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Tuesday, July 7, 2009

Do not judge lest ye be judged.

What a busy night for ETOH. We had at least five, but I may have simply lost track. One of the guys apparently crashed his ORV and hit his head. After he was rushed to CT, and he was starting to wake up, he was mumbling things. He said, "I have to go pee."

One of the nurses decided she had to put a catheter in, and nothing was going to stop her. She ripped down his pants, at which time the patient said, "Where are my legs."

"You can't feel your legs." She started poking his legs.

"You took my stuff away," the guy said. Apparently he couldn't find the worked "pants" in his scrambled alcohol saturated brain.

"I'm putting a catheter in you," the nurse said, "You're going to feel something cold."

"You will NOT touch me! I don't want that!"

"If you don't cooperate we'll have to hold you down!"

Now, I understand it was a busy ER that night, and the adrenaline was flowing, but I am a firm believe if a patient is adamant you just leave him alone -- drunk or not.

If there is one thing I've learned working with people the last 12 years, it's that when confronted with an undesirable option, most normal people's initial response is defiance. Then, after given time to think, they reconsider.

I mentioned this to the nurse. She said, "He's drunk. He deserves a catheter."

I stepped back, and got ready to help hold down the patient. I knew I was not going to stop the RN I knew the RN was not going to be stopped, and she wasn't.

I'm not picking on this one nurse, because this seems to be the general philosophy of nurses and doctors & other medical staff with anyone who drinks. They say things like: "Since he's abused his body he needs an incentive not to do this again."

That's also the reason every other invasive procedure the doctor can think of is ordered on these patients -- including ABGs.

Fine. I understand this philosophy. But I also understand that not every person who drinks is a drunk. In fact, most are not. Yet in the ER, all of you who drink are drunks.

But my opinion on this philosophy is that it is a bad philosophy. While many people drink, few are drunks. Likewise, all people, no matter how good, are fully capable of making stupid decisions. And just because someone has one bad night, drinks too much, and ends up in the hospital, is no reason to treat that person like he's a loser.

In fact, the person I wrote about yesterday who came in with a 476 ethonol level was not a loser nor a drunk. In fact, he works in a hospital in another town. He's like you and me, only he made one dumb decision not to cut himself off.

I've seen people come into our ER after doing something stupid, and those people aren't treated like losers. So, just because you don't know someone is no reason to alter this special treatment.

I'm sure every person who is reading this has done something he later regretted, including those who work in the ER who are so perfect they use the power they have to treat those having a bad night like dirt.

Likewise, every time a person walks into the hospital reeking of alcohol that person is immediately deemed a loser by medical staff. The truth be as it is, there are many members of the community who drink responsibly, and for whatever reason sometimes one of these people finds his way to the ER, either as a patient, or as a concerned mom or dad or friend.

Yes, there are those who deserve to be treated as dirt, but not every person who drinks. In fact, I've seen just about every member of that same ER team at bars or partys, or heard stories about their attendance at such places.

So, lest ye be perfect, one should not be so quick to judge. Or, stated another way, do not judge lest ye be judged.

6 comments:

Anonymous said...

My husband and I were hit head on by a drunk driver and barely got away with our lives. My grandfather (an epic drunk) broke my grandmother's arm in front of my mother when she was a little girl. He made a good living, but my mother's family never saw it because he drank it away every payday. My mother and uncle ended up in an orphanage because he would rather support the neighborhood bar than his own family. Drunks are selfish and think only of themselves and leave nothing but victims and tragedy in their wake. I'm on the nurse's side on this one.

Freadom said...

I do not doubt what you say. I have seen the worse of what alcohol can do, trust me. I've seen the shattered bodies, held their heads in my palms. It's not pretty.

My point by this post is that not all people who drink are drunks. Most people who drink do so responsibly, yet they are treated as though they are drunks and evil people all the same.

I suppose you can say the few people who cannot handle their alcohol , who are abusive in one way or another, create the vision that anyone who buys a 12 pack is a bad person.

Life is stressful, and a night on the town can be a great stress reliever -- if done responsibly. Most people have a few drinks, get happy, are responsible, and go on being good people.

Anonymous said...

How many responsible drinkers end up in the ED on an average basis?

Three of the five patients I had in SICU today were there due to alcohol related injuries. Each one was under the legal drinking age. We shipped one off today to live out what's left of her life in a nursing home. Her family is devastated.

What I'm getting at is if someone is a responsible drinker, we won't see them in the ED. We don't see 'Joe 12-pack' (unless, of course, he downs them all in under 2 hours). It's the irresponsible ones (or worse yet, their victims) that we see.

Freadom said...

Well, I did not write this post to defend drunks or bad people. My point here was that -- and this is just my opinion -- that one bad night, one stupid decision, does not make one a drunk or a bad person.

Every person makes mistakes. What separates the good folks from the bad is: did you learn from your mistake, or did you not.

Anonymous said...

Rick, I know you didn't. I appreciate your blog and can't begin to tell you how much I've learned from you.
I graduate in one month and can honestly say that you have helped me with my education just as much as my college and clinical instructors.

Thank you

David in Houston said...

Rick-
I appreciate your post. Yes, drunk drivers have caused a lot of pain and misery, but it is not the role of healthcare workers to "punish them". Justice should come through the legal system and criminal and civil penalties. Using an inappropriate and painful procedure perverts the role of a healer.

Did the nurse in question think that this was somehow going to cause the drinker to repent and never drink again? If you think along those lines a large dose of potassium chloride would be even better, although then the nurse would be guilty of murder rather than a lapse in Ethics and malpractice.

I wonder if she would feel the same if she had a couple of glasses of wine at a party, hit an icy patch on the way home and was involved in an accident? Say she has a head injury as a result and appeared altered. Would she deserve the same as she did?

I don't know about you, but I was taught as a child that two wrongs don't make a right.