Trau·ma  Junk· ie  ( 'trau-m&  'j&[ng]-kE) n. Slang
  1. One who has an insatiable interest, devotion or addiction to responding and assisting people with serious injury or shock to the body, as from violence or an accident.

The Type of Patients I Just Don't Want to Take Care Of...

There, I've said it. As much as I love taking care of patients, and as much as I enjoy working in healthcare, there are some patients that I wish I didn't have to waste my time with. As you read on, you'll begin to know what I'm talking about.

Inspired by a recent post on Respiratory Therapy 101, as well as another related post written by Glenna over at G's Spot, I've decided to speak my mind as well. I have that feared that doing so would make me seem like less of a CNA, less of an RT Student, or even less of a caring human being. However, when people present to the hospital that don't care about themselves or others, I often that it is a waste of my time to take care of them, although I do it anyway.

I'm talking about drug dealers, drug addicts, murderers in jailer custody, people who harm children in awful ways, people who commit hate crimes, and others along the same lines who use the entire hospital/healthcare system to obtain narcs from the ER staff, as a place to sleep for the night, or whatever. They are usually the most demanding, rude, patients I have ever come across. If you are not there the second they hit the call light, they'll just start yelling or hit the call button again.

Let me clear things up a bit before I go on. I have no problems with caring for a recovering addict who is making an effort to turn things around, or a prisoner of the county jail who is in custody during his hospital stay because he bounced a check and didn't have money to pay it back. But when I'm helping take care of a patient who genuinely doesn't care about their own life, I become sick of it after my first encounter with them.

Case in point, here is a conversation I had between a patient I was helping the nurse admit the other night:

"Do you have a history of, or are you currently using recreational street drugs?"


"So are you currently using illicit drugs, or do you have a past history with them?"

"Currently. I use Ice."

"When was the last time you used?"

"About an hour before I came to the ER. "

"Would you like assistance with overcoming your addiction upon discharge? Case management can find you a rehab program or we can ask your doctor to refer you to an addiction specialist."

"No, just hurry up with the 20 questions so I can go downstairs and smoke. Also, I need another blanket."
The patient had a history of Hep C, HIV, and who knows what else. She was admitted to the floor I was working on with chest pains, heart palpitations, and a few other cardiac dx's. I'm far from a doctor, but I'm going to chalk all of this up to her drug use. And do you know what is the saddest part of all of this?

She's on Medicaid. So everyone out there who works hard for their paychecks is paying for her to stay in our hospital. Blue-collar workers and doctors alike are all having deductions made from their paychecks to cover the cover of the neb tx's, CT Scans, EKGs, lab work, Morphine, and whatever else she gets while she is in the hospital.

But the worst part of it, I feel, is that we have to take care of her while she is there. Before you see me as uncaring, remember that there are patients in the hospital who are truly sick, not as a result of their wreckless lifestyle, who do need our help. And it is the latter group of patients that drew me to the healthcare field. I'll go completely out of my way to bring a blanket to the teenager with Meningitis, the elderly woman who is bedridden, or the guy next door him with pneumonia who can't walk more than a few steps without having to stop and catch his breath, but it really bothers me to have to do anything for a patient that have a general disregard for society, their own lives, or the lives of others.

I don't know why I have to take care of patients like this, but I do it because it is a part of my job. However, in my opinion, there is just no hope for people like her. The day she gets out, I'm 100% sure that she is going to start using again, based on the simple fact that history seems to repeat itself. And I'm sure I'll run into her again if I'm still at the same facility a year from now.

If I don't, there will be others like her. I'm going to quote the anonymous RT over at Respiratory Therapy 101 to sum up this entry:
Sometimes the best thing to do is to do nothing at all, and I think it’s high time we took that action in this case.
It doesn't get much more real than that. Do nothing. (If only it were that easy.) If a patient is just going to do the drugs again, it makes it that much harder to take care of them when they present with the same problem the next time.

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