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I think the term "blacks" should be changed to African-Americans, especially because Caucasians are not referred to as "whites" in the same article. It comes off as racially insensitive, ironically enough.

Getting a patient to use the numerical pain scale should be easy, right? Pick a number from one to ten with one being just a little bothersome and ten being the worst pain you have ever felt or imagined. Seems pretty straighforward to me.

But my patients sometimes look at me as if I've asked them to add the square roots of their children's birth dates and round to the nearest hundredth.

They stare at me and scrunch up their faces as if this is a scary pop quiz and they don't want to get it wrong. After a ten or fifteen seconds of agonizing, I get answers like, "Not quite a four and a half," or, "sort of a six," or, "somewhere between a two and a seven."

We all know about the 10/10 folks who want every prn measure available the second they can have it. But this other group seems really cowed by the complexity of the question. I've seen the same expression on people who have just been told they have to do a dozen algebra story problems. I feel for them. I really do. Sometimes I have even said, "Don't put yourself into a tizzy over this," and reassured them that they aren't being graded. Not even on a curve.

When I offer the pain faces as an alternative, I'm not sure if the face they pick matches their actual medical discomfort or if they are expressing the psychological intimidation they feel about having to choose the exactly appropriate not-so-smiley face.

It's not a big deal. We work it out and they get the meds they need. I'm just periodically amazed/amused at the overwhelming burden picking a pain face or number seems to put on some patients. Makes me wish I could offer them some light sedation before putting them through the ordeal.

http://news.yahoo.com/s/ap/20110131/...ealth_overhaul


Seems part of the arguement against Obama's bill is that people are going to be forced to purchase health insurance. Well........why not? A lot of states mandate buying auto insurance. Which one is more important? Doesn't seem like too much of a stretch to say you have to have it. Might help put an end to medical businesses having to give it away free.

So soon we forget. Many threads and even more posts comment about the "free care" we must provide in the ER and everywhere else. Seems to me this would be a step in the right direction to solve it. Whats the issue?

Eh, I'm all for it. Tired of running pain meds to a bunch of fakes who don't pay only to see another pt. with a real ailment get second rate care.

I had a patient tonight in her late teens, had a C-section back in May and spent some time in ICU recently due to an abscess and came to our floor (med/surg) a few days ago. This patient is morbidly obese and obviously very spoiled or just a brat. Her call light was on literally every 10 minutes....you would go in her room and she would want ice, or graham crackers, or want you to rub lotion on her. You would spend a half hour in there and AS SOON AS you walked out, she would have her call light on and say "can you send in my nurse." REALLY?? I was just in there. Then she would want to know why her food tray hasnt come yet or when was it time for pain medicine.

She is supposed to go home tomorrow but she asked me to wash her crotch and to scratch under her skin folds of her belly. I so wanted to say your arms arent broke! But I figured it would be less of a battle to just do it myself. Then 2 of her friends came....2 boys in their late teens, early 20's. The patient called me into the room to ask me if I could get them something to drink. I told her that there was a cafeteria and a vending machine room. She said they were broke as a joke. Hmmmm thats funny because they have a ton of tattoos and I can smell cigarette smoke on them but they cant afford a $1 bottle of pop or water?? I ignored it and walked out. Next time I came in to do something she said "did you ever find them something to drink??" I was about to blow a gasket....I calmly went and got them 2 glasses of ice water. Next time I came into the room theres the empty glasses sitting on the bedside table. The trash can was right beside them and they couldnt even clean up after themselves.

Next I am in the process of flushing the patient's PICC line with saline and heparin....I dripped a drop of saline on her and she says "umm thanks for making me wear it." I said "its saline, its not going to hurt you." Another friend drops by....theres a sign on the bathroom door saying it is for patient use ONLY. theres a visitors bathroom literally 2 doors down. The friend is in the patient's bathroom using it....I ask the patient where the friend is and she says shes using the bathroom. I tell her that theres a patient bathroom right outside and she gets huffy with me and says her friend "really had to pee." Come on you're not 5 years old!! Last but not least after I catered to this little brat all night she asks me to tuck her dressing into her skin fold because its uncomfortable....as I'm doing this as gently as I can she starts to scream...literally scream. And then bursts into tears and tells me I'm being too rough with her and she should have never let me do it. I honestly wanted to ask her what the hell was wrong with her. And the worst part about people like this is that they can treat you however they want and you cant say a dang thing back to them or you get in trouble! Its ridiculous that patients are allowed to get away with that stuff...I kind of neglected my sicker, more grateful patients because of this demanding immature girl. Thank you for listening to my rant, I feel a little better now