slideshow widget

Saturday, December 15, 2007

Here's my advice for hospital patients

Based on my own experience as an in-patient earlier this week, I've come up with a few bits of good advice for anyone going to the Emergency Room, or who might be a potential hospital in-patient.
  1. Know your rights as a patient
  2. Make sure you have someone with you.
  3. If you think a therapy might be ridiculous, you may be right
  4. Know you have a right to refuse therapy.

As you know from reading earlier posts on my blog, there are a lot of frivolous doctor orders pertaining to respiratory therapy. Knowing this, I ask nurses all the time if they get stupid orders, and usually they tell me they do, but can never think of anything off hand.

With no disrespect to doctors, I know they have a tendency to write orders out of habit and not necessarily because they are all necessary. Now that I've been that patient, I saw first hand what some of these frivolous orders are.

After I was told I was going to be admitted, and after I was stoned on phenergin, my ER nurse approached me carrying a foley kit. "The bad news is we don't have a male working who can put this in."

"I...don...crrrr..." slipped from my lips. I was trying to tell her that I didn't care who put the damn thing in, it wasn't going to happen.

Thank God I followed patient rule #1, because my wife was sitting right there and refused for me. She made sure the nurse was aware that we had a pact that the only time anyone would stick a foley in me is if I end up on a vent.

I like to call it a DNC order: DO NOT CATH.

"Why do you need to put a foley in him," my wife asked. "He can get up and pee."

"I don't know," the nurse said, and tossed it aside.

My wife added, "Just make sure you keep good track of your pee."

That was the end of that. In retrospect, I think this RN wanted me to refuse; that she knew it was a dumb order, but out of respect for the doctor she couldn't come right out and say it. I suppose this was not unlike me when I know a patient doesn't need a treatment.

Later that night, after I was admitted to the floor, a nurse woke me from a sound sleep. "I have to put these on you."

"What?" I said, groggily.

The RN said, "Sequential compression devices (SCS) to prevent you from getting clots."

"What do I need those for?" I know what they are for, but why do I need them?

"It's protocol to prevent clots." Clots? I can flip myself over no problem. And I didn't get clots when I slept in my own bed just last night.

"Okay," I said, "I'll try it." Why the hell am I agreeing to this? This is ridiculous.

Those damn things made my legs sweat, were excessively loud, and were extremely annoying. Not only that, but they made it nearly imposible for me to sleep on my side, which is how I like to sleep. These are coming off as soon as that nurse gets back in here.

"Why do I need these things again?" I said when she checked on me a half hour later with a syringe in her grasp. I proffered my arm.

"We have a standing protocol that all patients have to get these to prevent clots." She inserted the syringe into the IV.

"Every patient has to have these?"


"Well, that's ridiculous.

"I know." She's agreeing with me. That's it. She knows it's a stupid order.

"I thought it was just respiratory therapy that got stupid orders." Okay, shut up man; you're crossing into grumpy patient category.

She didn't say anything, finished her work on my IV. The machine beeped momentarily as she pressed a few buttons, and then she stood by the side of the bed.

What? Are you waiting for my order. "Then take these things off. I'm a young guy and I don't think I have a problem with clots."

"Okay," she said, and pulled the blankets from over my feet without hesitation. She's not argueing with me. That's reassurance enough. I heard the rip of the valcro as she stipped those things I couldn't remember the name of off.

I felt fresh air upon my ankles. Ah, that feels good. I rolled over and within a few moments was having pleasant dreams again.

"Do you think I need those things," I said to my wife when she arrived after breakfast the next morning.

"No," she said, "but I know sometimes doctors write orders just out of habit."

"I kind of figured that."

"You know you almost agreed to a foley last night? You were lucky I was here."

"Thank God for you."

She told me she remembered a time when she was working in OB when the doctor ordered a cath on a lady. She approached the doctor. "Why does this patient need a foley?"

"Oh," the doctor said, "I just wrote it out of habit. I'll DC it."

Dr. Tree said nothing about me not having a foley when he checked on me that morning. I wondered if he even knew he ordered it.

1 comment:

mielikki said...

good advice. I have been known, a time or two, to "forget" about SCD's on my young, moving patients. Glad your wife remembered the do not cath pact...