Saturday, January 29, 2011

The Customers

It’s nice to have friends who are also nurses. A few days ago, one of my very good friends (I’m looking at you, J) met up with me after a harrowing night shift to vent (errr debrief) about a challenging family member who demanded medical care only to refuse every single treatment option offered. I’ve run into far too many similar situations and they’re a pain in the ass to deal with Every. Single. Time. I greatly respect the fact that a patient knows their body better than anyone else and that those who live with chronic diseases often know more about effective treatments than emergency RNs and MDs. I for one welcome the feedback because it not only enhanced my own learning but allows me to provide better care. However, when patients come in armed with a medical degree granted by Drs Wiki and Google and expect us to follow random internet advice to cure what ails them because they are ‘customers’ of the health care system, it’s not going to happen. Ever. Why? Because we use best practice guidelines to provide COMPETENT and SAFE care even if that care contradicts the generous stacks of printouts from There are LEGAL ramifications to not providing care that is based on sound science.

One of my most irritating encounters happened with a middle aged man who came in complaining of shortness of breath. It was clear he had pneumonia (what with the raging fever, gunky sounding lungs and the dramatic expectoration of army fatigue coloured phlegm) but he absolutely refused the antibiotics citing concerns about antibiotic resistance and his consumer power. And yes, he had stacks of printouts, mostly with ads for weight loss remedies on the side, to ‘argue’ his case. Logic did not have a place in that exam room. I hate to get all flustered, but WTF??! Why bother coming into emerg at all?

This whole business about the customer always being right is total crap when it comes to providing safe, competent, evidence based care to a ‘customer’ who picked up their medical knowledge from internet pop-up ads and snippets of TV shows.

Sunday, January 23, 2011


It’s 0200, I can’t fall asleep (again) because of insane switch overs between days and nights so I decide to boot up my computer and watch some mindless movie to pass yet another insomniac night. While I’m randomly surfing, I check my facebook (of course) and this doctor with whom I had a major kerfluffle with regarding scope of practice and respect in general sent me a friend request! Not gonna happen. In fact, the privacy settings got bumped up even higher. Now I’m just too creeped out to sleep.

Friday, January 14, 2011

We (Still) Have No Cure for the Flu

The flu season is upon us and that means snotty noses, fevers, body aches, chills and generally feeling like crap for a while. You want to feel better quickly and that’s understandable. After all, having the flu sucks. But if you’re an otherwise healthy individual (ie: not old, no pre-existing respiratory diseases, etc), please don’t go to an emergency department demanding that the nurses and doctors give you Tamiflu. You’re depriving yourself of the comfort of your own home and bed and are spreading your germs around to people who are a lot sicker than you. There’s nothing we will do that you can’t do for yourself, like resting, taking Tylenol/advil for symptomatic relief and drinking a cup of hot tea. Also, if you’re a 20-something year old man-child, please don’t send your mother to the nursing station every 20 minutes to ask when the doctor will see you and if he can get something hot to drink. I’ve given your child Tylenol (which the doctor would have told you take anyways) and there’s a Starbucks in the lobby 10 feet away from you. They have all sorts of hot beverages for your precious baby. Following these tips won’t make the flu go away any faster but it will save you a huge wait time next to the drunk who keeps pissing himself that you could have spent sleeping at home.

Saturday, January 1, 2011

Is it possible to eat so much that your stomach starts to displace your internal organs?

Normally, I consider myself a discerning glutton but this holiday season has been filled with eating on a scale unheard of until about 10 days ago (right when I wanted to pick up working out on a consistent basis again). Normally I don’t eat during night shifts but when I worked straight nights during Christmas, I was powerless to resist the goodies of our annual Christmas potluck. I was deliriously happy when I realized that the majority of my coworkers were amazing cooks on the side! Then I was stuffed silly by my elderly relatives as soon as I got home from work. Tonight is not going to be any different. In fact, as I write this post, I have 3 beef dishes on the stove and some baklava in the oven for a dinner party tonight. The point of this post? I’m far too stuffed to write anything relevant to nursing so I’ll just raise a glass to great food shared with great company, holiday shifts that were uneventful and let me have a chance to actually get to talk to my coworkers and wish you all a very happy and healthy new year!