Professional Responsibility

Today I was late leaving work due to an urgent referral from a nurse. He had just heard an unusual question from our patient. The guy had asked him, "how long have I been here?" He was referring to the length of time he had been in TDCJ. The nurse came down the hall and told me he was concerned. This patient had never appeared confused before and today he seem to have an altered mental status.

I interviewed the patient - using a mini mental status exam - and determined he was not oriented to date, had impaired short-term and long-term memory, had reduced appetite, and had speech with an unusual rhythm. After he told me he had been missing meals, I weighed him and found he had lost 9 pounds in a 10-week period. A quick review of his medical record also indicated he had seen the medical provider a few weeks ago and received a tentative diagnosis of TIA (that's a mini stroke to us non-medical folks). The patient had been waiting on a referral for 2 weeks. As he was not evidencing any signs of a current TIA, the nurse and I had no choice but to send him back to his cell. Good luck!

So there I was feeling very bad and more than a little concerned about the patient, and I realized that unless my car could sprout wings, I'd be late for daycare. Great. I wish I could say these days happened rarely but I have some sort of patient crisis about once a week. I wouldn't mind so much if they'd happen earlier in the day.

BTW, when I looked up the patient's TDCJ information, I found he had been incarcerated for 21 years on a 30-year sentence for murder of an unknown male and attempted murder (with a hammer) of his wife.

Earlier in the day, I was facilitating group therapy and a colleague interrupted me to tell me one of my patients had another pseudo-seizure and I was needed in the ER. The group members were irritated by the interruption.

This evening, the daycare workers were (only slightly) irritated by me sliding in a few minutes late.

Why is it that no matter how hard I work, I end up either apologizing to some people or feel like I should?