All Patients are NOT Created Equal….

Despite having worked in EMS, as well as in hospitals on medical/surgical floors; Skilled Nursing Facilities, Emergency Departments, Operating Rooms and many roles over my years before becoming ill, and the fact that I now have extensive knowledge and experience being a patient, I have once again learned what I think is a valuable lesson that some of us forget over our time in service to others in healthcare. And the fact of the matter is that all patients are NOT created equal!

While I will readily admit that I am by far not your typical patient, I sometimes forget that not every person has had the experiences that I have had in being a patient. Not every patient has the same pain tolerance or thresholds. Not every patient has even the slightest understanding of how the healthcare system works, or what to expect when faced with a healthcare dilemma in their own lives, regardless of whether that situation is medical or trauma related.

This fact was reinforced for me over the last few nights by the woman in the room immediately adjacent to mine. She reminds me of the story I often heard as a child of “the boy who cried wolf.” When faced with even the slightest amount of discomfort, she screams such a high pitched wail that even staff from the other side of the unit come running, initially.  They are beginning to sense a trend and while they still respond immediately, they now seem to be realizing that she is in fact not dying or in need of immediate assistance as if she had fallen. I have even heard, on occasion a very large bang followed by her high pitched wail. Later to find out that she had not fallen or even moved out of her bed, so I can only assume that she has figured out that if she makes a noise loud enough to lead staff to believe she has in fact fallen, that they will respond quicker.

While I do not doubt she may well be in incredible pain,  I do doubt that she is going about getting the care she needs in the most appropriate way. Having never had a hip replacement, I am not attempting to diminish her level of pain, as I am quite sure having a hip replaced is not a comfortable procedure and leaves a great deal of pain immediately post-operatively.

I further doubt that any type of pain or discomfort gives her the right to verbally abuse nearly every single staff member with whom she comes into contact! Two nights ago, after being heavily medicated myself for the sole purpose of sleep, I laid in my bed listening to her berate a nurse for not giving her the attention she felt she deserved. The nurse tried her very best to explain that she was not, in fact, ignoring her, but rather had been tending to another of her patients and had been in the middle of a dressing change on the other patient. This woman continued to berate her stating things like “but you said you were my nurse,” implying that she believed she was this nurses sole patient.

When the nurse was finally able to escape the patient’s room to go get a few of the items demanded by this patient, you could tell she was visibly upset. I caught her attention and flagged her to indicate she should come into my room. As she did I whispered to her that she was now in a “safe zone” where she could take a brief respite from the abuse.  I have rarely seen a nurse so visibly upset and shaken by a patient’s lack of compassion for the people who have, for whatever reason, devoted their lives to caring for others.

Meanwhile out in the hall, you could hear thee same patient berating a nurse’s aide or patient care assistant as they are also sometimes called, for not having vinegar and honey on the floor, which is a well-known remedy for curing muscle spasms. She went on and on to this aide about how insensitive people were to her pain and her “requests” for assistance. As the nurse went on to give me my medications quickly so that she could go tend to this patient which would take a great deal of time, she apologized to me for my having to hear this. Why should a nurse have to apologize for a rude, inconsiderate patient?!?

If you find yourself a patient, there are a few things you must understand, which will not only make your stay more pleasurable or at the very least tolerable, but also keep your providers happy.

The demand for respect, compassion, and attention that you so blatantly demand goes both ways. Each and every care provider with whom you come into contact deserves the same things you are so rudely demanding of them! They have taken a great deal of time, sometimes many many years, and tons of student debt in order to help people like you. When you treat them poorly, all you do is cause them to wonder if they chose the right profession, if this is the abuse they have to put up with at work. And yes, yelling at, berating, or otherwise being inconsiderate of your nursing staff is, in reality, a form of abuse. While it may not be physical abuse, it carries the same punch as if you were to reach out and strike them across the face.

Secondly, when a nurse introduces themselves to you at the beginning of their shift and tells you that they will be your nurse for the shift, they are by no means being literal! Yes, they will be your nurse in the sense that they will care for you. But depending upon the setting in which you find yourself, they could have as little as one or two other patients, to as many as eight or ten. So be patient, and try to be understanding when “nobody comes immediately after ringing the call bell.”

Third, pain medication, except when given intravenously, which is rare outside the immediate acute setting of a hospital, and even more rare in an acute rehabilitation facility, can not, and will not work instantly! This does not mean you can demean the nurse for not knowing what they are doing or giving you less pain medication than you deserve. They have given you what the physician has ordered, and when given by mouth, it takes some time to work. A medication taken orally takes an average of fifteen to even as much as sixty minutes depending upon the patient and the amount of food in their stomach at the time of administration.

While natural or homeopathic remedies are becoming more accepted in general, do not expect them to simply exist on the unit you are on, even when they may be something simple as a concoction of honey and vinegar, they are not items typically found on nursing unit, nor can they be administered without a physician order despite the extensive training required of most RN’s, they are not permitted, as a general rule, to prescribe treatments of any sort without an expressly written or occasional verbal order from a physician. As such, even if the items exist, you will not be permitted to use them without first discussing said use with your physician.

The “Golden Rule” of life explains all of this in a nutshell. “Do unto others as you would have the do unto you.” By keeping this in mind you will make what may well an unpleasant situation much more tolerable for yourself, as well as those caring for you. And by all means, don’t forget the manners we were taught from a very young age. Saying please, thank you, “could you please do _____,” will get you much further than demanding respect which you yourself are unwilling to give to those from whom you demand it!

Article: “Hospitals struggle to address terrifying & long-lasting ‘ICU Delirium’ “

The following is a re-post to a friends’ blog, where she addresses a very real issue for ICU patients, that has been overlooked for way too long. This is a must-read article for anyone who ever has or knows someone who has had to spend time in an ICU regardless of whether the cause was medical or surgical.

The fact is, like many things in medicine, it is time to re-evaluate and update how the sickest patients are cared for to prevent long-term ramifications of that care. While most patients are simply happy to get out of the ICU, it is imperative to recognize that the ICU itself can cause trauma which must be addressed!

So head on over to the “As I Live & Breathe” blog and view her original post via the link below. Her post also links to the full article, which is well worth the few minutes it will take you to read it.

Important Article: Hospitals Struggle To Address Terrifying & Long-Lasting ‘ICU Delirium’

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