Wednesday, April 09, 2008


I would like to think that I have not become a hardened bitch and or nurse Ratchet, but tonight there seems to be a whole lot of "WTF" going on.
Explain to me this, if you are going to refuse services, why did you bother coming to the hospital. Why did you seek treatment.

Pt X, 61 year old obese female, admitted s/p flame burns to chest and right upper extremity. Burns noted to be mostly 2nd degree with some 3rd degree around the areola of her R breast. Pt went to the OR 5 days ago for autografting, donor site was the R upper thigh.

Where to begin with this patient...

#1: She's been primarily bed bound due to her bulky splint and dressing for the past 5 days; she's obese.
*She's been refusing her heparin shots.
Yes lady, I know they hurt like hell, but would you rather throw a clot and have a stroke or a heart attack, or both and die?

#2: Her blood sugars have been well over 200.
*She's been refusing her insulin.
Yes lady, I hear you when you say you weren't "diabetic" before you came to the hospital; however, you also do not have a primary care physician, nor were you testing you blood sugar at home. Did I mention that sometimes the stress of a burn injury can induce a temporary rise in your blood glucose level. Do you understand that the tighter we control your sugars, the better you wounds will heal?

#3: She's mal-odorous (I'm being nice here).
*She's been refusing her morning shower.
Lady, you sweat profusely, you have a weeping donor site, you have large breasts and abdominal folds that need to be washed so you don't get a fungal infection that will inevitably spread to your freshly grafted wounds and then you will be here getting IV antifungals that will turn your urine orange and you will pitch a fit because we will have to put in a foley catheter in order to accurately examine your kidney and liver function due to the toxicity of the medications you will be taking. FOR THE LOVE OF GOD, TAKE YOUR DAMN SHOWER!

#4: She complains about the food.
*She's been gobbling up every last morsel we put on her tray and mooches off of others.
*Lady, I'm sorry: that you think the mashed potatoes are too lumpy , that the chicken isn't tender enough, that the tea is a basic blend and not something of the organic variety, that we use smuckers peanut butter instead of jiff, that we serve oatmeal raisin not chocolate chip cookies, that we have Splenda not Equal, that we use white eggs not brown ones, that lunch and dinner are served on plastic trays, and that we supply plastic not metal silverware (it;s not like we are serving fillet Mignon)-wait, let me apologize for that too. Honestly, this isn't a five star restaurant. There are sick people here. Tell you what, if you hate the food that much, lie back and I'll put an NG tube in you. We'll pump you with liquid nutrition, you won;t have to taste anything.

#5: She complaints about the linens.
*She refuses to use hospital linens and/or wear a hospital gown.
Lady, I'll cut you a little slack on this, I agree, I wouldn't really want to lie on sheets that had previously been covered in god knows what, but your complaining about the thread count is out of line. And the issue about the gown, give me a break! The gowns allow for easy access. I have to change your dressings twice a day, It's not fair that I be required to strip you down like someone who's dressed to venture out in a blizzard. Please, for the love of god, and the sake of the patients who are really sick, cut the crap, and wear the gown.

Am I being unreasonable? I get that being hospitalized is stressful. I understand that you have lost control of your environment, that you endure painful procedures, that you experience aggravating delays in care, and that you really want to go home, but please, work with me here. I'm trying my best. Try and make the best of the situation. I want you to heal so you can go home but if you fight me on all the little things, time is going to stand still.

No comments: