25 October 2008

Patience with patients

My last shift tested my patience. I'm still struggling a bit with how I feel when I walk into a station that used to feel like a haven from the difficult situations I encounter on the truck. So I'm not always feeling my best when I leave for calls and I recognize that and try to keep it from interfering. I worry because I'm one of those people who wears their emotions in a clearly visible way and I really don't want my baggage affecting my patients.

Dispatched for a psychiatric problem, arrived to find a middle aged gent sitting on the outside steps of an apartment building. He really wanted to talk and not about his psychiatric issue beyond "I'm a professional drunk. Not an alcoholic, I don't go to meetings." (To which The Asian replied, "AA is for quitters.") Around the time I thought we were finally making progress toward getting him in the ambulance, he lights up a cigarette. We let him finish. Finally arrive at the hospital and I find out The Asian has made a deal with him that we will wait, AGAIN, while he smokes a cigarette before we go in. I'm not nicotine addicted, I don't know how you feel, but I do know that I'm standing around in the cold while you are trying to give yourself cancer. Apparently, I managed okay because the patient only commented on how great we were and how he appreciated everything we did and when he froze up a bit on actually getting into the ED room, we were able to talk him through it.

Dispatched for difficulty breathing, arrive to find FD applying an oxygen mask to 70-ish gentleman with history of recently (3-4 days) diagnosed lung cancer. On talking to the patient, he says he is not having any problem breathing and confusion reigns until we finally figure out the problem is with his portable oxygen tank and it's "broken hose." I find the slice in the nasal cannula, pull a new one out of our bag and I'm ready to make a break for the door. Then I hear The Asian sit down. WTF? He proceeds to spend another 15 minutes with this guy trying to make sure he knows how to use the tank, the concentrator and all the assorted pieces because guy seems a bit confused. I'm trying not to thump my head against the wall as the guy continues to insist that the tank isn't ready, or he's going to wear it now, or whatever all he's trying to convey with great difficulty. I'm convinced he's never going to get it. Finally a breakthrough comes when we understand that he wants to wear it now because he wants to go down and see his friends. I make sure he knows that he can call us or the FD if there is a problem with his oxygen and he's just happy to know we can fix it because he wasn't getting much help from the supply company.

In the end, happy patients. But I know that it wasn't because of my ability to stop and care about things beyond the medical-transport stuff and reminds me to make sure I'm looking for the cues that the patient needs more. It is an on-going challenge because I get stuck in the cycle of asking what they need and having them list things I can't affect and then not asking any more, even when it is a whole new patient with a different set of circumstances.

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