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Sunday, April 7, 2013

Why Bother?

Why do people bother to go to see the doctor?

It's not like most of them actually listen to what the docs and nurses tell them.  Some do.  That's great.  But this post isn't about them.

So many people come in to the ER or to their primary care provider (PCP) for problems, but don't seem to give a crap enough to do what we tell them to.

Case in point:
18 year old female with abdominal pain, nausea, vomiting in the ER.  Turns out the girl has a UTI.  We give her discharge instructions, along with a prescription for some antibiotics and set her up with our low cost clinic for follow up care by the PCP.

One month later, same girl shows back up with the exact same symptoms.  I happen to be her nurse again.
NurseHubba: Oh, no!  Sorry to see you back again (sympathetic tone, not irritated).  
Repeat Offender: Yeah, I didn't get better after last time you people (you people was said in a derogatory tone) saw me.
NurseHubba: The antibiotics didn't help?
Repeat Offender: Nope.
NurseHubba: Well, did you follow up with the clinic to get something else?
Repeat Offender: No.
NurseHubba: Did you take the whole bottle of antibiotics like we talked about?
Repeat Offender: No.  I didn't get them.  I can't afford to buy antibiotics! 
Let me make sure this is clear for everyone.  It was a $4 prescription.  She smokes.  She reeks of it.  She's playing with an iPhone.  Foregoing one pack of cigarettes for her prescription would have been relatively easy.  Hell, she could have panhandled outside the pharmacy to get enough for the script.  She can afford an iPhone and cigarettes, but not her prescription.  Then she bitches at us for not taking care of her properly.

People always want a magic pill for their problems.  In this case, we were able to get her one, but she still didn't take it.



  1. Ha, you didn't give her free meds; thats the problem. You expected her to take care of herself....ssshhhhheeeeeeaaaattt gyrl you be talkin' crazy talk iffen you 'cpect her to gets her own meds!

    (10 year ER nurse; 5 years oncology)

  2. While it's not ethical to lie to her face, if someone (who, I'm sure, you've never met, and have no idea who they are) were to post on some innocuous website a very official looking study extract about how cell phones and nicotine (or any other suitable fill-in-the-blank items) are huge risk factors for repetitive UTIs (or whatever the patient's problem is) progressing to brain cancer, ricketts, leprosy, decreased libido, and Rocky Mountain Spotted Fever, and she somehow ended up this time with a copy of the link, then it really isn't your fault what people believe, is it?

    Including a link to a companion website that lists as side effects of antibiotic therapy things like drastically increased weight loss, breast and penis enhancement, and increased intelligence probably wouldn't be amiss either.

    And since they want a Magic Pill, I swear by the holy name of St. Press Ganey that it must be all right to give them one.

    Extra credit if you list the author of the studies as Dr. Ivana Plaseebeau.