My new fave Doc and the "Curse of Dr. Smartass"

There was a standout resident when I was at my first hospital of employment.  Very personable, unpretentious, smart as a whip, and fabulous with the patients. He's now one of our internal medicine docs!! I can't tell you how much we all enjoyed working with him this weekend and how happy the patients were with him.  Oddly enough, he was in the same class as Dr. Super Shitty. LOL

I love listening to him talk to patients. He actually communicates with them more like a nurse than a doc. An example of Dr. Awesome's patient interactions goes like this: "Wow, that sounds really painful, I'm so sorry you are feeling like that. :( How about we try xyz to help with that and if that doesn't work, we have a few other tricks up our sleeves.  Don't you worry- we see this a lot, you will be feeling better very soon.  I promise."  What a joy having him with us and what a stark contrast to his former classmate.  lol!!

In other news, had one of the most difficult patients ever over the weekend. She's a frequent flyer, has been in and out of our hospital every few weeks for several weeks at a time since March.  She has a laundry list of issues, but her biggest issue is that she tortures the staff.  Even worse, she was an RN in a major city hospital in a trauma unit and she is extremely intelligent (has a PhD in nursing) and she's also incredibly demanding. Going into her room is a 45 minute minimum visit.  Plus, she's on contact precautions for VRE in urine, she uses the bed pan (frequently), and she gets 18 pills at 9 am (I'm not exaggerating), plus q8 hr IV antibiotics, q4 hour IV narcotics (supposed to be prn (as needed) but are basically atc (around the clock) ).  She's part Gargoyle (sits indian style perched in the center of her bed surrounded by pillows), part Drill Sargent part Drama Queen. 

Her story is she was exposed to an exotic bird about 10 years ago and contracted a severe illness from a virus that becomes airborne once excreted from the bird. (I am not putting the name of it on here in case someone who knows her googles the virus and sees my blog).  Anyway, she wasn't feeling well for a while.  Saw Dr. after Dr. finally after a few months a Dr. told her to tell him EVERYTHING she did for the past few months.. she mentioned the bird and he ran some tests and it turns out she had it- and several other people she knew were also exposed.  She is on long term steroid therapy due to adrenal insufficiency, asthma, insulin dependent diabetes, unbelievably high blood pressures- even with a slew of BP meds, non healing wounds, spontaneous hematomas, chronic constipation (oh how I love manually disempacting people just prior to a fleets enema- two days in a row) brittle bones that can break from just looking at them (side effect of long term steroid use),  a severely compromised immune system and she gets I   G   G therapy monthly which costs over ten thousand dollars per treatment (Medicare is kind enough to foot the bill for that), I'm sure I'm forgetting a lot, but you get the picture.She'd actually be a great person to give to a nursing student because she loves to talk and teach and because she's extremely complex and understands her specific disease processes very well and enjoys talking about them and answering questions about them.   Most of all she'd be a great nursing student case because it would weed out those students  who can't cut it in nursing pretty fucking quick. 

Here's what it's like taking care of her.

me:  *walk up to her door, begin donning gloves and putting on gown*

Gargoyle Lady: *in sarcastic tone* "Oh, it's time for the pharmacy, again."

me: "it sure is! how are-

GL: "pleasse get this wrinkle out from under my butt.. move this pillow from under my leg, no not like that.. PLEASE just move it UP"

me: "Oh you mean back-

GL: "Yes, UP just like that"

me: "ok, let's get these pills started" *scan wristband* "name and date of birth, please?"

GL: "Gargoyle Lady 666... these pillows aren't right.  I need you to stand them up straight-ohhh my back ohhh my God I can't stand it!!"

me: *move pillows from horizontal to vertical*

GL: *condescendingly* "Nooooooooooooo not like that" *motioning hands vertically* "like THIS" *motioning horizontally*

me: *turning pillows back how they were*

GL: "now stand them up"

me: "so you want me to fluff them a bit?" *fluffing pillows*

GL: "no, I want you to stand them up, yes, just like that."

me: *start scanning pills.  Get about 5 done*

GL: "When you get a minute, I need a box of tissues"

me: "ok" *scanning pills 6 through 8*

GL: 'While you are in here, can you tell me what my hemoglobin was and what my blood pressure as at 3 am when they rechecked it after the IV labetalol?" 

me: "sure, as soon as I'm done scanning these.." *scanning pills 8-10.. 'damn, the prednisone still isn't entered into the pharmacy system, have to manually admin this one in' phone rings.. aide calling to tell me she can't hear the BP in my dialysis patient, I need to recheck it manually.. tell her 'I will go in there next..' scan pill 11*

GL: "ooohhhh I think I need to have a BM .. GET THE BEDPAN.."

me: *put down pills go into bathroom, get bedpan*

GL: "ah that's it.. I sure have a headache I wonder what my blood pressure is right now.  You know you have to check it before you give me my labetalol.."

me: "the aide just checked it 30 minutes ago.."

GL: "It could have dropped too low for me to take it... oooooooooooohhh the pain ah ah!! The bm is RIGHT THERE  please help me get it out!!"

me: "I have to get some lubricant"

GL: "OH PLEASE PLEASE HURRY! AAAHHHHH"

me: *remove gown, remove gloves, wash hands go to supply closet down the hall, get lube, get her tissues she asked for. put items inside doorway of room -

G: "OOOOHHH AAAAHHH OOOOH IT HURTS HURRY HURRY"

me: *cheerily* "okay.. getting gowned up!" *use hand sanitizer, put on gown, put on gloves, put on another set of gloves (crucial step when shithole spelunking)  tie gown, take 2 steps toward bed-

GL: *flatly* "I think I got it" *pulls brown finger out of her own rectum

me: * 'well, that will go well with her breakfast seeing as how she can't walk to a sink to wash her hands'*

GL: "ohh OHHHH there's MORE!! Please help me!!"

me: *squirt lube on double gloved index finger, start coaxing out poo balls*

GL: "aaahhhh AAAAAAA ohhhh DIG DEEEPER! It's right there!"

I will spare you the rest of the story.  Now, imagine 24 hours of weekend spent just like that. 

Oh,  so the Curse of Dr. Smartass?  One day while 3 nurses were chit chatting with Dr. Smartass (actually he was the Dr. that came to talk to the guy with the trach who was driving me crazy two years ago.. I posted about it here: http://codebabe.blogspot.com/2010/07/best-of-best-and-worst-of-worst.html)  about Gargoyle Lady he said (jokingly):

"That's because she was a nurse.  All you nurses end up like that."   

To which my jaw dropped with a combination of disbelief and despise said in a low tone, but quite distinctly 'youuu fucker.."    The combination of his saying that and my F bomb in response pretty much had us all in utter hysterics for about 5 minutes.  Dr. Smartass can be assured, if I do turn into Gargoyle Lady.  I'M ASKING FOR HIM EVERY TIME I GO TO THE HOSPITAL!! lol