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Was That Even Necessary?

Posted Jun 29 2009 4:23pm
Why do people need to act like a complete arsehole?

I had a few encounters with my work colleagues recently during my weekend on call. I am a pretty easy going person. But I really could not tolerate those who are irrational.

I received a referral from the A & E department about an elderly gentleman who is now having difficulty swallowing and persistent vomiting. As a result, I was told he looked quite dehydrated. I said, "That's fine...just send him up to our medical ward for further assessment." Later, I received a phone call from the managers that his admission was highly inappropriate. First of all, I was told by this colleague of mine that I do now know this patient at all (which is very true...I have never met him therefore, assessment is even more imperative, no?). Then, our conversation went on like this:

Colleague X: What are you going to do about his swallowing problem over the weekend?

ME: Well, there isn't much we could do over the weekend, until he comes extremely unwell, he which he may require an urgent endoscopy. Otherwise, we should give him IV fluids and make sure he hasn't aspirated."

Colleague X: Exactly. You can't do anything for him over the weekend. If he were to get a can only do it on Monday, so why bother admitting him?

Again, I had to repeat myself.

Colleague X: I find it really hard to understand why someone with your capabilities would want to admit that patient from A&E.

I was utterly shocked and speechless.

ME: OK, look. If you think this patient is well enough to go home, why don't you document that in his notes, and discharge him from A&E. From my point of view, as I haven't laid my eyes on the patient, I would not know if he is fit for discharge. If anything happens to him, I am the one responsible because I am the person on-call.

I was arguing over the telephone! It was embarassing because I was speaking in the medical assessment bay where new patients were waiting to be seen. After a good 10 mins worth of arguement, we both put the phone down. I felt that it was complete unneccessary. I mean, I know we were verging on being short of beds, but I honestly could not simply discharge a patient without seeing him first. And I hate to say this, but, you are only in charge of the are not trained to assess whether the patient is fit enough to go home!!!

Urgh...I felt so frustrated after that.

Then, the next day, I received another mouthful from another colleague. This time it was because she thinks the patient has no comprehension of what was going on. She was unhappy that I told the patient about her diagnosis of cancer, and that she her prognosis was poor.

The thing is, this poor elderly patient of mine was clearly living the last few days of her life....and she hasn't been told what was causing her to feel so unwell. When I first assessed her, she could tell me the events leading to her hospital admission, she was well orientated to time, place and person! So on that basis, I felt she was able to understand what was going on.

This fellow colleague of mine, (lets name her Colleague G), was again being inappropriate.

Colleague G: Look, I find it shocking that you think she has even the slightest understanding of what is going on. She is completely off her head. She mumbles all the time! And you told her she has cancer?

Me: I completely respect that. But when I saw her, she was orientated, and was able to tell me her history. And she is my patient, she has the right to know....especially when she is so ill.

Colleague G: Well, I find that hard to believe. I have been a nurse for more than 20 years...and I know for a fact that she is utterly confused and has no comprehension.

Me: Ok...I know you have the experience. But even if she is that confused, she still has to be told.

I left the scene....and about 1 hour later, I received a phonecall from Colleague G. Mind you, I was on-call that day.

Colleague G: Ling, just for your information, I went back to ask the patient if she remembered talking to you. She said, she recalled that a doctor saw her, and she said something was wrong with my tummy. But she couldn't remember what was wrong with it. So there you go, for your information, she has NO CLUE what is wrong with her!

I was like WHAT?!!! Do you actually need to purposely call me to just prove a point?? Is there any need to do so??

No there isnt! Even she doesnt remember, I am still responsible for her, and she has the right to know.

Me: Ok then. Thank you for letting me know. (I was gritting my teeth while saying that). bye.

Man....what is wrong with these people?!


Maybe I have lousy clinical judgement. I dunno. This is so frustrating.
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