Thursday, June 21, 2012

In which Auntie Jo lays down the law.

I love my job I love my job I love my job I love my job.


People: Please research the symptoms of whatever disease or disorder you're going to try to mimic. Most physical troubles, including neurological ones, have a certain expected set of symptoms. Even conversion disorder has an expected course: while the physical manifestations of psychological stress might be weird and unexpected and unexplainable by other means, they're consistent.

A stutter that goes away with opiates is not a disease. It's an attempt to get drugs.

Likewise, there's a name for what you're doing: it's "abasia-astasia," and it means "No, she won't fall over and hurt herself; she'll only fall if I'm there to catch her or she's near something soft."

And frankly? If your weakness is distractable to the point that you yourself cannot remember which side you're weak on, I will call bullshit on your shenanigans and send you out the door tout suite.

I don't just have the population of Greater Sunnydale to thank for this; I have the combined Great Minds at Holy Kamole's emergency department. Therefore, I have some law to lay on them:

If you call and ask me to accept a stroke patient, you'd sure as shootin' better have done an NIH stroke assessment on that patient and be able to tell me his score. If you haven't, I'll tell you to call me back once you've assessed the patient, then hang up the phone gently.

Same deal if you call me with a patient who has a constellation of symptoms and you don't know his history. Same deal if you call me and say, "Well, we're not really sure what's going on, but we'd like to send him over to your NCCU."

Same fucking deal, dear doctors, if you call with a ninety-year-old, demented patient who has a temp of 38.2, whose labs show that he's dehydrated and has a UTI, and who is experiencing the same symptoms he had when he had his stroke two years ago. Incidentally, he's therapeutic on coumadin.

And, just as a reminder, if I accept this patient because I want to put a stop to your whining, but specify that he is to go to the regular neurology floor, do not under any circumstances then tell the bed board that I'd cleared him for a bed in the NCCU. The Wrath of Jo will be visited, not upon your grandchildren's grandchildren, but upon you, comprehensively and cheerfully.

This is because, as might be expected in a critical care unit, I actually have sick people to take care of. I got one on a Cardene drip, one with the most labile blood pressure I've ever seen, good Lord what is she doing going from 220 systolic to 77, maybe an abdominal binder would help, and one who is, sadly, getting ready to go home to Jesus due to a combination of factors, not least of which is an infection with some bacterium that only two people have ever gotten before. I got problems, in other words, because I got patients with problems.

Joe-Bob looking for a hit of dilly is not a problem. At least, he's not *my* problem. He's *your* problem. If you try to make him my problem, you'll have another problem, and probably a whole set of problems of varying, interesting types, right after that.

Thank you, as Katniss said, for your consideration.


mjennyt said...

Thank you, you have my day of OB/GYN seem relatively, sane.

Unknown said...

I can relate...some day's I have to repeat the same line...i love my job...and add I must not choke the crap out of these

Silliyak said...

And thus spake Auntie Joe....

cowango said...

You live in a whole nother world than I do. We're dealin' with some of those folks who want another hit. But it's still crazy out here.

RehabRN said...

Tout de suite? Jo, are you goin' all parlez-vous on us?

Well...;-> I know the feeling.

I just got complimented by an actual MD for being a real pain in the arse. Being that pain may save that patient's life.

I'm sure hoping and praying it was soon enough, 'cause I got mille fois irritated trying to drag that consultant in.

Sorry, that parlez-vous must be rubbing off...

Rosanna said...

'*GREAT* post, Jo!! I just have to ask, though, am *I* the only one who ever CONSISTENTLY thought that her/his R.N. Career - (in varied, NON-Psych Unit Nursing Jobs in 3 states) - was like............ bein' on the SET of the movie "One Flew Over The Cuckoo's Nest" (1975)??!! (Haha!!)

Between your Precious Patients (sent from Holy Kamole's Emergency Department) who INTENTIONALLY *M.*I.*M.*I.*C.*............ in your NCCU (!!)............ assorted physical, neurological, and/or psychological symptoms of different diseases and/or disorders............ AND............ the Dear Doctors in Holy Kamole's Emergency Department who - (because they don't do an NIH Stroke Assessment!!) - are effectively then tryin' to make YOUR workplace............ into an "OCCUPY NCCU" location or something, (i.e., ala' an "Occupy Wall Street" location!!)............ well, between those Precious Patients AND those Dear Doctors............ when you arrive home after work, doesn't it sometimes seem, Jo, as if you've just left............ the production set of an (almost surreal) movie??!! (Haha!!)

Ryan L. said...
This comment has been removed by a blog administrator.
Anonymous said...

All female nurses are perverts and unprofessional

The Second Career Nurse said...

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