From the Penalty Box

The last three weeks I have been in recovery from my meniscus surgery with orders for limited mobility and movement. Luckily I have been able to work in the front of the ER triaging patients as they walk through the door. I register them and assess their condition and then appropriately place them in a room behind the swinging doors to the ER. 

I love to be constantly on the move at all times, and recovering from knee surgery is anything BUT running around. Confined to my chair in the front of the ER with minimal walking has helped me heal, and is fondly referred to as my "penalty box", as it separates me from full patient care and "playing" with my coworkers.

While not the most exciting part of the ER, I have been able to draw great insight from the last weeks up front and had a little time to take a "time-out" and reflect. I recognize that every day presents an opportunity for growth. Being new to this role in the department it was an opportunity to really learn my strengths and weaknesses, reassess, and try again the next day. There was something to take away each day even if it wasn't taking the most critical patient in the department. 

The second was the value of a first impression. 

When you walk into the doors of the ER you typically don't feel well. You're scared, you're nauseous, your head hurts...etc. You pass through the metal detector and have to be cleared by security to then approach the nurse's desk for assessment and admittance to a room. This can be a scary passage for the patient, and at times an overwhelming position for the nurse when there are no beds available and the waiting room is filling up with multiple patients waiting to be checked in. 

I am the first healthcare provider you meet. You are uneasy and uncomfortable and the least I can do is give you a smile and assurance that I see you, I care, and I am going to help you. It doesn't do you any good if I appear annoyed, angry, or frustrated, or if I don't treat you with respect and kindness. While it can be a high tension position with lots of emotions in the waiting room, it helps you if I remain calm and listen to your concerns. 

Perspective is everything. 

From the eyes of the nurse I want to make sure no one needs immediate life-saving intervention; however, if I had my loved one in the waiting room, I too would be anxious to have them seen first and ensure the nurse didn't forget I was sitting there. Fear not, I see you, but only have so much control over the accessibility of beds and higher acuity patients are seen first. 

You sometimes yell, you sometimes lash out, you can be rude, you may have left the emesis bag behind, you may pace angrily, you may even choose to leave, but I promise I will be kind to you. I promise not to yell at you, I promise to give you a fresh emesis bag, I promise to respect you, and I promise to listen. I will watch you and assess you and intervene when necessary. I will advocate for you and I will get you a room as soon as possible. I will smile and I will remember that no one ever really wants to come to the ER. 

In the front or in the back I promise to remember the last three weeks. I will smile, and make it a point to make sure you are informed, aware, heard, and cared for.

I promise to treat you like I would want to be treated if I walked through those doors. 

In Your Shoes

I am the nurse, you are the patient. That is normal, that is how it is supposed to be every day I walk in to work. This normalcy can sometimes numb me to what it feels like to be on the other side. To feel tied down, needy, a little scared, and out of control. 

This week you were the nurse and I was the patient. First you asked me to exchange my comfortable sweats for a gown, complete with non-skid socks and a fall risk bracelet. I felt vulnerable and uncomfortable. I was a little snippy and recoiled immediately, realizing it was my vulnerability speaking and you were being nothing but nice to me.

Then you had to start an IV and it took three times. This was my fault for being dehydrated and having been NPO since the night before, but I wished you had just poked first at the vein I showed you. I smiled because I've been there and a nurse hates not being able to successfully get that first stick. I felt the vein blow and realized how much it actually hurts. 

You, the doctor, and the anesthesiologist approached me separately and confirmed that I understood the procedure and that all my questions were answered. This was nice. I felt as comfortable as a pre-op patient could and safe knowing my identity and surgery site had been confirmed multiple times. You knew I was cold and automatically draped with with a warm blanket. That also helped me feel better.

We wheeled into the frigid OR and I again felt uncomfortable as the nasal cannula was placed in my nose. The smell and taste of the oxygen made me queasy. I began to talk to the anesthesiologist and begged him not to over-sedate me. How much propofol are you using? I'm really trying not to be an obnoxious patient...they all laughed. All of a sudden the room became blurred and began to spin. 

What did you just give me???!!!

 That was some Fentanyl, he responded. I didn't want that! I hate you I moaned. I had never felt so dizzy. I also was miffed that he had administered the drug without warning me first. At least he had the courtesy to give me Zofran first. Again, feeling vulnerable and completely out of control. Then I was asleep. 

I look back and I think of you, the patient. I forget how scary and vulnerable it can feel to be tin your shoes. I forget to listen when you tell me which vein always works when you come in. I forget to bring you that warm blanket I promised you 20 minutes ago. Do I always explain all medications thoroughly enough before administration? Do I give you the benefit of the doubt when you lash out because you are afraid and don't know how else to respond? 

This week I was put in your shoes and I will take these lessons with me and remember next time what it's like to be you.