Nurses make Lousy Patients
[Lousy in the sense that I cause difficulty, not that I have lice or anything.]
This story stretches back a couple months, so brevitymay is not be one of the characteristics of this post.
Once upon a time, in the first two weeks of May 2018, I did a clinical rotation at the morgue. It was pretty fascinating, but not really hands-on because I do not do autopsies [I'm not even sure nurse practitioners are allowed to do autopsies, but I definitely am not an expert in forensic nursing]. Regardless, the point is that this rotation involved standing still while watching these pseudo-surgeries. I don't really like standing still, and this preference was accentuated because after a while, my right hip would kind-of ache. I complained of hip pain often enough that Mark told me to go see a doctor, already [he was nice about it, actually]. So mid-May, I tell my primary doctor that I've been having this achy hip, and I've noticed slight weakness in that leg, because I couldn't hold a warrior three yoga pose on my right leg as long as I could on my left. Not exactly debilitating, but my doctor is pretty good with investigating things [that's why I still see her, actually. usually I'm not a loyal customer, but I like this lady for her follow-through], so she ordered a lumbar xray. Something there looked suspicious, I guess, because her clinic--after trying 3-4 times to get a hold of me, but unfortunately always calling while I was busy at work--eventually told me to schedule an MRI.
That opened a whole 'nother can of worms, because the clinic wouldn't schedule the MRI until someone (probably me) paid for it, but because I pay attention [haha, small pun on "pay"] to the details on my insurance card, I knew there was a possibility the insurance company would pay for the whole thing, as long as I notified them of the need for the test beforehand. Now, I like my doctor, but her clinic staff is not exactly nursing-award material. I tried to convince them that there was another option (i.e. insurance) besides me paying, but they just repeated that the MRI couldn't be scheduled until I paid $100, which (per them) was a pretty good deal considering the total cost of the exam, so I should be grateful and just chuck out the money.
But I'm a nurse, you see, so I decided to be my own patient advocate.
I hung up with the clinic, looked up the number to call for the health insurance financial adviser, and got approval for waiving the fee for the MRI. I got a reference number on the transaction from the insurance company, called up the clinic, and provided that number to the clinic staff, who knew how to apply that number to get payment to then schedule my MRI [so it's seems like they knew waiving the fee was possible...suspicious].
So a month after the original hip-visit, I go in for an MRI. By this time the pain, triggered by movement, is radiating from my hip down the back of my leg, and giving me pins and needles on the bottom of my foot. It wasn't bad enough that I couldn't walk normally, but changing positions was getting uncomfortable. Fortunately, the MRI tech was AWESOME--5 star material--and she helped get me comfortable-ish (it's a hard narrow gurney; comfort is relative) with pillows and calming music and kind warnings and even provided a hand to help me sit up after the test was done. Also, she said that the disposable shorts looked great on me. Now that's kindness.
One week later, after calling several times to try to get the results (I was hurting more. pain is a good motivator for these things), the infamous clinic staff called me and told me the MRI showed I had arthritis of the spine [I read through the report later, and the word "arthritis" does not appear anywhere. That doesn't mean joint inflammation wasn't there, but saying I had spinal arthritis is 1) waayy different than the truth, because it implies the arthritis is the diagnosis (cause), not a symptom (effect); and 2) definitely unethical, because as a nurse I know that I am allowed to provide the patient with exam reports/results but not with any personal interpretations(i.e. what the results mean) because it's basically out of my scope of practice]. That gave me 4 days to think that I had a chronic progressive degenerative disease, that I would be severely limited in my ability to hike, run, or even have and raise children.
Fortunately for me, the clinic staffer also recommended that I see a spinal specialist, and after running potential doctors through the insurance/health-grade-rating/soonest-available-appointment filter, I was able to see an orthopedic/spine specialist just 5 days later. REALLY fortunate. By this time, the pain was so bad and near-constant (despite Aleve and muscle relaxants) that I couldn't sleep, couldn't sit upright, couldn't walk normally, and couldn't even do a basic yoga routine. I didn't wear any make-up and accidentally put my pants on inside-out [they're plain black yoga pants. nobody noticed except me.].
The definitely-old-but-very-competent spine doctor did a focused lower-extremity neuro assessment [motor and sensory checks], showed us the MRI results (where even Mark, with no medical training, could see a problem), and talked about treatment options for the lumbar herniated disc causing my sciatic nerve pain. He also very kindly gave me a prescription for pain meds, because not sleeping is not fun [being a couch potato is also not fun--rather boring, actually--but lack of sleep is worse. if you have doubts on that, remember my clothing choices].
The wonderful thing is I was able to schedule the epidural spine injection for the day after meeting with Spine Guy. The scheduler warned me not to eat or drink anything at least 6 hours before the procedure, so Mark very thoughtfully got me up at 2am to eat a bowl of cereal [I get up to pee around that time every night, so I was already semi-conscious]. Again, because I'm a nurse, I interpreted NPO no-food-or-drink as I-can-only-drink-water, since the staff of in-hospital contrast tests let our patients have a clear liquid diet until right before; maybe they're just being kind because it's cancer patients, but I figured it wouldn't ruin the test. I also wanted to keep my exercise bra on underneath the patient gown, since I knew it wouldn't interfere with magnets or x-rays or any procedure that is right above my butt, but Mark made me obey directions on that one.
Truthfully, I was not a happy person this morning prior to the injection--probably related to choosing to not take narcotic pain meds on an empty stomach. On patient check-in, I refused to fill out what medication I take, because I had just verified my medication list with the Spine Guy the day before; I changed the channel in the waiting room from news (which was agitating me) to a very-overtly-religious hospital calming program; and I wandered around in pain and frustration because I couldn't find a comfortable position. I actually cried in Mark's hair for a while (he was sitting down. otherwise I can't reach his hair, since he's too tall) and had him tell me a story to distract me.
When I was brought into the procedure room--about 12 hours after I had last eaten--unidentified (meaning I have no idea what the name was or their role in my procedure) people had me lay on my stomach and then prepped my back with fake tan lotion. Just kidding. It's iodine, but it looks like a really bad fake tan. Unfortunately, they then left me there with no way to contact them, no ability to look around, and a growing panic that I couldn't hold this position for very long because it FREAKIN' HURT. Actually, on reflection, I had indicated on the check-in paperwork that my pain was a 9/10, and even though the nurse practitioner, who consented me for the procedure, saw that and said I could get sedation, once I was in the procedure room, no one mentioned anything, or asked, about comfort level, pain and/or pain meds. Since no one was forthcoming, I eventually asked for some pain meds, but I think I was asking an empty room (keep in mind I am face-down on a gurney, with my feet toward the radiologist control room, so I had no idea where anybody was). At this point I broke my calm, started crying, and tried to go into fetal position without disturbing the sterile drape I knew was on my back. That move did get people's attention; one unidentified person told me not to move because I could fall [yes, I know that, #*%!, but something needed to change. also, I don't actually cuss (that question came up in the review of my medical history yesterday, but I think the Physician's Assistant was joking with me.) Anyway, I just felt really alone, in pain, and frustrated.] The same safety-focused person told me the doctor was right here ready to start, and he would be done in 5 minutes, but I told her I couldn't just lay at a 9/10 pain level for 5 minutes.
Either the radiologist doctor overheard that, or he noticed that I was in a semi-fetal position with tears on my face (but my makeup wasn't running, because I hadn't put any on. It's a plus), but he ordered for conscious sedation right away, at a higher dose than his apparently-unsympathetic-underlings requested, because, as he pointed out, I was miserable.
I tried to be helpful after that; I offered to assist with the chest electrode lead placement, and stay as still as possible for the actual injection that I never felt, and expressed gratitude for, like, everything. Either it was guilt-motivated or I was on some nice pain meds. Maybe both.
I got reunited with Mark right afterwards, and saw that he was being a STELLAR HUSBAND: he had got me food, and had already helped me take off my socks when changing to the gown (bending over really hurt), and several times lifted me into the stretcher prior to the procedure because I couldn't find a comfortable way to get from standing (painful) to laying (moderately painful) without going through the sitting (super duper painful) process. And, actually, that's kind-of how we got to the hospital in the first place. I was having a hard time getting into the passenger seat of the car, so he told me to just flop across the back seat and help me close/open the car doors.
After ascertaining that I could pee, I was discharged, and both of us went home for some sleep. It does mess up our sleep schedule, but whatever, I went on Medical Leave at work for this. [That actually made me feel guilty, too, because I happen to know first-hand that we have been really short-staffed recently, but "P7 nurse" and "couch potato" are not synonymous].
Sometimes, nurses aren't that great at taking care of themselves.
But we make pretty good medical historians. Look at the length of this post!!
This story stretches back a couple months, so brevity
Once upon a time, in the first two weeks of May 2018, I did a clinical rotation at the morgue. It was pretty fascinating, but not really hands-on because I do not do autopsies [I'm not even sure nurse practitioners are allowed to do autopsies, but I definitely am not an expert in forensic nursing]. Regardless, the point is that this rotation involved standing still while watching these pseudo-surgeries. I don't really like standing still, and this preference was accentuated because after a while, my right hip would kind-of ache. I complained of hip pain often enough that Mark told me to go see a doctor, already [he was nice about it, actually]. So mid-May, I tell my primary doctor that I've been having this achy hip, and I've noticed slight weakness in that leg, because I couldn't hold a warrior three yoga pose on my right leg as long as I could on my left. Not exactly debilitating, but my doctor is pretty good with investigating things [that's why I still see her, actually. usually I'm not a loyal customer, but I like this lady for her follow-through], so she ordered a lumbar xray. Something there looked suspicious, I guess, because her clinic--after trying 3-4 times to get a hold of me, but unfortunately always calling while I was busy at work--eventually told me to schedule an MRI.
That opened a whole 'nother can of worms, because the clinic wouldn't schedule the MRI until someone (probably me) paid for it, but because I pay attention [haha, small pun on "pay"] to the details on my insurance card, I knew there was a possibility the insurance company would pay for the whole thing, as long as I notified them of the need for the test beforehand. Now, I like my doctor, but her clinic staff is not exactly nursing-award material. I tried to convince them that there was another option (i.e. insurance) besides me paying, but they just repeated that the MRI couldn't be scheduled until I paid $100, which (per them) was a pretty good deal considering the total cost of the exam, so I should be grateful and just chuck out the money.
But I'm a nurse, you see, so I decided to be my own patient advocate.
I hung up with the clinic, looked up the number to call for the health insurance financial adviser, and got approval for waiving the fee for the MRI. I got a reference number on the transaction from the insurance company, called up the clinic, and provided that number to the clinic staff, who knew how to apply that number to get payment to then schedule my MRI [so it's seems like they knew waiving the fee was possible...suspicious].
So a month after the original hip-visit, I go in for an MRI. By this time the pain, triggered by movement, is radiating from my hip down the back of my leg, and giving me pins and needles on the bottom of my foot. It wasn't bad enough that I couldn't walk normally, but changing positions was getting uncomfortable. Fortunately, the MRI tech was AWESOME--5 star material--and she helped get me comfortable-ish (it's a hard narrow gurney; comfort is relative) with pillows and calming music and kind warnings and even provided a hand to help me sit up after the test was done. Also, she said that the disposable shorts looked great on me. Now that's kindness.
One week later, after calling several times to try to get the results (I was hurting more. pain is a good motivator for these things), the infamous clinic staff called me and told me the MRI showed I had arthritis of the spine [I read through the report later, and the word "arthritis" does not appear anywhere. That doesn't mean joint inflammation wasn't there, but saying I had spinal arthritis is 1) waayy different than the truth, because it implies the arthritis is the diagnosis (cause), not a symptom (effect); and 2) definitely unethical, because as a nurse I know that I am allowed to provide the patient with exam reports/results but not with any personal interpretations(i.e. what the results mean) because it's basically out of my scope of practice]. That gave me 4 days to think that I had a chronic progressive degenerative disease, that I would be severely limited in my ability to hike, run, or even have and raise children.
Fortunately for me, the clinic staffer also recommended that I see a spinal specialist, and after running potential doctors through the insurance/health-grade-rating/soonest-available-appointment filter, I was able to see an orthopedic/spine specialist just 5 days later. REALLY fortunate. By this time, the pain was so bad and near-constant (despite Aleve and muscle relaxants) that I couldn't sleep, couldn't sit upright, couldn't walk normally, and couldn't even do a basic yoga routine. I didn't wear any make-up and accidentally put my pants on inside-out [they're plain black yoga pants. nobody noticed except me.].
Truthfully, I was not a happy person this morning prior to the injection--probably related to choosing to not take narcotic pain meds on an empty stomach. On patient check-in, I refused to fill out what medication I take, because I had just verified my medication list with the Spine Guy the day before; I changed the channel in the waiting room from news (which was agitating me) to a very-overtly-religious hospital calming program; and I wandered around in pain and frustration because I couldn't find a comfortable position. I actually cried in Mark's hair for a while (he was sitting down. otherwise I can't reach his hair, since he's too tall) and had him tell me a story to distract me.
When I was brought into the procedure room--about 12 hours after I had last eaten--unidentified (meaning I have no idea what the name was or their role in my procedure) people had me lay on my stomach and then prepped my back with fake tan lotion. Just kidding. It's iodine, but it looks like a really bad fake tan. Unfortunately, they then left me there with no way to contact them, no ability to look around, and a growing panic that I couldn't hold this position for very long because it FREAKIN' HURT. Actually, on reflection, I had indicated on the check-in paperwork that my pain was a 9/10, and even though the nurse practitioner, who consented me for the procedure, saw that and said I could get sedation, once I was in the procedure room, no one mentioned anything, or asked, about comfort level, pain and/or pain meds. Since no one was forthcoming, I eventually asked for some pain meds, but I think I was asking an empty room (keep in mind I am face-down on a gurney, with my feet toward the radiologist control room, so I had no idea where anybody was). At this point I broke my calm, started crying, and tried to go into fetal position without disturbing the sterile drape I knew was on my back. That move did get people's attention; one unidentified person told me not to move because I could fall [yes, I know that, #*%!, but something needed to change. also, I don't actually cuss (that question came up in the review of my medical history yesterday, but I think the Physician's Assistant was joking with me.) Anyway, I just felt really alone, in pain, and frustrated.] The same safety-focused person told me the doctor was right here ready to start, and he would be done in 5 minutes, but I told her I couldn't just lay at a 9/10 pain level for 5 minutes.
Either the radiologist doctor overheard that, or he noticed that I was in a semi-fetal position with tears on my face (but my makeup wasn't running, because I hadn't put any on. It's a plus), but he ordered for conscious sedation right away, at a higher dose than his apparently-unsympathetic-underlings requested, because, as he pointed out, I was miserable.
I tried to be helpful after that; I offered to assist with the chest electrode lead placement, and stay as still as possible for the actual injection that I never felt, and expressed gratitude for, like, everything. Either it was guilt-motivated or I was on some nice pain meds. Maybe both.
I got reunited with Mark right afterwards, and saw that he was being a STELLAR HUSBAND: he had got me food, and had already helped me take off my socks when changing to the gown (bending over really hurt), and several times lifted me into the stretcher prior to the procedure because I couldn't find a comfortable way to get from standing (painful) to laying (moderately painful) without going through the sitting (super duper painful) process. And, actually, that's kind-of how we got to the hospital in the first place. I was having a hard time getting into the passenger seat of the car, so he told me to just flop across the back seat and help me close/open the car doors.After ascertaining that I could pee, I was discharged, and both of us went home for some sleep. It does mess up our sleep schedule, but whatever, I went on Medical Leave at work for this. [That actually made me feel guilty, too, because I happen to know first-hand that we have been really short-staffed recently, but "P7 nurse" and "couch potato" are not synonymous].
Sometimes, nurses aren't that great at taking care of themselves.
But we make pretty good medical historians. Look at the length of this post!!
Love and prayers for a speedy and successful resolution! You are a tough patient!
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