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Monday, January 26, 2009

Sometimes it's okay to lie to your patients

No, it's not a good idea to teach your kids to lie. But when you are dealing with old people, when you are dealing with sick people, sometimes it is okay to lie.

I know that goes against everything we learn as we are growing up, and it goes against everything taught by Jesus, but there are occasions when you simply cannot tell the truth.

This was the single hardest thing for me to accept when I became an RT. But it didn't take me long to wise up and start the lying.

My grandma was dying of MSA. She loaned me a chalice for my wedding. After my wedding I left it outside the wedding hall, and it was stolen. The last thing I wanted to do was upset my grandma in her sickened state, so my aunt convinced me to tell her it was in my garage.

My aunt Leota was 96 years old and dying. She and my grandma were best friends, and very, very close. She would have been heart broken if she would have learned her younger sister died before her. So her children decided not to tell her.

Many times I have had patients who are sick and dying, and do you want to be the one to tell them the truth. Not me. Then I'd have to sit there and console them, and explain all the detail. That's the job of the doctor not a humble RT. So, when the patient asks what's wrong with him, I lie and say, "I don't know."

A patient asked me why he is getting an Albuterol breathing treatment. "I have never been short of breath in my life," he says. As an RT I lie and say, "It will relax your lungs and keep them open."

Lord knows the Ventolin will do nothing for that person, but for PR purposes you do justice by honoring and respecting the doctor's ignorant order to do breathing treatments Q4 on the post op patient with perfectly normal lungs.

Another patient with lung cancer is having a coughing jag. "This will help your cough," you say. Well, no it won't. But at least it makes the patient and the patient's family feel like we are doing something.

Once we had a patient who was very confused. She wanted to talk to the police. She was crying and really wanted to talk to the police to report nurse abuse. So, by the request of the patient's daughter, I feigned to be a police officer. It worked . The patient calmed down.

A CHF patient was given Lasix and Ventoin at the same time. The next day he says, "Rick, your breathing treatment cured me." I lie and say, "Yes it did." Of course we know the truth is that the Lasix made him better. But how do you explain that to a sick man.

If I were to be honest, I'd say something like, "No. That treatment isn't going to do anything for you. I have no clue why your doctor would make me waste my time giving it to you."

But, your humble RT does not want to go there. He does not want to make the doctor look bad. So he lies.

Sometimes you can get around lying. Some times I say, "Well, I'm doing the treatment because the doctor ordered it." But to me this is a lazy answer. Why do I think this. Because my grandma taught me that "because" is never an acceptable answer.

Therefore, we come to RT Cave rule #34:

RT Cave Rule #34: Sometimes it's okay to lie to your patients. You may try to get around it, but you will many times decide there is no way to get around it no matter what your morals tell you.

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