Bad Romance

The other night, in the middle of a particularly chaotic shift, an attending asked me to pull the IV on a patient awaiting discharge. Grabbing some tape and gauze, I found the patient (not one that I had been taking care of) parked on a stretcher in the hallway.

"Hi Ma'am, my name's Second Shift, I'm one of the techs. The doctor asked me to pull your IV out so we can get you out of here and on your way home." Rather than expressing the look of relief that usually accompanies discharge, the patient instead reacted as if I had told her that I hate both puppies and rainbows.

Now, patients generally don't bring their A-game to the ER*. They're sick, scared, high, or hurt, and often frustrated about being stuck in a place they had not planned on visiting. Working in the ED, all the madness and morbidity is part of our daily routine, and at times it can become easy to forget the patient's perspective.

Nevertheless, while the patient inferred that "get you out of here" meant that I would be rolling her to the ambulance bay and pushing her into oncoming traffic, that's certainly not what I intended to imply. The patient became slightly agitated, demanding to know what doctor had decided to "throw her to the curb" and why "no one had told her anything." Despite multiple attempts at explaining the doctor was printing discharge instructions and on his way to explain her diagnosis, she would not calm down.

In retrospect, was my word choice overly-casual? Perhaps. Could it simply have been the last straw in what apparently had been a long an unsatisfying ER visit? Probably. Do I think the situation was a bit of an over-reaction? Yes. Should I be more on guard when approaching patients that aren't mine? Definitely.

I generally develop good relationships with my patients, so this episode was more surprising than anything else. I suppose I should be more careful in how I phrase things. In the meantime, though, I won't be expecting any gold stars from Press Ganey.

*The notable exception, of course, being the drug seekers, fakeurs, and people who literally have nothing better to do with their time than chill in the waiting room. They always give one hundred and ten percent.