A Letter of Discontent: To the Nurse who needs to assume less and listen more.

“Wow, nurses really eat their young.”- My boyfriend after the incident at the Trevose Advanced Surgical Center in Trevose, PA.

I have never been as appalled, insulted, and concerned simultaneously as I was yesterday. I feel compelled to share my experience, and my outlet of choice is writing this letter. I hope others read this and learn from it. This experience has taught me to really exercise and hone my active, and effective listening skills. To not know an answer is not a flaw, but speculating and dismissing without trying to understand is unacceptable- especially in healthcare.

“To the Recovery Nurse at Trevose Advanced Surgical Center:

First I would like to thank you for your professionalism for it was novice at best.

I understand and appreciate the steps taken to prevent prescribing unnecessary opioid medications. It is a pandemic the whole medical community is aware of and taking steps toward containing. I fully understand and sympathize with a packed Friday surgical schedule. It is hectic.

I do resent your judgment and condescending nature in response to my questions.

I was picking up my boyfriend from the surgi-center after he had a colonoscopy (scope) and another procedure. He complained of pain, described a bleeding incident, and feeling a stitch. Naturally he was recovering from the anesthesia and was not a reliable source. Knowing any sort of removal was not in the plan, and taking into consideration his state I wanted to know what happened intra-operatively and during post op care. (Note: He gave permission for me to acquire information during the pre-op.)

Your elevator speech including “you’re a nurse you should know, “ “read the instructions” and “ pack the area…just shove it [the gauze] back up” was Emmy worthy.

I apologize if my confusion aggravated you but packing a wound indicates an area to pack; if there was not a deep wound why would it need packing? Also due to the bleeding was it safe to give him the Motrin prescribed? Your answer of you ‘should know’, and ‘just read those papers’ was unacceptable. After getting my boyfriend settled in the car, I did finish reading those papers; those instructions that contraindicate one another. One was specifically for the procedure post-op care and the other for scope post-op care. Both explicitly advising do NOT give NSAIDS for pain treatment; alas in my hand was a script for Motrin so pardon my concern.

Your repeated answer of “I was not there [in the OR], but was there when the doctor wrote the script explaining patient instructions” was well noted. I understand your role is in post op, so I am sure you are aware of your patient’s mental capacity post surgery, namely memory comprehension and retention, are not acute. You assured you could not explain what happened intra-operatively, nor the rationale for risk/benefit in this particular case regarding bleeding risk and safe pain management.

I was not seeking anything stronger. Let me repeat – I WAS NOT SEEKING ANY NARCOTICS. Nor did I mention that at all. I do not believe he would need anything stronger. I resent the assumptive nature and dismissive attitude. As a two time Afghanistan Marine veteran, and Philadelphia firefighter his pain tolerance is unmatched, but having a procedure is uncomfortable and often painful for the first 24hrs. Since he was vocalizing pain and bleeding, pardon my concern when the instructions explicitly say do not take what his script prescribes.

Patient advocacy is not a flaw. Active and effective listening are two strong components of providing healthcare. Please take note.

Also, I am not sure who was responsible for the dressing but it was erroneously applied. It absolutely was “shoved up there.” Removal caused skin stripping and the pressure added from the EXCESSIVE gauze was – I’m sure – adding to the discomfort.

I must give a genuine thank you to the front desk staff and other pre-op/post op room staff for listening to my concern and allowing me to wait to speak to the surgeon. And thank you to Dr. Rosenberg for taking time out of your schedule to clarify and answer my questions.

I was seeking a simple clarification. Nothing more.

Sincerely,

Bridget Dwyer, BSN, RN, CWCN “