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September 5, 2010

STEPHANIE SALTER: Wait’s what broke the bridge (and nervous system) down

Stephanie Salter The Tribune-Star

TERRE HAUTE — During the past month my relatives, close friends and I have spent all kinds of time hanging around a hospital. One person was in — and out and in and out — and the rest of us were acting as support staff.

We experienced pre-surgery registration and lab work, surgery check-in, hospital admission for a few days, then discharge and — about three weeks later — emergency room, readmission to the hospital and a second discharge.

The common thread in each of these experiences was … waiting.

But the waiting was varied in length and intensity, which got me to thinking there ought to be a scale for waiting that’s based on those Wong-Baker pain scale charts that doctors and nurses show to patients.

You know, the ones that start with a hairless, happy cartoon face, smiling with “no pain at all,” and end with the round-headed symbol weeping and its features contorted in “the worst pain you’ve ever felt; excruciating, unbearable.”

Fortunately, our crew avoided No. 10 — the excruciating and unbearable waiting period that lies between entering an ER with a critically ill or injured loved one and finally hearing a physician say the person is out of danger.

We never even got to No. 8, which I would assign to the period your loved one is on the operating table for a high-risk or hastily scheduled surgery and you are in the surgery holding area in the hospital lobby, watching the OR’s double doors as if they might explode.

When the predicted two or three hours runs into four and beyond — and no one comes through the doors to call your family’s name — you reach No. 9 on the Waiting Pain Scale. Same with the 10 seconds that tick off when the doctor finally comes out and you try to read his or her face for signs of your loved one’s status.

We were blessed with a weeks-long lead time for pre-op education and plentiful assurances of a good outcome, so that made our surgery wait only a No. 6 or No. 7 on the pain scale.

Some of us reached 7 because our loved one is elderly and because we are superstitious (except for my brother-in-law, the veterinarian); we know just enough about medicine to scare the bejeebers out of ourselves with endless what-iffing. Also, being forced to get up in time to be at the hospital by 6 a.m. activated the physical pain scale for several of us, which made waiting tougher.

The fatigue factor contributed a few weeks later to three of us hitting No. 5 on the Waiting Pain Scale. The cartoon face at this spot looks unhappy, a tad bug-eyed, but not yet miserable.

We achieved (and passed) 5 during an in-room admission process that took nearly two hours, thanks to a computer crashing twice on the beleaguered intake nurse. This was our second hospital stay, when our loved one landed in the ER then back in the main hospital for a couple of nights.

The ER process had gone quickly until the decision was made to readmit “as a precaution.” Time slowed to a crawl, easily a No. 4 on the Waiting Pain Scale. The labs were back, all doctors agreed on admission, a room number had been assigned. Still, we waited and waited for a liberating orderly with a wheelchair to arrive and take us up three flights in an elevator.

As our fourth hour approached in the ER and our loved one was volunteering to walk up the three flights, our ship finally came in and we expected smooth sailing. But no. Just because our loved one — starved by now, very tired and heading toward No. 5 on the physical pain scale — had a bed in a nice, clean room did not mean she could eat or receive any pain medication. That had to wait until the intake process was complete.

Never mind that we had just provided a long list of medications, supplements, allergies and previous surgeries to the ER folks three floors below. Never mind that every bit of the necessary information was in the hospital’s cyber guts somewhere because our loved one had just been in not three weeks before.

“We have to do it this way,” the nurse said.

After the portable P.C. ate every prescription med, vitamin and tidbit of medical history the nurse had typed in (for the second time) all of us vaulted to No. 6 on the Waiting Pain Scale. All of us, that is, but the nurse. With the glassy stare and monotone of a war-zone inhabitant, she simply sighed, “This happens every few weeks.”

As we got deep into round three of the recitation of meds, the litany of previous surgeries and the rundown of symptoms that had brought us to the ER, we were wait-hurting. Asked to estimate, again, the last time our loved one had taken her fish oil and Vitamin D3, I passed No. 6 on the Waiting Pain List and was speeding toward No. 7.

Our loved one had passed 7 an hour before.

Two days later, we would be back down in the lower waiting pain levels:

No. 3 connotes “some discomfort” and is characterized by a cartoon-face mouth that is neither smiling nor frowning; the eyes look normal. No. 3 symbolizes the hours of waiting you do before you are discharged. You know your loved one is better and about to be sprung, so you can put up with almost anything without whining too much.

No. 2 carries a smile that is just a little droopier than the zero-pain grin, and represents slightly discernible, easy to tolerate waiting pain. It’s what you feel when you go back to the surgeon’s office for a follow-up appointment a few weeks after an operation, and the receptionist says, “I’m sorry, we’re running way behind.” No problem.

No. 1 is the pain-free, happy-as-a-clam, beaming cartoon face. It best symbolizes the waiting you and your loved one do when you are on your way to dinner and you get caught by a stoplight — right next to the hospital you will leave in your dust as soon as the light turns green.



Stephanie Salter can be reached at (812) 231-4229 or stephanie.salter@tribstar.com.

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