So I spent 4 hours in the Emergency Room this morning and I’m sick and tired of the stereotyping that seems to go on when you present with pain.
For the past two days, I’ve been experiencing severe pain & swelling in my left hand. I don’t remember hurting it but unfortunately, as I have Osteogenesis Imperfecta (OI), I can have done something as simple as just knocking it and have fractured a bone.
So as it wasn’t getting any better, and following the protocol set for me years ago that if it hadn’t improved after two days of Rest, Ice, Compression and Elevation (RICE) to seek medical attention I headed off to my local Emergency Room in need of an x-ray.
On arriving, the waiting room was empty which I thought would be a good sign. It was 5am on a Saturday morning after all. However, it took a while for the triage nurse to stop chatting with a colleague and to triage me.
She then took offense because I complained that her work area smelled heavily of berries. Apparently, she had used a berry scented hand sanitizer on her break and not washed her hands afterward. When I commented that perhaps this wasn’t such a good idea given that she was working in Emergency with people coming in with severe breathing problems she responded that some of the doctors wear cologne! Hmm.. I didn’t know that somebody else not following a scent free protocol made it OK for anybody else to not do so either!
Anyway, we got through triage with just a few more comments on my high blood pressure and low oxygen level (That berry scent sure wasn’t helping with either of those issues!) and she had me wait again.
Now my chart is clearly marked that I’m deaf. I know this because I’ve been at this hospital almost weekly for the past 2-3 months.
So about half an hour later she calls me to follow her to fast track. I haven’t got a clue what she actually said as she spoke to me from behind a pillar, but being the only patient in the waiting room still I had a good idea that she was probably talking to me, so I followed her.
We arrive in the next waiting area and again she says something to me, but with her back to me. So I wait until she turns round, and actually looks at me and ask her to repeat herself. At which point she became very defensive saying “I didn’t know that you’re deaf”. Hmm…
- It’s polite to face the person that you’re talking to especially when they’re not well – deaf or not and,
- You just did my triage intake and I know that my chart has it highlighted that I’m deaf.
This visit is not off to a good start.
Several hours later another nurse brings me into an exam room and reviews my situation with me. At this point, I start to wonder if that first nurse had stereotyped me and that was why I had waited so long to be seen when all I needed was an x-ray.
I am allergic or intolerant to all over the counter pain killers. So when the triage nurse had asked me what I’d taken for the pain I’d said nothing, and when she’d asked me what I’ve had to use in the past for pain given my issues with painkillers I’d replied ‘morphine’.
All of which is totally true but doesn’t explain the context. That is that I very rarely take painkillers and that the last time that I had to use morphine was after I broke my coccyx. However, I think that she just heard the narcotic use and put me in the category of drug-seeker.
Regardless, at this point, I give her the benefit of the doubt as this new nurse explains that the night doctor has been caught up with a major trauma and that the day doctor was coming on duty but had a backlog of patients to catch up on before they’d get to me.
A while later, I see the doctor and as expected get sent off to x-ray. Back from x-ray and the doctor informs me that he can’t see a fracture but that he’ll make sure that my x-rays get flagged with the radiographer for checking due to my OI. We discuss management – more RICE, follow up if the pain doesn’t improve in a few more days – and he asks about pain medication.
He comments on my intolerance to pain killer etc and then seems completely bewildered when I say that I don’t want a prescription.
I don’t want a narcotic. If I can’t feel the pain then I’ll hurt myself further. I just wanted to know if there is a fracture because the way that I need to treat my hand is different if there is.
So I left a bewildered doctor and headed home where I will actually still be careful with my hand until after Tuesday when the radiographer will have had a chance to ready my x-rays (It’s a long weekend here in Canada) and then I’ll start pushing the exercises to keep it moving as much as possible.
However, it really annoys me that there seemed to be this assumption that I was only seeking narcotics. All it would have taken is one simple question by the triage nurse and I would have stated up front that I didn’t want a prescription.
I live with chronic pain. I know how to deal with pain. I will very, very rarely use a narcotic. The only reason that I took the morphine when I broke my coccyx was that there was no way on earth that I could have laid still enough for the x-rays without it.
I would far rather feel the pain and use it to assess how well I’m healing and to limit myself than mask it and hurt myself further. I learned this the hard way by walking on a broken ankle when I was younger because I couldn’t feel it due to the pain killers that I’d taken (& could tolerate at that point).
So, please, don’t assume that people presenting in Emerg with pain are only after narcotics. If you think that might be the case, why not just ask us? It would make life a lot simpler for all.
As for me, I’m quitting here today as typing one handed is hard work! I also have a plea…