else.

I can be a 'hard stick', especially when I'm particularly sick, anxious, or upset. It's not unknown for it to take four attempts to stick me.

However, I've NEVER had the same nurse/phlebotomist make more than two attempts. They do try 1, get a new needle, recheck the site, consider trying a different site, do try 2.
If try 2 fails, they get another nurse. Usually the most experienced nurse present. I've never failed to have them get it within 2 tries. (And yes, they also choose their own site, resterilise the site, use a new needle, etc.)

I don't consider needing to make multiple attempts at something to be a problem.

I do consider failing to maintain sterility to be a problem.

The nurse should be explaining what's happening to whatever degree you want. I don't want to hear the details of the vein slipping away from the needle, some people do. I just want 'I'm sorry, this is being difficult. I'll give it another try in your other arm if that's okay?'
Also 'Okay. I'm going to get Jane - she's good with tricky cases. Do you want to lie down while you wait? need a drink of water?'

Nice, polite commentary, that simply acknowledges that your anatomy might be tricky - but that doesn't blame YOU.

1) don't look
2) don't think about it-- don't get tense, just know everything's fine, and, honestly, it really is totally not a big deal! (Really, it isn't.... unless they're using a needle that's about the size of a pen. Then panic. o___o )

Big snippage, and seconded.

Ever since I became a 'tricky stick', here's what I do. It's similar to what blumchenkinder listed.

* if necessary, dose myself with valium or ativan. (NOTE NOTE NOTE: this is with my GP and psychiatrists' permission. And I ask if that's okay for this particular set of tests FIRST.)

* Meditate while I'm waiting. (Or read a book, do some knitting, sketch whoever else is in the waiting room. Something which requires concentration, or something which requires meditative focus.

* Ask to be stuck while lying down. I have no idea why it helps, but it does. Sometimes that's not possible (eg, a busy ER and my particular problem doesn't require a stretcher-bed), but if it is possible, it helps me.

* Talk to the nurse. About anything. I initially started talking about being a hard stick and what happened to get me this way. Now I just say 'I'm sometimes hard to get a needle into, do you mind if I babble on about nothing to keep my mind off things?'. I've never had one who did, and I babble on about whatever's in my head.

* Never, ever, look. Ever. If you want to be sure of sterility practices, have a friend in the room to be your patient advocate and check for you.

* Bring a plush toy. My dentist is so used to me bringing in my plushie that when I forgot him, he asked about him - and was particularly gentle and careful that day.
No medical professional worth their licence should worry about you using a plushie to help you get past a procedure you find stressful. (IMO, anyway.)


Nowadays, having that whole series of practices, I've become a medium-stick rather than a hard-stick. There's only two good veins in my arms to use, but as long as I do all that, they get it within two tries. (If I don't... well. That's when they need to bring in the expert.)

[Difdi]

This thread reminds me of this one hospital in my area...it's common wisdom among EMTs, paramedics, firefighters and police that you go to Stevens Hospital to die; If you want to live, go somewhere, anywhere else. It doesn't matter if it's 5 minutes to Stevens, take your critical patient to the place that's 30 minutes away or just streamline things and deliver him to the morgue instead.

A few years ago, there was this big DHS counter-terror drill. Basic scenario was a radiological bomb in a high school locker room; The bomb went off "unexpectedly" and there were nine simulated-wounded actors in a room that was only supposed to have had 8 simulated-students in it. Local emergency services played their roles without a hitch; Police cordoned off the area, firefighters got the fire under control, NEST team contained the site, etc. Everything went great until the simulated-wounded were delivered to the closest hospitals, one of which happened to be Stevens.

The other hospitals handled things with varying degrees of competence, but it was as if the Stevens personnel just blew off the drill, and knowing it was a drill, just didn't bother with things like triage, or quarantine, or chain of evidence. The thing is, that level of performance is typical of them even for real injuries...

Put simply, had the drill been a real terrorist attack, everyone in that ER would have died of acute radiation poisoning. Everyone in the hospital would have had their lives shortened by 20-30 years due to radiation-related illnesses. After treating the simulated-wounded, Stevens Hospital released them; People with simulated-loss of limbs, dripping simulated-blood were just pushed out the door, rather than being assigned a room. No police were allowed into the exam rooms, nor were the nine suspects handed over for interrogation. None of the simulated-bomb fragments (simulated-radioactive evidence) were saved or kept separate, they all got tossed into the trash. Had it been a real bioweapon instead of a simulated dirty bomb, the entire region would have been at risk thanks to the incompetence of Stevens Hospital.

[Midnight12]

having learned from reading these threads and in general
if you are unsure or want answers advocate advocate advocate aka ask ask ask
if the person you are asking gets grumpy or defensive then its a sign they knew oh crud i screwed up and the patient knows it.
have only had a nurse get quiet on me when i asked for specific stuff such as water/ice or pain medicine and i apologized for bugging them and that i am a wuss for pain. So very sorry you had that kind of treatment and basically with the consensus of everyone here.

Its one thing to be a good nurse or dr but if you have NO bedside manner then its like the person is going through the motions. I doubt they'd like that treatment done unto them

[teh_blumchenkinder]

It might just be a distraction thing... and simple sugar is 'bad' because your body sends the sugar straight to the blood stream-- easy in, easy out.
Also, this. http://en.wikipedia.org/wiki/Creutzf...r_restrictions
BAM.
It gives it from the American Red Cross pov tho... it gives the link in-article however. RC is international/multi-national after all.

[Little Retail Rabbit]

1) don't look
2) don't think about it-- don't get tense, just know everything's fine, and, honestly, it really is totally not a big deal! (Really, it isn't.... unless they're using a needle that's about the size of a pen. Then panic. o___o )
3) engage and focus on the conversation you will have with the phlebotomist (that's the term for a person who pokes you with sharp things) if they are worth their salt/paper when you tell them what you've told us-- that you're nervous and inexperienced.
4) ... do you give blood? you should. I can't, due to Creutzfeldt–Jakob/Mad Cow/Kuru testing being spaztastic last time I heard (I was in England around the time of the 1980's panic)-- I might be a carrier! (If this isn't the case, dear god, tell me. this is why I don't give! The Red Cross members I mention it to all look at me like a ... two-headed cow! )
5) Do not get tense-- it hurts about ten times worse when you do. :shudder:
6) Eat fruit instead of lollies. Simple sugar's nasty for ups and downs. Just eat a solid meal with protein, fat, and complex carbohydrates at your normal time... maybe earlier to avoid nausea, and drink some juice or eat fruit afterwards.
7) WATER-- oh little fishes this is important! Blood volume and thickness is directly related to how much water you drink!

Thank you n_n No I never look O.O I just think that makes it feel worse. I am pierced and I've always been grateful that one cannot see one's own ear :P I will definately keep your advice in mind however, as, for the visa, I do require these blood tests (LOVE HURTS! XD). I was born during the 80s...I don't give blood (because of aforementioned needle scaredyness) but I don't believe thats a factor over here, although it probably is in the US. You are so right about tension though. I know its a slightly different thing but I had a deep filling done about 3 months ago, and whereas I used to suck up fillings before, I just ended up tense and the pain was worse because of it. Now I've gone and traumatised myself so I'll be needing to overdose on Rescue Remedy before I can go to my next checkup!

I thought hard boiled sweets helped because I've heard of tattooists offering them to clients who feel faint. Having said that, my brother's tattooist actually gave him a banana XD

[teh_blumchenkinder]

<snip>
I do not do well with needles myself, but if its a quick thing (like a vaccine or numbing at the dentist) its not so bad, because its a prick and its done. I'm not at all looking forward to my first ever blood tests. Which will probably be next year, as I'm hoping to apply for a visa so I can move to the US. I really hope the embassy doctors/nurses are gentle ; _ ; I'm also in my mid-twenties, and I have never needed a blood withdrawal, an IV, a urine test, nothing. I've only ever had a BP check up and dental work. The most intimate examination I've had is having thingies shoved into my ear-holes ^^;;

I'm gonna take a pack of lollipops to suck, keep my blood sugar up n_n Also can bite down on the stick if it hurts too much <.<

1) don't look
2) don't think about it-- don't get tense, just know everything's fine, and, honestly, it really is totally not a big deal! (Really, it isn't.... unless they're using a needle that's about the size of a pen. Then panic. o___o )
3) engage and focus on the conversation you will have with the phlebotomist (that's the term for a person who pokes you with sharp things) if they are worth their salt/paper when you tell them what you've told us-- that you're nervous and inexperienced.
4) ... do you give blood? you should. I can't, due to Creutzfeldt–Jakob/Mad Cow/Kuru testing being spaztastic last time I heard (I was in England around the time of the 1980's panic)-- I might be a carrier! (If this isn't the case, dear god, tell me. this is why I don't give! The Red Cross members I mention it to all look at me like a ... two-headed cow! )
5) Do not get tense-- it hurts about ten times worse when you do. :shudder:
6) Eat fruit instead of lollies. Simple sugar's nasty for ups and downs. Just eat a solid meal with protein, fat, and complex carbohydrates at your normal time... maybe earlier to avoid nausea, and drink some juice or eat fruit afterwards.
7) WATER-- oh little fishes this is important! Blood volume and thickness is directly related to how much water you drink!

[Little Retail Rabbit]

Actually, 42, what you've described sounds odd to me. I've never know anyone who needed a urine sample for the BC. I've been on the Pill for about 8 years now, and I only ever require a blood pressure check every 6 months due to a DVT family history.

Having said that, if you're from the US, I've been told American doctors really go out of their way to give what UK doctors consider unnecessary tests to avoid being sued <.< For instance, I've never had a gyno examination and will not be required to give one till next year, as UK doctors say there is no need for one before then. But then again, we have a nationalised health care system and not a private one, and US doctors are held more accountable I suppose.

[42_42_42]

None of my gynos have ever required a urine sample when I go in to get BC.

That is really odd. I've been on BC for 18 years (since I was 15) and I've always had to give a urine sample, no matter who the doc was.

[Dasota]

When I was younger, I wet the bed almost nightly. Dad took me to the hospital for all sorts of tests and every single one of them, I had to give a urine sample. Thing is, no one ever explained to 9 y/o me that you had to wipe first. There was about 2-3 years worth of urine samples where I had a bladder infection they thought.

You would think that they would ask if I wiped after going through all the questions, like does it hurt when I pee and the like.

I always thought the wet nap thing they gave me was for after I peed since peeing into the cup was a weird and awkward thing for me when I was young and I had no idea how to do it without making a mess of myself and the cup. Poor folks who had to handle the cups.

[Sapphire Silk]

I have to say... threads like this educate me. I'm not a demanding person, at all. I also have difficulty sticking up for myself or speaking up.
Now I know, thanks to this conversation. Thank you.

Absolutely! Please speak up! People need to say something when they're uncomfortable . . . and you don't have to be a jerk about it.

"Shouldn't you be using a sterile needle on the 2nd try?"

"Please use a new catheter if you don't get it on the first try."

"Please explain how you want me to give you the urine sample."

These are not unreasonable questions/requests.

[Little Retail Rabbit]

I need to stop reading these threads, they are freaking me out! I think my pee-pee has just curled up inside me to cry and being as I'm a girl, I wasn't aware I could do that <.< I'm so sorry for you!

I do not do well with needles myself, but if its a quick thing (like a vaccine or numbing at the dentist) its not so bad, because its a prick and its done. I'm not at all looking forward to my first ever blood tests. Which will probably be next year, as I'm hoping to apply for a visa so I can move to the US. I really hope the embassy doctors/nurses are gentle ; _ ; I'm also in my mid-twenties, and I have never needed a blood withdrawal, an IV, a urine test, nothing. I've only ever had a BP check up and dental work. The most intimate examination I've had is having thingies shoved into my ear-holes ^^;;

I'm gonna take a pack of lollipops to suck, keep my blood sugar up n_n Also can bite down on the stick if it hurts too much <.<

[teh_blumchenkinder]

I have to say... threads like this educate me. I'm not a demanding person, at all. I also have difficulty sticking up for myself or speaking up.
Now I know, thanks to this conversation. Thank you.

[MaggieTheCat]

42, if I had known then what I know today, I would have left there much sooner than I did, or at least started making some demands. That was literally my first time in an ER. I was scared, I was in pain, and I had no one around to consult with. Believe me, I wish I had said something to them while I was there. But I didn't know.

None of my gynos have ever required a urine sample when I go in to get BC.

I'm pretty sure the nurse used the same catheter on me multiple times. I wasn't paying too close attention but I don't remember her opening a new package, at least.

[42_42_42]

I have to say that you making it to 25 w/o ever needing an IV means that you are very lucky! I'm surprised you'd never had to give a urine sample before if you're on BC. Does your Gyno not require a sample at your exam each year?

Sorry you went through all the sticks and pokes. Remember that as a patient you have rights and if you are not comfortable with or confident in the skill of a nurse or doctor you can demand a new one, especially if they are unsuccesfully trying to insert something into your body (IV or cath). Also, if you don't understand what's going on, demand an explination. You can refuse for them to perform any test until they explain to you why they are doing it. If you are asked to do something that you are not clear on, speak up and ask questions. Yes, the staff at the hospital failed you, but you also failed yourself by not sticking up for yourself. Not all doctors and nurses have the best bedside manner and in the ER they're often so busy they get focused on getting tasks done and end up being very brusque. You have to advocate for yourself.

Anesthesiologists and Nurse Anesthetits are often able to get an IV in when others can't. If a couple of nurses have tried to stick you and weren't successful, you can request one of the above.

I can be a very hard stick, especially if I'm dehydrated. I've had several nurses each try and be unsuccessful (even with me giving them permission to try 3 or 4 times each, knowing how my veins are, I'm understanding about it) and them finally have to get the Anesthesiologist come down to IV me. I had over 2 dozen sticks all over both arms and up around my collar bone during one hospital stay for a partially blocked bowel. I was NPO the entire time and was extremely dehydrated, even with the saline drip. The first IV placement was really not well placed, was barely in, hurt and caused the IV machine alarm to go off unless I held my arm and hand just so and eventually clotted off. The 2nd one took over an hour to do and was when the Anesthesiologist had to come do it. They were very close to having to do a line in my groin. Soooo glad they didn't!

Maybe because I've dealt with being a hard stick my whole life, it doesn't really bother me. The thing that I hate the most is the automatic BP cuff. That mother fucker hurts! Unless I'm nicely drugged up post-surgery (ah, morpheine pump, how I love thee!), I won't let them use it on me. They can come in and do manual readings. The automatic cuff usually ends up always reading much higher than the manual anyway. I normally have really good BP, but put me on an automatic cuff when I'm not sedated and it will skyrocket.