Tuesday, May 1, 2007

A Letter to the Not Sick Man in Bed 1

Dear Mr. Not Sick Man in Bed 1;

I am sorry that you are having a rough day. I understand that it happens to all of us sometimes. Especially the part about running out of Lortab. I, too, am out of Lortab. The fact that I don't actually ever take Lortab is completely beside the point.

I appreciate the fact that you know that the words "chest pain" coming from your lips in the waiting room will get you straight back to a bed and force us to pay attention to you for at least the 15 minutes it requires to initiate the chest pain protocol. After all, you've been on this earth for 45 years, and it means a lot to me that you have learned these important things. Things like the fact that Morphine is an adequate substitute for Lortab, though I am so sorry that we had to poke that mean, mean IV catheter into your arm to give it to you.

I'll be happy to ask the Doctor for more pain medicine for you, just as soon as I'm done helping this lady in Bed 2. I am very sorry that she has interrupted your crisis today. I would put her in a different bed, so that you can rest a bit more comfortably as you wait in your Morphine-induced haze for your negative cardiac enzyme results to come back from the lab, but she needs to be in a cardiac bed, of which we have two, and of which you are occupying one. I know she doesn't appear to be sick to you, because she isn't flailing about and crying about her "terrible 12/10 chest pain", but that is simply because when I got her out of her husband's car just now, she was barely breathing. Her oxygen saturation is only 50%. And although her color may seem to be "normal old lady white" to you, I recognize it to be "truly sick patient gray".

I'm very sorry if we seem to be rushing around and not paying any attention to you, after all, you are having a very bad day. I realize that you need a cigarette. Indeed, you have been in that bed for almost 45 minutes. That's a long time to go without nicotine. I will address that as soon as possible. As soon as I have attached this mask with non-nicotinated oxygen to this patient. And attached these very large sticky patches to her chest. I understand that they are much bigger than the ones you got, but that's because we may have to shock her heart if it stops. It's only beating about 35 times a minute right now.

I'm sorry that the slamming of the drawers right by your head is so loud. These crash carts make a bit of noise when we're digging through them for Atropine. Perhaps you could write a letter to hospital administration requesting newer, quieter ones so that the next time you're in here requesting narcotics, our movements won't startle you.

I would be happy to bring you a glass of water. It will be a moment, though, because I need to finish this EKG. You remember that, don't you? That thing we did to you 30 minutes ago that said "Normal Sinus Rhythm" at the top? Hers says something just a little bit different, though. Think of it this way; you got an "A" on the test, she's currently getting an "F".

I apologize for not answering your questions quickly enough. You see, I couldn't hear you because of the stethoscope in my ears. I was trying to get a blood pressure on this patient because the machine can't find it. Oh, your blood pressure cuff is too tight? I'm so sorry. I'll fix that right away.

Yes, I realize that your girlfriend will be coming in to visit you later. But I'm going to borrow this chair for a little while anyway, because this gentleman is 85 years old, and he's not feeling so hot right now. I'd kinda like for him to sit down. Oh no, no, he's not having a bad day like yours. It's much different. He's watching the woman he's been married to for 67 years fight for her life. I don't think Lortab will help that.

Yes sir, I'd be happy to remind the Doctor that you need a note for work. Thank you for being so patient.

26 comments:

scalpel said...

Wow.

Jessica said...

People suck.

Flea said...

Your stuff is great. I'm adding you to my blogroll and bloglines.

Welcome to the fold!

best,

Flea

p.s. I don't hate ED's. That's a misunderstanding on my readers' part. I'll explain in full some day.

pps word verification = avgfak, not the best fak you ever had, but not the worst either

Jess said...

This should be included in part of the discharge paperwork. But then, gentleman of his caliber are far too busy to read through all that stuff, I'm sure.

I've had 2 complaints in the last 3 years....funny how they both came from drug-seeking pts just like this.

Well done.

ObGynThoughts said...

Excellent! Please continue!

Anonymous said...

Nice writing to capture the essence of what B.S. inundates the ER every day.

Mom MD said...

Ughh, that's ugly. Not unusual but ugly.

mielikki said...

Good lord, that story is just way too familiar to me. Those people are everywhere. . . sigh.

ERnursey said...

It is truly amazing what selfish assholes some people are. And what a high proportion of those end up in the ED

Rocky Mountain Medic said...

THIS IS THE BEST POST I HAVE EVER READ...IN MY ENTIRE LIFE!!!!!


awesome awesome awesome.

can i put you on my blog list, because i already did!

Kim said...

I can vouch for Flea - he really doesn't hate ERs! : )

I'm also with Flea on adding you to my blogroll - you have got to keep writing! : )

All I got for my word verification was "wnjujx"- I guess that's word verification speak for "windex" : D

John McElveen said...

You have Captured every drug seeking patient who has discovered our Urgent Care in lieu of the 5 hour wait at our ED. Hats of to you for continuing the Night Shift I bow!!!!....I can die in peace now. I am an instant fan. Thanks Monkey--for your service and for your description of every asshole in the US who is Chemically Dependant and proud of it! You just can't even Shame those peole!!!

Well written---I'll be back- gotta go take my Oxy-Methadone cocktail!

Might just be reflux??????

I was working the day I went to the Cath lab and had a Triple Bypass the next morning...and these peole.....sorry- you already summed it up for me- I just need to re-read!! LOL

Thanks,

John

Just A Midwife said...

This post is a thing of beauty. It should be handed out to patients as they walk in the door...except that they would all say, "See, THAT'S ME!! The really SICK one!! So drop what you're doing on that icky bloody person and LOOK AT MY SORE EAR!!!"

Xavier Emmanuelle said...

Found your blog today. LOVE IT! Is it cool if I blogroll you?

dr. nic said...

Great post. As of now, this post has been linked to, you have been blogrolled, and your rss feed bookmarked.

Mother Jones RN said...

I'm glad I found the link to your blog via Scalpel's blog. Great writing!

I'm adding you to my blogroll right now. Keep up the good work.

MJ

Nurse Kelly said...

Nurse MonkeyGirl: Don't forget his crackers and Sprite! Morphine can make your throat a little dry and the weed he smoked in the car on the way in is certainly creating some WICKED SERIOUS munchies.

Anonymous said...

wow! this post will stay with me for a long time...

the man makes me sad, but I find your patience inspiring...

geena said...

Nice writing.

Anonymous said...

I Love You. (Can I have a pillow and some food?)

shrimplate said...

They must be cloning this guy in Area 51 or something and sending them out to hospitals everywhere because we all know them. Or him. Whatever.

Personality disorders. Borderlines.

Tres difficiles.

Wanderer said...

Love it. One of the best posts I've read in a while. For sure adding you to the blogroll and checking back regularly.

911DOC said...

monkey girl, what manner of medical beast are you? methinks you are hiding an MD tag somewhere but perhaps its an RN tag. love your blog. word to your mother.

Janet said...

Great post! Though you may have meant it as a rant against drug-seekers, your post is also a great reminder for us potential patients that we are not the center of the universe, even if we're sicker than we've ever been. Nothing like a real tragedy to remind us that our everyday problems are really trivial.

Anonymous said...

Wonderful blog! My job is a Case Manager for Medicaid trying to keep these people out of the E.R.'s.... I'm really trying... It's hard to work with the unworkable! Flea.... good luck to you! My son is a 21 year survivor of Leukemia and it's docs like you that got him through it!

Mama Mia said...

You are killing me. I didn't realize that we were working side by side last night!!

I'm reading backwards through your archives and they are awesome.