Friday, July 20, 2012

The Lady Lies

Hard to believe that she is still alive, but the Lady on Elm is indeed alive and thriving.

And she still has the patient services representative on speed dial.

My boss plunked herself down at the desk and with eye's rolling detailed Lady's latest discourse of discontent, AKA complaint number 5,234.  There are two sides to this story but only one of them is the actual truth.

On one of those very busy nights in which all rooms were filled with mostly sick people, including two transfers and a death (with ER WakeTM) Lady started with her usual phone fu*kery.  She will ask who is on, if we are busy, and to speak to a specific nurse.  The secretaries all recognize her voice if she calls as she assumes they will; they are good at deflecting her if we are busy.  Lady is the single exception to my previous post on advice calls  that result in "go directly to the ER."  Our advice to her for her non-emergent complaints are usually "call your doctor in the morning".  However, Lady has her own decision tree; in fact it is some kind of game to get us to give her permission to come to the ER.  I envision her decision tree on poster board, thumb tacked to her kitchen wall; every thought she has, every question if it remotely concerns her maladies, her meds, or any fleeting thought that might potentially, even remotely, require a medical opinion or common-sensical response encourages her to  pick up the phone and/ or "go directly to the ER".  She doesn't drive and her family members are all sick and tired of her evening visits to the ER and have generally made themselves unavailable to her after sunset.  That leaves only the Big White Taxi with the Flashy Lights.

After several phone calls in which she was ignored, Lady got restless waiting for responses to her silly questions, so she skipped right to the "go to the ER" section of her poster.  She was tucked into a room by herself.  I don't know if she is capable of intuiting that there are other patients who are sicker or require more care, or if she just doesn't give a crap; several times she called out to me.  I would run in and stick a pulse ox on her finger or bring a glass of water or just wash my hands and give her whatever update I had time for.  Not much we could do for her anyway.  After about 2 hours she was diagnosed with a strep throat, sent home by taxi that we had to voucher with 2 doses of antibiotics since the pharmacies are always closed when she comes in. We had to wait 45 minutes for the cab to come from another town as the local cab was also closed at that time of night.  So we paid for her care, paid for her cab, gave her free antibiotics, and the hospital ate the overtime for 2 nurses while we twiddled our thumbs.  Nice.

 A subsequent visit during her usual one-stop shopping for outpatient lab work, x-rays, and buying loaves of Wonder Bread the next day also included a "check in" at the ER.  This confirmed that yes, she had strep throat.  Keep taking those antibiotics.

Two weeks later, Lady came in again with sore throat.  Yep, you guessed it.  Strep.

So as to the actual complaint.   Lady claims that prior to ER visit number 3, nobody ever told her specifically that she had strep. During each of her two previous visits.  Even though it is clearly written on her discharge instructions.

Me: "REALLY.  Well, that is very interesting because I was the nurse for both visits and I VERY SPECIFICALLY recall almost word for word the conversation I had with her about strep.  We had a deeply religious experience as we waited for her hospital-supported taxi transportation home".

Jane: "I know.  She lies.  She embellishes.  And the patient services rep is her bitch."

Me: "Well you can expect some very specific notes for all of her ER visits from now on.  You know how much I like to type.   I enjoy being creative, and since now she has been exposed as a liar I can say whatever I want".

Jane: "Yes, your notes are hilarious.  Very creative and descriptive.  You should write a blog"

Meh.  I should just finish my book.

Wednesday's Corner

Wednesday continues to make me shake my head; not a day goes by that she doesn't say or do something jaw-droppingly stupid.  I believe I will be making this the first of a Regular Feature here on EDNurseasauras, Still in the Trenches.

Wednesday's latest statement of WTF-ery was revealed after a meeting regarding the Clarification and Scope of Everybody's  job.  Wednesday thinks that all the work not specifically spelled out in her job description belongs to someone else.  That is, except actually putting the little test-tube thingies in the machine and waiting for the computer fairies to magically sprinkle results and glitter out of their butts.  This was also apparently a belief held by Morticia, her boss.

Wednesday: "Is faxing, calling doctors, and entering orders in my job description?  Because I can't see that those things are included"

Morticia: "No.  Therefore it is the job of the ER secretary by default"

Jane (my boss): "Um, it is still your job; if you look carefully you will see that there is a section that covers other unspecified duties that are required to provide optimum patient care.  We can certainly rewrite your job description to provide painful and minute detail if it is unclear to you".

Reasonable people will do whatever is reasonably necessary; nobody is asking either of them to scrape vomit off the rug or fill the soap dispensers.  

I know that my job description doesn't say "answer the phone if the secretary is busy".

I am sure that the secretary's job description doesn't say "fill the stapler", "order supplies", or "clean the rooms if the nurses are busy" or a hundred other duties.

I know for certain that the x-ray tech's job description does not include "fax records to the ER" or "help the nurses in whatever way you can if there is a code"

WE are a team.  Wednesday and her boss are apparently not on our team, not in our league, and in fact do not play the same sport.  

Actually, they are unaware that working as a team in any way, shape or form refers to them.  What a pair.

I am now retreating into my trench and pulling the dirt in on top of me.