Reality

What I wrote:

ATF 48 yo male supine in bed.  Pt is CAO X 3 in NAD.

My reality:

We’re going on a transfer, when we arrive the patient was  in bed and complaining loudly about everything from the size of the television in his room to the fact that we were late. (We’re not, btw.  He canceled us TWICE earlier because he wasn’t ready, then complained because we were on an EMS run when he was done with dinner.)  His overworked and clearly stressed out nurse was extremely happy to see us.

What I wrote:

Pt is non-ambulatory due to  general weakness and inability to transfer, Pt. was treated in hospital for anemia/hypothyroidism/abnormal labs, and is being transported back to his ECF for further care and rehab.

My reality:

Our weighs 400+ lbs.  He is able to stand and pivot according to his nurse, but refuses to do so on our arrival.  Our Patient then demands that we move him.  When he determines that our stretcher isn’t an acceptable distance from the bed he is laying on,  he demands we lower it (the stretcher) to the floor so that he can get out of bed and pivot to the stretcher. He’s been in the hospital for the last week due to the fact that his nursing home was understaffed and he hasn’t taken his vitamins.

My partner and I simultaneously rub our temples.  I go look for someone who will help us with a lift assist.

What I wrote:

Pt is moved to stretcher and secured with s/r and straps X2.  Cot loaded and secured in truck.  VS and obtainable hx taken and noted above.

My reality:

My Patient complained about the size of the stretcher from the time he sat down to the time we unloaded him.  We could only get the top and the bottom strap to connect (and those were both with extenders), and the side rails were for nothing but show.  When I tried to take his vitals, he allowed me to obtain his pulse and RR, but he refused to allow me to take his BP insisting that the cuff wouldn’t fit him.   When I looked through his paperwork and found little to zero on his history and dared to question him on it he shot me down, yet again.  I quickly retreated to the seat directly behind him.

What I wrote:

Patient rested comfortably and was conversational for duration of transport.

My reality:

Patient questioned the route we took (the most direct route), the potholes, and my Partner’s ability to add two plus two.  I sat behind him, a smile glued on my face.  I monitored his RR and color.  Given the amount he was complaining, I figured it was safe to assume that he had a patent airway and was breathing adequately.

What I wrote:

Upon arrival at ECF, we moved pt to his bed, securing him with s/r and leaving the bed lowered and the call light with him.  Report given and care transferred to ECF nurse with pt. in stable condition.

My reality:

When we finally got to the nursing home we were practically sprinting down the hallway towards our patients room.  Imagine his dismay when he discovered that his new room had NO television.  I managed to get his signature while he was on his cellphone ordering a family member to pick a TV up before they dared to come visit him.

I love my job.