Monday, March 12, 2018

Soylent Green is People!

I hate to keep harping on it, but there can be no doubt as to why we are a nation of obese morons.
Yesterday I had the following actual patients:

Vomiting for 3 days,
New onset atrial fib
General weakness and chest pain
Flu-like symptoms
Abdominal pain (2 patients)
Detox from alcohol and vomiting

All of which had the same overarching concern, having  NOT EATEN A SINGLE THING ALL DAY, and wanting food, wonderful hospital food before zofran, diltiazem, or ruling out a heart attack.

 Many patients comment on how awful the food is in the hospital, but sheesh, they can't wait to stuff it in their mouths.   Mostly it's the specific diet food trays that seem to be lacking in imagination and  is why patients ignore the healthy food choices and send their family scurrying for buckets of Kentucky Fried Chicken.

The cardiac and diabetic patients get Pale Trays.  There are restrictions on both, but without any discernible distinction of the food on either.  They consist of:

Some kind of chicken, probably baked.  It is boneless, skinless and....pale.  So, so pale.  Perhaps with a sprinkling of dried green stuff.  Could be parsley, could be green plastic shavings  from tiny plastic green toy army men, who knows.  The chicken is accompanied by some kind of pale starch, possible canned potatoes of some description.  Maybe some kind of fruit cocktail, which is also pale, but comes with a cherry, providing a bit of color in a wee plastic container, or some yellowish colored canned fruit.  The pale cherry,  the color of which does not appear in nature, sits on top.  And some vanilla pudding.  The latter two will be sugar free.

The  psuicidal psych patients are only allowed "finger foods".  They don't get disposable plastic utensils, they get cardboard spoons that can't be fashioned into a weapon.  So it's burgers and fries, pizza, chicken fingers, sandwiches.  But the burgers ALWAYS COME WITH A SIDE OF RED ONION.  Which smell bad when left about in the ER.  Red onions should be banned from the ER.

Regardless of how bad the food is, ER patients will complain about being hungry above all else.  If the chest pain is 5, the hunger level will be 10.

Pet peeve.  Aside from the disgusting stench of people who smoke 3 packs a day and leave their stink in my cubicle of a triage room, I also have issues with the food odors.  Sacks of burgers and fries often accompany patients to the ER, it being just too difficult to pass a fast food joint when loved ones have chest pain or abdominal pain.  Or other similar emergency.  That counter you just placed your feast on is where the urine samples go.  Yep, there, in front of the vomit sacks.  Sure, just put that right down there.  And your greasy French fry finger can go right here in my oximeter.  I'll just disinfect it.


How to class up your delivery and get VIP service in the ER

Repost, because it made me laugh.

Polite society has certainly gone the way of the hoop skirt.  Pardon my sainted bloomers, but the ability to express oneself in a reasonably polite and courteous manner, keep civil when one's opinion differs, or engage in respectful dissent is non-existent.  Many people unapologetically present their problems thus: "I have a pain in my ass" instead of "low back pain" without shame.  Descent into name calling and profanity to make their point is the new norm.  You can't reason with people, and it isn't just because they are dumber than a bag of hammers.  It is strictly ignorance because THEY THINK NOTHING IS WRONG WITH THE WAY THEY SPEAK.  Don't get me started on how they talk to their kids.

Hospitals have scripting and behavioral expectations for staff, why should we not hold patients to a higher standard?  How about a little accountability for unacceptable language, profanity, and inappropriate expressions?

I offer a guide for alternative language; scripting for patients if you will.

Instead of: "Why do you have to ask so many fu*king questions?
You might try: Forgive my impatience, my good woman.  Would you kindly assist me in understanding why you need to know what medicines I take and how it is relevant to any treatment I might receive for my chronic, debilitating, and narcotic-requiring back problem?  I would like to be an active participant in my care.

Instead of: "I have a mother-fu*king toothache, my pain is through the roof.  I can't afford no fu*ing dentist.  Just hook me up with pain pills, bitch"
You might try"Alas, dear lady,  I am irretrievably guilty of neglecting my dental health and am suffering from yet another exacerbation of uncontrollable pain.   I can imagine that it seems inconceivable that I have allowed this situation to deteriorate to this degree. I regret that my current financial situation severely curtails my ability to offer adequate  monetary compensation to a dental professional as I would be unable to purchase cigarettes, liquor, or marijuana.  Would it be at all possible to provide me with some additional narcotic pain relievers?"

Instead of: "I am sicker than anybody in this shit hole and I shouldn't have to wait for a room"
You might try: Please excuse me if I seem short-tempered, but might I respectfully request that my condition be re-assessed?  I understand that my man-cold is not especially urgent, but I do believe this  illness seems to have escalated in the 10 minutes I have been asked to repose in the anteroom"

Instead of: Any expressions such as  "Coochy pain",  "Kicked in the scrote",  "My girlfriend/boyfriend gave me some nasty-ass infection in my pu**y/dick".
You might try: I regret that I have a matter of some....delicacy to discuss.  Please forgive me if I offend you with any unacceptable slang, but...oh, I blush to say it...I have an injury/possible disease in my nether regions.  

Instead of: "I fired my doctor because he/she is the world's biggest douche bag.  He blew me off when I asked for an increase in my pain meds because he thinks I am full of shit".
You might tryI am currently between primary care providers, thank you.  We have come to an amicable parting of ways and I find myself in an unaccustomed awkward position.  Might I beg your indulgence in providing me with just a few of my usual analgesics just to tide me over until I have engaged another primary care provider?

Instead of: "What the hell am I waiting for?"
You might try: Excuse me, I completely understand that you are very busy caring for people much sicker than I am.  When you have a moment, might I trouble you for an update?

Instead of: "You are all a bunch of bitches/ c*ck suckers," etc.
You might tryI would just like to thank you so much for the excellent care you have provided me today.  I would love to let your administrators know how great my visit has been"

Let's raise the bar a little, people.