It's been my week for unhappy patients. I collect them like dust. Would that we could devise our own survey for difficult patients, wouldn't THAT be a hoot.
Some people just hit the door itching for a fight, pre-programmed to have some kind of issue. These individuals quite frequently come with potty mouth, bad manners, and a lack of patience in general. They are disrespectful of staff and other patients. Maybe it is defensive, based on a past experience or just having a bad day in general. I get it, for many people it is literally the worst day of their life.
Or maybe they are just an entitled A-hole.
Regarding the Worst Day people, I give them a lot of slack and take it in stride. As for the others, not so much.
A-holes seem to have a lot of similar characteristics, many of which, interestingly enough, begin with the letter A. The Big A. Which is just the beginning of the alphabet.
Some lead off with a clearly defined AGENDA, and are often ARGUMENTATIVE.
They know exactly what they want, even if it is ABSURD.
Some have lots of ALLERGIES.
Usually to NSAIDS or every narcotic except Dilaudid.
Often they ANTICIPATE a fight for what they want specifically, and use words like "horrible bedside manner", "letter to administration", and "calling my lawyer" when they don't get it.
Lots of patients become a strong ADVOCATE for their pre-determined diagnosis and treatment plan, no matter how bad an idea it might be. It has all been spelled out for them thanks to Dr. Google (note: I am not talking about informed patients who have done some research. Calm down.). They simply need a provider to write for their desired antibiotics or a therapeutic X-ray. Some sign in to the ER with the complaint, "Need an MRI". They do not get one. Hilarity ensues.
ALIBI is not a reason to come to the ER, but it happens a lot. Roommate stole your Adderall? Need a prescription refill? Need documentation for missing a court date? Too busy to wait for a PCP appointment for rash cream? C'mon down.
Rarely, after using foul language and creating a hostile atmosphere which does not produce the desired outcome, there will come an APOLOGY for their bad behavior. Not often.
Moving on, I present my top selections of the letters B-E.
Talking smack and BADMOUTHING about previous providers who did them wrong, be it in the community, another hospital, may have fired them for being an A- hole, or not helping them just because they broke their pain contract. Also they may refer to the last nurse who started an IV on their track-mark tattooed arms "that bitch that stuck me 11 times".
CUSSING: Uses the F bomb a lot. Complains about "the wait is f*cking ridiculous, my f*cking pain is f*ing out of control, this place is bulls*it". They don't "f*ing care if it's busy" or if people in the next room are trying to die.
DEMANDING, DILAUDID, DISRESPECTFUL, DRAMA: The first two self explanatory. Some examples of DRAMA? Sighing loudly. Moaning loudly. Banging the sides of the bed. Yelling out to the nurses every two minutes. Throwing themselves around on the bed. Whining, lots of that.
EXPLANATIONS, in which the patient is intent on convincing everyone that their particular problem is an original complaint, never before thought of in the history of scamming for narcotics. The pain scale does not apply to them, and usually it is 11 or more.
FAKE CRYING: See DRAMA. I need to see actual tears. Sorry.
I could move on to the rest of the alphabet, but….nah.