Doctor, Not Deity: Always Question & Trust Your Gut

    Rory Staunton, an 11 year old boy of New York, died a painful death that could have been avoided.  His story broke my heart as I read each word of his story.  As I prepare myself to enter the nursing field next year, I am becoming more acutely aware of how much the smallest details matter when it comes to the health of my patients.  I am not a doctor, and nor do I pretend to be, but I question things that do not seem right.  I have spoken up as a student many times to other nurses (usually the RN I am shadowing), my clinical instructor, the doctors I am working with, the parents, and the lab results.  I don’t question because I pretend to know it all, I question so I can learn.  If I don’t get myself immersed in the experiences provided by clinical, then I have failed myself in my education as well as failed my future patients.  This story made my stomach hurt and my heart ache as I imagined what it must have been like to be involved in his care.  It doesn’t condone what happened, but I am certain those involved have lost a good amount of sleep.

    It is not acceptable to shrug it off and say, “These things happen.”  Being a medical team member (surgeon, doctor, nurse, CNA, janitor) brings a tremendous level of responsibility and you have to bring your A game, your wits, your integrity, and your thick skin to work with you every single day.  If I am being honest, to hear someone is running fever, vomiting, and flush – first thing I think is virus.  If we all freaked out every time this happened, our ERs would be packed (more so than they already are)!  The cut, though an important clue, doesn’t make me freak out and think the worst.  Most of the time, these turn out just fine with a little Tylenol, rest, and fluid.  BUT, then you have that 1%.  The ones that get overlooked and pushed aside because it is all so common place.  In my opinion, the biggest factor here was that the parents kept seeking medical help.  That to me is a red flag.  Parents know their kids better than anyone.  If a parent is alarmed, and the kid looks like hell, something is wrong and the source needs to be identified and treated.  As a parent, if your guts say something is wrong, something IS wrong – and don’t stop until you get the answers you need.

    Example, last December, my 6 year old was ill.  She ran fever and was just tired and whiney.  Admittedly, day one, I thought it was a “virus” and treated it with rest, Tylenol, and fluids.  The next day, she complained that her “head hurt,” (which is not common at all with her).  I noticed a little bit of limited movement in her neck.  Instantly, alarms went off in my mind – I knew something was wrong.  It’s not because I am a nursing student who has been hitting the books and making A’s – it’s because I am a mother to a child I know very well and my “mom alarms” were sounding.  It was an odd hour, so the pediatrician option was out.  I told my husband, “I think she has meningitis.”  Funny – I had never seen it, and I think I read about it once.  He argued that it was probably the flu.  I said, “I want to take her to the ER.”  He knows when I say ER, that’s the end of discussion, so off we went.

    I filled out all the paperwork, provided our insurance information, and waited (impatiently).  The form read “reason for visit,” so I wrote, “I think my daughter has meningitis.”

    We went to the back to finally be greeted by a young ER doctor who literally smirked at my response.  “What makes you think she has meningitis?”  I went through the list of symptoms.  He said, “It looks like the flu to me.”  Inside, I was pissed.  Oddly, I know the pre-nursing school me would have gone home with her thinking I was insane to ever question the doctor and upset that I spent $200 to find out she had the flu.  Instead, I said, “I don’t believe it’s flu, I think it is something far worse, and I want a spinal tap to rule out meningitis.”  Of course he went into a speech about how painful they are, risk for infection, etc.  I asked for a flu test, but he said they are 50% inaccurate anyway.  After a good amount of arguing, he very reluctantly gathered the stuff needed for a spinal tap.

    My 6 year old has the strength of a 19 year boy on steroids.  She fought, screamed, and put up a terrible fight.  The doctor’s bedside manner was terrible (obviously NOT a pedi).  However, he managed to get the fluid, and it went to the lab.  My daughter was incredibly distraught, and so was I.  We waited for about an hour, and for that whole hour, I began doubting myself.  What had I done?  I demanded a spinal tap on a 6 year old that probably has the flu! My husband was a little upset and said, “It’s probably the flu.”  Even through the doubt, I still felt I had done the right thing.

    About an hour and ten minutes later, the doctor came in with a less than happy face and said, “Well, your daughter has meningitis.”  After he explained what the next steps were, he said, “I am surprised.  Usually I am the one arguing for a spinal tap.  How did you know she had meningitis?  Have one of your other kids had it before?”  “No,” I said smugly, “I am a mom, a nursing student, and I have learned to always trust my gut and speak up when I feel something isn’t right – it’s a mother’s instinct.”  He said, “Well, you did a great job.  I have never seen it before, and it really looked like the flu.  We’ll send nurse A in here to set an IV and get you a room on the pedi floor.  You’ll be here for at least a week, maybe more.”  Inside I felt vindicated and at the same time, sad my daughter was seriously ill.  But what if I had left that day without questioning?  What if I let the words of that doctor override my internal alarms?  Would I have a daughter today?

    Rory was an 11 year old boy who liked basketball.  He had parents who loved him.  He had overworked, overburdened healthcare workers who heard “vomiting,” “cut,” “fever” and shrugged it off.  The parents felt their needs weren’t being met and kept pursuing THE SAME DOCTOR.  Heartbreaking.

    Don’t let this be you.  I have seen so many patients get told something by a doctor and nod in agreement.  Then when the doctor steps out, they ask ME their questions.  I educate as far as I can, present ideas, ask more questions, and try to use normal vocabulary, diagrams, hand drawings, etc. and then I give them a pen and paper and say, “write down every question you have.”  Then when the doctor comes back, they are better prepared to address their issues.  If the doctor is there and I am there, I ask questions during the doctor’s counsel.  I do it for two reasons; one, for my own education, and for two, I want to make sure the patient understands as well.  Maybe it’s the mother in me that wants to patient to fully understand what’s going on, the treatment plan, etc.  It’s critical…because if something isn’t “feeling right,” chances are, something really isn’t right.

    If you get anything from this – I hope it is this: NEVER be afraid to question your doctor.  NEVER stop seeking answers.  NEVER ignore your internal alarm.  If you are uncomfortable with your doctor, maybe you have the wrong doctor.  NEVER be afraid to ask for a diagram, or to say, “Can you put that into English?”  It’s easy for medical people to speak in a jargon that only other medical professionals can understand, and it’s not intentional, honest.  But you have to have the guts to ask.  It is your health, and the health of your child.  Take it seriously and protect it fervently.

    God bless Rory and his family.  God bless the medical professionals that failed him, forgive them, and allow them to forgive themselves and to learn from this horrible mistake and tragedy.  If one person reads this and it makes a difference, I am thankful.  Always trust your innermost voice – it doesn’t lie.

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