Honesty

9 It is drilled into us over and over again in nursing school and throughout our careers to be a "patient advocate". Yet, again and again I come across instances where someone will not tell a patient the truth.

This week I had a patient who phoned in a transmission on his pacemaker. I received a call from the pacemaker clinic letting me know that the patient's battery was almost dead. In fact, it was 3 months past the due date to be replaced.... in other words it was barely hanging on! The nurse from the clinic told me that she had asked the patient to come to the clinic the next day for a more in depth interrogation, however she knew that wasn't necessary - he just needed a new battery. Hoever she still made him an appointment to come in. What should we do? This patient lives about 100 miles away from the office/clinic, is 70 years old.

So... I called the patient and left him a message. I called his daughter and left her a message. "Please call me back so we can talk about your pacemaker"

I spoke with the patient at length, who had been trying to find a ride to the hospital for this "pacemaker check". I explained to him that his battery was almost dead, and if he was going to make that long drive..... he instead should have ssame day surgery to get that battery replaced. I explained to him how he would feel and what could happen if his battery went dead. I told him I could put him on the schedule for that next day, including a full work-up by our physician assistant. Let's save him a wasted trip and just get it done!

As we spoke, the patient let me know how frustrated he was with the device clinic. He almost got a ride, with his daughter taking 1/2 day off work.... for an unnecessary 15 minute pacemaker check. His comment was literally "Why can't people just tell me the truth? Just because I'm 70 doesn't mean I'm stupid and can't make my own decisions!" I could hear the annoyance and the frustration in his voice when he said "this happens all the time! Nurses and doctors think I'm feeble and talk around me in circles instead of just telling me the truth!" He then thanked me for being honest and letting him know what was going on with his own health. Such a simple thing to do.... he shouldn't have to thank me for doing what is right..... that should not be the exception.

I know he is frustrated, and so am I.
It seems to me that the office visit would also be serving as a preop survey with basic vitals and appropriateness for surgery being reviewed via physical exam by the physician. Correct me if I am wrong. No responsible provider would schedule surgery on a patient they have not laid eyes on within the last 90 days.

Oh no, the visit was simply with the pacemaker clinic to check his device a second time. This means he would have met with the nurse checking his device... no vitals, no anything.... and definitely no physician.

Quote from brandybunsrnoh no, the visit was simply with the pacemaker clinic to check his device a second time. this means he would have met with the nurse checking his device... no vitals, no anything.... and definitely no physician.

The pt should have taken the responsibility to ask what the appt was for, if it was going to be such an issue. If someone calls me up and says when need to set you up for an appt, I don't care if I live a mile down the road, I want to know what it's for and whether or not I am going to rearrange my schedule to accomodate it.

Do you know for sure it was a nurse that the patient spoke to at the clinic and not a MA/Secretary?