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WOW! Almost two years without a complaint.

WOW! Almost two years without a complaint.

However, as I near two years without a patient complaint, or one that administrators have confronted me about, four complaints showed up and all four within a period of two weeks. Actually, two patient complaints, and for the first time ever, at least that I am aware of, complaints filed from staff, not one but two.

Let us begin with one of the patient complaints as somehow it all mushroomed from this one patient.

The patient, a 32-year-old female, who, after introductions, states her reason for coming into the emergency department was, “I cannot walk.” Life, limb or eyesight. Yes, an emergency by any definition.

“How long have you not been able to walk?” I asked.

“Since Saturday,” she replied. Well, it was Monday. Oh and a gentleman in the room laughed at her reply although I am not sure why.

“So you have not been able to walk since Saturday?” Again, it was Monday. “Have you gotten medical attention before today?” I added.

The gentleman laughing again. “No,” the patient replied. The gentleman laughing some more as if something were funny.

Then the gentleman decided to chime in his version of the story. But he is not the patient so I pointed that out and that I was talking with the patient. And he laughs some more.

“What was different today?” I asked the patient. The gentleman laughing.

“What do you mean what was different today?” The patient asked. The gentleman’s laugh coming to a halt.

“What was different today? If you have not been able to walk [which is pretty significant] since Saturday and have not gotten medical attention before today [Monday], what was different today?” I repeated myself.

The gentleman abruptly raising his voice at me from where he sat and saying, “Hey, what do you mean?”

So I repeated myself, again, “What was different today? If you have not been able to walk since Saturday and have not gotten medical attention before today, what was different today?”

The gentleman abruptly getting up from his chair and into my face, yelling, “Who the hell are you?”

The gentleman getting in my face so fast I instinctively took a defensive posture with the intent of going on offense in…3…2…1. However, after seeing I was not moved by his behavior the gentleman suddenly stopped yelling in my face. Not wanting to go to jail I walked out of the room. The gentleman then followed me into the hallway where he thought he would yell at whoever would listen, “Who the hell is this guy?”

Unmoved I simply said, “They can leave.”

Well, it was the change of shift so the night staff and the day staff were gathered at the nurse’s station for change of shift report when unexpectantly this gentleman’s drama took center stage.

No big deal, except someone, because there is always that one person, thought they could calm down the storm. This staff person returning the gentleman back into the room and the staff person shortly reappearing from the room to ask the attending physician to see the mentioned patient and smooth things out. The attending with good intentions but unable at the moment due to managing a number of critical patients offered to see the patient as soon as possible.

The enabling staff, adding insult to injury, states to the gathered crowd of nurses at the nurse’s station, who were giving and taking report for the change of shift, “They [the patient and family] were just fine. They [the patient and family] have been waiting patiently until he [NP J. Torres] went in there.”

Not one to hold back and who is known to go from zero to a thousand in a nanosecond I shot back, “You [enabling staff] were not in there so you have no idea what happened. Because of that you should be quiet and not say anything.”

I grabbed the next chart and went to see the next patient. And the next. And the next. By then the charge nurse and the house supervisor had visited the patient and family and some conversation had taken place with the attending physician who again offered to see the patient as soon as possible.

I saw the next and the next patient skipping over the first patient I tried to see and who was still in the rack as the attending had their hands full. After the dust settled and seeing six patients yet the first one was still in the rack I offered the patient’s nurse that I would see that patient. However, the nurse said the agreement was the attending would see them and the patient was willing to wait knowing it might be some time. Fine, and I saw the seventh patient before the attending could get to that first patient I had seen.
Shortly after the attending saw the patient the patient was discharged with back pain without mention of an inability to walk. Imagine that.

That was how that shift began.

Two days later, an email from the emergency department director that we had to talk about that patient and three other complaints in those two weeks.

I work at night, always have and always will, as I do not function well with the dynamics of the day shift. Nonetheless, I offered the director I would stay after a shift to talk rather talk during working hours or come in early or on an off day to talk about work.

So one morning, after a 12-hour shift, the director and I had the conversation. 

Interestingly, but very much appreciated, the director’s concern was more about what was going on with me versus what happened with any one complaint. The concern being that if I had been working to much, 12-hour shift and 16-18 shift per month, had the schedule caught up with me and why the complaints.

Interestingly, as well, the director mentioned in the 2-years I been working at this emergency department there had been another one or two complaints but the director dismissed them as insignificant. However, was now concerned after getting four complaints in the last two-weeks.

One of those complaints being from the above mentioned patient.

A second complaint was not from a patient but from the father of a patient, an adult patient, I must add. The director asking me if I recalled the patient and I did not, which I usually do not. However, the director mentioned that the father stated in the complaint letter that it was he who called me “An Asshole”. At that moment I thought to myself, “Right there and then I would have discredited that person. Not because the father of an adult patient called me names but because after that inflammatory name calling the content of the complaint no longer is factual but emotional and irrational.” However, without me mentioning it, the director’s take seemed to be the same as no more was mentioned about that complaint.

Those were the two patient complaints.

The other two complaints were from staff and as mentioned a new one as I have NEVER had I had staff complain. Well, not that I had to talk to administrators about.

Nonetheless, the first staff complain was from the enabler above. Interestingly, the director mentioned the same staff person was commonly in other’s peoples business despite not in that staff’s best interest. The complaint’s theme was that I was intimidating, make the staff feel uncomfortable and was a bully. To which I said nothing but got the impression the director agreed that the above patient complaint likely come at the encouragement of the staff who complained as well.

I rarely speak with staff other than for patient care and occasionally when all the work is done we might chat on occasion. I never float around the department like a social butterfly saying hello to anyone or asking about their kids or how their weekend went. Instead, I go to work to work and not to add people to my xmas list and much less to make friends. In the Army I recall telling the Joes, “You will not hear my mouth unless you F78K UP.” And they did not mind. Of course we had private conversation but public conversations were few and far in between as they are in my current role.

Having said that, one of the Army’s values is to “be discreet and tactful when correcting or questioning others.” However, before the Army I learned a different value from my mother and that was not to act a fool in public. My mother’s words, “If you act a fool in public I am going to embarrass you in public.” As we grew in age those words had a greater impact. Not because we feared the physical pain from her spanking us but because we feared the embarrassment that came with being spanked or scolded in front of peers. It was that fear of embarrassment that kept us in line and kept us from being a fool in public. I have found the same from adults that act a fool in public. Granted, they might act the fool once but never twice. And I shared that with the director as well that the staff had commented inappropriately in public thus I returned the favor.

As for the second staff complaint, and the fourth complaint total, the director mentioned to be aware of the complaint but did not have the specifics from who it was or what the complaint was about and our meeting adjourned on that note.

Not to mention, as I always say, when the dust settles following an incident where a patient complained what just happened was behavior you and healthcare administrators would NOT accept at home from our loved ones. Yet, healthcare administrators want us to accept that venomous behavior from those we are helping.
I say dismiss those who annoy us. Dismiss the rude. The entitled. The abusive. The demanding. And outsiders who have lead us down the wrong tracks. If we dismiss all those who annoy us it frees us to focus on those who value, trust and appreciate us for the care we give. But VERY IMPORTANT, in this we must stand in solidarity and not waiver otherwise those who annoy us will not change their behavior as long as they can find tolerance elsewhere.
Having said that, do I have to mention solidarity and siding with loyal employees and coworkers over petulant, unreasonable, angry and demanding patients or outsiders looking out for their own interest? This is not about us versus patients. This is about convincing patients that we are looking out for their best interest and if they desire we help them they must stand with us. If they decline then they must leave because asking to see others until they get what they want is manipulative and not what we are here for as it only divides healthcare workers trying to help others.
With that said, again, and as mentioned so many times, what needs to happen to take healthcare back is to get rid of the IDIOTOLOGY that got us here in the first place. We must NEVER see the ill or injured as clients or customers but as the patients that they are, ill or injured.

I know that I am not alone in these thoughts as I am sure that even the above mentioned enabler has dismissed those annoyed by. However, between the enabler and I it is I who is well aware of the wrath when healthcare workers do not file in rank to drink the Kool-aid. However, in order to take healthcare back and steer it in the right direction we must be bold and dismiss not only those who annoy us but their idiotic scripts and signage, standard uniforms, valet services and luxurious lobbies as well. We must push in a direction that puts healthcare workers and the care we provide first. Anything short of that only leads to frustration, even from those genuinely there to help others.

Nonetheless, likely this is the beginning of the end as the writing from previous dramas is on the wall. And again, because somehow being serious about the work one does is a flaw to some for some reason.

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