EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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48 OCTOBER 2018 | EMSWORLD.com PROFILES IN EMS Unmanaged Care Anne's memory remained spotty. When she mentioned her chest pain, the nurses reminded her that her husband did CPR on her the night before. At first it filled in the gap, but as the day wore on it became an accusation. Every time she'd ask for relief, she would be reminded about her husband having to do CPR on her. One even said, "You can't die from too much pain." This wasn't medicine, it was penance. She didn't need absolution, she needed treatment—yet the staff seemed unwill- ing or unable to acknowledge her pain. They did not want to manage her pain but were unwilling to treat her withdrawal or menopausal symptoms. Her pain scale soared, as did her vital signs. When her blood pressure escalated to 200/ 114, they attempted to treat it with IV medi- cations. Anne explained to them that this happens when her pain goes unmanaged, but all they wanted to do was treat the number—she had to formally refuse the antihypertensive meds. She was on Glu- cophage for her ovarian cysts; instead of asking why they gave her a diagnosis of diabetes and performed repeated blood glucose checks, even when she explained what it was being used for. Nobody con- tacted her primar y physician about any of this. They were alone. She felt lost, as if there was no one at the facilit y willing to advocate for her. They kept treating symptoms but never the actual problem. Chris struggled to help, but de spite both of their back- grounds, the staf f consistently treated them like they were unable to compre- hend what was going on. When they tried to sign out, they were told that if they did, insurance would hold them liable. They were prisoners of the ver y system they worked for and trusted with their health. With the label came the stigma and the loss of identity. They would ask Chris how he was doing, but not once did anyone ask Anne how she was doing mentally or if she was able to process this near- death experience, regardless of cause. Anne struggled with this, being around so many people in the same profession as she was. Perhaps that's what part of the problem was: She wasn't a patient, she was a mirror of what could be. Substance abuse in nursing, especially as a negative coping skill, is not a new subject. Twent y years ago researchers found that the prevalence of substance us e of all k in d s , f ro m cig aret te s to cocaine, was as much as 32% in nurses. ER nurses were 3.5 times more likely to use marijuana or cocaine, oncology and administrative nurses were twice as likely to binge drink, and ps ychiatric nurses were most likely to smoke. No specialty dif ferences appeared for prescription- For More Information Circle 42 on Reader Service Card QUICKLOOK ҃ƒ GoHCL.com • 1.800.848.1633 "[The scarlet letter] had the effect of a spell, taking her out of the ordinary relations with humanity and enclosing her in a sphere by herself." —Nathaniel Hawthorne, The Scarlet Letter

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