Heat is on

That's right, the heat is on...33 days over 100 degrees. But, the humidity has still been low, until this past week. The rain and clouds and the wind, it's monsoon season finally. All the native Arizonans are soooo happy, they actually go outside to be in the rain.

I have had a long week, the beginning of the week my patients were great and I went home feeling like I did a great job. Yesterday was a different story...just really had people that got on my nerves. It should be ok for me to not take care of someone if they refuse to help themselves. If you know what you are doing will kill you and you refuse to even try to stop...I should not have to help you or put my taxes toward helping you. I have 2 examples:

A 40ish year old male with chronic back pain and a HUGE family history of heart disease. He has already had stents placed in the not so distant past. He comes to our unit for chest pain and continually leaves the floor to go and get his Pepsi (since we can only give him Shasta colas from our floor stock and that's not good enough)...yeah he comes back with a Pepsi but also smelling of smoke. I repeatedly explain to him why it is unsafe to leave the unit, especially when he complains of sob and chest pain when he returns. He has not stopped smoking since he got his stents. So, he goes to the cath lab and comes back needing a CABG. He has had a cath before, his bedrest is only 4 hours and he is doing everything he can to try to get out of it. Then, he's up smoking in the bathroom. He says it's driving him crazy that he can't be the one who decides when he quits smoking, he wants to go home and set a date for 3 weeks from now or so and then he will be able to quit...wow, can you believe that logic? Not even the reality that he could have a massive MI and die is enough for him to want to stop doing what is killing him. Amazing, he doesn't think enough of his life...I know all you smokers out there are saying..you don't know how it is, it's hard...well, yes I do and yes it is hard but you have to want life more than cigarettes. I don't think the residents of Arizona or the US should have to foot the bill for this guy to have a CABG when he doesn't even want to try to quit smoking.

Do I sound angry, or bitter? I also had a female patient come in with chest pain, she's about 40 years old, also a smoker and morbidly obese. She says she goes to see her primary care doctor every couple of months for her high blood pressure. Her glucose level was well over 300 in the ER as well as her urine being positive for amphetamines and opiates. Her cardiac enzymes are way out of range (her troponin which should be less than 0.01 is 57). So, off to the cath lab she goes, her vessels are so bad they had to go through her brachial and even then they couldn't see all they needed to see..but what they did see was not good. She ended up going home on meds because the chances of her being able to survive the CABG were so slim...this woman is also on disability and she's out there getting high and killing herself by smoking and over eating and generally not taking care of herself. I was really glad that she wanted to go home on the meds, I don't think she'll make it which is pretty dam sad to say for someone so young, but she isn't doing a whole lot to help herself either.
I think that's my message for today, and why we as nurses can get burnt out. If people are out there and they know what they are doing is hurting them, yet they keep doing it, why should I have to try to help them when they won't try to help themselves? Why do we spend millions of dollars on healthcare for people who turn around and continue doing what got them in bad shape to begin with? When does the responsibility get shifted to the patient?
Really glad I got the day off today. Kinda sounds like I needed it huh? Remember non noc nocere.