But, when the doc is wanting to check things out to make sure there isn't something else going on other than post surgical pain, please don't argue. Or, if you do, don't get mad when you only get a pain shot.
Patient "Tough Guy" came in the other night with this pain. He was wheezing, had course lung sounds, but his biggest complaint was RUQ pain. Of course, Tough Guy just had his Chole, so I get that. Incision site looked great.
Doc wanted to help him with his breathing, but Tough Guy refused. Ok, fine. We'll give you a pain shot and send you home. The guy even got Dilaudid IM. He wanted it IV. Ummmm, no. We wanted to give Zofran ODT. He wanted Phenergan IV. Ummmm, no.
He continued to fight and argue, taking up way too much of my time. Eventually, I walked out of the room. On my way out, I told him, "If you want the shot, let me know. Otherwise, I'm getting your discharge papers right now."
Suddenly, he was ok with the shot. Still refused Zofran. Reason? He doesn't like the taste. Reason he didn't want the Dilaudid IM? It hurts. But, dude is ok with an IV? Nope, definitely fishy.
GOMER! (Get Outta My ER)
I'm queasy about an IM injection, I'd have to be incredibly desperate before I'd have one. But I don't really mind an IV. And before you think of it, I've never had an opioid (unless there was some while I was unconscious during minor surgery) and don't want any. So I can (maybe) understand the guy a bit there.
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