Dr. Nurse

The BBQ Pit
41

I don’t object to Nurse practioners for some matters, if they take me seriously. I had a nasty wart on my index finger that was partially under my fingernail. I saw a nurse practioner and he was able to prescribe medication that was stronger than Compound W and instructed me on how to use it and really get rid of my wart.

However that bitch who told me that I don’t need to see a doctor and I did not need chest x-rays and I did not have a secondary infection after my flu should be slowly drowned in green and red sputum because by the time I did get through her to a doctor, I was nearly ready to be admitted to the hospital. The infection was terrible and I was on antibiotics for weeks and weeks. She advised me to go home, rest, use robitussin and not be such a baby about the flu. BITCH. I have had bronchitis before, I have had pnemonia before. After 14 days of a fever and coughing and it getting substanially worse for the last 3 nights I could tell it was no longer just the flu. oh, she managed to like that to my weight too.

42

I’m scared to leave my town now… I’ve found good Doctors, nice nurses, and generally competncy all around.

It’s generally when you get accounting/upper management into the mix that you have problems. I have one hospital trying to bill US for something they missed the boat on filing for our insurance. If they’d filed in time, they’d have gotten their money. They goofed, so now they want us to do it. BooFuckingHoo. Widdle Hospital goofed and now is whining about their money. I’m not obligated to pay for their fuckup.

43

I once went to a doctor who prescribed me a particular antibiotic. I told him that I had tried it before and it upset my stomach. His reply? I am going to call it in and you don’t have to pick it up if you don’t want to. I haven’t been back.

44

I’m a medical secretary. When I’m scheduling an appointment for a patient, I need to ask what their specific symptoms are, because I usually order the tests (if they’re a patient of one particular physician, anyway. One doc I work for usually orders all of his own tests, with the other, I order the routine ones and then the nurse will specify anything out of the ordinary that needs to be done), and I need to be able to judge whether the patient will definitely need those tests to be prescheduled, and I have to give an specific indication for the tests. It just saves time, if I had to run to the doctor every time a patient needed tests prescheduled, we’d never get anything done.

As for demanding to speak to the doctor, there’s no way in hell that you’re going to call me and ask to speak to the doctor and get through immediately, unless it’s an emergency, and even then, you’ll probably get the nurse. Number one, my docs are busy, chances are, if they’re not in with a patient, they’re in a meeting, or otherwise engaged. More importantly, they need to have advance warning before they can talk with a patient, they need to have their history in front of them so they know who the patient is and the specifics of their disease so they can make recommendations. Unless the doctor specifically requests that a call be put through to them immediately, I always, under all circumstances, take a message. Now, if it’s a case where there is an emergency, or if the patient will only be around to take the call for a certain amount of time, I will tell the doctor to call as soon as he possibly can if it’s not something the nurse can deal with, it’s not like I’m not sympathetic to the patient’s needs, but nothing pisses me off more than a patient who calls DEMANDING to speak to the doctor and gets pissy with ME when I can’t put him/her through immediately.

Well, okay, almost nothing. The people who REALLY piss me off are the ones who call in and ask to be scheduled on a certain day at a certain time, so I pull strings and move things around so I can get them in, and then they call back and say that that day or time won’t work for them after all, either that, or they just don’t show up. Today, I rescheduled a patient appointments (an appointment with their physician, an appointment with a colorectal surgeon, and a Remicade infusion) THREE TIMES! Then you have the people who call you and ask that you schedule them an appointment 2 months in the future. This is not exactly high-priority when I have other appointments waiting to be scheduled for next week. So I say sure, I’ll schedule that and I’ll call you back as soon as I have everything arranged. Then they call back an hour later asking if I have it scheduled yet! When I say no, they insist I schedule everything while they wait on the phone! Like I don’t have other more pressing issues to take care of, like the woman insisting she have an appointment two days in the future, along with bloodwork, colonoscopy, and Remicade infusion, and all on the same day. Not to mention the fact that my job is a lot more than scheduling, I have clinical notes to transcribe, history dismissals, patient and nonpatient correspondence, along with all sorts of miscellanous things to type up. These things take time, and some people just can’t get that through their thick skulls!

All I want to say is, please, understand that the doctors are very, very busy, and no one is trying to inconvenience you, we’re just doing our best to make everything run smoothly. If you can just be polite and reasonable, I will work my ass of to get you what you want, I will do everything within my power to get you an appointment when you need it, I do it on a daily basis. On the other hand, if you’re rude to me, there’s no way I am going to go out of my way to get you what you are demanding.

45

Had to take my 3 yr old son in to the emergency room last night; he was doubling over from a pain in his abdomen. Apparently, their definition of “emergency” and mine are a little different. We were there from 11:30pm till 4:30am. Had to wait several hours to see a doctor, and then for less than 15 minutes.

Reminds me of an old tire commercial. The guy who owns the tire place is in a restaurant and gets terrible service from the waiter. He looks at the camera and says “If that guy were working for me, he wouldn’t be working for me.”

Any other business that ran itself like a hospital would fold. But medical delivers something people crave so much (health) that they can treat their customers like crap and they’ll still keep coming back.

Oh, my son’s doing fine today, thanks. Dad’s a little tired though.

46

Well, yes, it is. Your son was in pain, and you thought it could be something life-threatening, so you considered it an emergency. Nothing wrong with that.

The medical personnel, after triaging your son, realized that it was most likely not an emergent case and therefore saw the more emergent cases and the non-emergent cases that were there before you first. They are trained to know these things–and, you must admit, they were right. (I imagine appendicitis was your biggest worry. Did he have a fever?)

How would you presume to change the way the ER is run? Move the patients through faster? To do that, you’re going to have to hire more doctors, and it isn’t easy or cheap to get doctorate-level professionals to work the graveyard shift, particularly on the shoestring budget most ERs run on. Spend less time with each patient? You were already complaining that you only saw the doc for 15 minutes, and I’m surprised it was that long. See fewer patients? Most ERs are required to see everyone who comes in, regardless of the emergent nature of the case or the patient’s ability to pay.

I am glad your son is OK.

Dr. J

47

Back in my home town there was an ambulatory care clinic. It was not a free clinic, as i recall aout $40 for a normal appointment plus however much it was for any extras like tests, but you could be seen without an appointment and was open in the evenings. We do need more such clinics. They are convenient and can help take ppl with sudden but not life threatening problems out of emergency rooms and let true emergencies be seen quicker.

My husband had pus draining from his ear once. According to the nurse on the phone, he did not need to go to the emergency room to see a doctor that evening but he did need to see one soon. The only appointment that doctor had was in 3 weeks. He called around the next day. He finally convinced a doctor to see him in a week. I was furious with him for accepting this. I called and called until I found someone to see him the next day. The doctor that saw him said he had a 50% chance of losing his eardrum. The doctor had lots of other doctors look because it was rare to see an ear infection so advanced. He was put on a pill antibiotic and antibiotic ear drops. It healed fully thank goodness. I walk in clinic would have been just the thing, but no one new of any in the area.

48

DoctorJ wrote

Correct on all counts. However, my point still stands. There are plenty of businesses in this world that take customers on a random basis, restaurants for example. Sure, there are times when the wait at a restaurant is excessive and you go somewhere else. But in general, the wait is not excessive, and the waiter, cook, dishwasher, cashier, and others are able to work in concert to make sure you get seated, ordered and fed in appropriate times. They do this by making sure they’re appropriately staffed and managing the on-hand resources well. If they don’t, they go out of business.

Sure, it’s possible that yesterday was a really bad night for the hospital. It’s possible that several real emergencies came in at once or a few key doctors quit the week before. Maybe there were valid excuses. But I really doubt it because I’ve had (and seen) this experience too many times. It is my experience and my general belief that this is the norm. And the thing is that it will stay the norm because even if I’d have known I’d have to wait four hours, I’d have put up with it because there was nowhere else to go and my son’s health is important to me.

By the way, I didn’t know it was going to be four hours, because they didn’t know. And again, it’s possible that four very long cases came in before me, or that other emergencies came up in the main hospital, or whatever, but I don’t believe that’s the case. Again back on the restaurant analogy, they are typically able to predict a time when a table is ready because if they don’t they lose business. I have never seen or heard of reasonable time predictions in the medical industry.

Thanks. Me too.

49

But I can never recall being seen by a doctorate level medical professional at the appointed time. I also understand that there are no easy answers to that conundrum.
Sometimes when I am in the waiting room and there are no other patients, I imagine that the doctor is just setting back there reading in order to keep up the tradition of letting me wait… which I further imagine is adding to the doctor to patient mystique. The mystique of “if you have to wait for it, then it must be worth it”. Of course that is not the case, but when you log hours and hours in a medical waiting rooms as most of us have, you begin to get a bit delusional.

Maybe this is apples and oranges but…

My profession is teaching. No less important than any other profession. If you make an appointment to see me about your child at 4:00 P M. You can be guaranteed that within minutes if not seconds of 4:00 PM, you and I will be setting there talking about your child. And on some parent teacher conference days I have as many as 15 to 30 appointments.

I realize that this is completely off my original point and I won’t argue further unless it is moved to great debates.
PS Bill H. Glad your son is ok!

50

Well, it was once…
3 years ago next month, my 2 year old son was badly burned. It was a sunny Saturday in August, the emergency room waiting area was packed. I remember running in with him - too stunned to call an ambulance, we droive few blocks to the hospital - I stammered: "he’s burned!’, and all hell broke lose.
Nurses wer all over us, they took us back into the curtained area, and doctors appeared like magic! I remember a swirl of faces, people, so kind to me in my hysteria, so blessedly competent in their care of my baby.

They left score of tummy-aches and sprained ancles in that waiting room to help us, God bless them. I am sorry for your wait, but I am so gratefuk they were there to help my boy. He could have died, not from the burns, but from the shock and organ failure that can accompany the trauma he suffered.

We spent 11 days in the burn unit, and it became apparent that nurses are angels from heaven. They were so sorry they had to strip away the damaged skin every day, they were so sorry they had to clean the burns, they were so wonderfully kind to both Frankie and myself. They arranged for the mom of another burned child to talk to me - I was hating myself in a big way - they got a social worker to talk to my older son.

The plastic surgeon was a jerk, and we didnt see her very much.
Now my GP OTOH, I love her to bits! She delivered my youngest, and we all think she is a peach. Her desk staff SUCKS! They made my mom cry when she went in to ask for a prescription for a wig so her insurance would cover it. They kept telling her she had to have an appointment - HER HAIR WAS FALLING OUT!!! THEY WANTED HER TO WAIT A WEEK! They suck.

For all but the more basic stuff - paps, vaccinations, birth control etc, I go to the after hours clinic. No hassles there.
I take issue with ONE thing :

This is NOT MY PROBLEM.

If the doc cant grow enough balls to say: excuse me, I have patients waiting, then they need a kick in the head. Keeping people waiting because a Merck rep brought lunch is not acceptable.

51

I LOVE my current internist–very young, up-to-date, thorough, great staff, lovely nurses.
BUT,
I’m with Lee–I hate those damn nurses and doctors who just assume every problem is related to your weight–or, even worse, the fact that you are a middle aged “hysterical” female. I had one asshole of a doctor (female, no less!)tell me my chest pains were all in my head–after the nurse carefully reminded the doctor that I was on antidepressants. After hurting for several months, I went to my allergist and found out I had asthma–enough to make breathing difficult and my chest hurt but not enough to wheeze.
Then there is the GP in town. I wanted to get my daughter the vaccine for meningitis. The stupid nurse I talked to informed me there was no such vaccine! WHAT??? I just looked it up on the internet! I called the other local group here–they claimed they didn’t have the vaccine and wouldn’t be able to get it. So I took her to a pediatrician 120 miles away and paid $150 for the shot (not covered by insurance)and for a physical (also not covered by insurance) which they claimed was necessary if they were going to treat her for ANYTHING including giving her a vaccination. A couple of months later I took her to the second medical group for an unrelated problem–the nurse casually informed me that, “Oh yes, we carry the meningitis vaccine and it costs $75” Turns out the woman I had talked to told me they didn’t give it because they had run out and wouldn’t have any for a few weeks. Geez, thanks.
Then there’s the time I was deathly ill from the flu. The local gp I went to had a total of 3 patients in his office. I waited 3 hours to see this dipstick. Finally when I literally had to lie down because I was passing out, I got back to see this creep. Later I found out he was having an affair with his nurse and would be in the back with her while patients waited in front.
I’m just glad I found my current doctor. I’ll be glad when my daughter is old enough to use him, too. You can even call and talk to the nurse and if it’s reasonable they’ll call in a prescription for you!

52

I never said it was anyone’s problem. I just included it as an example of one of the delays that can occur at any time. As for the doctor “growing balls,” if he throws out any rep, we stop receiving free samples of drugs. The problem there? We give those samples to patients when they can’t affort their prescriptions. Sometimes there just aren’t generic drugs he can prescribe instead. We like being able to provide enough pills to start patients off on their treatments without having to wait months for the insurance to come through.

53

Great point, but if they are 2 hours late getting back from a doctors appt, they might get fired and lose the insurance.

My point?

After an hour, simply tell the rep:* I have patients who need care, excuse me.*

Either that or cut WAY back on the patient load so they dont have any appointments in the afternoon.

54

Tiggeril

I sure hope you haven’t left your patients waiting too long to post these long and informative replies.

::runs from the room quickly::

55

::follows with a Jell-O filled balloon, shrieking obsceneties::

56

aha wrote

Thanks. And today, everything was fine as well; fever seems to have died down. BTW, that’s him in the picture with me on the pix page.

57

Restaurant traffic is predictable. Peak hours are breakfast lunch and dinner times, when the bars close, and when nearby places like movie theaters and amusement parks let out. The staff knows how long it takes to serve drinks, cook food, and so on. Hospital traffic is not predictable. Incidents that have to take priority,like Kelli’s son being burned, can happen any time, and not every medical problem is textbook, so some can’t be dealt with in a set time.

I also have this to say about nurses. When I was six, I fell off the back porch (1 story off the ground. Luckily our patio hadn’t been built yet). I was petrified, because I was old enough to know that people can lose their memories and get paralyzed when they fall off things, but not old enough to realize that if I’d gotten up with my memory and the use of my limbs, then I was certain to stay that way. When I got to the hospital, the nurse said something (I forget exactly what) that convinced me I wasn’t doomed. The doctor finally showed up, and I chirped, “Oh, the nurse says I’m fine!” He gave my mom a look as if to say, “Oh, these kids; she actually thinks the nurse knows something!” But that was part of her job; to keep kids, and patients in general, from tripping out. I’ve always had positive experiences with RNs. A few years ago, Mr. Rilch had a virus, and again, it was the nursing staff who were the caregivers, while he saw the doctor for literally five minutes. Afterwards, I gave the RNs a sack of gourmet coffee.

But that’s my experience. If I’d been tended to by an unpleasant RN, or a group of them, or if I or someone close to me had had lifesaving surgery, I might have a different tune.

58

Rilchiam wrote

To some degree, sure. And so is hospital traffic to some degree for the same reason. It’s the nature of random events that if you have enough of them, they become more predictable. That’s why casinos and insurance companies not only stay in business, but have extremely predictable revenue streams.

As I said in the previous post, it’s possible that there was some serious burn victim or heart attack before me. It’s possible that the hospital had two key doctors break their arms the day before I came in and they were short handed. It’s possible a giant flash flood had wiped out half the hospital and they were out of beds and everybody was busy mopping up. It’s possible, but I doubt it. Because this long delay without any advance warning of a long delay has happened every time I’ve had dealings with a hospital. Batting 1000. And not just me but everyone I know.

Now, there are plenty of good things about modern medicine. My wife and I had quite a bit of trouble and heartache in the baby-making department, but thanks to the expertise of some excellent medical people, we have two wonderful children. It’s safe to say that without medical assistance there would be no kids. And I’ve had several experiences in my life where people I love are alive today because of medical experts.

But that doesn’t change my complaint: the medical industry treats people with far less respect (especially for their time) than they deserve. If the service they delivered wasn’t so highly prized, they would have no customers and would fold.