Thursday, December 30, 2010

A few favorite lines from patients

1) My boyfriend and I were just fooling around. I think I sat on it. No, he didn't put it in there. I did sit down hard though. Will this take very long? (you know where said object was found)
2) No, I'm not pregnant. I had a bad ham sandwich. (you know how this turned out)
3) Well, I know I'm not pregnant. My mother told me I couldn't have sex until I was married. (yeah.Righto. We know the right answer to this one too)
4) I only take them Dilaudid pills if my pain is 10/10. I think my roommate stole my prescription. (yeah, sure)
5) It IS an emergency. It will only take a minute to get the medicine won't it? I was supposed to be at a party a half hour ago! (Guess what-they might be madder at you)

Monday, December 27, 2010

Blatant Abuse of the System

I remember as a new nurse knowing I could change the world in just little ways. I was just as idealistic as any newbie. I'm quite positive all experienced healthcare workers remember those days.
I knew I really cared about people and that I really wanted to learn as much as possible as fast as possible. I wanted to be in on every code and be a part of every critical patients care.        
I got over that.
However, I didn't expect the blatant abuse of the healthcare system. I surely didn't know it was to smack me so hard. Thinking how incredibly healthcare has improved reminds me that the abusers have become more enterprising.
The first inkling was actually surprising, a nice little old lady who met the Rescue Squad at the end of the road to her house with her suitcase in hand. (The Rescue Squad volunteers were not healthcare professionals but caring citizens willing to take Advanced First aid or EMT classes so they could help their neighbors/community.) The Little Old Lady's country doctor would willingly put her in the hospital so she could 'recuperate.' Once safely in her hospital bed the whole flower carrying family would arrive to pay homage to poor Mama. I suppose it was a win-win situation really, Mama got the attention she needed and craved from her busy, guilt ridden family. She also got her Darvocet filled. Medicaid willingly paid the bills. Yeah, that's not so horrible I guess. People still go to extreme measures to scare their family into attention- it's just more expensive now. Of course now Mama is in the nursing home and when the very busy family goes to see her on Mother's Day- Mama eats up the attention, the guilt ensues and it's 911 to the rescue. Of course sometimes they haven't seen her in some time and she's lost weight and gotten more frail making family even more frantic and guiltridden.

I'll admit, I don't get as upset about that type of abuse as I do the more rampant and vile practices of feigning injury or illness. Of course we generally can see right through the bullshit. Of course we are powerless and of course they know it. They get the drugs or free pregnancy test (If pregnant they can even an score an ultrasound that can help date the pregnancy so they can figure out who is the 'baby daddy' and even get a picture to show the dude) or maybe they get the work excuse they came to score. We routinely get to pay for all this courtesy Medicaid/Medi-cal.  Maybe they get a few more minutes of attention they crave from the person on the other end of the ever-present cell phone they are crying into while motioning for us to get them a blanket, footies or maybe even re-fill their juice cup or get them a sandwich. The Baby-Daddy drama is the most fascinating to watch.
Where but in America can you call 911 for a ride to the ER for 'Chest Pain' then once in the back of the ambulance tell the real story "I thinks I got a vaginal infection." I've seen 911 called for "I feel like I might throw up." or  "I had a headache all night." And "No, I didn't take nothing. I didn't have no money to buy no tylenol."
Funny, they had the money for the cigarettes. Or beer. Or fancy nails. Or crack cocaine. Yes, we will give you a prescription for some Tylenol. (Medi-Cal/Medi-Caid  will pay for it if you have a prescription. Why pay for it yourself?) Oh, you rather have Vicodin? Yes, I'll also tell the Doctor you really need that Phenergan with codeine because you cough so much at night.
Yes, I know you're allergic to Morphine and the other medicine that you think begins with 'D' is the only thing that helps you. (The 'D' medicine used to be Demerol, now it's Dilaudid)
Oh no, I'm sorry I can't push in in your IV real fast like you also wanted the Benadryl given.
Yeah you could call a taxi but you get "faster service in the ER if I call 911". These abusers also know that when EMS is called through the 911 system that they can’t be refused and can’t be made to pay. We also get our share of bogus info,addresses and phone numbers. You can refuse to give any info including your name. We cannot refuse to help you.
We have had our share of people calling 911 from the waiting room so they "can get back quicker." 
No, we don't forget what you've done. Nor does EMS (Emergency Medical Services) For a bit more: