Tuesday, January 25, 2011

The Lady on Elm Street

One of our least favorite frequent fliers individuals well known to our facility is a very large lady (over 400 pounds) for numerous non-emergent complaints. In fact, she utilizes the town ambulance service several times per week for her free taxi ride transport to the ER. On one less than joyous occasion, the ambulance stretcher malfunctioned, causing this plus sized lady to plummet to the ground. Never mind that two of the EMT's sustained injury. Now, when the ambulance is toned out to a medcal call at number x Elm Street, an entire batallion of responders is activated. Self preservation. In addition, if transport is required, there is call service who sends a bariatric stretcher. More self preservation, as well as shielding the town from a lawsuit.

Once her care is completed (usually some minor dressing change, an xray of a wrist, elbow, knee, ankle from fall, or abdominal pain that she suffers from chronically) she is ready to go home. On the return trip, she invariably asks for a taxi voucher. The local taxi service is reluctant to take her because she rarely wears more than a nightgown and robe, her fuzzy pink (or used to be pink) slippers that smell like pee, and she leaves the back seat of the cab a mess. Since the single cab company knows the address, there aren't many who are willing to risk their backs to heave her out of the cab. We don't have the authority to give the cabbie a whopping tip, but usually they deserve it; consider it combat pay.

Sounds like this lady is a pretty sad case, doesn't it? That because of her size we are reluctant to provide care? Consider her problems her own fault? Don't care that she has nobody to care for or about her?


So wrong.

We have all tried so hard with her; most of the doctor's have had caring heart to heart chats with her about how dangerous her weight is for her health, discussed options ad nauseum, services, alternatives, health promotion. The Talker has spent hours with her; Cindy Lu Hu has spent hours with her; Gil has spent hours with her; Cripes has spent hours with her; even Bobo has spent hours with her. Her response was to lodge a complaint against each and every one of them because they discussed her weight.



How can you help someone manage their health by ignoring (forgive me) the elephant in the room? Can't be done.

Kerry got written up because she tried to arrange a home health aid. Why? It was none of her business what her home was like; never mind that she smells like a goat. Kerry did it out of concern for her well-being and she was repaid by getting a complaint. So has Sherry who has seen her as a home-care patient. So has Mikki. So has our boss, Jane. Jane had this little gem to share:

"I was putting ornaments on the Christmas Tree in the waiting room and I dropped one of them. It landed on the floor and shattererd. The Lady from Elm Street was sitting in the waiting room and said to her companion (with whom she had managed to get a ride for an outpatient blood draw), "Did you see that? She threw that at me! It's lucky we didn't get cut! I should complain"

I gave her a steely glance and said I hope you are kidding, in a deadly voice.
She backed down and said she was. "

I learned that there had been no less than 20 complaints over the last two years; she must have Patient Services on speed dial.

We all know how this will end.

She will have need of care for a life-threatening issue when she calls 911.

More likely, one day EMS will find her dead in her house.