Posted on 12/30/2006 1:54:50 AM PST by 60Gunner
Christmas Eve was a solid-gold nightmare. We had one open bed in the entire hospital, and the private ambulance services were bringing in critically-ill people without calling us, because they knew if they did, we would divert them to hospitals that we knew had open beds. But they make their living on calls, not on mileage. (This may differ in other states. Armed & Christian may correct me on this point.) So after the fifth "patient dump," the staff in my ER and the private ambulance services were not experiencing a lot of good will toward each other. And of course, the practice of patient dumping so saturated our ER that we had to place the hospital on "divert," meaning we were so full that there was neither room nor staff to care for any more patients until we cleared out the patients we had. There was no room at the Inn.
Most of the patients we had on Christmas Eve were genuinely sick. On my shift I cared for two patients who had had strokes, one patient who had a heart attack, a family of four who had carbon monoxide poisoning (a non-English-speaking family), one patient with acute appendicitis, two female patients having miscarriages, one elderly female with a hip fracture, and one psychotic female frequent flyer who neglects herself in order to get attention and pain medications. (This time she nearly killed herself by laying in her bed for nine days without getting up to go to the bathroom. She was, of course, a frigging mess. All this to get attention. She was also one of our private ambulance "patient dumps.")
That was one long, long Christmas Eve. I dragged myself to bed, sore and tired, at 9PM and awoke, sore and tired, at 5AM on Christmas Morning.
Man, this is going to be a long day, I thought to myself. Christmas in the ER usually is. I was not worried that someone would die in my ER on Christmas; people die every day (but as it turned out, none died in my ER on Christmas). I suspected that if Christmas Eve was any indication, Christmas was going to be a rough ride.
Boy, was I right.
It started off ominously. I schlepped in at 7AM to find only one patient in the entire ER. I went through my area checklist (trauma cart inventory) and sat down, sipping my coffee. Nobody dared say the word: "Quiet."
That one word, when uttered by an on-duty ER staffer, can send the whole day spiraling into hell. The whole staff sat in uneasy silence. Then the medic line rang. Five minutes later, it rang again. And again, and again, and again. And then the aid cars began calling in with short reports; six in a twenty minute period. By 9AM, the walk-ins came flooding in. By 9:30, the ER was full, and the triage area was filling fast.
Now, let me acquaint the reader with the demographic of the Christmas day ER patient, because it is not comprised of the usual crowd. Nobody in their right mind wants to come into the ER on Christmas, for the love of Pete. So what we see are the really, really sick people, the people who slice their fingers while preparing the meals, the people who slip and fall on whatever causes them to slip and fall (ice, gravy, beer, etc.), the people who get together when they shouldn't, and of course the absolute lunatics.
In the morning, the usual crowd comprised of the genuinely sick ones. Heart attacks, appendicitis cases, one full-term lady in labor (on Christmas- cool!), a couple of strokes, a couple of really sick kids, a seizure, and a bowel obstruction. But as the morning wore on, we got more and more lacerations (knife vs. finger). And then the psych cases began rolling in.
We had one obese young woman with the classic hallmarks of Meth addiction who insisted she be classified NIK (no information known) because the Mafia was after her. Never mind that she dragged her whole family with her. They also decided to check themselves in for various reasons. Her mother began loudly and obnoxiously retching in the triage area (BLEEEEEEAAAAACHH!!!! BLEEEEEEEAAAAACCCCCHHHHH!!!!). She didn't produce anything, of course. She just sat there and retched, loudly and with great flourish, whenever she saw someone looking at her. She fell strangely silent when nobody acknowledged her. Situational nausea, I guess.
As the day wore on, we saw the usual assault victims.
"Usual assault victims," you ask?
Yep.
You see, Christmas is one of those holidays that brings families together, even when they have no business being anywhere near each other. Uncle Phil arrives, gets drunk and obnoxious, and someone decides to tell him to pipe down. He declines, and rudely so. He takes a swing at Cousin Ed. Ed parks a left hook in Uncle Phil's mouth. Uncle Phil arrives at our ER drunk, belligerent, swinging, spitting bloody froth at us, and with a BAC of 384. I'm not making this up.
Never mind decking the halls. Somebody "decked" Uncle Phil, I thought.
So the twelve hours I spent in the ER on Christmas Day were not idyllic. Guess who had the Mafia runaway, her mother (BLLEEEEAAAAAAHHHH!!!!!!) and Uncle Effing Phil?
Where's the frigging eggnog?
Thank God she understands my sense of humor....
Will you please add me to your ping list? I enjoy your posts! Thanks.
You're lucky YOU didn't end up in the ER after that comment! ;^}
60Gunner..Your wonderful humor helps you to survive a tough working environment..You are a hero..I know about the demands of nursing because I am an RN. Have a great 2007!
Thanks for all you do. The last five years of my in-laws lives we made more trips to the ER than I could count (numerous strokes, heart problems, etc). The staff was always 100% professional. The ones that really got me were the Sunday evening "patients" who obviously did not want to go to work on Monday. Even those of us waiting could tell they were faking, only exhibiting their symptoms when an Er staff member was looking their way. Guess I am way too cynical for ER work.
Classic progression of Meth baddiction and or use. She has arrived at paranoia. Next step is Suicidal/Homocidal.
Metamphetamine is also known as 'Speed", Crank, Crystal. On the AFTER shots, look for the abrasions on the face. This is because they get "Bugs" (Itching under the skin, due to the drug) and scratch their face raw.
http://www.policevids.com/showvideo.php?id=1615
My aunt used to work in Parkland Hospital (Dallas) ER admitting. She had some real good stories, and the best one was about the psychotic hispanic that came in, stripped all his clothes off except he kept a knife, and rode naked up and down in an elevator until they could finally catch him.
Keep on plugging, 60. I used to be an ER RN, but now I work at our state psych facility. It's way more calm, believe it or not. I find that as I get older, I miss the intensity of multiple patients, all demanding attention at the same time (in one way or another), with clamoring doctors, families, assorted "significant others," radio calls, phone calls, and the occasional code (just to spice things up) in the midst of it all,... much less than I used to. Have fun!!
I sell, service, and repair medical vacuum pumps and breathing air compressors and of course there is great excitement when that stuff quits working. And since I am self employed, time of day and day of the year mean nothing. If it's broke, it has to be fixed. Upside is that iron, plastic, and rubber doesn't fake being broke or give me any crap about how to fix it.
I am forever humbled by cops, medical workers, soldiers, firemen, teachers, etc. who do the grinding hard work that keeps civilization functioning while interacting with people who often haven't yet figured out how to be civilized.
"assault cases"?
The OR I used to work in called them members of the Knife and Gun Club.
Pinging Sorta Bichy - she may wish to share here...
I usually carry the ER beeper for the RT dept. Usually I enjoy the ER, but man, it's been slammed recently. We really need an RT assigned there FT, especially on weekends.
Amen to that, brother. Amen to that. Especially the cops, although all that you mentioned have an important role.
Family member #1: My mother in law went into diabetic coma, experienced a heart attack, and her body temp was 91 when the paramedics arrived. She has other health challenges including severe asthma and her kidneys are failing (she's refusing dialysis). She's 81 and her treatment possibilities are limited. You can figure out her time frame from there I imagine...
Family member #2: My step father was taken to the hospital due to chest pain. He had a stent and pacemaker installed last summer. Now he needs a valve replacement (Jan 9 scheduled). He's a *young* 79 w/o the heart problems - we're hopeful.
Family member #3: My brother in law came home from the hospital today - yeah! He had a hip replacement and is doing quite well...says the post surgery pain is far less than the pre surgery pain. :o)
Thank you again for all you do. The detailed appreciation would take oodles of space.
My Christmas eve shift went fairly well. I sewed up a total of 6 people who cut the wrong dotted line. The type A flu is still going strong so numerous kids (2 months to 15 years) were treated, several with concurrent strept and/or pneumonias. The complimentary WE-DONT-SPEAK-NO-STINKING-ENGLISH Protocitizens made their appearance with skin rashes of 2 months duration mixed in with the usual heart attacks and , yes, The "We went to see Mama in the nursing home (for the first time in 6 months) and She don't look so good so we brought her here" crew that stand in the way and weep crockadile tears when we tell them that bed sores do not appear over night.A new group this year was the "Other-than-citizens" with "the gift that keeps on giving", yes-------SExuallytransmitted diseases" I guess the gift that keeps on giving is made in true Holiday spirit..I went to bed on Christmas day thinking "Thank God (literally) it is over for another year". NOw I can hardly wait for NEW YEARS EVE! Yep! I am a GLUTTON for punishment.
Ping list, please!
Oh my Gosh! In California it is an actual medical term used by emt's, firefighters, and the hospitals. They call it "hispanic panic".
lol hubby was a firefighter in a hispanic town here for about 15 years (33 years total service) before he couldn't stand it anymore and retired.
I need to pass this story along to my sister, also an ER nurse.
I hope you got plenty of egg nog after THAT shift!
We're 12 days out from my husband's hip replacement due to aseptic necrosis. He's limped for 30 years, but it didn't bother him until early this year.
I have a new hate for TED hose.
I'm sorry, I forgot to express my condolences for your mother-in-law, and hopes for your step father and brother-in-law.
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