Others have linked to this article, whose title is a bit misleading, since they point out that multiple nurses and...
Others have linked to this article, whose title is a bit misleading, since they point out that multiple nurses and triage staff didn't insist that this person's pain level required more attention and the system really does depend on multiple people and multiple contacts with the patient. If you waited for just the doctor (or PA or NP or medical student or resident, etc.) to come see you, it would often be a long wait. That aside, the personal stories of some others prompt me to mention something that is not about pain, but it is about dismissing females.
I have an allergy. It can be very bad. I have had to be given epinephrine. Having had the first anaphylactic reaction at the age of 3, I am familiar with the whole thing. So I am somewhat able to remain outwardly coherent while my body is trying to permanently shut down. Nevertheless, if I walk in and tell you I am having a severe allergic reaction that is heading toward epinephrine time, I may need to be taken seriously.
Fortunately, this is not like someone with sickle cell, who might have a crisis that is managed with opiates and need immediate care and treatment, because they are frequently treated as drug addicts/seekers first, medically ill patients second. I can't even imagine that. It's horrible. It probably doesn't help that they are people of color, who are likely presumed to be drug addicts/seekers for socially messed up reasons anyway.
So about me. Had horrible reaction, went to urgent care. Nurses jumped all over me, because triage the potentially dying, yo. Doctor was like, well, you aren't in anaphylactic shock yet. Gee thanks, let's wait until you have to hook me up to machines. Eventually get treated and reaction resolves, yay. Doctor talking to me includes following statement: well, sometimes people just have reactions because of anxiety. Excuse me? I caused my immune system to freak out because of anxiety? Apparently, one can cause their immune system to do funky things just by being an hysterical female. Who knew.
So, yes. Stupid things are thought and said and while it is much harder "in the trenches", it is nevertheless critical for the whole system to think first, and judge later, if at all.
And I'm particularly offended in the article by all the women who had to have walked by this woman and patted her on the head and dismissed her. I would not judge all emergency care by this article, I've had very good care in ERs, but what happened in this article should not have happened at all. If they are this overwhelmed, this ER needs some systemic changes, like diverting patients to elsewhere with capacity if they are stable, and better triage staffing and procedures.
http://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/
http://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515
I have an allergy. It can be very bad. I have had to be given epinephrine. Having had the first anaphylactic reaction at the age of 3, I am familiar with the whole thing. So I am somewhat able to remain outwardly coherent while my body is trying to permanently shut down. Nevertheless, if I walk in and tell you I am having a severe allergic reaction that is heading toward epinephrine time, I may need to be taken seriously.
Fortunately, this is not like someone with sickle cell, who might have a crisis that is managed with opiates and need immediate care and treatment, because they are frequently treated as drug addicts/seekers first, medically ill patients second. I can't even imagine that. It's horrible. It probably doesn't help that they are people of color, who are likely presumed to be drug addicts/seekers for socially messed up reasons anyway.
So about me. Had horrible reaction, went to urgent care. Nurses jumped all over me, because triage the potentially dying, yo. Doctor was like, well, you aren't in anaphylactic shock yet. Gee thanks, let's wait until you have to hook me up to machines. Eventually get treated and reaction resolves, yay. Doctor talking to me includes following statement: well, sometimes people just have reactions because of anxiety. Excuse me? I caused my immune system to freak out because of anxiety? Apparently, one can cause their immune system to do funky things just by being an hysterical female. Who knew.
So, yes. Stupid things are thought and said and while it is much harder "in the trenches", it is nevertheless critical for the whole system to think first, and judge later, if at all.
And I'm particularly offended in the article by all the women who had to have walked by this woman and patted her on the head and dismissed her. I would not judge all emergency care by this article, I've had very good care in ERs, but what happened in this article should not have happened at all. If they are this overwhelmed, this ER needs some systemic changes, like diverting patients to elsewhere with capacity if they are stable, and better triage staffing and procedures.
http://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/
http://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515
Last night, I had a gall bladder attack for the first time in a couple months. I knew what was wrong and I did what I could to manage the symptoms, so all I really lost was sleep. But it was bad enough for me to imagine how much worse it could be - and what it would be like to pull 2 kids out of bed so Drew could take me to the emergency room at 4 o'clock in the morning. It probably took longer to come down from that stress than it did for the medicine to work enough to get me to sleep.
ReplyDeleteLast time I checked, you're an MD. Since when does an MD with a known medical condition get second guessed? If nothing else, professional courtesy assumes that as a licensed MD you are competent to diagnose your own symptom when exposed to a known allergen.
ReplyDeleteThat does add to the lols, but you don't want to hear about my dealings with the allergy specialists at a fancy schmancy place when trying to determine if there was a way to tamp that allergy back down a bit. Oh, ok, just a bit.
ReplyDeleteThey insisted on repeating scratch testing. Which I told them would probably cause nothing (per the testing that was done as a child). Then they finally agreed to do sub-cutaneous testing (very, very diluted), which is supposedly completely discredited, blah blah, except it is very specifically applicable to my allergy. Ok, fine. 30 seconds later the nurse is OMG and I'm all, so could I take a benadryl **, if that's not going to mess up your data collection? And the head doctor is like, well, ok, but you still don't technically have an allergy. Know what? I don't care what you call it, or which textbook rules it violates, kindly do something that involves my not dying. K thx bye.
** It took two to get the pseudopods and swelling that were going up and down my arm to stop. But it's not a valid test and I don't have an allergy. Imagine my face.