Answering the Phone
I originally intended this blog to be sort of a commentary on my job. Not really complaints, just odd occurences that would seem interesting if I were a non-medical person and some occurences that seem odd regardless. Here's one that happened quite a while ago, maybe 3 years ago while I was still getting my feet wet as a House Officer.
As House Officer, or the HO, I am called to see peri-operative patients for numerous things. There is the typical patient in pain, or nausea, or HistoryandPhysicals, but every once in a while there are those calls that one cannot receive enough training for due to their unique nature.
I was called to do an H and P on an old lady. She was around 90 or above and needed an ORIF of the hip. This is surgery for a broken hip, a deadly problem for a woman her age despite just being one broken bone.
As I was looking over her chart prior to going in her room, the nurse nudged me and gave me the "cuckoo" sign. I thanked her for her warning and asked how long she's been disoriented. She apathetically told me she didn't know, and that she had been like that since her shift began.
When I walked in the room, I saw your basic skinny LOL (in the hospital this is little old lady). She instantly locked eyes on me, and before I could introduce myself, she blurted,"THANK GOD YOU'RE HERE, COULD YOU PLEASE GET THE PHONE!" Looking at the quiet phone next to her bed, I asked why. "BECAUSE IT'S RINGING!", she said, as if it were the stupidest question she has heard in the past 90 years.
In this situation, you humor them. I've told this story aloud since it's occurence, and this method has caused sympathy, laughter, even stern questioning from the lay person. But anybody who has worked with the elderly knows it's useful to humor a disoriented patient while you are doing a task, if done respectfully.
As I examined her, I realized she was quite able and willing to obey commands like opening her mouth, breathing deep, etc. Yet as soon as she seemed with it, she worriedly asked me to get the phone. She must have said it 10 times, and each time I told her I would right after the exam. I humored her. Starting to wonder if I would actually go so far as to pick up the phone, I finally asked her who she's expecting a call from.
"My sister's calling me on the phone."
"Why isn't she here with you now?", I asked with feigned interest as I felt her pulse.
"What about my sister?"
"Where is your sister now?"
"My sister died 3 years ago?"
Nothing seemed odd. She was senile. She missed her dead sister in a time of stress. Seen it before. I asked her about her sister since the topic seemed to calm her. Over the short time I examined her, she told me with a smile how she or her sister never married and were best friends all their lives. They even lived togethor over the last decade of her sister's life.
I said good-bye with a big smile and tried to again explain what was wrong with her hip, but she insisted I answer the phone. She heard the phone and there wasn't a damn thing anybody could do about it.
At the end of my shift, I was at the OR desk waiting for my shift to end at 11pm when the charge nurse asked if I heard about the Code Blue in Recovery. It's not strange to hear codes in a hospital, especially ICU, but in Recovery, right after surgery, it's sort of a big deal.
She told me it was that hip patient of doctor so and so, and she died. I said, "wow, that must have been exciting, who was anesthesia?" and asked other typical questions.
Suddenly it dawned on me that it was my patient I had seen earlier that day. I made sure it was her and told the nurse my experience on 4 east, and she wouldn't beleive me. I'm not one to instantly jump onboard a story from the Great Beyond either, but I have to admit I was impressed. Both the nurse and I looked at eachother, wondering who would say how weird it was first. Two healthcare workers, used to dismissing sad stories under their mental carpets, grappling with the possible spiritual aspects of Death in their workplace. After the chills subsided, one of us said something like, "that's some crazy shit" and left it at that.
At the end of my shift, walking through the empty dark parking lot and getting in my car, I couldn't stop thinking about that old lady, and how she kept asking me and probably everybody else who walked in the room to answer the phone. I think I was the only one on the floor who knew she thought it was her sister.
The road to recovery for a 90 year old woman in a nursing home with a surgically reduced hip fracture is tough. Miserable in most cases, especially if they are senile. I mean miserable. A whole lot worse than living in dignity and privacy with your sister and best freind in the last decade of your life. I really don't have any idea of what heaven is, but her calm and happy account of life with her sister made me think that's probably her idea of it.
If you ask me, I would have answered the phone, too.
After a while, I started the car and drove home.
As House Officer, or the HO, I am called to see peri-operative patients for numerous things. There is the typical patient in pain, or nausea, or HistoryandPhysicals, but every once in a while there are those calls that one cannot receive enough training for due to their unique nature.
I was called to do an H and P on an old lady. She was around 90 or above and needed an ORIF of the hip. This is surgery for a broken hip, a deadly problem for a woman her age despite just being one broken bone.
As I was looking over her chart prior to going in her room, the nurse nudged me and gave me the "cuckoo" sign. I thanked her for her warning and asked how long she's been disoriented. She apathetically told me she didn't know, and that she had been like that since her shift began.
When I walked in the room, I saw your basic skinny LOL (in the hospital this is little old lady). She instantly locked eyes on me, and before I could introduce myself, she blurted,"THANK GOD YOU'RE HERE, COULD YOU PLEASE GET THE PHONE!" Looking at the quiet phone next to her bed, I asked why. "BECAUSE IT'S RINGING!", she said, as if it were the stupidest question she has heard in the past 90 years.
In this situation, you humor them. I've told this story aloud since it's occurence, and this method has caused sympathy, laughter, even stern questioning from the lay person. But anybody who has worked with the elderly knows it's useful to humor a disoriented patient while you are doing a task, if done respectfully.
As I examined her, I realized she was quite able and willing to obey commands like opening her mouth, breathing deep, etc. Yet as soon as she seemed with it, she worriedly asked me to get the phone. She must have said it 10 times, and each time I told her I would right after the exam. I humored her. Starting to wonder if I would actually go so far as to pick up the phone, I finally asked her who she's expecting a call from.
"My sister's calling me on the phone."
"Why isn't she here with you now?", I asked with feigned interest as I felt her pulse.
"What about my sister?"
"Where is your sister now?"
"My sister died 3 years ago?"
Nothing seemed odd. She was senile. She missed her dead sister in a time of stress. Seen it before. I asked her about her sister since the topic seemed to calm her. Over the short time I examined her, she told me with a smile how she or her sister never married and were best friends all their lives. They even lived togethor over the last decade of her sister's life.
I said good-bye with a big smile and tried to again explain what was wrong with her hip, but she insisted I answer the phone. She heard the phone and there wasn't a damn thing anybody could do about it.
At the end of my shift, I was at the OR desk waiting for my shift to end at 11pm when the charge nurse asked if I heard about the Code Blue in Recovery. It's not strange to hear codes in a hospital, especially ICU, but in Recovery, right after surgery, it's sort of a big deal.
She told me it was that hip patient of doctor so and so, and she died. I said, "wow, that must have been exciting, who was anesthesia?" and asked other typical questions.
Suddenly it dawned on me that it was my patient I had seen earlier that day. I made sure it was her and told the nurse my experience on 4 east, and she wouldn't beleive me. I'm not one to instantly jump onboard a story from the Great Beyond either, but I have to admit I was impressed. Both the nurse and I looked at eachother, wondering who would say how weird it was first. Two healthcare workers, used to dismissing sad stories under their mental carpets, grappling with the possible spiritual aspects of Death in their workplace. After the chills subsided, one of us said something like, "that's some crazy shit" and left it at that.
At the end of my shift, walking through the empty dark parking lot and getting in my car, I couldn't stop thinking about that old lady, and how she kept asking me and probably everybody else who walked in the room to answer the phone. I think I was the only one on the floor who knew she thought it was her sister.
The road to recovery for a 90 year old woman in a nursing home with a surgically reduced hip fracture is tough. Miserable in most cases, especially if they are senile. I mean miserable. A whole lot worse than living in dignity and privacy with your sister and best freind in the last decade of your life. I really don't have any idea of what heaven is, but her calm and happy account of life with her sister made me think that's probably her idea of it.
If you ask me, I would have answered the phone, too.
After a while, I started the car and drove home.
posted by All Rounder | 5:03 PM
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