September 29, 2009

Ever Chewed Out a Healthcare Worker?

sinking-nurse

My hospital is around the corner from Gucci, Coach, and the Apple Store.  (Swank huh?)  I’m sure sneaky shoppers try to park in the hospital garage at patient rates.  It’s the front desk staff’s job to make sure they don’t.

A few years back, I had a particularly horrible post-surgery appointment: The doctor was great but the news was bad.  It took three hours and involved an unexpected and painful biopsy of newly found tumors.  The doc explained why the samples looked extremely suspicious of cancerous.

Shannon and I were crushed, our minds fried, our bodies exhausted.  We waited in line for the elevators, made it down to the lobby, and waited in another line for parking validation.  “I can’t do your ticket.  I need to see that you were at a doctor’s office.  Go upstairs and get them to initial a blue slip,” the front desk woman said while multitasking on her cell phone.

We know the parking routine well, but we totally spaced this time.  I pointed to my fresh, turtleneck-sized bandage. “Ms., I just had a surgical procedure.  I’m a cancer patient in a lot of pain and need my husband to get me home fast.  I don’t think I can make it back upstairs.  Can you call my doctor’s office for verification?”   No.  She would not budge.

As Shannon began the trek back to the doctor’s office, I told her to get a job where compassion is not needed, where she doesn’t have to think too hard or interact with cancer patients.  I dropped plenty of F-bombs into my statement.

Yesterday was Yom Kippur, the Jewish holiday where you atone and ask for forgiveness. This incident came to mind, even though it was a few years ago.

Living with an incurable illness can be infuriating. My mother always says honey goes farther than vinegar. And she’s right.  But I’m human and have my breaking points.  Especially when it comes to inefficiency or stupidity in the medical system. The perfect, ethical, Girl Scout side of me says two wrongs don’t make a right and there are appropriate ways to direct my anger.  But the realistic side of me says cancer sucks, and if you are going to act like a total idiot to me on a really bad day, I might act like one back and not feel too badly about it.

Have you ever gone off on a medical worker?  Did you feel justified?  Did you ever apologize?  Do you think I should have apologized?

Read more outrageous exchanges between cancer patients and medical staff in Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s.

Post to Twitter Post to Facebook

Tags: , , , , , ,
Comment(s)

  1. Anita Says:
    September 29th, 2009 at 12:31 PM

    Kairol,

    I had a moment like Shirley McLaine had in Terms of Endearment, it wasn’t about pain killers but something else, so I can relate to getting angry and yelling at a healthcare worker. I know Terms of Endearment, not the best cancer movie to talk about because the patient dies. Some healthcare workers I have met recently, try to say something funny yet it didn’t seem funny to me at the time. Less than compassionate anyway.

    Great post as always,

    Anita


  2. charissa Says:
    September 29th, 2009 at 2:37 PM

    As a healthcare worker, and a cancer widow, i felt a need to chime in on this, even though I dont have a good answer just yet.

    I can tell you, though, that I am overworked, and every person I deal with on a daily basis expects me to handle their needs as if they are the only person I have seen all day. I get paid too little, and work too hard, and still manage to try to be friendly at least 95% if the time.

    As a healthcare worker, we have rules, and we get in trouble when we bend or break them. Im not trying to excuse the actions of a disrespectful front office worker, merely saying that we cant always express to a patient/client why we can or cant do a thing they are asking us to do.


  3. charissa Says:
    September 29th, 2009 at 2:39 PM

    Oh- and Id also like to say, you never know what the person on the other side of the counter is dealing with. The entire 10 months that my husband was sick, and in these 6+ months after his death, I have had to chug away at my job, smile on my face, with not a single patient knowing what I had/have been going through.

    Point being- we’re ALL human.


  4. Kairol Rosenthal Says:
    September 29th, 2009 at 9:26 PM

    Thanks for your input Charissa, for walking into my line of fire. Workers in any field have to comply with rules, and even more so in the overly administrative world of health care. That’s why I think there is even more compassion needed – because as patients we are battling with the exhaustion of these rules every day too. We are not having to hide behind a smile as you have so intensely had to do. We are out in the open with our puss and discomfort and exhaustion. I think of the nurses, administrators, receptionists who have been empathetic, understanding, and kind to me even in the face of having their hands tied. If they cannot give me what I want or need, but go the extra mile to show they care and are sorry, it goes such a long way. I could be wrong, but I feel like I can usually tell the difference between an overwhelmed healthcare worker and one who is just callous and would rather be chatting with co-workers about their boyfriends while they accidentally type the wrong date on my medical records form. Thinking of you a lot recently and hoping you are well. Kairol


  5. Anita Says:
    September 29th, 2009 at 10:40 PM

    Kairol and Charrisa,

    Charrissa I understand and empathize with you. I am sorry that you are a cancer widow and a healthcare worker. You have my deepest sympathy and my respect. Having lost my parents to cancer and being with my mom in the hospital towards the end, it was tough for me and my mom was a hme health aide, so she was a healthcare worker too and gave all power to her oncology nurse whom she trusted with her life, thank god because she was great and caught things in my mom when chemo was giving her problems or the cancer had spread.

    Thank god for healthcare workers where would we be without you.

    Anita


  6. Pat Steer (Gaelen) Says:
    September 30th, 2009 at 11:02 AM

    Wow — I do see both sides, and I’d like to think I try to appreciate the humanity in everyone. But like Kairol, I’ll admit that when I’m fresh off a treatment or procedure, I’m maybe not at my best so dealing with someone who is also having a bad day is probably even trickier.
    I used to get my port disconnected at a satellite office of my oncology practice — where there was one of those buzz-for-admittance traffic arms blocking the driveway entrance (to keep hospital patients out of the oncology practice’s free parking area.) Leaning out the window to my left, with my left-side port accessed, was painful at best. One day, I buzzed. No answer — although I could clearly see the receptionist at her desk. She could see me, too, but for some reason, she didn’t buzz me in for what seemed like forever. No apology from her; in fact, she asked me what I hadn’t pressed the buzzer! When I responded, it probably wasn’t my finest moment of diplomacy. OTOH, two weeks later when I drove in to be d’cd, the barrier arm was gone. Guess I wasn’t the only person who’d had a tantrum.
    The only other healthcare folks I’ve gone off on were insurance specialists — most recently, the person who refused to approve my local pharmacy’s request for authorization for my Xeloda scrip. It was 9pm on a Friday night, the weekend before Christmas. I was to start the meds and radiation at 7:30 a.m. on Monday morning (Christmas Eve.) The insurance specialist insisted that my policy would only cover the Xeloda (about $2500 worth of meds) if I purchased it from their online pharmacy and had it FedX’d to me, and I not-so-respectfully suggested that there was no way they could get the shipment to me on a holiday weekend in time for Monday morning’s dose. She coughed, called her supervisor, and he called the local pharmacy in the morning with the authorization number.
    Yes, rules are rules. But common sense ought to prevail more than once in awhile — and when it doesn’t, in my case I have a tantrum. Usually, I get what I need. And no, I don’t apologize. I try to be as respectful and reasonable as possible, but I do have a breaking point and I’m not afraid to use it.


  7. Wendy Says:
    September 30th, 2009 at 9:35 PM

    GO KAIROL! sometimes ya gotta do what ya gotta do. I’ve done it once or twice and sometimes it’s necessary to lay it all out and hope they understand and I imagine they do and if they don’t appreciate what we go through then I say they deserve the tongue lashing. There’s no excuse for being rude or not making an exception for someone in a great deal of pain. If they really can’t make the exception bc the boss is watching or something, then they should say they would like to but they can’t instead of just a brusque “NO.”


  8. Pierre Says:
    September 30th, 2009 at 11:19 PM

    Yes, I chewed out a medical provider. I was in the hospital for my second brain tumor just after my craniotomy — so you KNOW I was in a great mood and had the impulse control of an Italian crack baby. I was at the tail end of my Gamma Knife Radiation procedure (about as pleasant as it sounds), an all-ay procedure, when my mom, who was with me, asked the radiologist “what causes these tumors?” He shrugged his shoulders nonchalantly and said, “Ahh, it’s just from the radiation treatments from the last brain tumor. Why, people who had radiation in 1984…yeah well, I see them on their fourth or fifth brain tumor.” That was his answer to my crying MOTHER, 10 minutes before going to a radiation procedure. So, when Prince Charming finally got up and turned around, I used all my pea-brained energy that day to kick the SOB is the ass! We haven’t spoken since. Brain tumors are not for sissies.


  9. Pat Steer (Gaelen) Says:
    October 1st, 2009 at 5:03 AM

    I do understand that we’re all human, and on my good days I’d like to think that I respect that. But when I’m fresh off a treatment or feeling sick, with nausea and fatigue running my life, I’m not sure I’m always at my best.
    The Friday before Christmas Eve in 2007, I tried to pick up my scrip for Xeloda from my local brick/mortar pharmacy who had the drug on hand. My pharmacy carrier refused to authorize the payment and insisted that the only way I could get Xeloda covered by them would be to have them deliver it through their online procedures. They insisted they could FedX it to me in time for my 7:30 a.m. treatment Monday morning (it was 9 p.m. Friday night, and did I mention it was Christmas eve weekend?)
    I went completely off on whoever was on the other end of the phone. It was over $2500 worth of drugs, it was covered by my company, and they were denying me on a shipping procedure. I demanded to speak to a supervisor, demanded that he call the pharmacy and authorize the immediate local delivery of the scrip, threatened to sue them for misrepresentation of benefits.
    They called the local pharmacy and approved my prescription (but told me if I needed more, I would *have* to get it through them.)
    I didn’t apologize. In fact, I reported the pharmacy to our HR department.
    Rules may be rules, but when common sense clearly isn’t present, I do make my displeasure clear — and I did that before cancer. ;-)


  10. Kairol Rosenthal Says:
    October 1st, 2009 at 11:08 AM

    Pierre – I’m very curious – was that a metaphoric kick or did you literally go for foot to butt contact? Either way, hats off to you for making a statement. I have to concur with Pat – making my displeasure clear is not new to me since cancer. Now I just do it over matters that are sometimes the difference between life and death. Thanks for all of your comments! Kairol


  11. Jennifer Says:
    October 4th, 2009 at 3:40 PM

    While I haven’t chewed out a medical worker (though I’ve wanted to) – my best friend has. She chewed out an ultrasound technician for being insensitive – and really not following protocol. I don’t think you need to apologize for expressing yourself ever, and I would have chewed out that girl too, and my friend’s ultrasound technician. If you aren’t a sensitive and caring person – perhaps working in the medical field where you have contact with patients isn’t for you. I am in chemo now and lately I’ve been really glad for my ChiliPad – It’s a mattress pad that lets you cools or heats the bed, mine lets me set any temperature between 46 and 118 degrees. They also make ones with two temperature zones. It really helps with heat, chills, pain and sleeping problems.


  12. Pierre Says:
    October 4th, 2009 at 4:48 PM

    Kairol,

    It was a a literal kick in the butt! Despite my best efforts, I don’t know how hard the kick was, given the state I was in—ya know, with the drainagetube still attached to my head to capture excess blood draining from my brain. However, I think watching me trying to kick the guy in my Frankenstein drag definitely drove home my point. He had the senstivity of a porcupine, and I just qish I had had the mental capacity at the time to say something clever. But I believe what does around comes around :)


  13. anonymous healthcare worker Says:
    October 8th, 2009 at 1:46 PM

    I am a healthcare worker who schedules newly diagnosed and recurrently diagnosed cancer patients to see the surgeon and then schedule their surgeries and the follow up visits to the surgeon – some patients are calling for their 20 year follow up appointment!

    Day after day I am gifted a level of intimacy and trust from these patients that makes my job feel like I have been elevated to a higher position than is actually documented on my job description. I am a total stranger that they are instructed to call after receiving just about the worst news they could possibly get. Regardless of what they have already been told by other healthcare professionals about the survival statistics or whatever else they might expect their future to hold many of them are sure they will probably die before I can get them scheduled to meet the surgeon. The different ways that people try to communicate the level of urgency that they are feeling has been a source of entertainment not annoyance for me. After hearing different scenarios for over 12 years I still get to hear a new one now and then and it never ceases to amaze me.

    Some of the people I talk to are all business and just want to get right to the basics – when can I see him – when can he do surgery? No problem. I have those answers. However, a greater number of the patients do not make it through this first phone call without my knowing a great deal about them, their families, the cruise that they had dreamed and saved for years to take might need to be cancelled now, the upcoming wedding of an eldest or baby of the family. The significant anniversary plans that are all now thrown to the wind. The upcoming birth of a much anticipated first grandchild in another state and grandmother was so looking forward to going and staying there and helping out the first few weeks. Now after she gets off the phone with me she has to figure out how she will break this news to her beloved child that is currently in the one of the happiest times of her own life. And now all the joy seems to be vanishing right before their very eyes and I can feel it through the phone line.

    My motto has been that any one of the patients could be my mother, sister, grandmother and I treat them with as much respect and compassion that I can muster no matter what type of day I have had or what type of problems I am dealing with. If my own problems were too great to deal with I don’t come to work that day. There aren’t too many personal problems that aren’t at least temporarily erased by talking to a newly diagnosed cancer patient trying to deal with what has just changed the world as they knew it.

    Patients who call me back wanting to apologize after having behaved in a manner which they describe as “I am not usually like that, or I didn’t know what I was saying,” are told that they are not held responsible by me for their behavior for at least the first year because most of them have never done this before, without practice how are you supposed to know how to behave when you have just been diagnosed with Cancer?

    It is not easy being 100% every day on the other end of the phone. If you don’t really care about people you should not be in this business because you really can’t fake it. I feel blessed to have been given the opportunity to be invited so intimately into so many amazing people’s lives. I have been thanked so many times and so many ways that it becomes embarrassing at times. After reading about all the unfortunate encounters that patients have had with other healthcare workers I just felt compelled to use this forum to let people know that there are those of us out here whose lives are enriched by helping you navigate the cancer landscape – way more than we are enriched by our paychecks. The behavior at the bottom is usually directed from the top so next time you have such an encounter do not be shy about letting your doctor know that their standards are somehow getting mucked up on the way down the food chain to the point of downright rottenness. Otherwise you will be using your precious energy trying to figure out how to deal with the bad egg during a time that all you really need is the golden egg.

    I am sure that if I should ever get diagnosed with this disease I have no idea what I will say to my counterpart on the other end of the phone to make sure they understand my level of urgency but I sure have a large reference of material to choose from and I thank you all for sharing so much of yourselves with me.


  14. anonymous Says:
    October 14th, 2009 at 4:17 PM

    I appreciate hearing from “anonymous healthcare worker.” My experiences as a young adult cancer patient were a total nightmare, starting with the accidental overdose of a chemotherapy drug during my very 1st tx (horrible mucositis, vomiting, white count in the tank) and ending with a jackass of a physician who refused to do the followup protocol recommended by the oncologist because “it cost too much.” Seriously, I am not making this up. Funny how they all wondered why I was getting increasingly distressed and uncooperative.

    Although I would love to never set foot in a doctor’s office again, ever, I know this isn’t realistic. So it’s good to know there are people out there who genuinely do care and want to do their best for patients. Sometimes we vent on sites like this and it can scare others away – it was brave of you to speak up and I do appreciate it!


  15. Wendy S. Harpham, MD Says:
    November 22nd, 2009 at 12:09 AM

    Dear Kairol,

    I doubt the parking-ticket validator considered herself a “healthcare worker,” even though she knew she was dealing with patients. I can’t know what she thinks, of course. And it doesn’t justify her actions at all. Nobody under any circumstances should respond the way she did to you.

    This is why I’m bringing this up: From the patients’ point of view, it is important to differentiate between the workers like her (who patients may never see again) and the healthcare workers on whom they depend for their medical care. Lashing out at nurses or physicians could be more complicated and the consequences more serious.

    Here is a column I wrote for oncology professionals, discussing why patients can be rude or snippy on occasion (and why they deserve some slack). http://tinyurl.com/OT-Blue

    With hope, Wendy

Leave a Comment