I don't see surgeons taking a lot of crap and i don't see the attendings taking a lot of crap but residents and interns in IM do take a bunchload of crap. Surgery residents do take crap. Patients in the hospitals are so rude these days, well at least down here they are, it's sad they're crying about people going to specialty. I mean who wants to put up with an uneducated hiv, hepatitis drug seeker who insists on getting dilaudid?!
Doctors work hard to get where they are. Years of med school, crazy years of residency, putting up with insurance companies and meditech afterward makes me think they deserve every penny they get. The whole entitlement attitude from patients here is one that makes me want to go into a special where i don't have to deal with family members or patients themselves.
My heart goes out to nurses on these medical floors who have to put up with the bulk of the nasty attitude. I mean a resident only takes part of the crap if they decide to come up and see the patient. The nurse on the other hand is constantly on the floor and has to put up with peoples nasty attitude. For example, i've six patients, 3 primary cares, and i've joints i need to wash up and get in the chair in the morning. In order words, i'm overworked, stressed out and i have to put up with nasty attitudes. I wonder what would happen if med/surg nurses went on strike? Maybe the patients would learn to appreciate them? I doubt it!
I had a nasty patient last night, who just got on my very last nerve. He yelled at my charge nurse and i just had to walk over from the next room to tell him to not yell at us because we're trying to help and he doesn't own any of us. That shut him up for a couple of hours, then he started acting up again. 31 y.o male with HIV, Hep C, IVDA hx, all that crap along with the most nasty attitude. I pity the desperate female who has to put up with sight of him, let alone his attitude. The ER nurse couldn't stand him, the resident just said he's nasty and i think he's a pitiful thing. I guess the only way for him to gain some form of control is to yell at anyone when making any demands.
I respect everyone who works in the US health system, putting up with law school and other non-medschool graduates legislating healthcare in whatever way they seem fit. It's these same patients who eat the fruit of their actions. The sad thing is that there are those who are grateful and appreciate the help and sometimes, they make it worthwhile.
Showing posts with label cases. Show all posts
Showing posts with label cases. Show all posts
Thursday, January 27, 2011
Wednesday, June 23, 2010
The case of the maggot infested foot
God being so kind, yesterday was good. ER sent a patient up. As most times, report was shady but the nurse mentioned that the patient, who presented with blisters on bilateral feet that was infested with maggots, was all cleaned up and they'd gotten rid of the maggots. YAY or so i thought.
So up came the guy, btw, he is one of the sweet homeless folks ( i need to blog about the kinds of homeless folks who come to the hospital one of these days) but anyway, after getting him settled, i proceeded to do a skin assessment. when he walked in, i noticed an open wound, from a blister that had burst, on the plantar surface of his left foot. my goal was to figure out the length, breath and depth of it so i can apply an appropriate dressing. In so doing, i noticed something black between his great toe and 2nd toe so i went ahead to take a better look thinking it was gangrene. I mean with all the diabetics in bmore, i see gangrenous toes so often it almost looks like a normal variation of the foot and toes. Anyhoo, i open up the toes and out comes MAGGOTS!!! I freaked silently because i'd hate to have the patient think whatever. Anyway, i say maggots and the nurse doing the validation with me goes "let me see.
" Seriously?! if i was doing a skin validation with someone and they said maggots, i don't think i'd be so quick to see although on second thought, i'm soo nozy when it comes to medical stuff. Tell me a patient in room so and so has this and i'll make sure that even though i've no business in that room, i'll see it. So in hindsight, that would have been my reaction as well. Anyhoo, i call the resident asking if she'll like to order something for me to use to get rid of the maggots because i was told the ER had the guy soak his foot in something. The nurse wasn't sure what.
She turns around and asks me what would you like for me to order? I find it wierd that after 4 years of medical school, you expect a nurse to make a medical judgement for you. So i tell her i think the ED used betadine and she says i'll order it and she never does.
Anyway, the thing here is that there are tons of homeless people here who live in terrible conditions and go through awful things that Christe Eleison! makes my heart ache at times when i see them. To come to the point where maggots feed on you feet? boy, i thought the dead were the ones who had those little creatures feed on them. Are you better off than the dead or not? i mean the only difference is that you breathe but like the corpse underground, you're organic matter.
So up came the guy, btw, he is one of the sweet homeless folks ( i need to blog about the kinds of homeless folks who come to the hospital one of these days) but anyway, after getting him settled, i proceeded to do a skin assessment. when he walked in, i noticed an open wound, from a blister that had burst, on the plantar surface of his left foot. my goal was to figure out the length, breath and depth of it so i can apply an appropriate dressing. In so doing, i noticed something black between his great toe and 2nd toe so i went ahead to take a better look thinking it was gangrene. I mean with all the diabetics in bmore, i see gangrenous toes so often it almost looks like a normal variation of the foot and toes. Anyhoo, i open up the toes and out comes MAGGOTS!!! I freaked silently because i'd hate to have the patient think whatever. Anyway, i say maggots and the nurse doing the validation with me goes "let me see.
" Seriously?! if i was doing a skin validation with someone and they said maggots, i don't think i'd be so quick to see although on second thought, i'm soo nozy when it comes to medical stuff. Tell me a patient in room so and so has this and i'll make sure that even though i've no business in that room, i'll see it. So in hindsight, that would have been my reaction as well. Anyhoo, i call the resident asking if she'll like to order something for me to use to get rid of the maggots because i was told the ER had the guy soak his foot in something. The nurse wasn't sure what.
She turns around and asks me what would you like for me to order? I find it wierd that after 4 years of medical school, you expect a nurse to make a medical judgement for you. So i tell her i think the ED used betadine and she says i'll order it and she never does.
Anyway, the thing here is that there are tons of homeless people here who live in terrible conditions and go through awful things that Christe Eleison! makes my heart ache at times when i see them. To come to the point where maggots feed on you feet? boy, i thought the dead were the ones who had those little creatures feed on them. Are you better off than the dead or not? i mean the only difference is that you breathe but like the corpse underground, you're organic matter.
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