Monday, 26 October 2015

Recognising I can't solve the world

I currently work on an acute medical ward. Our patients are poorly, but mostly in the short term we can diagnose and solve their problems so that they can be followed up as outpatients or by their GPs. Their medical problems, that is. We have limited success with their social problems, and as for their spiritual problems...

My patients are challenging, even when medically they are straight forward. What do I saw to the young woman who has overdosed three times this week but says she isn't trying to kill herself. Can I ethically give her any medication at all to take home, even though she's in pain? Actually I would rather sit down and explain to her that she is loved and has incredible dignity and that even though life has treated her badly, it doesn't have to be this way, but I can't do that because I don't have time and I don't have any kind of relationship with her, she won't even make eye contact.

How do we deal with the patients with serious mental health issues? If I have 3 hours to review 25 patients, I can't really deal with the one agitated patient who wants to ask me a lot of (possibly irrelevant) questions, who is never there when the doctor comes to see her because she keeps going out to smoke, and who is only in hospital because their persistant self-harm makes a not very serious problem much, much worse.

And then there's our favourite frequent flyer who is frankly, bonkers, (psych assessment pending) and also seems to think that every single member of staff on the ward is there only for him. He needs a pen, he needs the phone, he just wants to talk and medically speaking, he doesn't really need to be in hospital. He's also either seriously confused, in denial or compulsive liar. As my technician said to me this morning, his readmission has ruined the whole week.

As a Christian, I know I am supposed to love these people. What I am learning though, is that the best way to love them is to do my job. So I might want to sit down with them, and their families, and their neighbours, and work out how best to look after them (because their non-medical problems are so much worse than their medical problems) and solve everything, but that's not what I'm there for, nor any of my colleagues, and their problems are the problems of the world and will definitely take more than three hours to fix, but I increasingly doubt whether anyone outside the hospital has realised this.