Should they be treated the same? If I knowingly put my body at harm, not once, but multiple times... should I get the same kind of care?
The healthcare motto is "Do no harm." Unfortunately that can't apply to everyone. I'll let you in on exactly what I'm thinking here. My last patient is the PERFECT example. Here's how the doctors dictated history and physical starts...
"This patient is allergic to animals yet still has three cats and a dog in their home. They have longstanding chronic obstructive pulmonary disease and smokes 2 packs of cigarettes a day. They are here today with shortness of breath with normal activities worsening over the past week. They will be admitted for a course of IV steroid treatment to decrease airway inflammation." (Although inspired in part by a true incident, the previous is fictional and does not depict any actual person or event)
Now, the nurses' response it to treat and do no harm. Have I lost my compassion or am I not the only one who just wants to scream?? My response would be this... get rid of you animals, stop smoking, and then maybe we'll talk about giving you some treatment. The healthcare system has done their part every six months to make sure can breath. But what are YOU doing to make sure you can breath? Oh... you're inhaling tar that coats your lungs and sucking down cat hairballs? Winning combination there. At this rate we may even get to see you three times a year.
Okay. My anger is out. Back to the question. Where do you draw the line for self inflicted illness? Is there a line? Is it grey? If there is one, can someone show it to me and these patients on the other side?
We can mandate by law that parents give appropriate care to their children. If they aren't being taken care of we can take them away or force the parents to change their environment. Why can't we make our patients change their environment? Let's call social services and have them remove the animals from the home. Test for nicotine use and cease care when demands aren't being met. But no... everyone has the right to treat their body like a piece of trash if they so wish to. So if someone chooses to treat their body in a way they fully know will cause them harm, why can't we choose not to treat them?
Maybe the patient would think a little harder before buying the pack of cigarettes next time if they knew they wouldn't get a weeks stay in the hotel when they couldn't breathe. Maybe they could have the determination to quit their habits. Maybe then we as healthcare providers could say, "I can see you're making every effort to keep yourself healthy despite you bad choices in the past. I would love to help you in any way possible!"
Now don't get me wrong, there are some self inflicted injuries that I truly believe should be treated with every effort and compassion. For instance a car wreck from reckless driving. Yes the person caused the wreck, however hopefully it will be something they can learn from and admit they made a horrible mistake. They deserve a second chance. Heck everyone deserves a second chance. But I'm not sure how many chances I'm willing to hand out and then pretend the behavior is acceptable. Because bottom line I think it's a waste of money, resources, time, and compassion. Because these types of patients suck the compassion out of people who have to care for them over and over again; and I want to keep my compassion ..........
The healthcare motto is "Do no harm." Unfortunately that can't apply to everyone. I'll let you in on exactly what I'm thinking here. My last patient is the PERFECT example. Here's how the doctors dictated history and physical starts...
"This patient is allergic to animals yet still has three cats and a dog in their home. They have longstanding chronic obstructive pulmonary disease and smokes 2 packs of cigarettes a day. They are here today with shortness of breath with normal activities worsening over the past week. They will be admitted for a course of IV steroid treatment to decrease airway inflammation." (Although inspired in part by a true incident, the previous is fictional and does not depict any actual person or event)
Now, the nurses' response it to treat and do no harm. Have I lost my compassion or am I not the only one who just wants to scream?? My response would be this... get rid of you animals, stop smoking, and then maybe we'll talk about giving you some treatment. The healthcare system has done their part every six months to make sure can breath. But what are YOU doing to make sure you can breath? Oh... you're inhaling tar that coats your lungs and sucking down cat hairballs? Winning combination there. At this rate we may even get to see you three times a year.
Okay. My anger is out. Back to the question. Where do you draw the line for self inflicted illness? Is there a line? Is it grey? If there is one, can someone show it to me and these patients on the other side?
We can mandate by law that parents give appropriate care to their children. If they aren't being taken care of we can take them away or force the parents to change their environment. Why can't we make our patients change their environment? Let's call social services and have them remove the animals from the home. Test for nicotine use and cease care when demands aren't being met. But no... everyone has the right to treat their body like a piece of trash if they so wish to. So if someone chooses to treat their body in a way they fully know will cause them harm, why can't we choose not to treat them?
Maybe the patient would think a little harder before buying the pack of cigarettes next time if they knew they wouldn't get a weeks stay in the hotel when they couldn't breathe. Maybe they could have the determination to quit their habits. Maybe then we as healthcare providers could say, "I can see you're making every effort to keep yourself healthy despite you bad choices in the past. I would love to help you in any way possible!"
Now don't get me wrong, there are some self inflicted injuries that I truly believe should be treated with every effort and compassion. For instance a car wreck from reckless driving. Yes the person caused the wreck, however hopefully it will be something they can learn from and admit they made a horrible mistake. They deserve a second chance. Heck everyone deserves a second chance. But I'm not sure how many chances I'm willing to hand out and then pretend the behavior is acceptable. Because bottom line I think it's a waste of money, resources, time, and compassion. Because these types of patients suck the compassion out of people who have to care for them over and over again; and I want to keep my compassion ..........
Pretend it is YOU who has these horrible "addictions" and ask yourself, "How many times would I want someone to show me compassion?" I do see the point though, just making another one. Being an addict myself I see from a different perspective than you, one, without actually becoming an addict, you will never understand. Pops
ReplyDeleteI completely understand addictions. However, I wouldn't define owning animals that you're allergic to when you have a respiratory disease an addiction. See what I mean? I'm talking about stuff that easy to fix but people don't. It's called noncompliance. They don't take any of their medications so they come in with a heart attack every year. It really does happen.
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