10.07.2012

The Numnut Patient

So, in order to vent my frustrations and be completely unprofessional (for I'm too gutless say these things aloud at the time), here is where I'll be collating a list of numnuts I encounter at work. Live, learn, and don't repeat!

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Patient is about to undergo a total hip replacement. We find out just before wheeling him into the OR that his xray bag only contains a film of his chest. He makes a complaint about the admissions process, stating it was unclear and he was never explicitly told to bring his hip xrays too.
Dude. Hip replacement. Wouldn't hip xrays be logical here? Not the sharpest tack in the barrel..

Patient shows up to ED with a fifth metacarpal (finger) fracture. Why? He punched his friend.
Dude. Stop punching people. Especially friends. People with anger management problems, especially at 16 years old, should not have the luxury to access free medical services to fix up self-inflicted injuries. Like someone once pointed out.. the guy who punched someone else's window gets his hand fixed for free whilst the window's owner needs to call out a repairman and fork out money to fix the damaged window even though it wasn't their fault. now how is that fair?!

Patient's son requests rehab for his elderly mother who is 5 days post-hemiarthroplasty (half a joint replacement) of her hip. Sounds fair enough right? Not for a demented lady from a nursing home!
Ok, so this might be the numnut son but still vexed me to no end. A few more days in hospital getting physiotherapy once a day is NOT gonna help your mother walk better. Are you mental? Rehab means following directions and doing self-exercises. You, of all people, should know as you've got a physiotherapist of a daughter and been through rehab yourself. You seriously think your demented mother who can't speak a word of english and cutely woots like an owl will be able to benefit from rehab!? Get real.

Patient cuts her finger a a tin can. Shows up in the ER with her employer (she's an au paire). Everytime someone approached her to do anything (like look at her cut, insert a cannula, etc), she screams like a moron with a litany of "no no noooooo!" in that flat, obnoxious way a two year old would as a tantrum erupted.
FFS, grow up. I don't have time to deal with an immature little brat like you close to midnight. your tendon is visible and we're doing this for your own good so shut up and deal with it. If you don't want anything done, feel free to leave the department and risk infection or functional damage to your finger. Plus, do you really want to be throwing a tantrum in front of the guy whose kids you're minding as their au paire? Idiot.

Patient complains incessantly of lower back pain. He's had it for over ten years, ever since he injured his back during a football tackle. Immediately after being introduced by the nurse, he straightens up from the pool table and clutches his hip, complaining of hip pain and proceeds to limp towards the examination room. Three steps later, he's walking with normal gait and hops onto the examination bed. Crosses his legs, takes off his shoes and proceeds to crack his toes. One by one. Inches from my face.
First of all, EWWW!! Second of all, if you're going to lie about random body parts being in pain, at least play the part more thoroughly. You must think I'm dumb, or you must not be the brightest bulb in the room, if you think I haven't done my background checks and realized you're dependent on opiods, have a history of aggression, on a detox program and is still craving your drugs. And as for the idiot registrar that asked me to see the guy in the first place, AT LEAST PUT HIM ON REGULAR PAIN RELIEF AND GET A BLOODY XRAY BEFORE YOU CALL FOR AN ORTHO CONSULT NEXT TIME!!

Patient cuts her thumb whilst gardening. That was four months ago. She shows up to the ER today because the base of the thumb looks a bit black with cellulitis and has a bit of ooze seeping out from two little puncture wounds. She now wants something done about it.
Did it not occur to you that something was not quite right when the base of your thumb started to develop this black patch that kept growing bigger? Was it not unusual to have redness and swelling and pain there too? Did you not think of seeking a second opinion when your general practitioner started to DIG at the black hole and make it worse? and last of all, WTF were you doing for the past four months?!?!

Patient stubs little toe on an outdoor sign in front of a liquor store. Aforementioned patient gets brought in BY AMBULANCE, but walks in. Superficial laceration seen at the little toe, not actively bleeding. Decided that it would be a good idea to argue with the triage nurse about how soon he should be seen, demanding to be seen by a doctor straight away. Leaves the emergency department without being seen by a doctor. First of all, it's a little fricking cut ON THE LITTLE TOE. Why the hell would you waste a few hundred dollars to call an ambulance, especially when you could have walked with the injury in the first place? And secondly, you selfish moron... your little cut on your little toe is just that. A Little Cut. What gall you have, to insist on a doctor seeing you immediately and ditch the pregnant lady who is bleeding from down there to attend to your little cut on your little toe?! Fuckwit.

Kid falls off his bike and is CARRIED into the emergency department by his parents. Said kid is screaming the house down with his swollen ankle in tow. Said kid isn't such a small kid. Twelve years old. A prepubescent teen. One that refused the ice pack to the ankle. One that is now waiting for xrays. Still snivelling. Still complaining of pain.
Look kid, unless you are Doogie Howser MD, shut up, stop screaming, take your painkillers and let the nurses put ice on your swollen ankle. Otherwise, get out of the emergency department and stop wasting everyone's time and resources. Walk out. I dare you. 












10.05.2012

anger management

One big convoluted thought process led me to this particular thought that made me lose my train of thought.. that I cannot understand, but will always appreciate my mom not losing her cool this one particular time. It was so long ago, I can't even remember what sparked the whole incident. I vaguely remember being very upset, in my pajamas, with an equally upset mom. My dad was in Burma at the time. For some reason that I still can't fathom, my mom had me write a letter to my dad to air my grievances and she faxed it over to him in Burma. I can't even remember if my dad replied by fax or phone call, or replied at all, but the letter-writing was therapeutic in itself. I calmed down enough to go back to sleep. Back then, I thought my mom was an evil stepmother witch of a character and looked at her every so often with a look of distrust. Twenty-odd years later, I can exuberantly exclaim.. what an awesome mom for coming up with such an awesome way to diffuse a kiddie tantrum!

Backtracking a little.. this whole thing stemmed from a particularly frustrating day at work. I KNOW that everyone sympathizes with me and a lot of them get very very mad on my behalf at some of the things I deal with at work that is simply out of my control, but becomes my responsibility to correct anyway. Today was one of those tips of the iceberg that bobbed above the surface. Made me reflect on how I deal with the shitty situations at work, and wonder if there's a better way. At the moment, I take deep breaths and the mini-shit storms pass. Very few disappear like that though. The majority of time, I end up whinging to a sympathetic ear, or to the ear of someone I respect as a colleague or a friend. Sometimes, I get a dose of reality and I suck it up. Most times, I get validation and then, the anger passes. Personally, I worry that at some stage, these people I rely on to vent must surely become sick of my incessant whinges. Incessant not because I like to whinge all the time, but incessant because without fail, there is at least ONE incident on a daily basis that involves me cleaning up someone else's mess.. for the sake of the patient(s). Look, I wouldn't be able to sleep at night knowing that someone was missing their dose of antibiotics, or something important to their treatment, just because I refused to write it up "because my colleague is supposed to do it but didn't, so it's not my problem." So I continue to clean up. And I continue to whinge. 

Obviously, this isn't working out too well. I'm going to one day exhaust any good will and listening ears, or drive my blood pressure so high I bust an artery or something. But is there a better way?

Writing things down used to work for me as a kid. It still does, hence the existence of this blog. Most things are too minor to survive the one-hour drive back and still have enough kick to keep my blood boiling. Not sure what to do for now but it's something to ponder about, I guess. The saving grace is that my numnut colleague will be away for a week or two soon. I'm happier with him gone. I do more work, I'm more tired, but at least if there's shit to clean up, it's my own doing with nobody else to blame.