Me: “Hello, so you’re having some chest pain?”
Patient: “It just hurts.”
Me: “When did it start?”
Patient: “It just hurts.”
Me: “Where on your chest?”
Patient: “It just hurts.”
Me: “Anything make it worse?”
Patient: “It just hurts.”
Me: “Ever had this before?”
Patient: “It just hurts.”
Me: “Fine, enough, I’ll just order a bunch of tests.”
————————————————————————————–
Nurse: “Your chest pain patient wants to know what’s taking so long.”
Patient: “So how come my chest hurts?”
Me: “Gee sir it’s kind of hard to say since you answered none of my questions.”
Patient: “Is it stress?”
Me: “No, that’s my chest pain, thanks.”
September 9, 2008 at 6:41 am
You knowm my standardized patients in school always gave straigtforward answers to the actual questions asked. I wonder if that is part of the problem with JACHO and other such organizations. They never went past the standardized stage in their training and don’t realize that actual patients often don’t give answers that make any sense.
September 9, 2008 at 10:01 am
I think I had this guy as a patient when I was in nursing school. He was a recently extubated young guy who was on dialysis and had a zillion medical problems. And every time you talked to him he had chest pain.
Pt: Nurse, I have chest pain!!
Me: What does it feel like (stabbing burning aching)?
Pt: LIKE PAIN!
Me: Can you rate it on a scale of 1-10?
Pt: IT HURTS!
Me: Does it move anywhere?
Pt: MY CHEST HURTS!!
Me: Does anything make it worse or better?
Pt: NO IT HURTS! CHEST PAIN!!
Turns out it was GERD. While intubated, he hadn’t eaten anything via the normal route for two weeks, and was not following his prescribed diet–he was sneaking orange juice (SO not on a dialysis pt’s diet) and cold toaster pizza whenever the staff was out of the room.
September 9, 2008 at 10:46 am
Similar rhetoric to above.
Pt rips the ER cubicle divider down thrashing.
Think kidney stone in an inarticulate patient.
September 9, 2008 at 11:12 am
we have a lady like this who comes in from dialysis.
every time during dialysis, she says “i’ve got chest pain”, so they stop her dialysis and send her in.
never has it turned into anything…but when you ask her what it’s like, it’s “it just hurts”.
September 9, 2008 at 11:24 am
You wanna know what my CP is caused by? Not talking to a buddy in awhile…damn you.
Re: the post
Dude, just give him some Demerol already!
September 9, 2008 at 5:26 pm
Every day in triage:
How would you describe your pain? “A ten!”
No, I mean, how does it feel? Sharp, stabbing, throbbing, achy?
“A really bad pain!”
Where does it hurt?
In my stomach!
Your stomach is up here, is that where it hurts?
No, way down here by the crotch. Okay.
Any pain with urination?
What’s that?
Peeing?
Well it’s itchy down there…
But does it hurt?
I said it’s itchy.
And so on until I just decide “not serious” and move on.
September 9, 2008 at 6:10 pm
Eye Vay! I cannot stand it when people can’t even get it together to even give one smidgen of useful history.
September 9, 2008 at 8:17 pm
it hurts and I need that stuff…
you know….
p…
per….
perca….
percasomething….
September 10, 2008 at 1:27 pm
[...] through some of the headlines on my MedWorm feed this morning, when I stumbled on a headline saying ‘It just hurts’. I had to click on it and here is what I read: Me: “Hello, so you’re having some chest [...]
September 10, 2008 at 11:11 pm
Thin the herd!
September 18, 2008 at 7:16 am
Retired Educator, here. Making and imparting sense is obviously something of import to me. So I was brought up short recently when, while in the hospital for some drastic, but successful, surgeries, I was trying to explain my pain to my superb orthopedic surgeon. He sat with his head cradled gently in his hands, and it occured to me to inquire as to whether or not I was making “any sense.”
“Not really,” he replied, “but it doesn’t matter.”
Ouch. I can only imagine the response from a lesser medico…
You poor folks have to deal with the “It just hurts” population, as well as with my type of narration — made up of what my long ago freshman comp professor called “too many words.”