A Real-Life Hospital Drama

Colin T. Son

Disclosures

March 27, 2009

Most people who work in healthcare can remember their first day at the hospital. Many also have innumerable tales about patients they've cared for -- some touching, some sad, some truly tragic. Medicine is drama, and experiences with illness shed some light on the nature of humanity.

Inside the hospital, some of the providers with the best stories are the nursing staff. Gina Rybolt, a veteran critical care nurse, collects such stories on codeblog. Some of the stories are her own while others are submitted by fellow nurses or patients or other healthcare workers. And many have important lessons for anyone working in a hospital.

Code Blog hosts Grand Rounds
March 24, 2009

A recent post offered this story about providing false hope to patients:

It was one of those rare nights on midnight shift where the ER was eerily quiet... As we sat and talked about non-nursing related things in our lives the Ambulance phone went off. I got up to take the call. "This is A-1 Ambulance. We're bringing in a 20ish year old male with severe injuries to both of his legs..."

The patient arrives to the ER 5 minutes later without any relief from the previous Morphine. His legs are deeply cut and crushed at the level of the knees where the car clipped him... [T]he patient kept asking me if he was going to lose his legs. "Please, am I going to lose my legs? Please tell me." I couldn't answer him, I had no way of knowing at that time but the prospect of him losing his legs was a good probability. He had no pedal pulses and no sensation below his knees. I told him, "I don't know right now, we have to wait to see what the tests tell us." It was an honest answer. He turned to the Patient Care Technician and asked her the same question, she immediately responded, "No, you're not going to lose your legs, quit thinking like that. Everything is going to be fine..."

I took her aside and told her that telling him he was not going to lose his legs was not a very good thing to do. I told her that she could have very well given him false hope and that is the last thing you want to do to a patient. She apologized to me and told me "she just wasn't thinking."

The night ended without any more trauma and we all went home to our beds. I had the following day off and went about my normal routine. The following day I returned to work and my arm was grabbed by the Patient Care Tech that had helped me with the young man two days earlier. Her eyes were red and swelling with tears. "He lost both of his legs," and as she spoke the words the tears rolled down her face. "They cut off both of his legs, they couldn't save either one of them." At first her words were not registering in my mind until I realized what she was talking about. The young man who she told would be just fine had lost the very thing he was so concerned about and wanted reassurance about. The tears welled up in her eyes more. "How could I have done that, how could I have said everything was going to be ok?" My heart went out to her. In her attempts to ease his mind, she let him down and herself. "How can I ever make this up to him?"

I shook my head back and forth and said, "You can't do anything for him, but you can learn from him and never tell anyone things that you don't know for sure. You learned, and learning is a good thing." She replied, "Yeah, I learned, but I still have both of my legs."

Other stories on the blog touch on universal themes in healthcare, such as the difficulty of conveying the world of medicine to your friends and family or the trouble with futile care. Codeblog is worthwhile reading for any healthcare worker or patient, or for anyone who is merely interested in the drama of medicine.

This week, in addition to her regular plethora of stories, Gina will be hosting Grand Rounds. Grand Rounds is the weekly best of medical blog writing, featuring pieces from physicians, nurses, patients, students, and others.

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