Feeling cynical...
Posted: 11 Jul 2015, 06:04
Now that I've actually GOT a couple of days to rest and re-group and seriously, have no *real* reason to rant tonight, I'm going to rant, anyway. What IS it with these people who come to the hospital and pack a suitcase as big as a freaking HOUSE??? WTF??? Do they think they're going to freaking move IN??? Lemme tell you folks, just to save yourselves a whole bunch of trouble and preparation. Do not, I repeat, NOT, pack anything which isn't absolutely necessary for your continued existence for the next three to five (at the most!) days! This means your cell phone, your iPad or laptop (if you possess one), a couple of pairs of clean pajamas, a bathrobe and a pair of slippers, your toothbrush and hairbrush, the clothes that you intend to wear home, dentures, eyeglasses and/or hearing aides and, for all you nicotine addicts, an e-cig, since there's not a hospital in existence anymore which allows smoking ANYWHERE on its property! All of these things listed could, conceivably, fit into ONE decent-sized overnight bag! So WHY are so many of these folks bringing in multiple bags, including, in many cases, HUGE suitcases on wheels??? I actually HAD a recent knee surgery patient tell me, when I asked why she brought so much stuff with her, that she expected to remain with us for AT LEAST ten days!! This woman was, perhaps, one of the "innocents" who have no clue what Medicare and/or insurance companies allow...for a knee replacement, you'll only stay, at maximum, for three days barring medical complications, and that, only to satisfy Medicare's "qualifying hospital stay" requirements if you need a rehab facility afterwards. Normally, your average knee replacement is out MUCH sooner than that...usually only an overnight stay, or TWO days at maximum!
While I know that MANY folks actually LOVE being in the hospital and many hold "court" while placed there (when one thinks of it, it's a shame, really, that this is the ONLY time in their lives when many of them actually have visitors!), it's also apparent that many also know the "rules" of the game, i.e. that their insurance company will pay for "x" number of days for a particular surgery/diagnosis and that's it...unless, of course, one manages to "create" a "medical" reason to keep one there a little bit longer. I've had patients who've run up the thermostats in their rooms, cover themselves with multiple blankets, etc., in order to create an elevation in their body temperature that, to those less educated, might possibly pass as a "fever" in order to get themselves an extra day or two in the hospital, where they can continue to treat their nurses as wait staff and servants. It used to fool me, too, until I learned to check the thermostats in the rooms, pull off the extra blankets, get the patient OUT OF BED AND MOVING, get him/her to use his/her incentive spirometer (a most necessary instrument in pulmonary "toileting"), and THEN to re-check the temp! Amazing, how in at least 99.5% of cases, that temp will go back down to "normal" range within 15 minutes or less! I could go on and on, to list the multiple "complaints" that the average hospital "addict" will come up with in a desperate attempt to remain in the hospital for just a few more days, and someday, perhaps, I will. I'm convinced that there's a halfway interesting (but very cynical) book just waiting to be written about my nursing career; but you get the general idea. Sometimes, these folks just DON'T want to leave! They'll be noncompliant with their therapies and act seemingly "helpless," until such time as their Doc finally tells them that they need to think about placement in a "rehab facility" (aka "nursing home"), since there's no longer any "medical" reason to keep them in the hospital. It's always *amazing* (cough) when suddenly, they become MUCH more able and functional, and are usually out the door and on their way home by the time another day passes. I've seen that "miraclous" turnaround more times than I care to count which is, perhaps, why I've become such a jaded, cynical bitch in my old age.
There are many days when I question my cynicism and wonder whether I'm truly suffering from that "compassion fatigue" that we nurses are warned about. And then, I look at the number of surgical complications I've caught over the past several months that many more "complacent" nurses have missed, and consider the fact that I've saved a couple of lives and, in other cases, have certainly saved the "quality" of other lives (in two cases, at least, I've spotted symptoms of a lumbar hematoma in one patient and cauda equina syndrome in another, BOTH of which may well have resulted in the permanent paralysis of said patients if immediate intervention wasn't aggressively sought and obtained! Yes, I've awakened far more surgeons than I care to count in the past year!). Is THIS not some kind or "reward" for putting up with the "hospital addict" BS I've long learned to deal with??!!?? I think so. Yes, far too many of my patients are manipulative, attention-seeking a**holes who treat me as though I'm their personal "slave," and this DOES have a tendency to burn one out on the job. But the fact is, I STILL make a "difference." Not often enough, to be certain, but certainly often enough to know that my experience is still VERY much needed at my current facility and, until I manage to train a nurse (or two or three) on the finer points of spinal and orthopedic surgeries and the very REAL complications which can result from them (which is easier than it sounds -- most "new" nurses come out of school thinking that they know it all, already!), it probably ISN'T time to be changing my place of employment at ANY time in the very near future....
While I know that MANY folks actually LOVE being in the hospital and many hold "court" while placed there (when one thinks of it, it's a shame, really, that this is the ONLY time in their lives when many of them actually have visitors!), it's also apparent that many also know the "rules" of the game, i.e. that their insurance company will pay for "x" number of days for a particular surgery/diagnosis and that's it...unless, of course, one manages to "create" a "medical" reason to keep one there a little bit longer. I've had patients who've run up the thermostats in their rooms, cover themselves with multiple blankets, etc., in order to create an elevation in their body temperature that, to those less educated, might possibly pass as a "fever" in order to get themselves an extra day or two in the hospital, where they can continue to treat their nurses as wait staff and servants. It used to fool me, too, until I learned to check the thermostats in the rooms, pull off the extra blankets, get the patient OUT OF BED AND MOVING, get him/her to use his/her incentive spirometer (a most necessary instrument in pulmonary "toileting"), and THEN to re-check the temp! Amazing, how in at least 99.5% of cases, that temp will go back down to "normal" range within 15 minutes or less! I could go on and on, to list the multiple "complaints" that the average hospital "addict" will come up with in a desperate attempt to remain in the hospital for just a few more days, and someday, perhaps, I will. I'm convinced that there's a halfway interesting (but very cynical) book just waiting to be written about my nursing career; but you get the general idea. Sometimes, these folks just DON'T want to leave! They'll be noncompliant with their therapies and act seemingly "helpless," until such time as their Doc finally tells them that they need to think about placement in a "rehab facility" (aka "nursing home"), since there's no longer any "medical" reason to keep them in the hospital. It's always *amazing* (cough) when suddenly, they become MUCH more able and functional, and are usually out the door and on their way home by the time another day passes. I've seen that "miraclous" turnaround more times than I care to count which is, perhaps, why I've become such a jaded, cynical bitch in my old age.
There are many days when I question my cynicism and wonder whether I'm truly suffering from that "compassion fatigue" that we nurses are warned about. And then, I look at the number of surgical complications I've caught over the past several months that many more "complacent" nurses have missed, and consider the fact that I've saved a couple of lives and, in other cases, have certainly saved the "quality" of other lives (in two cases, at least, I've spotted symptoms of a lumbar hematoma in one patient and cauda equina syndrome in another, BOTH of which may well have resulted in the permanent paralysis of said patients if immediate intervention wasn't aggressively sought and obtained! Yes, I've awakened far more surgeons than I care to count in the past year!). Is THIS not some kind or "reward" for putting up with the "hospital addict" BS I've long learned to deal with??!!?? I think so. Yes, far too many of my patients are manipulative, attention-seeking a**holes who treat me as though I'm their personal "slave," and this DOES have a tendency to burn one out on the job. But the fact is, I STILL make a "difference." Not often enough, to be certain, but certainly often enough to know that my experience is still VERY much needed at my current facility and, until I manage to train a nurse (or two or three) on the finer points of spinal and orthopedic surgeries and the very REAL complications which can result from them (which is easier than it sounds -- most "new" nurses come out of school thinking that they know it all, already!), it probably ISN'T time to be changing my place of employment at ANY time in the very near future....