Monday, June 22, 2015

Unclear On The Concept

One of my patients this weekend had special requirements before he would consent to be treated or admitted to the hospital. He instructed me at great length about all the difficulties of being a strict vegan, who will not eat or use any animal products of any kind, and how that will impact his care.

As we prepared to close his wound, he asked to see the label on the suture kit to make sure we weren't using silk thread. He also asked to read the ingredients on the antibiotic ointment to make sure it didn't contain lanolin. Later he had me call the food service department, on speakerphone, to confirm that our vegan meals are separately prepared and cannot cross-contaminate with any animal products.

He insisted we write in his chart that he will immediately sign out AMA and leave the hospital if his care products or meal tray were to contain anything at all non-vegan.

After all that was settled and documented, he asked for "a cup of coffee with 2% milk."

Monday, June 15, 2015

How Not To Be Seen Faster

Some people are always trying to skip to the head of the line in the ED waiting room. Last week in North Carolina, one patient who felt she had been waiting too long decided to set off the fire sprinkler system. This is not an effective way to be seen and treated sooner.

Other ineffective strategies include:
  • Shouting
  • Calling ahead
  • Coughing on me
  • Calling me names
  • Showing me money
  • Showing me a weapon
  • Showing me your boobs
  • Claiming you are a nurse
  • Claiming you are a physician
  • Claiming you are the hospital CEO
  • Offering me a ride in your new Cadillac
  • Offering me one of your McDonald's fries
  • Sitting in a wheelchair you don't actually need
  • Holding your breath while I measure your pulse ox
  • Telling me, "Write down 'unconscious' so I get seen first"
  • Telling me your buddies will "get" me if you're made to wait
  • Any sentence beginning with, "Now listen here, motherfucker"
None of these ever result in your being seen by the doc any faster. (Some of them will generate an immediate response, but only from a pack of several professionally looming young men with badges and crew cuts. Our hospital security officers are highly competent, intensely protective, and do not understand the phrase "just kidding.")

If you want to be seen first, all you have do is be the sickest person in the room. Manage that and you'll go straight to the head of the line.