Saturday, March 24, 2007

P.I.T.A.

Have you ever encountered a "PITA"? If you deal with people, the answer certainly has to be "yes!" What's a PITA? It's a Pain In The Ass, that's what!

A PITA can be a coworker, a patient, a family, or Heaven forbid ... a doctor. We have had a gaggle of PITAs at Work this past week. Our biggest PITAs were family members. There were two patients in particular that had associated PITAs. The patients themselves weren't PITAs, but their families certainly were. PITA #1 was mild compared to PITA #2, but was a huge PITA nonetheless.

PITA #1 belonged to a 30-something patient who had a MAJOR surgery, but was very stable and not a problem in and of him/herself. Spouse, Mom, and Sister were another story, though. Patient needed a calm, quiet environment with minimal stimulation, but Family wasn't willing/able to provide this. They constantly hovered, talked to, and touched Patient. The end result? The most impressive projectile vomiting I have ever witnessed.

Also ... despite our rule of no overnight family, they demanded to spend the night with Patient. The stimulation and constant calls to the nurses continued. Fortunately, the projectile puking didn't persist. The minute Patient would wake up, Family called for pain or nausea medicine. Patient didn't want or need said medicine. They constantly spoke for Patient and made requests on Patient's behalf. Patient finally got the balls to tell them to knock it off. Thank God they (notice I said "they") went home while I was off. If I had to care for them one more day, I'd have probably poked myself in the eye with a pencil.

PITA #2 was exponentially worse than PITA #1. This PITA belonged to a little old person who had a potentially life-threatening injury. Son in PITA #2 family was the Power of Attorney for healthcare, but you'd never have known it. There is a physician in the family, but Doctor isn't a blood relative and doesn't practice here ... not even in this city. Doctor decided that s/he would make all decisions, regardless of what Family wanted. Doctor was even overheard asking other family members, "Who's the doctor here?" Too bad Family was spineless and felt they couldn't stop Doctor in his/her tracks. And too bad Patient's doctors were the same way. ALOT of arguing and wasting of time could have been avoided. You'll be happy to know that Patient is doing fine and wasn't done in by the potentially life threatening injury.

Who spends the most time dealing with PITAs? You guessed it! We nurses do. I just want to go to work and take care of my patients, not their PITA families. Sometimes I think to myself "A little Valium for Patient ... a little Valium for PITA ... a little Valium for me". Of course, we all know that's not the answer. We just bite our tongues and bring more ice chips served up with a smile.

Carrying on the theme of asking from my previous post, I frequently ask myself:
-When did nursing get this way?
-Why do PITAS act the way they do?
-Didn't anyone ever tell them that the ruder they get, the less anyone wants to help them and the more people avoid them - not the other way around?
-Is this a hospital, or is it the Hilton?
-When did it become OK for PITAS to berate nurses?
-When did it become OK for administration to tell nurses to endure this abuse in the name of "customer service"?
-Maybe most importantly ... Why do I go back day after day for more? Sometimes I wonder, but deep down I know. It's for the Patient, not their PITA.
~RWS

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