I'm discharging a gal in the hall bed for gastroenteritis with her husband/boyfriend/babby's daddy/s.o. present. It's one of those dynamics where the patient really doesn't ask you any questions, but just kind of looks wide-eyed at you while companion does all the talking. To be fair, as someone who is super shy, this doesn't bother me as long as it's not an obvious domineering douche relationship, which this wasn't. No, it was one of those I'm asking the questions cause I know you won't type of dynamics, except it was. not. working. The message I was trying to convey was just totally not getting across.
I have a basic spiel for most common illnesses. My gastro spiel goes something like, "yeah, these symptoms are really a bummer, and unfortunately there's no treatment for the virus itself, but we can treat your symptoms and try to make you comfortable. Fortunately this usually runs it's course within about 48 hours on average, in the meantime try to rest, take your nausea medicine, and make sure you're drinking lots of liquids in small quantities..etc" Except dude was really hung up on the "there's no treatment for the virus" part.
"Wait, so what is this medicine?"
"It's two of the same medication. It's called Phenergan, and we're giving you pills and also suppositories if you can't keep down the pills. You can take it every 4-6 hours or so for nausea and vomiting. "
"Okay. So the medicine is just for the nausea. You aren't going to give her anything for the virus?"
"Well, no, there's no medicine for that, it just has to run it's course. But this medicine should make it a lot more bearable."
"What about the diarrhea?"
"We just recommend Immodium over the counter after the first 24 hours if it's still happening."
"Okay, but you're not giving her anything for the virus?"
"No, there's not any treatment for the virus, unfortunately."
"But, wait, why aren't you guys giving her anything for the virus?"
"Because it's not a thing. Scientists haven't invented it yet. "
"OH. "
One of my coworkers was walking during the last part of that conversation- as soon as the patient left and I rounded the corner, he immediately started laughing at me. Did you seriously just answer that question with "scientists haven't invented it yet?"Well, yeah. Look, I hope I don't sound mean because I genuinely don't mean to be. But sometimes, things aren't getting through and you have to just go off script and hope for the best. Luckily the message seemed to get across in this case.
HA! Sometimes you just have to break it all the way down girl! I sat here yesterday and read all of your entries! I love your honesty and you have a new fan!
ReplyDeleteI did that too. When I first came across her blog I printed the whole thing out, and read it from the beginning like a book. She is so freaking hilarious, I swear at times I was laughing so hard I had tears rolling down my face.
DeleteI don't think you sounded mean at all. Obviously this guy didn't know that viruses aren't treatable. Now he does. Yay, you.
ReplyDeleteHN, I think it's the perfect answer; it's true, it's simple, it's direct, it's understandable. I love it.
ReplyDeleteCan i use it ?~!
Can I use that phrase also?
ReplyDeleteIt reinforces the point without being mean. I know in my ER, we'd probably see her the next day and the day after that for the very same thing. Some people don't understand that there's not a magical pill for everything.
This literally made me LOL.
ReplyDeleteI so want that Magic Stick though. It would have feathers and glitter. We'd wack you over the head and you'd be cured.
ReplyDeleteI'm not in the medical field, but I love your blog. I worked in social services with the same type of population you deal with. This particular entry hit me on a personal level because virtually none of my friends (I'm 60 years old) can understand why my doctor doesn't give me an "antibiotic" when I get a virus. They all seem to get prescriptions from their M.D. even when they're diagnosed with a virus. Do doctors really still do that just to placate their patients?
ReplyDelete>>Do doctors really still do that just to placate their patients?
DeleteYes.
(I'm a veterinarian, and some of my colleagues do this, too. Don't know why they don't use HoodNurse's explanation, which works for me.)
I get the same question all the time "the docs don't DO anything for it"- meaning they aren't going to get that magic cure....to which I reply well, yes they are....medications to help keep your liquids down IS doing something...and then I go on to tell them that "vomiting and diarrhea are like your annoying and irritating friends...if you don't let your body get rid of the virus quickly by vomiting....you stay sicker longer. V&D are happening for a purpose and your body is doing a great job of getting rid of the virus - you just need a little help calming it long enough so you don't dehydrate." I usually get a hesitant yet positive response ...
ReplyDeleteI work in peds CVICU and every now and then we will have a kiddo that is neuro compromised after CPR, ECMO, etc. The parents never seem to get the whole "His/Her brain does not work properly" piece of the puzzle when it comes to the kid walking, talking, hearing, seeing, swallowing, and on and on. It's rough to try to explain that a lot of their dysfunction is due to their brain, and there is not a lot we can do to fix it. Ugh.
ReplyDelete