frustration

Kaiser Permanente In California is being sued for dropping off unwanted homeless patients at Skid Row. Here is video surveillance of a delirious woman clad with only a gown and slippers getting out of taxi and wandering about before someone finds her. Sad, but this is the status of our health system.

I work for the county hospital. We are understaffed, underpaid, and in debt and yet our Emergency Room and clinics are constantly overflowing with uninsured poor but MANY hard-working MIDDLE CLASS patients.

I come to work frustrated, I drive home frustrated and I get home frustrated.

My job is great when I encounter my favorite, easy-going, loving, thankful, fun, smiling, reasonable patients. But they are FEW AND FAR BETWEEN. Most of them are unappreciative complainers who think that they are the only patient I have. They come an hour late but I see them anyway because their medical conditions demand that I see them. Yet they are still unappreciative. They want this and that, that make me repeat things over and over, they are rude to our staff, and to top it off THEY SMELL. These are patients that the entire staff cringes when they come and have to mentally prepare themselves when they know they are on the list to be seen that day. They are infamous.

I would like for all of them to just get into one room together and complain to one another so they can compete for the "I have the worst life" prize.

No more Nice Dr. Dinah

There are several providers in our group who are not nice and don't listen to their patients. Or perhaps they selectively choose not to listen to particular patients so they can get rid of them and pawn them over to someone else.

For three days in a row I have gotten this: "I decided to switch to you because so and so didn't listen to me" or " I didn't like him" or "I heard you were nice." This happens to all doctors, some people don't like me on the first appointment and so they see someone else. But when it happens more than usual there is a problem.

Sure, if I were in a competitive environment vying for patients I wouldn't mind getting more of these patients, but like I said, we are inundated with patients. Everyone would rather increase their productivity rate with EASY patients rather than tire themselves with the difficult ones. We are rewarded for productivity not on how nice we are or how we handle difficult patients.

The thing is I'm getting too many "DIFFICULT" ones. And when I mean "DIFFICULT" it's not just medically, I find medically difficult patients challenging. But when they are difficult medically and/or difficult in their personality, their NEEDINESS, or drug-seeking I get frustrated and MAD.

Some patients are so DIFFICULT that they have cycled their way through our group of doctors. When they can't have their way with one doctor, they find the next one. Each doctor is relieved when this type of patient has moved on.

They are demanding. They want us to go out of our way ALL THE TIME. They're in the 20s, walking around fine and want me to declare them disabled, want a handicap sticker, a letter to exempt them from jury duty, a letter asking a judge to move their son who is in a state penitentiary to a closer one so they can visit him, a refill on medication even though I haven't seen them for a year, a consult to this and that without letting me examine them, a 5 page form stating why they should have power scooter rather than a wheelchair when they always walk to your office, all their meds refilled when on the bottle it clearly states that have 3 refills!, vicodin/darvocet/lortab because "someone stole theirs."

I just want to be mean. I want to tell them what I think. I want to say I am tired, I'm sleepy and I want to YELL. I want to be mean enough so they will leave me and move on.

Writing this makes me a little less frustrated. I have a lot of great patients and I guess they aren't as few and far between as I mentioned. I have made home visits after hours because I do care. But one difficult patient= 10 good ones b/c of the mental and physical time and toll they take.

I'm honored to have this role in life. I'm just tired. . .

PAIN

I've been spending my time AROUND pain lately. First, I've been subjecting myself to pain. Last Thursday entailed the removal of tons of nevi/moles to my back and chest followed by 2 fillings and a wisdom tooth extraction the following Friday. Two weeks prior I had a crown placed and another 2 fillings. I can honestly say I handled myself well in all instances as the perpetrators of my pain all said I was a "good patient."

The interesting thing about causing pain or observing pain whether physical or emotional is that we all handle it better when the person receiving the pain "handles it" well too. We like people who handle pain well b/c it makes us feel better or maybe relieved.

When a woman screams louder than any other in the obstetrics ward, everyone is slightly bothered. We can't concentrate. Same goes for anyone in the ER. Everyone is basically in pain there and the squeekiest wheel doesn't always get the best care or attention.

How do we handle emotional pain of others? When my father was diagnosed with prostate cancer last year, I didn't cry b/c my father never acted like it phased him. He put his faith in God for healing and is doing fine now. I asked my mother how he "really was" and she said he was fine. I think I would have been more distraught had I known he had not been doing well "emotionally."

I've had to inflict pain lately too. Several patients of mine have a new diagnosis of cancer that I found serendipitously. Relaying the message is always difficult but I always offer a prayer and most people don't refuse it.

While I haven't had that much physical pain to endure, I've had some emotional pain. I had a needlestick 6 weeks ago while doing a procedure on a past IV drug abuser. I couldn't get labs on her that day to check if she has HIV/AIDS b/c there was no lab personnel at the clinic. She said she'd come back. After weekly calls and her cell phone disconnection, she has yet to come back. Which, well, leaves me in emotional pain about my future. I had a few tears here and there, alone. I thought not being there for my son and husband, not having anymore children b/c of the risk. I believe I have nothing BY THE GRACE OF GOD and evidence based med says the % chance is low that I could. BUT STILL. AFter a month, I finally sobbed (yes that's the word) with my husband-- at night-- in bed-- so he couldn't see me. It was a good cry and in faith and confidence, I haven't cried since.

Pain can be lonely because your pain is yours and yours alone. No human can feel it for you, but Jesus can. He is there when you are going through it and knows about every event that led up to it. He endured the emotional pain of loneliness and rejection as well as the physical pain of the Cross. He can relate. He is the great Comforter who relieves the burden of our pain, rejection, & loneliness.