Friday, April 15, 2016

Which is better?

I recently had a patient complain to my boss about something out of my control.

Long story very condensed:

The last four hours of my shift I got four new patients.  Two of these people were septic (systemic infection, potentially fatal, both requiring a lot of attention), one had a small bowel obstruction (extremely painful, requires a tube that goes up the nose into the stomach), and the last patient (the one who complained) had chest pain with no other clinical signs or symptoms (usually send home with recommendations to follow up with cardiologist).

Each time I entered the room of the fourth patient I would begin by apologizing for the delay and the doctor was working as fast as he could.  I would continue by updating him with everything I could. He was always pleasant with me when I spoke with him.

At the end of my shift I reported to the nurse so I could go home.  Sometime after I left the fourth patient became irritated, stood at the nurses station and exclaimed we should not be working short staffed (by this point he had been in the ER for over six hours, one hour in the lobby, the rest waiting for the doctor). Referring back to the other patients I was working with, the doctor was also helping multiple other people.  We were a little busy.

After my coworker threw me under the bus (she claimed she would not use my name when replying to boss man), I clarified the situation to my boss.

His response confuses me.

  1. NEVER apologize to a patient. They come to the ER, they should expect to wait
  2. NEVER tell the patient we are busy
  3. Instead tell them "the doctor is spending quality time with each and every patient and he will spend quality time with you as soon as he is available".
How is this better than saying "we've been busy, the doctor will get to you as soon as possible"?  In my mind I hear the exact same thing.  My wife agrees with how my boss told me to handle future situations.  She described him as a "Spin Doctor" (all I heard was Little Miss Can't Be Wrong).  

I make it a point to be upfront with all my patients.  I understand both statements are the same.  I also understand one is more politically correct.  

If I were your nurse which would you prefer me tell you?  If anybody reads this, please let me know in the response section.

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