Friday, March 25, 2011

Vague Patients

Twas an mid morning in RAZ ( our medium sick area), I saw a patient that was ready to come in on the tracker. The generic listed issue was a headache.  I popped them in a room and went to put the chart up on the rack. Normally I go in and assess the patient myself right away but since Dr Awesome was ready to see the pt right that moment we went in together to save the patient repeating everything twice (good thing we did). 

Dr Awsome: Hi, whats going on today
Pt Vague: I think Im sick
Dr A. Whats wrong?
Pt: I don't feel well
Dr A: How do you not feel well
Pt. I just feel sick
Dr A. Can you explain a bit more.
Pt:  I can't go to work.
Dr A. Why can't you go to work?
Pt: Because I don't feel well. Im Sick
(that reads quickly but really took about 2mins!!)
Dr A. So do you have a cough, a fever, throwing up, headache? Whats not feeling well
Pt. Yes
Dr A: Yes to what?
Pt. to all of them
Dr. So when did you start not feeling well?
Pt. Im not sure
Dr A. " Yesterday, last week, last month?
Pt:. last week, I think. I have a headache and feel dizzy when I stand up to fast
Dr A.- Examines pt. Asks more specific questions receives more vague answers
Dr A- you have to flu. Take tylenol and advil and drink lots of fluids. Melanie will give you some here to start.
I go and get meds and go back in to give to pt
Me- Here is some tylenol and Advil. (give my usual speil about the two)
Pt. Tylenol and Advil arnt the same thing?
Pt. Are there any food I shouldn't eat.
Me. You mean now, no whatever you want just make sure you drink lots of fluids
Pt. No, I mean are there any foods I shouldn't eat to not catch the flu?, How do you actually catch the flu? How do I get a BC healthcard?....

Two months later
Same Patient, Same Doctor Awesome, Same Me.
Generic Triage note is Chest pain, non cardiac.
I see that it is same patient, Dr Awesome and I chat, see that he has been here for minor things over the last two months, decide that we should also make sure things are fine at home and he is not seeking other help.
Dr Awesome: Hi, what brings you here today?
Pt Vague. I don't feel well.
Dr A- what doesnt' feel well? ( This time we only went 2 rounds of "Im sick", not 7!!)
Pt. My chest hurts?
Dr A- Where? When did it start?
Pt- All over, Im not sure
Dr A. Does it get better or worse with any thing such as movement, deep breath, cough?
Pt- Yes
Dr A. Yes?? Yes to what most people can say if it gets better or worse with something
Conversation Continues
Me- Here is some Tylenol and Advil for your pain
Pt- I don't want anything for pain, I just want the pain to go away naturally
Then why on earth did you come in!!!!

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