Every once in a while a patient comes along that you just can’t have any compassion for. If you’re lucky, it’s only once every few years, if you’re unlucky it’s once a year. If it’s more than that, you’re really unlucky.
These patients are among the hardest to treat because they are so unpleasant to deal with. It might not even be that they are difficult, insulting, or even abusive, although that is often so. It’s not even because they are “bad” people who have committed heinous crimes. Often they are completely innocent victims, but they are just off putting.
Then there are the manipulative patients, the ones that know the system and abuse it to their advantage and your detriment. Some of them have done this to their friends and family so much that they are cut off from all contact with them. Others have so abused all of the area hospitals that they are pretty much persona non grata everywhere. Others have had numerous run ins with the police who no longer care to deal with them because their crimes are so low level that no judge will put them in jail.
Some are a combination or even worse, all of the above.
These are the patients that are the first to complain if they don’t like you or don’t like the level of care you provide. They consume management’s time with frivolous complaints, but since THEY usually don’t have to work, they have plenty of time to pester your bosses. Which doesn’t make your bosses particularly happy with you. You know what rolls down hill and who is usually at the bottom, right?
The biggest problem of all with this class of patient is that they often have legitimate medical problems that they have neglected or been non compliant with treatments for. Like the “Boy That Cried Wolf”, they have called 9-1-1 so many times for trivial or non existent complaints that the tendency is to just dismiss them out of hand. Then, that one time, they call and it isn’t BS, it’s real.
Which is where we get in trouble. When one of these patients goes south and it appears that the EMS, police, or ED staff that were supposed to treat them didn’t do everything right, the media always seems to become enormously interested in their plight. Those family members that haven’t even thought about them in twenty years form an instant Boo Hoo Brigade to grieve over good old what’s his name and demand justice. Which for some reason always seems to be in the form of a check. Or several of them. They become victims of evil caregivers that just didn’t care enough. They are proof that the system needs to be overhauled.
The lives of too many competent, caring people become living hells until all of this is resolved.
Which is why it’s always vital that we take extra care to bite our tongues and pay special attention to their complaints. We need to make sure that every i is dotted and every t is crossed on our PCRs. We need to put on our best happy face and not let the mask slip even a little bit. Keep the snide comments that are just waiting to burst out inside where they will do no harm. Or at the least keep them inside until you are well clear of the hospital.
Don’t let your career be derailed by some low life piece of crap that knew all the buttons to push and pushed them in the right order.
That’s todays lesson
“I learned long ago, never to wrestle with a pig, you get dirty; and besides, the pig likes it.”-George Bernard Shaw
Odd as it may seem, I am often the one calming these patients down (not the dead ones).As long as I keep returning to my assessment/reassessment, instead of responding to the baiting of the manipulator, they haven’t much to complain about. I assessed the person and delivered care. It also helps to be able to laugh at yourself, which I find pretty easy to do.
As difficult as it can be, sometimes I play a game. On particular pains in the ass, I treat them with a kindness (read: stickey-sweet) that is inversely proportionate to my desire to skull-drag them. In doing so, I challenge myself, entertain my co-workers (partner, police, fire, nurses, etc), and appease the aforementioned pain in the ass. Everybody wins. Sort of. It has also actually been shown to improve the patients demeanor once care is transferred to the ED nurses.
Remember…sometimes it isn’t “us” that has refused to treat/see these patients. We’re (EMS) often times the low end of the hill that catches the doo-doo runoff and have to face/deal with the patient no one else will see, until they finally do what they threaten to do, often times resulting in successfully accomplishing what they threatened in order to get attention. Accidental-unintentional suicide…..who’s to blame in the end?