I have been working in the Rheumaholiday ward for the past 2 weeks. (note it is rheuma-holiday not rheumatology...=P)
As this ward is a Day Ward, patients normally come in as a gang on a Monday and by Thursday, most of them would have been discharged. The majority of them are admitted for intravenous infusions of various drugs (eg. iloprost and immunoglobulins).
Basically, I function as a clerk-o-meter and a vampire (i suck blood from everyone) in the ward. Sounds pretty simple eh? Yes it is....but the only thing that I really hate about is certain patient's attitude. I don't mean to say that they are rude or nasty, it's just the way they act at times. Many of them are season ticket holders to the ward. Hence, they become VERY demanding.
Two examples:
"Hey, doc, I want you to put the venflon into the vein at the back of my left hand."
OR
"Hi doctor, no venflons at my hands, please put them around here. (whilst pointing at her antecubital fossa)."
Who are they to decide where I want to put the bloody venflon??! I really get annoyed when patients say all these things. Sheesshh!!!
To make matters worse, they do not have the greatest vein in the world! They have connective tissue diseases....hence, they have thick skin or tiny fragile veins. So, it is certainly not up to them to choose where they want the venflon inserted.
However, I just told them that I'll try my best to find a vein there, but if I can't, I'll have to try somewhere else (in a very polite manner, of course). Sigh.
oh, btw, here is another example:
"Oh, why are you putting in the green venflon? I have always had the pink one."
(the patient was referring to the size of the venflon)
Now, what was that all about?!
It's not yours to decide, dude!
4 comments:
Hahahaha.. such cute patients..
So funny.... patient's "autonomy" mah.. let them choose the colours la.... maybe they'll see cuckoo birds flying in circles around their head as well.. if they picked the wrong "colour"!
hehehe.. adds some drama, action and comedy to the ward.. :P
Sometimes, as a junior doctor, we do need to respect patients' request, after all, it is their anatomy and they know BEST which site is easy to needle (after numerous attempts by different doctors).
I usually ask the patient first which site is easy to needle.
Another tip regarding branula insertion, try use the smallest size possible (e.g. blue) when infusing solution that is "non-irritant", because you can prick back the same vein again. Use larger bore needle e.g. green (size 18) when infusing "irritant" solution.
Larger needle size causes more trauma and hematoma.
Therefore, the color or type of branula counts.
who are they to decide?.. Its their freaking body..
If you dont agree with the patient, you should ask them why and explain to them why you disagree.
Because they are the' season-ticket holder', they probably have a lot of experience dealing with the disease, maybe they have a personal reason not wanting the venlon there.
Patients are generally interested to know about their disease and their management.
yeap...i agree that patient have the right to decide what they want, coz it is their 'freaking' body.
Season ticket holders they are... but they should understand the fact that they do not have the greatest veins in the world. The reason is simple. Its just coz they do not like it there, or they find it difficult to move their fingers or arms.
The problem with them is, although you have explained, clearly yet nicely, to them why I can't put it there, they give me a sour face and start to grumble.
And, refering to the colour of the branula...i think the colour certainly counts. You certainly can't push fast IV with a blue venflon, and moreover, these patients are receiving irritant infusions..and they certainly need a bigger bore one!
Post a Comment