It’s humbling, landing yourself on a stretcher, and viewing health care from the perspective of a patient. One of the most common things for an asthmatic, is experiencing chest pressure, and shortness of breath - it’s a tightening of the throat that suddenly wakes you up at night, a pain that can perhaps be described like a persistent ache in the chest, like all the air is sucked out of you, and actually quite scary if you’ve experienced it. And so, with all those symptoms, I did what any (dumbass) health care provider would do, I ignored it, hoping it would go away. Nurse managers tend to get annoyed with sick calls, so I went to work - it’s a critical care environment, no worries, I’d be ok.
Except I wasn’t, and the charge nurse knew it, and still asked me to take what was evidently going to be the unit’s most unstable patient, about to come out of the OR: I stopped for a minute, and considered it from the patient’s point of view: it wouldn’t be safe for them to have a nurse who wasn’t on point. And it wasn’t safe for me, since the sob and chest pressure was unrelieved - so, even though I could tell it annoyed the charge nurse, I went to the ER (despite my reluctance, I knew how busy they are, and thought I could avoid it). I can’t say I was too surprised to discover my oxygen saturation was 86 (oops). I felt incredible fear (well, first denial, if I’m being honest). Fear, of all the cardiac and respiratory possibilities, (plus I’m scared of needles), and as they worked me up, I felt my heart racing, although I stayed very quiet, having no choice but to put my trust in their care. I willed my mind to the serenity of sun and seaside of Bondi Beach, and tried to let go of the frightened feeling, but it wouldn’t dissipate. It was the phenomenal care of the nurses, who somehow knew that even though I was silent, and looked relatively calm - they surmised I was trembling on the inside, and scared beyond belief. I am thankful for nurses who do not assume quiet patients aren’t nervous or frightened. They were run off their feet in work, drunk patients cursing and knocking things over, fast tracking patients quicker than I could puff through my nebulizer, stretchers lined the ER, waiting room with a steady flow of people, and yet their care was of excellence.
Four things I (re)learned today. 1.Never forget how frightening, or vulnerable it feels to be a patient. 2. Ignoring chest pressure and difficult breathing is probably not smart. 3. Taking four flights of stairs, instead of the elevator into work is probably not smart either. 4.ER nurses are tops.
The most frustrating thing? Being denied the prescribed medications by the pharmacy, ones that medical evidence has proven will help treat me, (insurance will apparently only accept mail in prescriptions of “maintenance” meds). Really?! Dang. Albuterol is a first line medication in the prevention and EMERGENT treatment of asthma - considered a ‘rescue inhaler’ to be carried around at all times, and a lifesaver when it’s severe. (It was the first thing they gave me in the ER). It’s a bronchodilator, which provides immediate relief, not a medication that a patient who may experience sudden shortness of breath ought to wait via snail mail. The insurance company rep’s helpful response? “You just have to wait.” (Thanks for the empathy). Companies that are more talk, than action when it comes to the person at the bottom of the food chain. Shrug.
I’m a nurse, so I at least have emergent treatment available on my unit, (but not at night time, or days off) - and what about all the patients who do not have any immediate access? What about the people who wake up in the middle of the night with shortness of breath while they wait for their medication to be approved, and delivered? This is unnecessary time and effort expecting patients to jump through all the hoops just to get the basics needed to take care of their health. I can understand why people aren’t as compliant. It’s a flashback to when I first immigrated and had no health insurance, or quality of care. This is precisely why ER’s may still be overrun with admissions that might have been prevented, despite a really great recent change to afford everyone the right to health care insurance - they just can’t get the meds in time to prevent the issue. Frontline Health care is evolving, with the Affordable Health Care Act, isn’t it time Insurance companies followed with vital medications, instead of regressing? Hopefully, this will change soon too. Thank goodness for emergency room nurses and doctors, and their extraordinary patience, compassion and care - although I hope I do not see them again too soon.
It’s a few days later, and I’m waiting for the irritation to pass, so I can write a clear headed formal letter of concern, (void of the curse words I’m currently thinking). It’s likely one voice won’t make much of a difference, but heck, I’m trying anyway.