Ortho docs, orange sherbet and X-rays

Among nurses you will find that we have our favorite doctors and our least favorites. I am sure that that comes as no surprise to most of you! There are even a few specialties where the nice ones shine brilliant stars because the norm is that the docs are so rude, god-complex, oh, my list could go on... Good at their skill but when it comes to bedside manner and doctor/nurse relationship, well lets just say their isn't any!

Orthopedic surgeons are on the top of this list for me and due to our hospitals growth I very rarely see patients with these types of diagnoses so don't encounter their doctor's either until this week...

Patient number one had recently had back surgery and had returned due to back pain worse than before or after his surgery. He was miserable. The nurse on the shift before me had worked all day with him attempting to get his pain under control without much relief. She had made multiple calls to the doctor and had gotten little in the way of answers. When I arrived the doctor was there for the first time all day and had agreed to change his pain medicine. Relief was on the horizon... Or so we thought.

Meanwhile patient number 2 is across the hall with an infected knee joint waiting for his orthopedic consult to further his care. I talk with his wife who has been waiting all day in hopes to speak with the doctor. In her words, "I would have been here with my husband anyway but this waiting is killing us..." On deeper investigation into his chart it appears that the doctor was notified almost 24 hours before. I call the on-call physician and explain the need for my call. He isn't happy with ME. I explain that nursing had notified his office and therefore it is in their hands and that while I am not expecting him to come in at 9pm I do expect some sort of answer for my patient. He finally agrees to listen to my plea/predicament and asks for a review of the patient's chart. I finally do have something to tell my patient. By the time this is done though, the wife has left to take their son home. I am feeling frustrated but the patient is pleased.

Back to that other patient with all of that back pain, he's still hurting, hurting bad. I have tried everything I can think of medically and even have offered him orange sherbet, like that's gonna help. He begins talking about his family, 2 girls ages 5 and 6 and a little boy 8 months old. I start talking about my plethora of nieces and nephews, we get to know each other. He's smiling now. I ask how bad his pain is and he has to think about it, still says it's "up there" but it isn't his main focus. The next time I'm in his room, we watch some of the exit polls (have I mentioned that it's election night??). The next time I think I actually was able to give him something for his pain but the next we argued McCain vs. Obama. He was still in pain but through becoming his friend as well as his nurse he was able to get some relief from the pain. He even got some sleep that night.

And patient number 2? That doctor that didn't want to be involved when I called him came in at 5am to evaluate him!! He agreed with the diagnosis and the treatment that was in place and by the time I was going home that patient had discharge orders!

I don't particularly like orthopedics, I don't like their doctors and the patient care can often be very heavy but both of these patient's turned out to be alot of fun to care for.

The next shift I was on the other end of our department as the pediatric nurse. Though not actually a pediatric in hospital standards I admitted a 15 year old who had broken his arm. Oh yeah, yet another ortho doc!!! This kid turned out to be so much fun to take care of! He has high functioning asburgers syndrome which just made his responses and questions a little bit different than that of a "normal" 15 year old. It was too soon for pain medication so I at first used this as a divertional technique... I pulled up his x-ray to show him his fracture because for some reason it is true with all boys that scars and broken bones are COOL! He loved it. By the end of the night, he had in fact received the pain meds that I am sure he needed becase he infact had done a doozy of a job breaking that arm but I had also showed him those x-rays 3 times!

I was explaing to him what to expect when he had surgery and how his pain would change and he says, " wouldn't it be freaky if I came back and had stiches on my chest???"

In the end it wasn't any of the medication that I gave to any of my 3 orthopedic patients that made them comfortable it was going the extra mile. I don't want this to be a pat on the back but as a reminder that the extra mile often is only a step or two.