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Triage Rage - De File
Does Collecting Make You Feel Dirty?
cbertsch
cbertsch
Triage Rage
Well, I recently returned from a second visit to Urgent Care, where I was infused with steroids and diagnosed with strep throat and an infection of the uvula, which may or may not be related to the former. The highlight, though, was my initial triage session.

I had the same person both days. Yesterday she asked me to rate my pain on a 1-10 scale. "Do you mean overall or just the throat?, " I asked. "Just rate your pain," she replied. Guessing that meant that I should focus on my throat, I said, "Between 6 and 7." She glowered at me. "That's a little high, isn't it?" Flustered, I tried to collect myself. "It's an arbitrary scale anyway," I said.

Today she recognized me and said, "Why are you here?" I replied that my throat had worsened and that I wanted to be seen before my regular doctor would be able to do so. She then asked me if I take any medication regularly, even though my answer from the day before was sitting right there on the chart. "No, I replied. I use an albuterol inhaler as needed, but not that often of late."

She pursed her lips. "When did you take your first does of antibiotics yesterday?" I told her it was around noon. "I thought you told me you weren't taking medication." I made the Bertsch sound, a violent exhalation scraped off the roof of the mouth. "Regular medication, you said." She looked down at the chart. "Wait a minute. You're still contagious then! You could be infecting everyone out in the lobby! Why didn't you just go to your PCP?"

This time I became unflustered more quickly. "Do you want me to leave? Because I don't need any more of this." She turned her head towards me. "I just want you to know that strep throat stays contagious after you start taking the medicine." I sighed. "I know a lot about strep throat, ok? I wasn't sitting near anyone."

"So why are you here again?" I glowered back at her. "Look, last time I saw a PA. This time I'm hoping to get a doctor." She smirked. "Well, a PA is what you're going to get!" Then she got up and walked out of the room.

As it turned out, the rest of the visit was uneventful. The rest of the staff was courteous. And I did get to see a "real" doctor, a nice lady who has treated Bean on several occasions who reassured me, "You know your own body better than anyone," before having the triage nurse send in my steroid dosage. It's a wonder I wasn't poisoned. . .

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Current Location: 85704

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Comments
From: maruta_us Date: June 29th, 2006 08:05 pm (UTC) (LINK TO SPECIFIC ENTRY)

re: traige rage

Geez, man, sounds like prison (well, except the kindly "real" doctor part).

Speaking of steroids and prison, here's a feel good (or at least feel better) story about the roid rage of Florida guards and the prison softball circuit...
http://www.theledger.com/apps/pbcs.dll/article?AID=/20060406/NEWS/604060417

Feel better soon!
cbertsch From: cbertsch Date: June 29th, 2006 08:07 pm (UTC) (LINK TO SPECIFIC ENTRY)

Re: traige rage

Wow. I'm in awe that you survived your time inside without losing your soul.

In other news, Joe left Bad Subjects in the fall. We're trying to make do in his absence.
lunarcamel From: lunarcamel Date: June 29th, 2006 08:07 pm (UTC) (LINK TO SPECIFIC ENTRY)
Wow, you and K are attracting some pretty amazing idiot-employee interaction karma. Did the triage worker have an idiotically spelled name as well?
cbertsch From: cbertsch Date: June 30th, 2006 03:19 am (UTC) (LINK TO SPECIFIC ENTRY)
Alas, no. It was very generic. But she was still evil!

(And Mercury is going into retrograde, if it hasn't already arrived there, which explains everything.)
derdriu From: derdriu Date: June 29th, 2006 08:10 pm (UTC) (LINK TO SPECIFIC ENTRY)
You know, I have a tendency to cut people (particularly nurses/police/etc) a lot of slack due to the fact that it is wholly possible to just be having a bad day and handling it poorly, but that whole scenario with her just begs to be made into a formal complaint. I would call in on her or something, because her attitude is entirely out of line and unprofessional in the extreme (not to mention antagonistic).
cbertsch From: cbertsch Date: June 30th, 2006 03:20 am (UTC) (LINK TO SPECIFIC ENTRY)
I thought about it, but felt too under the weather to complain. Maybe I should go back a third time just so I have the energy to report her rudeness!
commonalgebra From: commonalgebra Date: June 29th, 2006 08:11 pm (UTC) (LINK TO SPECIFIC ENTRY)

hmmm mmm.

I KNEW it. They do secretly judge you when you rate your pain on that stupid numbered pain scale. When I had a horrible bout with my back (hey, you were there...it was while I was in one of your classes--no causal relationship, I'm sure), I had to answer that dumb question...and I was asking for clarity--is it a scale of MY pain: 10 being the worst pain I've ever experienced?...or is it the worst pain I can imagine? I know it sounds absurd...but I thought, childbirth must be worse than this. The nurse was NOT helpful. Finally, I woefully underrated my pain. Kiyomi and my mother (she worked at that hospital and had come down from her unit to be with me) teased me endlessly for my questions and low rating of pain...I couldn't even stand up straight, but I think I rated my pain as a 4.

This summer, before my surgery, one of the nurses was talking to me about pain management. She used this scale and said I would have some pain afterwords--and what number on the scale should we work toward? what was I comfortable with? Jesus god. How is my saying a "3" more precise and descriptive than "I can tolerate a little pain--maybe moderate to intense aches and muscle soreness, but very little searing, burning pain. And, I have a low threshold for queasiness." I asked her this question--why my way wasn't better--and she laughed--"well, it's just the way we do it." Oh. Good reason. I thought there for a while there wasn't a good reason for this wonderful "tool" for understanding pain.

Basically, I've decided I'm going to always just say my pain is a 9--I mean, not only am I sick enough to wait in this goddamn waiting room for an hour, but I will also brave the outrageous co-pay and usually unhelpful results of the visit.
cbertsch From: cbertsch Date: June 30th, 2006 03:22 am (UTC) (LINK TO SPECIFIC ENTRY)

Re: hmmm mmm.

It's our cultural -- and political -- preference for the quantitative, one that precedes the nation's founding -- see Ben Franklin -- and was well-established by the time De Toqueville came here in the 1830s. We trust numbers. We are suspicious of eloquence. We are Americans. And we are a plague.
_luaineach From: _luaineach Date: June 29th, 2006 08:19 pm (UTC) (LINK TO SPECIFIC ENTRY)
St. Joe's (which is the only hospital I'll go to in the city after UMC almost killed both me and harry) pain chart has little smiley faces of various degrees of smiley/frowny next to each number, so that you can choose between the visual facial clue or the number.
commonalgebra From: commonalgebra Date: June 29th, 2006 08:33 pm (UTC) (LINK TO SPECIFIC ENTRY)
faces are better.
jakemacalister From: jakemacalister Date: June 29th, 2006 08:27 pm (UTC) (LINK TO SPECIFIC ENTRY)
I love the nurse pract at the Med Center here. She is knowledgeable. I just sent her a big thank you email for not being that. I am so sorry. It's one thing to feel like shit, it a very different thing to be treated that way. And you can quote me.

Jake
cbertsch From: cbertsch Date: June 30th, 2006 03:25 am (UTC) (LINK TO SPECIFIC ENTRY)
I had one great nurse practitioner in California and an ok one here. But the rest have been frustrating. They seem baffled by patients who can discuss their problems with some degree of insight.
kumaraka From: kumaraka Date: June 30th, 2006 12:09 am (UTC) (LINK TO SPECIFIC ENTRY)
I'm not sure if my chiming in constantly is annoying, but..

The scale is supposed to be administered "On a scale of 1 to 10, 10 being the worst pain you have every experienced and 1 being almost no pain, where would you rate your pain?" That's a little less arbitrary for the patient, all though it still doesn't help the doc.

Steroids for strep? Did I miss something? Were they worried about an Asthma exacerbation?
cbertsch From: cbertsch Date: June 30th, 2006 02:17 am (UTC) (LINK TO SPECIFIC ENTRY)
My tonsils were swollen and my uvula was very swollen, to the point where it was difficult to feel like I was getting sufficient air when I breathed through my mouth. I don't know whether the uvulitis infection diagnosed by today's doctor could have been caused by the same strep bacteria or not, but the steroids were for the swelling of the uvula primarily.
frostedfuckhead From: frostedfuckhead Date: June 30th, 2006 01:10 am (UTC) (LINK TO SPECIFIC ENTRY)
don't know if you caught my latest entry, but it stands as fair proof of the ineptness of urgent care.

they sent a burst appendix home with an anti-anxiety med.
cbertsch From: cbertsch Date: June 30th, 2006 03:28 am (UTC) (LINK TO SPECIFIC ENTRY)
I did see that. This guy who works at our Trader Joe's -- he has been there for years -- told me tonight that he was having acute pain in the area of his appendix and was sure it was going to rupture. He went to the E.R. and the triage person wouldn't let him jump ahead in line. Fearing that he might die, he went to his truck, fetched his pistol, and walked back inside threatening to shoot his foot so he could get treatment. The cops came right away and he was being operated on within ten minutes. The doctors later said that another ten minutes might have meant the end for him.
flw From: flw Date: June 30th, 2006 02:17 am (UTC) (LINK TO SPECIFIC ENTRY)

Know your own body

If you know your own body so well... why are you sick? You don't know your own body, that's why you go to the Doctor! You know what that stupid Nurse is doing wrong? She is involving you too much. Here's what Nurses should do, say, "The doctor will be with you in a bit. Please have a seat." Smile.

They must've put a "pain in the ass" note on your file. I'd be careful going there. Plus, when you're in pain, you don't see the world the same way. And when you're anxious the world looks different. Here, you are in pain and anxious. Some people get passive in that situation, some people get defensive. They like the passive ones. Their sustems are built for passivity. And they work (by and large) for passivity. You get defensive. Try being actively passive and trusting with these people. They deal with this shit all the time.

What the Hell did your Daddy do to you! I am going to go beat that somnabitch up. Where is he! I'm'a gonna kick his ass!
cbertsch From: cbertsch Date: June 30th, 2006 03:30 am (UTC) (LINK TO SPECIFIC ENTRY)

Re: Know your own body

Hey, I wasn't that defensive. I just want to be treated with the respect I deserve as someone who tries to stay informed about the everyday ills that befall me. Oh, and my daddy wouldn't let me mow the lawn -- or do any other outside chores, really -- because he was afraid I'd break the lawnmower and/or other tools.
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