The New Heart Doctor

12 Mar

Patient is 95 years old. Demented. Came from the nursing home with complaints of chest pain 10 out of 10. Family is complaining about the care at the nurisng home. The new heart doctor assesses the patient. The 95 year old female is happily eating her lunch with a big smile on her face.

New Heart MD: “What brings you here?”

95 year old patient: “I have chest pain.”

New Heart MD: “On a scale of 1-10 with 10 being the worst how bad is the pain?”

95 year old patient:” 10″

New Heart MD: “Nurse will you start this patient on heparin gtt and nitro gtt stat please.”

Nurse: (confused and perplexed) “Really? Ummm, I will wait for you to write the orders and then fax them to pharmacy.”

okey dokey!  {I am not running though.} I mean is this MD serious?  10 out of 10 eating her lunch, smiling from ear to ear?

One hour later….Heparin and Nitro infusing quite nicely.

Nurse: “Are you having any pain?”

95 year old patient: “Yes”

Nurse: ” Where is the pain?”

95 year old patient: ” In my chest”

Nurse: “How bad is it on a scale of 1 to 10 with 10 being the worst pain in your life?”

95 year old patient: “10”

Nurse: “OK you can go back to your nap now.”

Seriously.

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One Response to “The New Heart Doctor”

  1. Nurse Blog March 15, 2009 at 13:44 #

    I think this is a perfect example of subjective “pain-rating” vs objective observations. Both subjective and objective indications for pain is important, but when these two indicators do not agree, I think this calls for something else to break the tie. I believe the tie breaker here is an “level of orientation” assessment on the patient to determine how reliable is her subjective report of the pain. The qualified nurse who hooks-up the GTN/heparin infusion would benefit from looking at this case from this angle. It couldn’t hurt. Plus it will is one more argument in favor of the nurse should there be a court case, which is a likely scenario since it has been mentioned that “the family already complained”, indicating that family is aware or trying to be aware of patient’s care.

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