Saturday, March 29, 2008

How to have a good stay in the hospital, or:

Driving your nurse crazy, in three hundred eighty four thousand, six hundred forty-two easy steps.*

Adopt a lofty tone. Nobody here will remember how important you are. Therefore, it's crucial that you remind them at every possible opportunity. Condescend as often as possible. Refer to your nurse as "The Girl". Refer to every female doctor as "Nurse"--they love that. If you can, work in a shadow of doubt about your nurse's or doctor's competence. Ask repeatedly if they've "ever done this before."

Don't forget to bring your four-page, single-spaced list of demands. Make certain that you've listed all of your drug allergies, even if they're not actually allergies, on the first page in bold type. List all of your previous surgeries on the second page, with editorial comments such as "spent six weeks in hospital--doctor's fault". On the third page, specify that you be transferred to the "VIP floor" only. The fourth page will have plenty of room for you to note your food preferences, the fact that you don't want to be served on plasticware, and that, regardless of your latest test results, you refuse to be put in isolation.

Refuse to have an IV placed in a spot where it is least painful and most convenient for all involved. If necessary, lie about previous surgeries to that extremity in order to manage this. Nobody reads your history, right?

Be noncompliant with treatments. If you can't turn off or change the settings on the IV pump because it's locked, the next best thing is to unplug it and leave it unplugged until the battery runs down. If you've been ordered to remain on flat bedrest because of a cerebrospinal fluid leak, by all means sit up as often as possible. Conversely, if you've been ordered to walk at least three times a day, make as dramatic a production as you can of getting out of bed. Moaning and groaning is required; sagging to the floor whimpering is optional but effective, especially when done in front of your family.

One very important note about treatment noncompliance: If you are diabetic, ensure that your family brings you huge amounts of sugary food. Hide it in your room. Hide it in your bed. Hide it on your person. The Girl needs exercise, which she will certainly get when your blood sugar comes back at 1300 mg/dl.

Work the occasional old-fashioned derogatory term for racial minorities into your conversation. Those People have to be reminded where they stand, after all. The Girl and the other nurses will be glad you're reinforcing the social order, even if they don't act like they are.

Invite all your friends, fellow gang members, remote family connections, and strangers on the street to come visit at all hours. Instruct them to talk loudly on cell phones in the hallways. Send whatever small children they bring into other patients' rooms. The pre-teens should be told to ask for ice cream and sodas, repeatedly, at the nurses' station.

If you can't get what you want, call your doctor at home. This is particularly effective if done at 3 am, and if your doctor doesn't have admitting privileges at the hospital where you are. Bonus points if you have a doctor who'll call the nurses' station and bluster.

Speaking of bluster, if you have a family member who's a doctor, use that person the way God intended: To attempt to bully the staff of the hospital into changing treatment protocols.

(Special note for those with medical family members: Be sure that if your son-in-law is a staff physician at the hospital, he is the primary physician on your case. It's been too long since the last ethics course refresher; the staff could use the training.)

Remember that medical people, nurses in particular and neuroscience nurses in especial particular, are too dumb to know if you're faking a seizure. A well-timed fake seizure will get you two extra days of Ativan and Dilaudid.

Instruct each and every one of your family members to call the nurses' station every sixteen minutes throughout the day for updates on your condition. Phone trees are for the hoi polloi. Extra points if you can arrange to have several family members call at once during shift change.

If all else fails, barrage the director of nursing, chief medical officer, and police with phone calls. People in management will have a better idea of your treatment needs and activity restrictions, your diet orders and medication regimen, your physical therapy schedule and dressing changes, than your nurse or doctor. 

*I wish I were capable of making this shit up. 


Penny Mitchell said...

I pray this is a composite of many, many dozens of people? Please? Lord? Confirm for me that one human isn't capable of doing more than a couple of these things concurrently? Or I'll have a seizure and it won't even be a fake one?

GuitarGirlRN said... You've hit the nail on the head.

And this is why I'm glad I work in the ER, and rarely have to deal with these people for more than a few hours at a time, until they go upstairs and become your problem. I always warn the nurse I'm giving report to: "This patient's family is VERY involved in his care. VERY. If you get my drift."

Ian Furst said...

Nice post -- fake seizure guy brings back some fond memories of wasting 12 hours in the neuroangio suite while on-call with practice liability on one phone and dilantin IV in the other.

AzRN said...

you took care of her this week, too?!

shrimplate said...

It happens every day.

Once on an old Seinfeld episode, Jerry got one of those nuisance sales calls, and he asked the person calling if he could have their home phone number so he could get back to them later.

That works. Try it.

daralala said...

ugh we have this really obnoxious guy on our floor right now (in my med/surg clinical) and i may be a student, but i think i can flush a friggin' heplock. he asked me if i knew what i was doing, if i'd ever done it before. i said "many times" and to myself, "including on your heplock just yesterday!"

NurseB, FNP2B said...

I hope this wasn't all in one day for you! I didn't know whether to laugh or nod my head in agreement because I've seen these people before!

Anonymous said...

She must have been discharged from my hospital, gone to AzRNs, been DC'd there and gone to your hospital. (;

Anonymous said...

These kinds of Pts and family make me "so glad to be a nurse" (heavy sarcasm intended)

David said...

how i love you.

I have had every single one of those things happen.

But I, at least, thought I was the only one to have had a patient call 911.

Anonymous said...

I bet the waiting 2 hours for a glass of water for a bed ridden person isn't taken into consideration on any of these things, right? Or what about the person who died in the emergency room with everyone walking around them, I bet if they had a person yelling about how important they are would have been in there best intrest and they may still be alive today, what about the person who was in the emergency room for 24 hours and called 911 to get help since no one was helping them. Or no sleeping pills for the person with insomnia since they have to be up at 6:30am for the dr. since he only does rounds in the morning? I think you have forgotten that the Pts are not pieces of meat and that they deserve consideration. I'm sure there are some that abuse the service, but come on if you don't want to be in the medical service industry then you need to get another job! Night time janitor in an office building might be the way to go! I hope I never have to go to your hospital since your attitute is one that you should quit now and save the Pts and yourself some agrivation.

And having a diffrent nurse come in every 30 minutes, how is a Pts to remember the name, just last night I went into my dads room and there was a name tag on the wall saying who his nurse was and who the aid was to taking care of him but guess what, when she came in the room and I said hello "Kelly". She looked strangely at me and didn't know who I was talking about and then she told me that "Kelly" was not there since the previous morning! So you tell me what am I to call you when no one is keeping up on what the procedures are. If you don't have a nurse hat on, are you a lab assistant, Dr, or what? What is safe to call some one when I don't know what you are?

Asking a Dr if they have ever done something is a good question to ask since how do I know if the dr is established or not since the HMOs throw everyone at you? I would rather have a Dr who has done something simular on someone else, instead of having the foot doctor, who may be filling in for a friend doing my heart surgery. (extragivation on that one to get the point across)

"Refuse to have an IV placed in a spot where it is least painful and most convenient for all involved." - least painful for the Pts, shouldn't that be?

"Work the occasional old-fashioned derogatory term for racial minorities into your conversation." - Old people when in suffering conditions revert back to what they were use to, you need to take some refresher courses on treating people.

With all that said I do agree with you about the phone tree, and the friends and such with noise and so on.

And yes I'm posting as Anonymous.

Carol said... can just be super nice and get almost everything you want and everything you need.

I know, shocking!

What tools.