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Hello [Volunteer Supervisor].

I wanted to bring something that concerned me to your attention. Allow me to preface my mail by stating clearly that (as you may be aware) I have no formal medical training other than CPR and basic first aid, so please view what I write through the lens of someone ignorant of even basic nursing principles. That said, I would not be bringing this to your attention if I didn’t feel that it had profound implications for patient care.

It is an unfortunate – though perhaps necessary – requirement that one put aside one’s discomfiture at hearing the more audible signals of distress when working in an emergency room. By its very nature, our clients are those who are likely to be severely injured, and the pediatric nature of the work that you and I are around further compounds the issue. Young children are incapable of understanding their plight, incapable of understanding why doctors and nurses must sometimes do things that hurt them. That is simply the nature of emergency medicine for children, and not one that is always easily sidestepped.

However, there are times when it can be, and should be.

Last Monday when I was in the ER, there was a patient who was there for eye pain. (In U4 or 5, I believe.) She was young – very young, two years old. They had been there for a long time, and they were evidently waiting for a doctor to see them. So long, in fact, that the family had gone to sleep while they waited in their room. During the very end of my shift, two doctors entered her room and starting doing a procedure. And again, sometimes doctors need to do things that hurt. I get that, and I’m not bothered by it insofar as it’s for the patient’s well-being. This time, however, from my perspective, they were being unnecessarily hasty. They used no sedation for this procedure (whatever it was) and the entire time the child was crying – no, screaming in agony. This was not a cry of being tired and wanting to go home, it was one of terror and pain.

And – again – unfortunately, it’s sometimes literally impossible to get around that. But the reason I’m mentioning this is because several of the nurses that were there were wondering aloud to themselves why they hadn’t waited for her to be sedated before starting whatever it was they were doing with their array of metal implements.

This has profound implications for the hospital in several ways.

1) The pain experienced by the patient themselves, which was – if her cries were any indication – agonizing.

2) The parent’s conception of how their daughter was treated. If I were a parent, I would certainly wonder why two doctors came into the room, woke up my little girl, and started doing things that caused her horrible pain without putting her to sleep beforehand.

3) The general “culture” of a hospital, and certainly one of [the hospital’s] reputation and eminence, should always be one of caring and empathy, and avoid the all-too-easy-to-fall-into trap of seeing patients as biological machines to be manipulated into wellness, instead of people. If indeed anesthesia was indicated, and foregone not for any contraindication but merely for purposes of time or convenience, that speaks incredibly poorly of the attitude of the doctors involved.

I wish to stress that I am only writing this because the nurses themselves were wondering what was going on, and I felt that if given their expertise even they thought that the doctors were being unnecessarily hasty, there might be something to it. My goal in writing this is merely to bring to your attention something that I hope was unavoidable, but may have been unnecessary. It may be the doctors were acting with the greatest compassion and standards of care, I don’t know.

I am not an anesthesiologist, or a doctor, but I do care deeply about the patients that we see, and I want to make sure that they are being treated with the greatest respect and care possible, and not being caused unnecessary pain due to an over-dedication to a schedule or a fatiguing of a doctor’s compassion.

That is all. Have a good weekend!

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I feel my letter was the right thing to do. If anything, I could have maybe been a little stronger in my criticism, though I don’t know that would have served my purpose. We’ll see what happens.

Exit, stage left.
Sparks