An unpleasant experience

Now while a medical career sounds glamarous, it has a dark side. I'm not just talking about the competition for jobs, back-biting etc, but also other things like rectal examinations, which no patient likes and while there surely can't be a doctor who finds it pleasureable to do (and if there is one, who on earth let him/her be a doctor?), it is very necessary. Another very necessary unpleasant task is dealing with patients who for some reason you find difficult to get along with.
It might be that their condition is purely 'functional' ie there isnt anything physically wrong with them, but they will still complain of pain here or pain there, or carry on having pseudoseizures whenever you are near. Or it might be that they are non-compliant and even telling them that they will die should they not take their medications does not help. Or they might not like being in hospital and make a scape-goat out of you.....as happened to me today.
Mrs X is a 60-something lady with CCF*. This is her second admission in two months with an exacerbation. She hates hospital. She was started on iv frusemide**, which meant a close eye had to be kept on her U&Es - ie daily bloods. She doesn't like needles (fair enough, who other than iv druggies does?) and venepuncture on her is difficult as she jerks her arm. From previous experience, I took a student nurse along with me, to hold her arm, as even though she says she will not move her arm, she continues to. Today she didnt want blood taken from her right arm, but was lying on her left arm, and would not turn. So I asked whether I could take the blood from her right today and we'd swap to her left tomorrow. She was okay with that and i put the tourniquet on her arm, and the student nurse steadied her arm. The first time the needle was introduced, she jerked. The second time it went in, and the necessary samples were easily taken. As I was leaving her bedside, she asked me whether I would like her to do the same to me - I said that I wouldn't and that unlike her, I, touch wood, did not need close monitoring of my blood. During the entire process, there was no word of complaint.
Later on the nurse looking after her comes to tell me to speak to - she is not happy about this morning. I took the nurse with me - a third party is always a good idea - both as protection for oneself, and also as a mediator. Despite acknowledging that there may have been a misunderstanding, and that I didn't mean to cause her harm or pain, she still was not happy. She was also starting to get worked up, and said she would 'take it further'. No further conversation was necessary - there was no point.
An hour later we were on a ward round - me and two senior doctors. She pointed at me and said that she wished to change doctors - when asked to clarify, it was just me that she had a problem with - she wished never to see me. My SHO explained that we work as a team and that I am part of that team, and that if she wishes she can change consultants. She expressed no such wish.
I have decided to have nothing to do with her that involves personal interaction. I do not feel the need to force myself upon her. And if it means that should the phlebotomist come by to do her blood when she is otherwise occupied, or I have to examine her, I will not. Will she be at a disadvantage? Well maybe she'll get seen later or have her bloods done later....but I doubt that she will suffer as a result. Which makes me realise how little I have to do on a personal level, and how much more of a glorified clerk I am!
My feelings about this are very mixed. I have been advised by all not to take this personally - that I am just a scape goat of her anger at being in hospital and at various things about hospital. And I don't think I am taking this personally. But when one goes into something like medicine as a public service, as I have, it is disheartening to have a patient react like this. And so early in ones career.



*CCF = congestive cardiac failure - ie heart not pumping blood effectively around the body.
**fruesemide = furosemide - if you happen to be American (although i accept it is now an international term....but still!)