patients, patience

The last two nights at work a few of my patients tried my patience. It is an exercise in control and I can say with confidence that trying to have any type of rational, useful conversation with someone who is intoxicated from alcohol, is a losing proposition. So, what to do? How do we protect the inebriated from themselves, protect ourselves from them and not lose our cool? It ain't easy, although any bartender can tell you that. Of course the bartender has the option of tossing their patron - I do not.

Fortunately in one case, I was in the position to sedate the spittle spewing screaming woman who wanted to: call her barely-teenage-son at 2:30am/leave/call her lawyer/sue my ass for holding her hostage. It began like this: 60-something woman went on a bender, broke her ankle in two places, and appeared in the hospital - son and ex-husband in tow - with her ankle wrapped in a pillow. She couldn't tell me who wrapped her ankle, what happened to her, where she was, or what kind of medical problems she might have - only that she was sobbing because her husband left her for another woman (last year) and would then suddenly stop crying, state casually that she thought she only twisted her ankle and, if I didn't mind, she would just go home. When I tried to explain she couldn't just "walk out" because she broke her leg - not to mention that she was confused and I was concerned about head trauma from her fall, she waved me off saying it wasn't broken, she doesn't remember falling and that I should just tell orthopedics to go away (the doc standing at the foot of the bed who tried to set the break when our patient really started screaming in earnest). Earlier she tried to leave before we realized what an unreasonable joy she would be, so she fell in the hospital once - fortunately I had already examined her and could say for sure she incurred no new injuries. To this end, we placed a restraint vest on her.

I love the "posy" (restraint vest). This device allows a patient to be secured to the bed but still have full use of their arms, it simply keeps them in the seated or supine position. The ironic thing about the "posy" is that any reasonable rational person who was in one and wanted to leave, would simply untie it and take it off - It is designed for the confused patient because it doesn't seem to occur to them to untie themselves, verifying to us that they truly merit it as well as keeping them from falling. It also brings to mind an entertaining visual and new meaning to the phrase: "pocket full of posy's".

My lady screamed at me and in general until I thought the blood vessel in her temple was going to pop. So I gave her something to help her SHUT UP. She slept like a baby after that for the better part of 4 hours, which benefited her for the fracture would surely be painful when she woke, and for the sake off all our other patients.

But screaming lady number 2, she wasn't my patient. She was in the stretcher next to one of my patients who had severe abdominal pain and profuse diarrhea. When he was trying to get back into his stretcher from trip number bazillion to the bathroom, I had unlocked the break on screaming-lady's stretcher and moved her half a foot to allow him to get into bed, and then moved her back. She had been lying with a sheet over her head prior to this and suddenly whipped herself in my direction to accuse me of unnecessarily moving her stretcher. I explained why I had and she told me that I needed to ask her to move her bed, that this would be the "polite" thing to do. I don't know where she learned this word "polite" but I assure you it's not the same word I learned, nor the same one that Miriam-Webster has described in decades of dictionaries. She repeated - ad nausea - and in no uncertain terms, I needed to ask her if I wanted to move HER stretcher. I told her I did not. I didn't say it with any emotion, I did not raise my voice or say it any differently than the way one might say "do you have the time?". This prompted a series of explicatives and a slurring, condescending diatribe on "respect", at an impressive and escalating volume, of which I was the first recipient. My personal favorite was "faggot-ass-bitch".

My father and I recently had a conversation about the use of the term "respect", particularly used in the common vernacular of "you need to respect me" or "she disrespected me" in reference to someone not kissing your ass.

Suddenly I was recalling all the lovely folks I'd encountered as an EMT when I wanted to curse the guys who brought her in. Yes, your tax dollars hard at work. I continued to care for my guy and replied to her spew one or two more times, without anger and a wee bit of sarcasm, until one of the other doc's smiled at me and told me to go take care of another patient. She knew I was just fodder for this - also very drunk - person and that she might settle down if I walked away. It was half true, and I steered clear until she passed out.

Still, I wanted to stick my face in hers and tell her to SHUT THE FUCK UP. That no one in the ER should have to take her abuse, be subject to her vile and ignorant rants, and why the would I ever respect someone who is loaded and lying her own piss?

Yes friends, it is difficult to have patience at times - even when I know I have a significantly better life than those borrachos who come in and push us with their behavior. I know they have problems I would not wish on anyone and I have plenty of pity for them and their situation. Still, I wish we had a special room where all the screaming assholes could be together, where they could take one big TIME OUT, and when they could control their mouths, I would happily take care of them.