Let's Go Shopping !!!!

Dear Patient;   I invite you today to go on a shopping trip with me.  No need to bring your wallet, we'll only be shopping for "thought provoking" items.  You know, the things that make you go "hmm." items.  Pick your favorite place, envision it.  Got it?  Be sure to look out for those "RED light ER specials" they may just save you at some point in your life, if you end up going "Beyond The ER Doors."   Buckle your seat belt, I'll drive.

We've arrived at the destination of your choice;  (Remember, your brain may not have chosen to come to the ER but your body demanded it) much like this trip.  Your brain may not have wanted to arrive but you needed to "pick something up." 

The first thing you may notice is that your store of choice has a "greeter." Someone whose job it is to "welcome" you to your "shopping experience" whether you want to be here or not.  Many hospitals now offer that same service.  Greeters.   Personally, I'm not sure the "greeter" concept is effective or not, or if being "greeted" has truly "enhanced" my shopping experience from entrance to exit.  See?  I just bought my first hmmm" moment.  Are you "hmmming" too?

Shopping cart in hand, we head down the first aisle of your choosing. You are having trouble finding your first item, and so you stop a "sales associate" to ask if they might help you find it and are met with blatant disregard.  "I don't know where it is, maybe try aisle 10." and they turn away from you and back to their laughing conversation with their co-worker.  You've just met the  first person you actually PAY for your shopping experience when you get to the register to check out.  Are you walking away feeling a little put off by that first experience?  Did you say anything to the sales associate?   Most of us probably said a little something, some, maybe more than others; such as or perhaps;  "If you don't know where to find it, then could you find out or find someone who does?" and with the look on the sales associates face, you are supposed to feel "sorry" for interrupting much less expecting anything from this person.   Did this person lay one hand on you?

And now let's compare our shopping prices;   Would you have allowed this same person who could NOT answer your questions, who seemed indifferent to your experience, who looked at you as a "whatever" human being.......would you have allowed them to stick you with a needle?  Give you medication, put you in a gown, put oxygen on your face without STOPPING them in their tracks?    The answer should be a resounding "no" but so many times, I watch patients compromise THEMSELVES, sacrifice up, per se, their lives, (and yes, it is your life, we start IV's, push medications and do all kinds of things to your body), without so much as a question from you.   Did we just put that thought provoking item in our shopping cart?

Moving on you want to try on a pair of jeans.  You arrive to the dressing room only to find that the jeans are dirty and the snap is broken on the zipper.  Did you slide those jeans on your body regardless?  Did you take that soiled, broken pair of jeans out to the person at the desk and say "I'll be taking these."???   Of course not.   But you will slide into a hospital gown without even having looked at it to see if it's clean or soiled.  (Hospitals are not perfectly running machines Dear Patient, and like ANY other place on this planet, not every single person does their job to 100% on every given day) - understand I'm not slighting or stating this to be fact, rather, it is another "thought provoking" item you might want to recognize and purchase.   Is your gown clean?  Sheets clean?  Stretcher clean?  Side rails clean?  Do you know how many people are on that stretcher in a given day?  The good RN's/Tech's and House-keepers truly make a valiant effort to clean their area's, wipe those stretchers with antiseptic after a patient leaves, prior to putting a clean sheet on.  Make sure yours did.   Germs..........don't get turned away at the door by the '"greeters."

You  are now in the kitchen items;  You purchase a few things.  A couple of spatula's and a mixing whip.  When you get home, will you place those directly in your kitchen drawers?  Of course not. GASP.  Because you say to yourself "how many others may have touched these and where were their hands prior to touching them?"  and so they go directly into the dishwasher.  After all, you want to protect yourself and your family from germs and anything else that might make you ill.    

 Dear patient.   Did your RN wash their hands?  Use the alcohol dispenser prior to touching you?  If they come into your room rubbing their hands together, chances are, the answer is yes.  If not - you have the RIGHT to ask them to wash their hands.  Do they wear gloves when starting your IV?  Those gloves protect us, but they also protect YOU.  Is the equipment they use clean?   When they are gathering their supplies (this is one of my biggest pet peeves) - and they tear tape to use to tape down YOUR IV, do they place those tape pieces on the stretcher railings?  They are going to place that same tape near the now open "wound" they created with a needle, that leads directly, into YOUR bloodstream.   Dear Patient;  every nurse has their own way of taping down an IV but putting that tape on a stretcher railing should not be part of it.    
 
<Side Bar> OK ALL RN'S TAKE A BREATH;   I'm not saying anything you don't know to be fact.  I personally, use a sterile (right out of the package) occlusive first, tape to the hub so if the IV works its way loose, I can still tighten it and use tape on top of that to reinforce how secure it is.  If I need to tape prior to the occlusive, I will actually give the patient some alcohol rub to clean their hands, and put my torn pieces of tape on the back of the hand I won't be using for their IV.  That way, at least I am transferring from the patient, to the patient.    Other idea's are welcome welcome welcome.   Keep in mind, what I'm talking about here is protecting OUR patient.  Thoughts?

Okay Dear Patient; we now have a couple of "thought provoking" items in our cart.  You with me?    Let's head on up to the register to check out.

As we approach the registers, the lines are long, the wait is long.  We start searching frantically for the shortest line, the one that will get us out of here quicker.   SOMETIMES they will open a new line to help propel the customers out faster in a more satisfactory manner.  Sometimes, you have no choice.  You will be waiting in line.    You know those things they put up by the registers hoping you might pick one up at the last minute and spend more money?  We are going to do just that.   We're going to pick up one more last minute, "thought provoking" item.

Dear Patient; We really do try our best to meet your needs in the most efficient professional manner available to us;  many times, we can "open another line" by working as a team (staff that are not busy are professional enough to help those staff that are busy) but there are just going to be times that we cannot "open" that additional line.  We may be working short.  Maybe one or more nurses has called in sick and we have no replacement, which increases the amount of patients the remaining nurses must care for.  It increases our stress levels for sure and your waiting times.  We are responsible for you and good RN's don't take that responsibility lightly.  Just as we should try to meet your needs, please consider that our "hurried" nature may have nothing to do with our "caring" nature. It may have everything to do with how many patients are standing in "our lines."  

At this point, Dear Patient, you do always have the choice of "line jumping." We all do that if we feel it will "hurry" us out the door. Doesn't always work does it?  And why are we always in such a hurry anyway?  You can line jump in our Emergency Department too.  Did you know that?   If you feel that your ER Doc, RN/Tech are not meeting your needs or have slighted you in any way, you have the RIGHT to line jump and ask to see the "Charge Nurse" and she can assure a smooth "check out" process for you from that point forward. 

As we push our cart back to the car, you have already processed in your mind whether or not the shopping experience was a positive or negative experience for you. It will affect your "choice" to return to the same store again. 

In your ER experience, it is our job to understand your needs and to address them to the best of our ability.  We need, encourage and appreciate your willingness to help us, help you.  (Didn't Jerry McGuire say that?) 

I think we have sufficiently "filled" our shopping cart today;   I hope your experience, was a pleasant one and thank you, for shopping with me and allowing me to drive you along during that ride;  Trust;  What a powerful, powerful emotion.  

Now that we've started your IV - maybe tomorrow we can roll your stretcher out of the ER on a field trip we can call " The hospital experience."  Rest up.  OH, and be careful with that IV and have you given us that urine sample yet?