Thursday, November 23, 2006

R-E-S-P-E-C-T, Find Out What It Means To Me

There are many things I try to be nonjudgmental about. I try not to think you're a big whiney baby when you come to the ER to have a sliver removed from your foot. I try not to think you need to be committed when you come to the ER to have a q-tip (or some other foreign object) removed from your nether regions. I try really hard not to think you need to step off the edge of a cliff if you come in screaming that you're dying when in reality all you need to do is fart.

I try. I usually fail.

I guarantee that I will treat everyone with respect, no matter what. I will treat you the same, but I will think you are a lunatic in my head.

If you tell me that your child has kept you up for 5 nights in a row, you haven't had an ounce of sleep, and you need some medicine to put your child to sleep so you can get a moment's peace - I won't believe you. And I'll probably think you're a bad parent. I will still treat you with respect.

If you tell me that the Vicodin you've been taking for 3 months isn't working and now you want to try something else, and "why no ma'am, I haven't been to any other doctors for this" - I won't believe you. I will find the 5 pharmacies and 13 doctors you've been getting drugs from. I will still treat you with respect.

If you tell me the president is an alien who comes into your head everynight and tells you to place foreign objects in your orifices - I won't believe you, and I will call for a mental health evaluation. I will still treat you with respect.

If you are a doctor who is yelling and screaming at me, spittle flying out of your mouth, face turning red, telling me I'm a bad nurse - I won't believe you, and I probably won't like you. I will still treat you with respect.

I will treat you with respect, and I will expect the same. I am a nurse, yes. I work in the ER, yes. But I am still a human and deserve to receive the same respect that I give. You don't have to like me. You don't have to think I'm a sane, rational, compassionate person. I probably don't think any of those things about you. Yet, I will treat you with respect.

Can we not all expect the same from each other?

The Difference Between Life, Death, and Drug Seekers

When you come into the ER yelling, moaning, and twisting in agony because you have a sprained ankle - I will hate you. Why will I hate you? I will hate you because the man in the next stretcher is dying of an excruciatingly painful form of cancer, yet he is silent. He is silent, and dignified, and asking for pain medicine "when you can get to it dear. It's really not a big hurry. I've been dealing with this for 6 months now." You, on the other hand, are screaming at me to "hurry up and get my fucking morphine bitch! I've been waiting for 20 minutes now! I'm in pain, ya hear me? I'm in fucking pain!". Yes, that is why I will hate you.

The difference between life pain and death pain has amazed me more than once. The man who threw his back out hauling cement blocks is begging for relief, while the woman who is here on hospice respite and is probably going to die in the next 2 or 3 hours is calmly waiting for her turn on the IV morphine train. The woman with a knife in her leg is screaming like she is dying, but the man who is actually dying next door - he just wants his family close so he can say goodbye.

I don't understand it. I'm not sure I want to. I just want people to respect the fact that someone having a bigger crisis than them may be in the bed next to them. And I may be needed more over there. I probably won't respond quickly to you if you scream at me to get your pain medicine. I will be busy with the man next door who is passing from this world. His problem supercedes yours. Your pain may last longer - but you'll still be alive at the end of it. He won't.

Now I'm not saying that all people in pain are whiners. I'm not saying that if you come in complaining of pain I will roll my eyes, take a deep breath, and say, "Whatever - come on back." I will believe you are in pain. I will treat your pain as able. I will be respectful to you as a human being. The moment you start screaming and cussing at me - you've lost me and my respect. The moment you disrupt every other patient in the ER by demanding your "fucking morphine" you will have lost me.

Pain is subjective. Reactions to pain can be controlled. Most of the time.

Tuesday, November 21, 2006

Hog Tied

He arrived at the back door in a large white vehicle with flashing blue and reds on top. It was a bad sign. It's always a bad sign.

Mr. Law Enforcemen Officer (Mr. LEO) proceeds to drag out Mr. Violent Man. Mr. Violent Man is shouting and screaming - in Spanish. I don't speak spanish. Dr. Q doesn't speak spanish. No one on duty speaks spanish. This is not going to be good.

"Did you check him for weapons?" I ask.

"He's clear", Mr. LEO replies. I then notice that Mr. Violent Man is hogtied. Hogtied with white rope. Why is this important? I'm not really sure - but I remember the white rope and how it was frayed on the edges. Mr. LEO and 5 of his closest similarly dressed friends assist Mr. Violent Man into the ER.

"Puta! Puta! Puta!" He screams at me.

"No hablo espanol" I reply.

"Fucking Bitch" he says in perfectly accented English. Oh yes, it's going to be a grand day.

A translator finally arrives. She looks lost a minute into the conversation. She proceeds to tell us that Mr. Violent Man is not making any sense and can't follow a conversation. She asks why he's here. When one of the police officers say "He was threatening his co-workers with a chainsaw", her face drains of color. We have to bribe her with candy and offers of free medical care to get her to stay.

Mr. Violent Man takes 8 mg of Haldol and 10 mg of Versed to calm down enough to get him to quit yelling and lay obediently on the stretcher. He soon starts singing the Mexican national anthem to us, horribly off key. But he is happy - happy and calm. After all, that's what matters now, isn't it?

Dr. Q finally gets close enough to examine the patient. Why is it that the nurses are the first line of defense? Dr. Q just smiles and pushes us forward in front of him. "To the hold room!" he shouts, like a king commanding his army. Mr. LEO and his 5 buddies immediately obey.

"Hey! Wait!" I yell. "Don't forget the patient."

Reluctantly they turn around. After we remove his restraints, they escort him to the hold room. I can hear the words "Viva la Mexico!" resounding down the halls.