Nurses as Patients
They say doctors are difficult patients but I think nurses can also be. Not that they want to be any more than doctors set out to be. I believe the challenge comes from laying in a bed knowing so much about what goes on - on the other side of it. Knowing that decisions about our care are being made for us, knowing there is an element of control that is lacking can be frightening to us.
We want to know everything that is going on. We want to know what the practitioners are thinking and planning and we want to call all of the shots. But there is a reason why we are in that hospital bed to begin with and that often carries a barrier with it. Perhaps there is an emergent situation attached to it and the doctor or nurse is not in a condition to be involved with the decisions and the plans to the extent he/she would really like to be. Perhaps side effects of medications leave the patient too sedated to interact with the staff during certain rounds causing him/her to miss out on some of the decisions and planning.
In recent years, consumers have become more educated and involved in their care. This has made some practitioners uncomfortable as they have been held more accountable by patients to discuss their plans and answer questions posed by them.
I was talking to a friend of mine who suffers clusters and migraines like I do. We talked about the challenges we have faced as professionals who at times have found ourselves as patients. We talked about what it was like when we have been more knowledgeable than our colleagues about our condition and how it made us feel. It is hard because we do not want to come across as "all-knowing" and yet we want to be sure we are getting the best care possible.
It can be very frustrating when a professional who is qualified and credentialed tries to help a colleague but is shut out by a health care professional who doesn't care or doesn't want to learn. It becomes a concern if that professional is taking care of you. It can become a sticky situation if it isn't diffused quickly. Perhaps the issue can be tactfully addressed by asking to review the plan of care at which time you can have the practitioner clarify the reasoning behind any choices. If there is any concerns they should be voiced immediately and dialog opened at that time. If there is resistance, then perhaps a second opinion is in order.
Another issue my friend mentioned was the fear of asking for pain medication. She said she was afraid of being labeled as a drug-seeker so she suffered in silence. She waited for the nurses to ask her if she needed the meds then she agreed to take them. Or she would ask them to bring them on their next trip down to her room.
It was obvious that she allowed herself to suffer needlessly but the fear of being labeled was significant. She worked at the hospital where she was hospitalized so these were her co-workers she was being cared for by; she didn't want to develop a bad reputation. How difficult a situation that must have been.
When I was hospitalized, I laid it out on the table with each employee. I told them I was concerned about that issue but if I was in pain I was going to ask for my pain meds. As a pain specialist I knew and understood about the issues of addiction, tolerance and dependence and knew I didn't have a problem with any of them. Pain medication is most effective if it is taken when the pain is in its early stages and not when it is out of control. So I would ask for it early on and hope it took care of the situation. If not I would let them know. And I kept track of the characteristics for them so it would help them with their documentation. I figured it was the least I could do for them.
I happened to work at the hospital where I was recently hospitalized as well. And I am thinking about putting together a little in-service presentation in the coming weeks using my admission as a case study on the care of a patient admitted with a pain syndrome. This way I can help educate the staff. They are a wonderful bunch of folks to work with and they did a lot to make me feel better. I look forward to assisting them in their professional growth and development.
Related Topics: Technorati Tags: migraine, cluster headache, medicine, chronic pain, nurses, patients, health and wellness
We want to know everything that is going on. We want to know what the practitioners are thinking and planning and we want to call all of the shots. But there is a reason why we are in that hospital bed to begin with and that often carries a barrier with it. Perhaps there is an emergent situation attached to it and the doctor or nurse is not in a condition to be involved with the decisions and the plans to the extent he/she would really like to be. Perhaps side effects of medications leave the patient too sedated to interact with the staff during certain rounds causing him/her to miss out on some of the decisions and planning.
In recent years, consumers have become more educated and involved in their care. This has made some practitioners uncomfortable as they have been held more accountable by patients to discuss their plans and answer questions posed by them.
I was talking to a friend of mine who suffers clusters and migraines like I do. We talked about the challenges we have faced as professionals who at times have found ourselves as patients. We talked about what it was like when we have been more knowledgeable than our colleagues about our condition and how it made us feel. It is hard because we do not want to come across as "all-knowing" and yet we want to be sure we are getting the best care possible.
It can be very frustrating when a professional who is qualified and credentialed tries to help a colleague but is shut out by a health care professional who doesn't care or doesn't want to learn. It becomes a concern if that professional is taking care of you. It can become a sticky situation if it isn't diffused quickly. Perhaps the issue can be tactfully addressed by asking to review the plan of care at which time you can have the practitioner clarify the reasoning behind any choices. If there is any concerns they should be voiced immediately and dialog opened at that time. If there is resistance, then perhaps a second opinion is in order.
Another issue my friend mentioned was the fear of asking for pain medication. She said she was afraid of being labeled as a drug-seeker so she suffered in silence. She waited for the nurses to ask her if she needed the meds then she agreed to take them. Or she would ask them to bring them on their next trip down to her room.
It was obvious that she allowed herself to suffer needlessly but the fear of being labeled was significant. She worked at the hospital where she was hospitalized so these were her co-workers she was being cared for by; she didn't want to develop a bad reputation. How difficult a situation that must have been.
When I was hospitalized, I laid it out on the table with each employee. I told them I was concerned about that issue but if I was in pain I was going to ask for my pain meds. As a pain specialist I knew and understood about the issues of addiction, tolerance and dependence and knew I didn't have a problem with any of them. Pain medication is most effective if it is taken when the pain is in its early stages and not when it is out of control. So I would ask for it early on and hope it took care of the situation. If not I would let them know. And I kept track of the characteristics for them so it would help them with their documentation. I figured it was the least I could do for them.
I happened to work at the hospital where I was recently hospitalized as well. And I am thinking about putting together a little in-service presentation in the coming weeks using my admission as a case study on the care of a patient admitted with a pain syndrome. This way I can help educate the staff. They are a wonderful bunch of folks to work with and they did a lot to make me feel better. I look forward to assisting them in their professional growth and development.
Related Topics: Technorati Tags: migraine, cluster headache, medicine, chronic pain, nurses, patients, health and wellness
4 Comments:
Hi Indie, Thank you so much for sharing. My biggest fear in all of my fm illness is facing the doctors that treat you like a 1st grader. I have lived in my body 51 years now & know it very well. I have also studied everything I can about fm & many other diseases. I try to be very careful when I go to a doctor because most of them are very touchy if you act like you know anything & very self-righteous if you don't. Preventative medicine is so encouraged now days, why are doctors so touchy...Aren't we suppose to be involved in our health care??? Anyway Thank You so much for anything you can do to help our care become less "scarey" feeling!!!
I have been experiencing tremendous pain over the last 5-6 months. I ache all over with no apparent explanation. But, today I was watching a commercial about fibromyalagia. It concerns me because this could be the explanation that I am looking for. I have the majority of the symptoms that were listed. I am afraid and really don't want a doctor to look at me and think it's all in my head. What should I do? Catrina
Dear Indie,
I enjoyed reading your blog about the issues with pain and pain medication. My issue is the 'experts' on fibromyalgia publishing articles that say narcotic analgesics don't work for fibromyalgia pain. I agree that nothing totally takes away fibromyalgia pain BUT, narcotic analgesics help to lessen the pain. It's frustrating and inhumane to be left to suffer because doctors are afraid that someone might become dependent on pain meds. What's the lesser of two evils, suffering unnecessarily in pain or depending on pain meds to help you maintain your job and make it through the day? I'd go for the latter. What say you?
MSL
Hello Anonymous. I can appreciate your comments. There are a significant of doctors out there practicing with misconceptions regarding issues surrounding substance abuse. Until they become educated and practice appropriate pain management people will continue to suffer needlessly. They need to understand that the use of narcotics in a responsible way is valuable and appropriate for pain management. Formal pain management training in Medical education curriculum is way past due. They need to get past the notion that peopel who seek pain relief in order to function and run reasonable life is not a sign of addiction and drug seeking. Until a paradym shift occurs, we can not make headway in overcoming this crisis in the US. Thank you for your comments. I look forward to talking with you again soon. Indie
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