Today's fun involved a female patient with numerous visits. While she has some actual real physical problems (not that she takes care of them) and is supposed to be on THE COUMADIN she would much prefer to take copious quantities of Percocet rather than THE COUMADIN because, you know can die from chronic pain but not, apparently, from multiple blood clots. Whatever. On her last visit she presented with a rash. Well, she had sunburn. She yelled at me because I was rude for saying she looked like she had been in the sun; NOBODY, nobody should be asking her about sunburn, it's not the reason why she was here. All crap.
Mostly this patient gets shut down because her complaints are stupid and she is already so stoned she is slack jawed and drooling. Mostly the visits end in rage (hers, not mine) because she fails to get what she wants so she feels screaming, name calling and threats will be successful. Thanks to the Pirate's helpful hints about documenting the exact language used by patients, my documentation of such encounters is now quite colorful. On the two or three occasions when the patient was lucid to make good her threats and use a phone to complain, her own words were read back to her. Of course she yelled at the patient rep that I was a liar. This gets old after awhile.
Today, though, The Pirate gave her Dilaudid for her headache because she is allergic to NSAIDS and can't take Tylenol because of her liver and she is allergic to everything else. Sigh. But she got shipped down for a complimentary head CT before she was kicked to the curb. The Pirate is relatively new, you see. And we are ever mindful that just because someone is a drug seeking, low life, abusive, suck-the-life-out-of-you attention whore does not mean that they might not have a life threatening problem, see.
Report to the next nurse went along splendidly because she was well known to the staff there. When I got to allergies, which were numerous, the nurse replied, "Yeah, I know, when you click on her allergy tab on the EMR, (electronic medical record) the lights in the whole city dim out"
Yeah. Narcotics were prescribed by 11 different providers in the last month according to the pharmacist.