one day during inpt med at the VAMC

how we keep our cool when patients curse at us, spit on us, hang up on us and in general vent all their frustration on us is an intriguing question. 
take for ex my HIV pt with acute on chronic pancreatitis whose pseudocysts grew to the point where now he had to have them drained.  and let’s take the run-around that i had to deal with as i called GI Surgery who only after multiple pages and phone calls finally told me that Special Procedures had to drain the cysts.  It took two days before this was handled and then another 3 days afterwards to get the CT to assess for the cyst sizes–whether or not they decreased with the PIG tail catheter in place.  He drained and when we got another CT, the Specials informed us that he would need at least another week prior to obtaining another CT to see if they would need to go in yet another time.  During these periods, it was often necessary for the pt to be NPO and he was very much adamant that he needed to stay in the hospital to gain weight.  Now that’s not the reason we had kept him so long but in his mind, that’s what he wanted.  And after we have gotten the run-around as we are the main medical team, we have to continue to discuss the issue with the patient who now feels that he’s not being treated well, should be given more attention and wants to sign AMA.

How many of our patients want to sign AMA?  How many times will they vent their frustration on me?  I’m only a messenger but to them I’m still a doctor.  I have to spend most of my time on the telephone, paging the different consult services, returning phone calls, dealing with nursing frustration and pettiness, family turmoil and social work mess.  1001 people with 2001 questions, demands, expectations, (mis)understandin

gs and somewhere, somehow I’m supposed to know it all.  But I don’t–not because I don’t care–but often b/c I don’t know.  And in this venue, ignorance is a crime.

About papillion

Intense Often Moody Transparent Exquisitely sensitive Animated Never satisfied Curious Eternal Romantic Creative Devotedly Christian Encouraging Multi-layered Loving Quick Judge Critical Forever evolving View all posts by papillion

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