Bloggers, (no) thanks for the advice

I could have listened to some people and administered narcotics to every single patient with a complaint of pain because I may be wrong about the patient faking it. They say, who am I to decide if patients are really in pain?

I also could have listened to some people and only focused on the current patient because “the only patient that matters is the one in front of me,” because “there is no other patient” and “there is no other call” while I’m on the current one.

I could have.

Instead, I used my head.

Besides, I didn’t want to get laughed out of the hospital. Yes, I am fragile and have no self-esteem.

In addition, I was a patient advocate… for all the other future patients who may actually require the services of the ED.* An individual patient doesn’t exist in a vaccum without other patients.

When we bring a bullshit patient to the ED, are we being the advocate for this patient, or the more deserving patients who actually need the ED? Since when does responding to a call – and a patient – automatically enter me into an arrangement that requires that I advocate for this patient regardless of how much s/he does not need emergency services?** I advocate by helping people solve their problems, not blindly giving them narcotics or taking them to EDs for no good reason. How does it help anyone if a patient who should go to the waiting room ties up a precious bed instead because the ambulance crew, without considering the subsequent chain of events, starts IVs unnecessarily, administers narcotics to everyone, and thus prevents the ED staff from sending anyone to the lobby?

Prehospital care? How about prehospital triage?

The other day (OK, who am I kidding – it’s really every day) I brought this shitbag woman with a complaint of “pain” to the ED, and she is the worst kind of asshole, rudely demanding “something for pain.” Yeah, right. Just be quiet and lie on the gurney. As it turned out, the charge nurse instantly recognized her and sent her straight to the waiting room, walking or not.

If I recall correctly, it went something like this, “You were just here last night. We have a pain contract with you, meaning you don’t get ANYTHING here. We told you we will not give you anything. Your doctor knows that we will not give you anything. Go to the waiting room. Can you guys put her in a wheelchair and take her out there?”

“Fuck you! I can’t sit in a wheelchair!”

“No one cares. Go to the waiting room.”

The same tour, I brought this bed-confined woman who said she “felt an aura” and “woke up in bed,” claiming that she had a seizure. She said her whole body was hurting “so bad” after the seizure. I could smell the bullshit from the street.

I did exactly two things on this call – her vitals and my paperwork.

When we showed up at the hospital, many of the staff knew who she was.

“She’s been coming here looking for drugs for 9 years.”

Boy, was I glad I didn’t set myself up to be laughed out of the hospital.

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*Before you jump all over me, this absolutely does NOT mean bullshit patients aren’t treated with respect, as long as they behave. This also absolutely does not mean I won’t post about them later.
**Again, being an advocate and being respectful are two separate things.

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