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Friday, April 2, 2010

RT Procrastinate, RT hope and RT frustration

I remember when I was 11-years-old in 1981 I was admitted to the hospital for exacerbation of asthma. The RT in the ER put a nasal cannula in my nose, and I plucked it out. He put it back in later, and I took it back out.

I imagine my lips were blue, but that thing in my nose made me feel uncomfortable. I didn't want it. So, on day #2, my doctor ordered for me to be put in an oxygen tent. I know the order was written in the morning, and the RT came in and explained the procedure to me. Yet I had a feeling he didn't want to do it.

It wasn't until about 4:00 he mosied in and set up that tent, and by dinner time I was out of the tent intent I was never going back in. So, in retrospect, I'm thinking that RT was involved in a grand case of RT procrastination. By definition, this is where an RT delays setting up something ordered via a stupid doctor order.

Another example was tonight when I had a patient come in because she fell and broke her femur. Due to a blood gas that showed her CO2 was 64 she was ordered on BiPAP. She was in no respiratory distress and had no other indication for the BiPAP. So, I participated in RT procrastination.

I suppose another definition her is RT hope. You delay, and then you set it up hoping the patient will realize he doesn't want it, it's inconvenient, and refuse the therapy. However, more often than not, RT hope merely comes down to RT frustration, which is irritation that a patient says something like, "Well, the doctor ordered it, so I must need it."

Look, patients, I was 11-years-old and I knew a stupid doctor order when I saw it. If you don't want to do it, if it makes you uncomfortable, and you don't need it, refuse it. That's simple common sense.


TOTWTYTR said...

Many patients don't realize, and many practitioners capitalize upon that ignorance, that they can refuse any treatment or any portion of a treatment without refusing ALL treatment. I had a patient that refused to let me start an IV in the field, but still wanted NTG for his chest pain. After making sure that his vital signs were OK, we gave the NTG.

The triage nurse couldn't quite grasp the concept. Oh well.

Anonymous said...

I have many co-workers who will force breathing treatments on the proverbial gallbladder surgery patient who had never heard of breathing treatments until their moron doctor ordered them Q4ever after surgery - even after the patient questions the legitimacy of the order. I, on the other hand, agreeing with the patient, spin on my heals, note patient refused treatment and move on my merry way.