My least favorite thing in nursing

[Sapphire Silk]

Had a conversation with one of my former students in clinic last week. He's now working full time on the unit where I take my students for clinic. We got to talking about various patient issues when the subject of my least favorite thing in nursing came up, and how I had to get involved with it three times in one day.

My least favorite things in nursing are, in descending order:

3) Giving rectal suppositories
2) Giving enemas
1) Digital disimpaction of stool.

Last Spring, I had to help a student give lactulose (a laxative that removes ammonia from the blood and a common treatment in liver failure) by mouth and by enema, then help another student disimpact a patient, then help yet another give rectal suppository.

This got me to thinking of the health care professionals here:

What are YOUR least favorite things in Nursing (or Allied Health Professions)?

[Seshat]

Does 'carer' count?

When A is at her most manic, and wants to drive. And I KNOW her judgement is impaired, and letting her behind the wheel of a car is incredibly dangerous, and I have to find a way to convince her not to.

Or conversely, when she's at her most depressed, and literally fighting us to get her hands on a knife or as many depressants as are in the house, because "it's the only way to get anyone to help me!"


... thankfully, neither of those have happened in the last couple of years, since we got the right balance of meds. But I've been in both situations in the past.

[trailerparkmedic]

Bugs. I cannot do bugs. I don't mind suctioning crusty, soupy trachs. I can tolerate hefting a massive, yeasty pannus out of the way for a Foley. I gag even thinking about cleaning out Mr. Elephantitis Legs with Maggots who comes in every few months. I cringe at the thought of leeches. I can't do scabies.

[telecom_goddess]

Bugs. I cannot do bugs. I don't mind suctioning crusty, soupy trachs. I can tolerate hefting a massive, yeasty pannus out of the way for a Foley. I gag even thinking about cleaning out Mr. Elephantitis Legs with Maggots who comes in every few months. I cringe at the thought of leeches. I can't do scabies.

all of that sounds pretty gross.

I couldn't handle anything that you guys do ever

[trailerparkmedic]

Well, it would probably help if Mr. Elephantitis Legs with Maggots was nice, but he's a complete asshole. He also has massive fissures in his legs from poor hygiene and I'm guessing having the elephantitis for so long. I don't know; maybe it's not true elephantitis, but whatever it is, his legs smell horrid and he usually has bugs.

I think I'd put diabetic foot wounds as a second on my list, though the worst part of them is that they are often associated with dislike #1. I hate the smell of wound and I'm always sad when it results in an amputation.

I will say that Lactulose enemas are a special brand of suck because the medicine is so sticky and you're usually doing it because the patient is very confused, which makes the whole process worse.

Man, I had no idea what I was getting into when I took my job.

[jedimaster91]

1. Lung Scans. They have this alarming tendency to contaminate everything with radiation.
2. Smelliness. I would be just fine up to my elbows in entrails. In fact, that would be kinda cool. But I can't deal with the smells. Occasionally we get a smelly patient and I have to spend the entire time either holding my breath and/or trying not to gag. Oh, and if someone starts vomiting, I won't be far behind. Can't handle the smell or the sound.
3. Really, really sick people. There's a reason I chose imaging over nursing. Several, actually. One of which is to limit my time around the terminally ill. On the occasion we get a really sick one, I'm an emotional wreck by the end of the day. Thank heavens for doggie kisses and violent video games or I don't know how I'd cope.

[Amina516]

Mucous and bugs..........eurgh! . If theres a roach in your ear, im not even going in the room (its happened...more than once). If you have a tracheostomy filled with mucous and im suctioning it out, im trying to hide my gagging and heaving. Maggots I can deal with. Smells can be interesting... yeah, I know lol. I love blood. Fun to play with clots. ...ummmm..yeah.

My least favorite things in nursing are, in descending order:


1) Digital disimpaction of stool.

Interestingly enough, digital disimpaction is considered an MD only procedure in the ER im in (I did it all the time all the floor). Guess who takes great pleasure in that fact? Not them.

[Metody]

Putting violent patients in restraints, especially the little old ladies who start screaming that they're being raped, and especially when there's visitors around. I think the worst part of it is not feeling bad about restraining them if they've been violent. I feel like I should feel worse about it, but dang, it sure is hard to have sympathy for a person who's tried to punch me or scratch out my eyes.

Wait, I want to add to this: I don't mind ugly, smelly wounds (ohmygosh I want to be a wound care nurse so much), but I hate really juicy trachs. That noise!

[Dytchdoctir]

Since you asked:

1. Nurses who refer to me (a paramedic) as an "ambulance driver".

2. People who show up at multiple car collisions, airplane crashes, shark attacks, etc., identify themselves as nurses (they are usually lying, or have not worked in a health care setting for years, or work in a dermatologist's office) and proceed to tell me how I'm doing it all wrong.

Having said that, I have nothing but respect for ER nurses.

[trailerparkmedic]

If theres a roach in your ear, im not even going in the room (its happened...more than once).

Oh HELL no. Especially since in Texas we have normal small roaches, and then we have giant 3-5 inch long ones that fly. Yeah, that wouldn't fit in an ear....but I'm still not getting anywhere near the patient, regardless of how big the roach is.

Interestingly enough, digital disimpaction is considered an MD only procedure in the ER im in (I did it all the time all the floor). Guess who takes great pleasure in that fact? Not them.

Don't you love that rectal exams during traumas are provider only exams? I also love that in my ER collecting samples for fecal occult blood testing is a provider-only thing.

[trailerparkmedic]

Putting violent patients in restraints, especially the little old ladies who start screaming that they're being raped, and especially when there's visitors around. I think the worst part of it is not feeling bad about restraining them if they've been violent. I feel like I should feel worse about it, but dang, it sure is hard to have sympathy for a person who's tried to punch me or scratch out my eyes.

I laugh at a lot my psych patients. Not in front of them, but you know how you sometimes have the choice between laughing and crying? Yeah, they're kinda hilarious ("I'm going to get the government to hack your brain") but then you realize this is a real, probably scared person with people who love him/her and it's very sad.

I really stopped feeling bad about restraints after a psych patient punched me in the eye (while we were restraining her physically and chemically) and the DA wouldn't press charges because she was a psych patient. I have a very tough time with confused patients, though we're pretty good at snowing them. I mean, that's probably not the most therapeutic response but the environment in our ER is terrible for scared, confused people and while we do our best to distract them and calm them down, sometimes it's better to just give them some Ativan or Benadryl until we can get them into a less terrible environment.

[Sapphire Silk]

Does 'carer' count?

When A is at her most manic, and wants to drive. And I KNOW her judgement is impaired, and letting her behind the wheel of a car is incredibly dangerous, and I have to find a way to convince her not to.

Or conversely, when she's at her most depressed, and literally fighting us to get her hands on a knife or as many depressants as are in the house, because "it's the only way to get anyone to help me!"(

Absolutely it counts! My sympathies. I go through this with a close friend every couple of years. Fortunately, she's always had the wherewithal to call me at 2 am when she gets manic and suicidal. I never mind though; we've been through too much together.

Well, it would probably help if Mr. Elephantitis Legs with Maggots was nice, but he's a complete asshole. He also has massive fissures in his legs from poor hygiene and I'm guessing having the elephantitis for so long. I don't know; maybe it's not true elephantitis, but whatever it is, his legs smell horrid and he usually has bugs.

I think I'd put diabetic foot wounds as a second on my list, though the worst part of them is that they are often associated with dislike #1. I hate the smell of wound and I'm always sad when it results in an amputation.

Man, I had no idea what I was getting into when I took my job.

I know you what mean. I didn't, either. I can deal with just about any odor out there you can name: blood, bile, vomit, phelgm, infection, you name it. Stool makes me retch every time. 27 years in this job, and it's still all I can do not to puke when I smell shit.

One of my students a couple of years ago wasn't so lucky. She left a nice coating of her dinner on the patient's room wall. Funny . . . there was corn in it, too.

I doubt Mr. Elephantitis has that. He probably has a bad case of lymphedema, which would produce all the problems you describe. I've seen maggots a few times; gross, but I'd rather deal with that than shit.

Interestingly enough, digital disimpaction is considered an MD only procedure in the ER im in (I did it all the time all the floor). Guess who takes great pleasure in that fact? Not them.

I've found it varies depending on the department. Some make it a nurse job, some don't. It's a common job in hospice; part of our standing orders for constipation.

Rectal exams for other purposes is strictly an MD job though, and I've annoyed more than one for making him do his own job. I hate rectums that much.

Since you asked:

1. Nurses who refer to me (a paramedic) as an "ambulance driver".

2. People who show up at multiple car collisions, airplane crashes, shark attacks, etc., identify themselves as nurses (they are usually lying, or have not worked in a health care setting for years, or work in a dermatologist's office) and proceed to tell me how I'm doing it all wrong.

Having said that, I have nothing but respect for ER nurses.

Re #1: Ugh. I would never do that to a medic. Granted, I've known some paramedics that make me want to scream because of their incompetence--but the issue was the person, not the job. Likewise, I have a lot of respect for what paramedics do, and I could never do it.

#2: I hate that one, too. CNAs and CMAs who try to pass themselves off as nurses make my teeth ache. RNs who don't work in acute care, but think they know how to handle a trauma scene make me crazy too. When I stop at an accident I render first aid, then get the hell out of the way when the EMS folks show up.

[kpzra]

I would hate the nights of drunk call after drunk call when they would give no indication of being about to vomit...usually right onto my boots in the rig.

Although the dead kids were the worse.

[crazylegs]

#1 Ocular injuries - I don't know why but eyes just squick me out. Come to me with your leg half hanging off and I'll deal with that, come to me with some penetrating trauma to your eye & I'll be dry heaving in the corner.

#2 Being a maternitaxi. You are pregnant. You've had 9 months to plan your arrival to the delivery suite, even if you put aside a small sum of money each week for a taxi you would have more than enough money to go the mile from your house to [Local Hospital]. If the baby was half hanging out I'd be more than happy to help but walking past your 3 cars while you skip down the stairs after the first twinge is more than slightly annoying.

#3 Being criticised by someone who has watched Casualty/ER "But they did it differently on...".

#4 Being called an ambulance driver by anyone.

[Metody]

Oh, wait. Can I add 'lying patients'? Or maybe it's 'lying ER nurses', I don't know. There is considerable and bitter debate about this on my unit.

"But they said you guys would give me all the pain medication I needed up here!"

"They said I'd get four milligrams of Dilada when I came up here!"

"They said the doctor would see me right away when I came up!"

"THEY told ME that you'd let me go smoke."

On one hand, that'd be a jerk thing for the ER to do to us, and it's funny how these things are always self serving for the pt. On the other, there are days when I can sympathize with the desire to do anything to get this person away.