I've been a medic for 16 years and a nurse for 6. I had a funny thing happen today. I happened to be working on the ambulance but it could just have easily been on the unit. I personally hate long winded posts, so get ready because today I am GUILTY. I was transporting a late 50s guy who was being transferred for EP study following a NSTEMI (r/t recurrent Vtach). I asked him what meds he took and he said "it's none of your business, you are just giving me a ride". I was dumbstruck for a second and my impulse was to "inform" him that the state of Colorado required that I gather medical history, allergies, medication and perform a full assessment on every patient, but I didn't. I stopped and smiled to myself, realizing that this guy had made his choices and I would leave him to his problems. Of course I just read his chart.
I felt like telling him that the 4 vessel CABG he received 7 years prior was a miracle of modern medicine that few people in the world would have been lucky enough to receive. I didn't want to rub it in his face that two vessels were 100% occluded, the third 90% occluded and his LIMA was the single vessel providing all of the blood flow to his heart. I felt like telling him that by failing to even see his doctor once or quit smoking was a slap int the face to the surgeon who had dedicated his life to curing cardiac disease. I felt like telling him that I knew his Na was 139, his K 5.2, Bun 24, creatinine .9, and the significance of his troponin of .12. I felt like telling his the report of Vtach that I had received was clearly rapid Afib, and that I knew 50 ways (OK 10) to save his life if his EF of 30%, septal and apical hypokenisis failed to sustain him. But I didn't.
He was a tough guy, 6'4", worked as a trucking supervisor, 260lbs, handlebar mustache and had a ring tone from one of the the Cling Eastwood spagetti westerns. I wanted to tell him that yes, Clint was a badass but he won by being the clever trickster, not by being a dumbass, and that that he wan't being clever at all. A clever man would listen to his doctor, or quit smoking. Is there anone in America who doesn't know this is bad for you? But I didn't. I treated him with courtesy, gave a report and dropped him off. In my younger years I would have been ******, but now, I just feel sorry that he wasn't smart enough, or got enough hugs as a child, or for whatever reason he seemed unable to face his problems and take action to stay alive. I guess I just realized that to be a nurse, is to take people as they are, and treat them the best we can.
