What a novel concept! Does Cooper mean to say that patients should be taken seriously? And why not? Regardless of cause for concern, it is never really appropriate to not heed a patients concerns. It does not accomplish anything other than to cause undue stress to the patient and family which could in turn make things rough for the nursing staff and doctors. In addition the stress on the patient could cause complications in medical compliance as well as surgical procedures.
Cooper expertly examines both sides of multiple chemical sensitivity and explains that though the cause of this condition is unclear and there is no universal consensus on how to diagnose or treat it, MCS afflicts millions of Americans. She states that theories of causation include both the physical and the psychogenic, however the patients concerns should be heeded. Coopers article reviews a case study and offers recommendations to guide nurses when treating MCS patients in the hospital. It is most refreshing to see an article published that is concerned with what can be done to make the situation better rather than simply trying to prove whether or not the condition is real. It is simpler to just accommodate sufferers. Most medical conditions that are now readily accepted as physiological in origin were once considered psychogenic. Asthma, diabetes, and Parkinson's are just a few examples. It is not unreasonable then to assume patients are telling the truth.
Regardless of etiology a patient should be made as comfortable as possible, particularly in hospital settings which are often stressful to begin with. It does not matter whether tachycardia is caused by stress from a perceived chemical threat or caused by a physiological response to real volatile organic compound (VOC). The patient still has tachycardia that requires intervention and could become life threatening or cause surgical complications.
A caring provider who believes that a patient's concern over incitants in the hospital setting is psychogenic could calm the patient simply by removing the incitants of concern. If the cause is psychogenic the problem is resolved. A dual benefit is that if the incitants really are contributing to physiological discomfort, the patient will feel better too. So regardless of etiology of MCS, the best measure is to simply remove the incitants as the patient wishes.
While this seems like a simple solution, patients often must negotiate and in some cases demand proper accommodations. Hospitalization can be a frightening experience for an MCSer and can indeed worsen health to a degree. It also pays for the patient to be aware. Having a family advocate can be extremely important as well.
The abstract for this study is replicated on the next page with all the reference information necessary to obtain a copy of the full text study. It would be well worth distributing a study like this to nursing staff in preparation of a hospital stay. While scientists fight over the etiology of MCS and debate over the physical vs. psychogenic cause, patients still need medical care. Some of that medical care has absolutely nothing to do with MCS other than requesting and receiving accommodations during a hospital stay for other procedures. MCS should not come in the way of appropriate care and measures are simple and easy enough to take to make MCS patients more comfortable and safe. In turn, hospital staff will also be have less stress from unhappy or sick patients. Addressing the special needs of MCS patients is crucial to ensure the safety and health of patients, both physical and mental.
From a patients perspective there are several things that can be done to make things easier when admitted to the hospital:
· Pass out materials to nursing staff now, while the hospital is not needed so that they are more familiar with MCS should a hospital stay become necessary.
· If being admitted for routine procedures, bring a doctors note from your MCS doctor specifying your individual needs.
· When possible, have a family member with you to back up what you are saying and lend credibility to your concerns.
· Discuss accommodations with your doctor prior to admission.
· Always wear medical alert jewelry stating you are chemically sensitive and keep a doctors letter to that effect on your person for unexpected emergency admission.
· Familiarize yourself with the nearest hospital that knows about MCS.
With a little planning you can have a successful hospital stay.
Cooper C. Multiple Chemical Sensitivity in the Clinical Setting: Although the cause and diagnosis of this condition remain controversial, the patient's concerns should be heeded. Am J Nurs. 2007 Mar;107(3):40-7.