All Aboard the Toradol Express!!!

I wish I had a nickel for every time I have heard, "You have my records" (sorry, I don't, and I'm not interested enough to go look for it), "I take that little blue pill for my high blood pressure, don't you know what it is?" (nope, it's one of thousands) "My doctor knows what I take"(yes, but your doctor pawned you off on the ER, now, didn't he?). I bet the average ER nurse spends at least 1/3 of a shift doing what patient's should be responsible for. I feel bad for the pharmacists who have to take calls from us to verify a patient's meds because they were too lazy to write them down. Come on, people, it takes 30 seconds. And if you don't know what you are taking and what it's for, you probably shouldn't be taking it.

Don't get me started on the drug seekers. Tonight we had an impressive attendance of the "Better Living Through Chemistry" Club. Everyone got a shot of Toradol. I admonished the doc that we only had a limited supply even though IT IS A MIRACLE CURE. The woman who came in cradling her shoulder with 10/10 pain had no trouble lifting it to give an obscene gesture on the way out. And that guy with the hip pain who limped in had such a spring in his step as he slammed out that door (probably on the way to the other hospitalin town. Guess they didn't get the memo that Dr. Nonarcs was on duty.

Having a family member become a hospital patient really makes you think about your own practice. My physically active husband returned from a pre-op appointment for elective shoulder surgery with symptom-free "changes in my EKG" and was turfed to his cardiologist. Another EKG, an Echo, and next thing you know, he's headed for the cath lab. While on the table (and after finding a couple of significant occlusions) he now has a choice of the metal stent or the medicated stent. Choice A means ASA and Plavix for a few months. Choice B means ASA and Plavix for over a year, and by the way you can forget about that shoulder surgery. Since I happened to have a friend who worked in the cath lab, she drags me back to help my husband with this decision. This is a problem considering he is one takes 3 trips to the store to decide on a pair of jeans. I will say the interventionalist was VERY patient with him; decision made, medicated stent.

In the ICU, Jane, his nurse, seemed to understand my husband's "what the hell just happened here", deer-in-the-headlights look and promptly got him some Ativan. She patiently answered all of my husband's questions and got him settled in. She signed out to Leslie at change of shift, who handled my husband beautifully with the right mix of humor, authority and caring. My husband had some leaking around clip in the artery, so in comes the Resident Twins. This is an equal opportunity teaching hospital, so they neither speak English nor posess people skills. Oh, and they travel in pairs for added fun. I refused to leave until I made Leslie promise that she would turn my husband over to someone more than competent at change of shift, and keep Frick and Frack away from the patient.

I picked husband up at noon the following day and all was well. He is home now, testing me at every turn, angry that he can't have his surgery and not yet grasping that the ticking time bomb in his chest has been defused. A little perspective is useful.