Monday, August 10, 2009

Patients, like customers, are not always right

Are you familiar with the website Not Always Right? I just became aware of it a week ago and have been making my way through their massive archive of retail hell stories that seek to "level the playing field for those of us who toil and sweat every day trying to juggle demanding customers and often unreasonable corporate expectations." Pretty funny stuff and I recommend it, though if you read too much in one sitting your contempt for humanity might poison your soul a bit.

I wish it had been around when I was working at a certain large electronics chain in the music/DVD/video game department. It would have soothed. Once after closing, encouraged by my co-workers, I performed a rant about customers being confused or even angered by the concept of alphabetizing which ended with me making the case for tearing out all the CD racks, digging a giant hole, and dumping in the CDs just so we could say things like, "Oh I think there's a rich vein of Celine Dion thereabouts."

That reminds me of the time that a middle-aged guy came up to me with a vague request for mood music. After a couple failed attempts to find what I thought he was looking for, Windham Hill-type music or cool jazz was what everyone else wanted, he leaned in close to me and murmured, "Mood music, you know, like for sex?" More than a little put off, and being the snarky little music snob I was, I marched over to the compilations section and put an Excursions in Ambience volume in his hands nodding portentously. Sure I was messing with him, but in all honesty, I think Seefeel, Air, and Spacetime Continuum provide a great soundtrack for doing it.

Anyway, I was especially excited/trepidacious to come across several medical stories on Not Always Right.

Story 1
Story 2
Story 3
Story 4
Story 5
Story 6

That last one reminded me of my patient who had had their aorta repaired just the day before. Since it was the part of the aorta that passes by and supplies blood to the stomach and intestines, she was NPO (no eating or drinking). She asked for ice chips and I explained that she couldn't have any.

"Your digestive system is not up to speed yet and taking in fluid could cause nausea and vomiting might cause your repair to bleed."

"The last nurse let me have ice chips!"

"Well she shouldn't have. The doctor has ordered nothing by mouth, I'm bound to follow his orders, and I've explained why it's detrimental to your health."

"But I've already had ice today," she whined loudly.

I told her politely but firmly that she could wet her mouth with oral swabs, but no more ice. What I really wanted to say was,

"Do you really want to risk massive internal bleeding for the ephemeral treat of ice chips?! Would you let your child eat candy until they writhed on the floor with a searing stomach ache just because Grandma let them go hog wild on a bag of Jolly Ranchers? Lady, get your priorities straight."

I like my patients, but sometimes...


  1. this pt i had was on a ventilator and was trying to form the words, "I want water!" Of course he couldnt have any. Later when doing the neuro checks, I asked him "Can you hold up two fingers?" he held out his middle finger.