Does anyone besided me feel really stupid giving a breathing treatment on a young, physically fit, post-op patient who has clear lung sounds, has never smoked, has clear lung sounds with great air movement, and does a 5,000 on the incentive spirometer?
You walk into the room, "Are you short of breath?"
"Do you smoke?"
"Have you ever smoked?"
"Have you ever been short of breath?"
"Well," respiratory therapist clears throat, resists the urge to sigh, "your doctor wants me to give you a breathing treatment."
"What's that?" The patient rightfully asks.
"It's something to dilate your lung muscles and help you breath better."
"But... I can breath just fine."
"Funny how healthcare works, isn't it."
"Well, I guess if the doctor thinks this will benefit me somehow, I'll do it."
"Yeah, and he thinks it will benefit you every four hours too. So, I hope you don't plan on getting a lot of sleep."
"Well," the patient said, "I think I won't be needing it at 4 in the morning, though."
It's at this point I often inform the patient, if I think they can handle it, that they probably don't need the treatment, and have a right to refuse. The frugal one's will call the doctor's bluff, take a hint, and refuse the useless therapy that costs $89 a pop, and that's being conservative.
Yes, I feel stupid on these occassions. I feel like I want to tell the patient their doctor is a dink.
Then again, bored, many of these patients say, "Go ahead! I'm bored. Give me the treatment anyway." Which reminds me of a new type of Ventolin called "GoAhead-olin."
Check out the Ventolin types above (or click here) as I've updated the list.