Thursday, September 17, 2009

Killing me with Kindness

There are those patients who are rude, demanding, entitled and prone to screaming temper tantrums. Those patients are fun to (figuratively) bitch slap back into place and/or throw out of the department. They are also fun to blog about because they showcase the scummy depths of immaturity to which people can sink when their demands are not immediately met.

Then there are those patients/families that on first impression seem to show genuine understanding about wait times and how busy the department can become and for a while, they leave you alone. And then the call bell starts ringing. You go into the room with high hopes of all being well. Turns out the patient wants an extra blanket. “Sure, no problem” you say as you bring one fresh from the blanket warmer. “Those rooms are chilly” you think. “Anything else while I’m here”, you ask. “No dear, that’s all, thank you”. You get back to doing whatever it is you were doing, and then the call bell rings again. You go back into the room and this time, they’re asking you to readjust the telemetry wires because they’re uncomfortable. You do your thing, give the patient a winning smile, do a quick little assessment and then leave. Then the charge nurse brings a new patient that will take up some time and sure enough, the call bell goes off again. “Please dear, can you tell me how much longer will it be before I see the doctor?” The department is swamped (as usual) and you tell them once again it’ll be a while but in the meantime, they’re being carefully monitored. “While you’re here, can you get me another blanket? Also my IV is feeling uncomfortable. Can you bring me something to read? I’m really hungry as well – do you have any dinner trays? How long could it possibly take for the doctor to see me? All I want is a quick little x-ray and some medications” And then you think, “I’m so fucked – this is going to go on for the entire shift”. You also realize that you should have set limits waaaaayyyy long ago when they first comfortably ambulated inside their room.
When you actually can’t answer their bells, they get extremely upset and use all available tricks up their sleeves to make you feel like you’re scum for not holding their hands through their terrifying ordeal when in reality you’ve got 5 other patients and ever increasing amount of orders that you have to carry out so your entire team doesn’t chew you out for slowing down patient flow. Finally you have to put your foot down and tell them to use the call bell for emergencies only – holding the urinal in place while I have to be the third party listening to a detailed cell phone conversation about how the new son-in-law is a complete schmuck does NOT qualify as an emergency.

The entire encounter reaches a disheartening conclusion when the patients and families want to speak to the charge nurse about how their reasonable requests were ignored throughout the length of their stay despite the fact that a nurse was in their room almost every 45 minutes. “At least I documented really well” you think as you trek it to Starbucks for yet another latte after having downed an Advil. Some days, defeat is inevitable.

5 comments:

midwest woman said...

congrats on your blog recognition and your first year anniversary. The passive agressive butter wouldn't melt in their mouth narcissistic call light abusers are the worst. Hope your charge stood up for you.

Liz said...

I have never seen or heard a typical 12 hour floor shift described so well....

I realize you're in the ER, but this was also my reality as a floor nurse. Of course, I'd get the same pt. 3 days running, so my hell would last a tad longer. And of course, the problem was usually lack of boundaries set at the beginning (because they seemed so 'normal' and 'reasonable')!

Love your blog, and though I wasn't aware until I read the above comment, congrats on the recognition!

Old MD Girl said...

Such a great description of what goes on in the ED. Sometimes they get better when they get transferred upstairs..... but sometimes no.

I get treated like a waitress sometimes too. It's not NEARLY as bad as it is for the nursing staff.

DreamingTree said...

Oh, do I recognize this patient! The rude ones are much easier to deal with than the passive aggressive, high maintenance folks. And, they always seem to have an endless stream of family members, resulting in an increase of needs. My favorite is when family says, "just call the nurse, Mom, that's what she's paid for." Grrrr.....

Anonymous said...

Hope you have a nurse manager that supports you. I live in Canada and someimes I wonder......
Also work telemetry