Wednesday, January 2, 2013


ER Nursey recently posted about a migraine pt. that she had. Apparently this lady defied existing 'expectations' of Migraneurs who frequent the EDs and refused narcs - instead preferring alternatives.

You know what really hits me about that post (and other patients like her)?

They're polite. They apologize. They're generally civil and nice.

Don't get me wrong - I'm a pretty generous guy. I give ample leeway to the fact that being sick/in pain/miserable tends to alter pts. behavior somewhat (makes 'em irritable, cranky, fussy etc.) and to a point; I'm willing to let that slide and chalk it up to the pt. being "sick". I get it - you're sick. You're hurting. You're in pain. You're feeling miserable.

By and large, a good majority of my "sick and irritable" patients respond to my care and ministrations in a positive manner.

But right from the days of my working on the floor to my current job in the ED, there's certain kinds of pts. who just win me over with their verbal and non-verbal cues.

Be it the 96 year old great, great grand mother who had the misfortune of fracturing her hip who only wants "A couple Tylenol and an ice pack dear. I'll be all right".... to the 60-odd year old man who has not urinated in 12+ hours, in severe distress and pain with a grossly distended bladder (and abdomen) from the pressure; grit his teeth, smile thinly and say "do what needs to be done Doc" [more on this later]... to the 45 year old single mom retching and vomiting air, in incredible pain from the cancer that's eating away at her trying to smile and put on a brave face for her kids while her only concern is to "get better because Tommy has a school play coming up and he needs me".

The examples are numerous. But their effect is the same.

Someone once said: "Attitude - it's all the difference between and adventure or an ordeal".

I'm by no means stating that people who are sick or who are in pain are having an "adventure". BUT, their attitude of how they deal with their illness or pain speaks volumes about their character.
Especially when you contrast that behaviour against patients/family who don't give a damn.
"Don't give a damn?! How can you say such a cruel thing?!"

- when you have someone come up to the front desk and say "I need help getting XYZ outta the car".... well, how did XYZ get IN THE CAR in the first place??!!
- when you have patients, who the minute they cross the ER entrance; seemingly become invalids - they drove themselves here, walked from the parking lot to the sign-in desk... and from then on were completely incapable of helping themselves - including walking, toileting themselves etc.
- when you're accused of being a racist/chauvanist/motherfucker/'you're lucky I didn't punch you in your motherfucking face'/etc. --- all for requesting co-operation from folks so that I could figure out what was wrong with 'em....