Sunday, August 06, 2006

• Back before I worked in healthcare, Jon would sometimes come home from work, annoyed at the rude treatment he received at the hands of his patients—usually uneducated people at the lower end of the socioeconomic ladder-- and I would always say something along the lines of, “Consider the source. Why let it bother you when people who are that ignorant are rude to you?” Now I understand what he's been talking about all these years. When someone stands over you and says, “I come up here three times and YOU ain't done nothin',” (even though you have done all that is in your power to help her) it is no balm to your feelings to consider the fact that she is a fifty year old woman with an eighth grade education. In a way, the lack of education on one side makes the confrontation worse. I've been in tightly controlled confrontations with people who are my social equals and they are different because in those cases, the people do have an understanding that their behavior is inappropriate, and it's almost funny to see their upbringing fighting to suppress their righteous indignation.

  Here's the thing about Emergency Departments: they are supposed to be about stabilization. People come in and think, “I'm sick! I feel horrible! This is an emergency!” They get angry when run up against a system that prioritizes patients rather than one that is first come, first served. You could feel like death warmed over, but be perfectly stable, and thus a good candidate to cook in the waiting room for a while. The people who are having heart attacks, anaphylaxis, are on the verge of suicide, or face loss of life or limb if not given immediate attention will always get taken ahead of everyone else.  I've seen an adult woman throw a tantrum because someone who collapsed on the waiting room floor was taken ahead of her toothache.

  And lest you think we are totally heartless in the ED, I'll tell you that we have an Express Care Clinic, because it's understood that someone who just needs a few stitches or who thinks he broke his wrist, is coming to the ER for a legitimate reason, and would be best served if treated quickly. But Express Care is specifically for lacerations and minor injuries or illnesses that will not require any type of diagnostic testing, and so the tummy aches, the nausea/vomitings, the dizzies, the headaches, are not candidates for Express Care.

  I worked with the new person today. Her xanga nickname will be Disaster Lady. Today's dramatic pronouncement: as she was pouring hydrogen peroxide into her hear (at work!)--”It's all plastic in there because of the tumors.”
  

  Okay.

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