Experiencing the professionalism of nurses and medical residents

Today I became a patient.  If you follow me on Twitter, then by now you know what happened.  Yes, I am embarrassed by what happened, but I’ll relinquish my HIPAA right to privacy for this moment.

This afternoon I swam nose-first into the sidewall in the pool.  (I haven’t been swimming in awhile and I forgot to bring goggles, so I wasn’t really looking.  Laugh all you want …)  It didn’t hurt all that much, and I wouldn’t have even noticed any issues for a little while if blood hadn’t come gushing out.  Jane, the lifeguard at the Y, was very helpful in getting me settled on the side of the pool while I held pressure.  After holding the icebag on it for 10 or 15 minutes, I was able to palpate the bridge of my nose, and then it hit me.  There was a dent in the side and a small bulge on the opposite side.  Yep, I had broken my nose.

With two little kids, I didn’t want my wife to have to bring them to the ER, so I drove home, grabbed some books, and headed to the ER at the hospital where I work.  I figured I’d be there all night.  I mean, a broken nose is nothing compared to the typical emergency room traffic.

I parked in my usual lot and walked toward the ER.  By a stroke of luck, I ran into an ENT colleague on my way in (he was heading home for the day).  When I told him I was heading to the ER for what I thought was *laugh* a broken nose, he took a quick look and agreed.  He gave me a quick rundown of what could be done, since I really didn’t know.

I was triaged and put into a room within 15 minutes.  Within the next 15 minutes, a financial representative and 2 nurses had come in, none of whom really had any idea that I work at the hospital.  As the second nurse was getting all of my information, 3 ENT residents (a 4th year, a 3rd year, and an intern) walked in.  If I wanted my nose reset, they offered to do it right there with local anesthesia, or I could have waited a few days and had it done under sedation in the OR.  I was a bit nervous about having my nose reset without sedation, but I decided to go ahead and get it done while I was there.

As they told me, the local anesthesia was definitely the most uncomfortable part.  It was not a fun experience by any means, but it was only a few minutes.  By the time the anesthetic had fully numbed my bridge and septum we were ready.  Less than a minute later it was done.  All I felt was a pop, as if I had cracked my knuckle.  I expected much worse.

Within three hours I had left the ER.  Three hours?  It is quite possible that I set a record for fastest overall ER visit and successful management of a nasal fracture.  Maybe it was just a slow day in the ER, but it was more than just the rapidity of my treatment that impressed me.

They engaged me as a participant in the decision-making and treated me like a person, not a like a guinea pig, which we have probably all seen.  Whenever I was uncomfortable the 4th year ENT resident stopped to ask me how I was.  He took the opportunity to teach the intern what should be done at key steps [If you have never been a patient when one doc is teaching a junior doc about your condition, it is quite interesting!]. Everything about his bedside manner was what I would expect from a seasoned doc.  The entire team of health care professionals impressed me.

With everything we hear about the lack of professionalism in the current state of medicine, it was quite a comforting experience to witness firsthand the professional comportment of the nurses and the residents.  Although I have no idea if this was the same way that every patient gets treated, I hope it is.

Ryan Madanick is a gastroenterologist who blogs at Gut Check.

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