Saturday, February 7, 2009

expressing yourself

In ER world, nurses see lots of creative and innovative ways that patients choose to "express themselves." Why hold your anger inside when it can only lead to heart disease and aneurysms? Let it all out in the ER. The nurses are trained to therapeutically address your concerns. We are caring individuals.

Some ways that our patients like to release their pent-up feelings and emotions:

1. Tossing the written prescription on the floor in front of the nurse's station and storming out, all because the doc wouldn't write for Lortab or some other narcotic that the patient could sell on the street. Minutes later, housekeeper finds the word "bullshit" scribbled on the stretcher mattress.

2. One of my favorite nurses likes to advise his patients upon discharge to "drink plenty of water, eat your vegetables, and wear your seatbelt at all times in the car." Problem is that obese women who come visit us with barely a cold don't want this advice. "I sat in the waiting room for 4 hours just to be told to eat my fucking vegetables!"

3. Triage assessment on a patient brought in by ambulance goes like this: patient transferred to bed with help of EMS personnel, nurses assist patient into gown and instruct patient to lay down so that we can take vital signs, patient purses lips together and blows out a spitball straight into the air while two nurses are hovering above attaching electrodes. Or sometimes, the wall gets decorated. Safer for the nurse at least.

4. Phrase of the week: "I don't care." I don't care about this shit, I don't care about what you are prescribing me, I don't care what you say even though I myself chose to come here, I am not being admitted, I don't care if I have to pay the hospital bill out of my own pocket if I sign out AMA because you know that I won't pay it anyways.

5. Patient is bleeding profusely from surgical dressing, chux upon chux pooling up with blood. "When will I stop bleeding? Can I take a bath when I get home? Why do I have to stay here?" Fed-up Dr. Q responds with "I can't tell the future." Yes sir, go on home now, get blood all over your car and have your wife call EMS when you decide that you would rather bleed in the hospital.

Now I know why we studied therapeutic communication in school. Because it works so well in the ER. Patients always respond positively to logical reasoning there.


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