Wednesday, March 30, 2011

A Little Compassion People

I am an avid reader of medical blogs...I absolutely love them. I especially enjoy ER blogs. Student nurse, nurse, PA, Doc, it doesn't matter, I read away. I find it a bit odd that I enjoy ER blogs considering that I know I will never work in an ER myself. I don't have what it takes. I can handle an emergency, that is true. In fact I become very detached and just "do it". Once the emergency is over I melt down. I can't handle the adrenalin rush that occurs immediately following the end of the "event". Many years ago I was loss prevention in a major department store. I did the job well, catching many people, employees and customers, stealing. I helped secure one of our other stores after a major earthquake (had to travel 45 miles in destruction to do so). Part of my job involved arresting people. There's a specific procedure that has to be followed from suspected theft, through person leaving the store where it becomes actual theft, through the arrest, paperwork, and police involvement. I had no problems with any of this; however, the moment the police (or parent depending on the situation) left with the arrested individual, the rush would hit. Many people thrive on this, I do not. I get hot and begin to sweat, my hands shake, then my whole body begins to shake, I have palpitations followed by a feeling that my heart is going to beat so darn hard it's going to rip right out of my chest. My legs go weak, and I feel nauseous. I know that this will happen to me each and every time I am presented with an emergency and therefore, I plan to get through my ER rotation somehow, and then never set foot in the ER again.

Most of the time I really enjoy these blogs. I am appreciative of the the writers. These people see the worst of everything society has to offer and keep coming back for more...inspiring sometimes, amazing nearly always. One pattern has emerged that alarms and disappoints me though...the treatment of psych patients in the ER...perhaps "attitudes toward psych patients" is a better statement since I am certain that the actual treatment is appropriate...please tell me I am correct here! I understand that psych patients are a very difficult population and that it takes very special people to work with psych patients exclusively. My Aunt has been a psych nurse for several decades and she is truly very a good way!

What I have noticed is a lack of understanding, and along with that, a lack of compassion. Sure, the blogs are often written as a form of venting, I get that, but I don't see a lot of negative attitude directed at people whom have had an accident not due to drinking or drugs, or towards people whom have had an acute exacerbation of a chronic illness, etc. I see comments in particular towards people having panic attacks. Things like "your panic attack is not going to become a heart attack if you don't get your ativan right now". I know this is true, you know this is true, people who have panic attacks know this is true. I have had trouble with panic attacks, now well controlled, so I can speak with some authority about this...people in the middle of a panic attack do NOT know this is true, regardless of what their knowledge is when not having a panic attack. People having a panic attack will not believe you when/if you say this to them. If the heart becomes the focus when the panic attack hits, the person will absolutely believe not that they are going to have a heart attack, but rather that they ARE CURRENTLY HAVING said heart attack, and if they have not learned cognitive skills to cope or the attack has become full-blown, there is absolutely nothing you can say that will change their mind. Once the attack is over, the person will realize that it was a panic attack, they will probably be embarrassed, and they will fear having another attack because it is so frightening and so embarrassing. Is it really so hard to understand they are having irrational fear and physical symptoms that will pass if you just have a little compassion and give them the ativan? Let me repeat that...give them the ativan. If you have another patient that has a life or limb threatening event happening, then by all means, make the panic attack wait, it may even pass on it's own given a little time. However, getting angry with the panicking patient that actually believes they too are dying does not help, them or you.