Excuses
Expanding on the previous post, here are some of the reasons people give for not wanting to be admitted to the hospital, along with my replies:
1) I don't want my (family member) to worry about me.
How worried will they be when they find your cold dead body in the morning?
2) I need to feed my dogs.
Who is going to feed them after you're dead? Call them.
3) I have a big presentation tomorrow.
This is what sick days are for. A heart attack is an excused absence.
4) I'm flying to ______ in the morning.
It's not safe for you to fly.
5) I can't afford to be admitted.
You can't afford not to be.
1) I don't want my (family member) to worry about me.
How worried will they be when they find your cold dead body in the morning?
2) I need to feed my dogs.
Who is going to feed them after you're dead? Call them.
3) I have a big presentation tomorrow.
This is what sick days are for. A heart attack is an excused absence.
4) I'm flying to ______ in the morning.
It's not safe for you to fly.
5) I can't afford to be admitted.
You can't afford not to be.
Labels: excuses, patients, perspective
posted by scalpel at 9:59 AM
10 Comments:
For #5---I usually come at the patient (who always has untreated htn, newly-diagnosed DM and chest pain with a wife who dragged them in kicking and screaming) with something like "the bill might set you back for a bit, but death sets you back forever." Seems to get the point across...
Well if that doesn't get your point across, nothing will. I mean nothing you're ALLOWED to do...
(You're not allowed to wack stoopid patients round the back of the head with a chart, are you?)
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How bout a list of excuses people use to WANT to get admitted and your responses as to why they don't?
Strange coincidence; I had a patient last week AMA with mult PE's and + DVT. He said he had to take care of some business first then he would return, he never did. It is too bad people put monetary bs above their health, even in cases of life and death.
X2 on ERP's suggestion.
About 6 weeks ago I took my wife to the ER (she works in an HIV lab and was exposed and needed to start a course of prophylactic treatment which is an entirely different story) and observed an interesting patient being brought into the emergency department. As we sat at the registration desk waiting for the nurse to get a needle stick person on the phone a gentleman came up to the desk asking where his neighbor should go. He indicated he had been asleep and his neighbor knocked on his door asking him to drive him to the ER. He otherwise did not know his neighbor, not even his name. He indicated to the nurse his neighbor "tried to commit suicide" and wanted to be admitted. I noticed a slightly overweight, balding man standing behind him with a bag of what was presumably his personal belongings. This man's forearms appeared to be scratched up and slightly bleeding. It looked like he cut himself with a plastic knife. He sat down at another registration area before I could smell the stench of what I would guess was whiskey but quite honestly could have been anything. He was asked what had happened where he just kind of shrugged, looked down at his arms and reached them out for the nurse to see. He was asked if he intended to hurt himself at which time he replied with a nod and kind of kicked at his bag as if to suggest he intended to check himself into some sort of psychiatric care at the hospital. The nurse cleaned and dressed the "wounds" and promptly dispatched security to take him to wherever these folks go. I think at some point this guy even knew what floor he would be going to without the nurse having even discussed it. The whole thing was mildly humor but mostly pathetic. Clearly no real attempt was made at suicide.
A side note: You all should know that 1 month supply of HIV drugs is nearly $3,000 -- I don't know how people afford such treatment! Aside from the cost, the body's physical response to the treatment is also just about horrible. My sister went through chemo for advanced breast cancer last year and it didn't seem to affect her as adversely as the HIV drugs my wife took. Fortunately her actual likelihood of infection from her particular exposure was less that .03 -- in fact significantly less -- but she's overly cautious and the treatment reduces the risk to practically zero and it put at ease even though it was a miserable month.
We had a middle aged man come in for chest pain and was to be admitted but he refused. The physician, nurse and his wife tried to convince him he should stay. His wife told me it was because they didn't have insurance. We automatically give Charity care to self pays and I told her that would help but doesn't cover the physicians or medicine.
He signed out AMA.
Co-workers (Ed nurse and paramedic) were on a plane-in the air on their way to their honeymoon destination when a man had an MI. They did CPR on him but he didn't make it.
No one plans an illness or an accident and they come at the most inopportune times..I guess because there is never a good time.
Denial can be so strong.
I fear I would be one of those patients resisting admission. My reason would be because the beds are uncomfortable, and I wouldn't get any rest. I also do not like having people who are busy (nursing staff) doing things for me and would probably not feel free to ask for things that I might need if it caused them any trouble. And I wouldn't appreciate a dietician's intervention in my diet. I need to avoid the pyramid scheme diet to keep my bowels intact, but my way is unpopular with dieticians.
Whatever I've got, I'll get well easier at home.
Great List!
Referenced it on Your Er Doc becasue I hear the same things all the time!
Thanks!
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