Sure, it’s all my fault

Medicine is a wonderful field to work in.  When you provide good care, most patients are appreciative and thankful.  When you provide adequate care, they are still appreciative and thankful.  Unfortunately you run into the occasional non-compliant patient.

I’ve said it before, but the medical field is organized much like the military, at least when it comes to the fundamental structure.  You have the doctors who act as officers, and then you have the nurses who act as the enlisted personnel.  Just like the military, the higher ups make the orders and the lower downs carry them out.  The commanding general would say, “go charge that hill!” and while he stayed back in the rear, the enlisted people go get shot at.  Doctors will say, “give this medication, change that dressing, get that post surgical patient out of bed and walking…” and the nurses do that, often receiving the brunt of the abuse from the patients when they do not wish to or refuse comply, which is their right.  If the patients don’t comply the nurses get growled at by the doctors.

Lather-rinse-repeat.

This brings me to a patient that I had last week.  Let’s call her Miss Nuh-uh!

Miss Nuh-uh! was prescribed a list of medications which it is my job to give.  She was suffering from bad constipation bordering on an obstructed bowel and  was prescribed an entire drug store worth of laxatives to get things moving.  The problem is that she got it in her head that the only thing that would work was something called digital disimpaction, which is as bad as it sounds.  Yup, that is actually sticking your hand up her ass and scooping out the contents.  Yuck!

Fortunately I didn’t have to do that.  However, to get a hand shoved up her butt, and to make sure she would eventually get what she wanted, she started to refuse to:

  • Eat
  • Drink
  • Take all her medications (except pain medication)
  • Follow any and all doctors orders.

OK, that’s her right.  However she also suffers from really bad arthritis, hence the reason she was taking her pain medications.  I was very conflicted about this.

Why?

Because I am very glad to assist her to relieve her arthritis pain, but does anyone care to take a shot at what side effect most pain medications cause?

Yup, constipation.

So she would relieve her pain, only to have the other problem get worse.  It gets better!  Miss Nuh-uh! then started blaming me for her problems with the lack of progress in her colon.

That’s right, she refused to follow the advice of her doctors and then promptly blamed the medical staff for the lack of progress on resolving her issues.  The last time I had something like this happen to me it was after P had broken up with me and then promptly blamed me for his drinking problem.  You know, that problem that started a couple decades before we met.  Something that contrary to what I’ve heard, I didn’t enjoy.  I mean really, how could I enjoy the constant threat of lawsuits, threats to break and enter into my home, and other things?  OK, tangent off.

Needless to say I was frustrated with Miss Nuh-uh! I half expected her to blame me for winter being cold and aggravating her arthritis.  *shrugs*

On a positive note, the biggest thing nursing is teaching me is just how thick a skin I can develop.  A trait that is quite handy when dealing with our “me first”, can’t be bothered to follow societal customs, world.

The good news is my cancer patients love me.  They are always disappointed to see me leave at the end of the day, so for that reward I can tolerate the occasional Miss Nuh-uh! when I have those people to look forward to seeing and helping.  I’m still a bit humbled when I see people like them facing such an adverse situation, remain so outwardly positive.

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