The only way to deal with patients like Mrs Chunn is to set your limit. In another word, tell her like it is when you have finished your job with her and get out of the room. Or she will keep you there FOREVER.

I bet Dr Kale will agree with me. It was 1100 when he made rounds to our unit. He went to Mrs Chunn's room and routinely had a head-to-toe check up with her within 2-5 minutes. He asked questions about medications, improving signs and symptoms and reviewed the treatment plan with her. It usually takes a doctor 5-7minutes in patient's room. Then another 5-7 to put in the orders in the computer and talk to the nurse if there are any changes made. Doctors then will leave for their own private practice for that day until they make rounds the next day.

It was noticeable that Dr Kale stayed there when I have finished passing 2 patients meds that morning. Mrs Chunn is here for difficulty breathing for a week at home. Most of the patients here who are having DIB are either COPD'ers or CHF'ers. The treatment of both diseases is similar. The patients are given nebulizer treatment and antibiotics if they develope penumonia. The hospital is no different than a private business. They want the patients to get treatment as effectively as they potentially can. Once they are stablized, which means if they can breathe, can eat, can poop and pee, they will have to be discharged. Its like a big ol' manufacture line.

Dr Kale hurried away out of Mrs Chunn's room before I even had a chance to talk to him. Then there came 2 residents who are assigned to have Mrs Chunn as a patient during her stay. Dr Yussif is a senior resident here. I have always liked his way of talking to patients politely and answers questions in as much detail as he can. I saw them staying there doing the doctor's routine things for a while.

"What was the problem there?" I asked Dr Yussif because most of the time they were standing there listening, which is rarely seen in young doctors. "Something is wrong.....She is mental...We stayed there for 20 minutes." he said. A-ha! So that is why. The 2 young residents stayed in one patients room for 20 minutes when they usually spend 5-7. Of course Mrs Chunn is thought to be "a mental". I started laughing inside. Then when I read through the progress notes where they documented the visit, "20 minutes" with 4 underlines. This resident documented everything including how much he spent in patients room. I have to say this is one of the smartest things I have ever seen.

FINALLY! Finally somebody agrees with me. I have always thought its my problem that I can not meet up the expectation that a nurse has to be so nurturing, caring, and patient that I almost feel like screaming inside and feeling like a nut when I can not wait to get out of the patients room when theres a little bit too much to bear. Then I have learned that you need to count the freaking time you spent, CONSCIOUSLY, and documented it. A-ha!

Around 1600 Dr Kale called about Mrs Chunn. "Purr, please put in a psych consult for Dr Jamil to see Chunn." he said. "For...?" I was kinda clueless, trying to think what I have missed there. Depression? Anxiety? Confusion? "For lack of insight." Dr Kale said it like it is. What?! "I was there in the room for a lengthy discussion with this patient. She did not seem to grasp." He said. To grasp the fact that a doctor WILL NOT usually spend freaking 15-20 minutes in a single patient for something like a chronic sinus or asthma problem. Thats about what Dr Kale did not say and I could hear it out loud.

Since when a patient who can not shut the f*ck up is being lack of insight? Then I guess I have my own "mental problems" as well. LOL.