Tuesday, December 9, 2014

Warning: This post contains graphic images

   The actual title to this post is "Learning to Look Up". I put the disclaimer at the top because non-medical individuals are allowed to be disturbed by blood and insides of the body being outside. It is nothing shameful.

   When I walk, I frequently find myself looking down. I am not the most coordinated of people at times and can easily get distracted by my surroundings and misjudge a corner of a wall or fail to recognize the spread of a rolling chair. I regularly find cuts and bruises on myself from unknown causes. Hence I look down.

   Sometimes I catch myself "looking down" at work. Focusing on tasks and diseases and failing to see a person with needs other than a quick IV and medication. I rush through my tasks so I can finish my charting and fail to be the one to actually see the person in the gown.

   One such time in my life, God reminded me to look up. A patient was assigned to me with complaints of lower extremity/calf pain. She was in tears and saying her leg felt like it was going to explode. Unfortunately, tears in the ER are a norm and must be sifted through. I will admit, I took her semi-seriously. I had just discharged a horribly dramatic drug seeker who had attempted to use up all of my compassion and dragged me through mounds of hypochondriac "issues". This new patient had been brought back to the exact same room and I had walked in with a remaining attitude from the prior encounter.

   I walked out of the room to grab my IV supplies. I re entered and began assessing the patient while starting an IV. Labs drawn and as thorough an assessment completed as possible with her tears and pain, I returned to find a Doctor to address a bit of the pain so that a better assessment would be possible.

   After giving her some medication, she was less tearful and able to share her story. She had a blood clot in her leg that was a result of an accidental kick during a game of freeze tag. She was being treated appropriately, but today things changed and suddenly she began having excruciating pain with occasional loss of sensation.

  What were these bizarre symptoms? Drug seekers come in all shapes, sizes, appearances, and sometimes I still get tricked. If it wasn't that, there are some emergencies it could be. When you did the physical assessment, her leg looked just a little more swollen and was just a little more warm. It gave all of the characteristics of a normal leg with very subtle differences.

   Ortho was consulted. They wrote her off as being dramatic but the Doctor and I began considering something more. We paged again and demanded they take a second look. A pressure was checked in her leg. Sure enough-no drugs, true pain. This patient was dealing with compartment syndrome, a true emergency where the pressure is too great in a compartment of the muscle which can cause irreversible muscle and nerve damage as well as blood flow problems. The patient was prep'd and rushed off to surgery to have a emergency fasciotomy.

I tell this story, partly so I will remember the lesson learned of always taking things seriously until proven otherwise, but also to remind myself to remember the humans around me. I allowed my emotions from my prior patient to influence my treatment of another patient. While there was "no harm done", the potential was present. Additionally, I was lacking in my compassion levels due to a prior experience. People are human. They make mistakes. They also make life better. Our judgement or preconceived notions need to be dropped when it comes to being loving. Jesus gives love freely to all and my prayer for today is to stop "looking down" and start loving others more.

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