Post by medic09 on May 20, 2009 18:46:16 GMT -5
The other night I got a 'withdrawal' patient in the ER. Quotation marks, because much of his presentation wasn't typical illness from withdrawal. It often he appeared he was just being difficult. He was supposed to go to the sobering center, but was up and vomitting so much that we couldn't send him. Since I had an empty treatment room, his nurse transferred him to my care for the rest of the night.
This fellow was lucid, and his responses were appropriate. At times he behavior was a little 'off', but seemed forced or contrived. Same with his vomitting. I was giving him pretty hefty amounts of Ativan per protocol, but he was just soaking it up with little effect. I was often in the room answering his calls, and he was giving me orders as to what meds he expected.
Up to this point in the narrative, I'm okay. Some are just demanding. But this guy kept getting up out of bed, taking off the monitor leads, pulse-ox, etc. Every ten to fifteen minutes I had to remind him that for his own safety, he had to stay in bed. He could call, and we could get whatever he needs. He kept getting out of bed; 2-3 times/hour. At one point he got up, and started off down the hall to get himself some ice. Of course, he tore out his IV. No simple matter, given that he had lousy drug addict veins.
So now, I gave him a piece of my mind. I told him he was acting like a spoiled brat (he's 29 yo), and he needs to cooperate with us so that we can give him good care. At one point I also pointed out this is an ER, and we have genuinely sick and injured people who also need our attention. I was using a pretty angry tone of voice after a while. I pointed out we didn't want to use physical restraints. We gave him Haldol eventually, and that didn't do much either.
I wasn't genuinely angry, though I was getting annoyed by his confounding his own care.
I'd like to think that I acted in line with the Rambam in Hilchot Talmud Torah, that a teacher musn't every be actually angry with a student, but they may act that way to get a point across and discipline them. Even so, the tech commented this was one of the few times he'd ever seen or heard me sound angry with a patient. (I did it once when a patient accused us of "Nazi treatment", and once when a patient endangered one of our female techs, a little cowgirl who could've kicked him to hell and back, and I threatened to deck him.)
So, is this appropriate for a Jewish nurse's behavior? Is this consistent with how the Torah teaches us to treat others, especially our patients? Have any of you similar concerns?
This fellow was lucid, and his responses were appropriate. At times he behavior was a little 'off', but seemed forced or contrived. Same with his vomitting. I was giving him pretty hefty amounts of Ativan per protocol, but he was just soaking it up with little effect. I was often in the room answering his calls, and he was giving me orders as to what meds he expected.
Up to this point in the narrative, I'm okay. Some are just demanding. But this guy kept getting up out of bed, taking off the monitor leads, pulse-ox, etc. Every ten to fifteen minutes I had to remind him that for his own safety, he had to stay in bed. He could call, and we could get whatever he needs. He kept getting out of bed; 2-3 times/hour. At one point he got up, and started off down the hall to get himself some ice. Of course, he tore out his IV. No simple matter, given that he had lousy drug addict veins.
So now, I gave him a piece of my mind. I told him he was acting like a spoiled brat (he's 29 yo), and he needs to cooperate with us so that we can give him good care. At one point I also pointed out this is an ER, and we have genuinely sick and injured people who also need our attention. I was using a pretty angry tone of voice after a while. I pointed out we didn't want to use physical restraints. We gave him Haldol eventually, and that didn't do much either.
I wasn't genuinely angry, though I was getting annoyed by his confounding his own care.
I'd like to think that I acted in line with the Rambam in Hilchot Talmud Torah, that a teacher musn't every be actually angry with a student, but they may act that way to get a point across and discipline them. Even so, the tech commented this was one of the few times he'd ever seen or heard me sound angry with a patient. (I did it once when a patient accused us of "Nazi treatment", and once when a patient endangered one of our female techs, a little cowgirl who could've kicked him to hell and back, and I threatened to deck him.)
So, is this appropriate for a Jewish nurse's behavior? Is this consistent with how the Torah teaches us to treat others, especially our patients? Have any of you similar concerns?