I was surprised at the strong reaction to my post on Saturday about creepy patients.
If I asked a patient to touch my penis, I'd be fired. (I'd also be insane.) Creepy patients are lucky. We can't fire them. We still have to treat them. And we do. But doctors and nurses are still human beings-- of course there are going to be patients we like and patients we don't.
The thing it seems like too many patients don't understand is that when we want to take tests, when we want to keep them another day, when we tell them something-- we're not trying to torture them, it's not punishment, and it's not for our benefit. It's for theirs.
So if someone's going to throw a fit when we tell them we need to do another MRI-- of course I'm going to try and explain why they need it, of course I'm going to try to convince them it's for their own benefit-- but at some point, what more can I do? Because, really, I don't care. If you don't want us to figure out what's wrong with you, if you're going to throw a tantrum every time we want to give a necessary test or give you a pill or do something YOU NEED, if you're going to "threaten" to leave-- at some point it's like, fine, it's your body, it's your health, if you want to go, go-- you're not here for my benefit, you're here for us to help you. If you're going to stand in the way of your own care, then you can leave and give us another bed to treat someone who actually wants our help.
Because, yeah, the customer is always right-- except when the customer is a patient who thinks his cancer was caused by the Advil he took that morning, and doesn't understand when we say we need to do a whole bunch of tests to see what's going on.
Tuesday, September 1, 2009
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Hi. I'm an intern at another hospital, probably in another state, and I have to say I've really enjoyed reading your blog. Although it sounds like you're in a pretty shitty inner city hospital, judging by some of your posts. I rotated through a shitty inner-city hospital quite a few times, and all of my compassion for, and all of my aspirations to treat the underserved--vanished overnight.
ReplyDeleteAnyway I think what's setting off the huge reaction is--you're touching on the classic beneficence v. autonomy question. Honestly, I think a patient who requests that a nurse touch his dick is probably disinhibited and has vascular / senile dementia with frontal lobe damage, but that's just my two cents...
I have to agree, though, it can be really frustrating dealing with a patient (or his family!) that perseverates on the most minor of details, blaming all of their problems on one or two details. Even more so when they bring up the two classic offenses in the Problem Patient playbook: (1) "I am a nurse/tech/doctor's secretary, and my clinical judgment is superior to yours" and (2)"I know a lawyer and if anything goes slightly wrong I am going to sue the living shit out of you".
It is at that point that I wonder if I should perhaps give up on medicine and take up a more harmless and yet more satisfying vocation, like joining the Army and shooting people overseas.
And in about a year and a half, you're going to keep patients waiting around pointlessly for your benefit - so you don't have to process a new patient, so you can go home and get some sleep.
ReplyDeleteLooking back over this blog must be fun for you.
Not saying I wouldn't do the exact same thing of course.