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?
Victims of "These two dudes. . ." (We figured that one dude couldn't have done it all by himself.)
5 o'clock Sunday afternoon, just when the family fights are about to peak, seems to be when someone has to distract or escape the fuss and bother. Or maybe, it's when the kids are leaving.
Another event to set our clocks by: During Fiesta, we used to see all the laboring women show up crowning or with delivery eminent after 11 PM, because no one wanted to leave the party or because the family had them out walking all day to speed labor.
Then, we heard about the weddings planned after the births.
Where hubby worked the fire station sat right off main street. The guys used to take bets on how busy they would be on a Friday night related to how many trucks they saw going by with beds full of Bud and Bud light.
Of course these same firefighters wore kevlar vests on their runs.
So glad he got enough years in to retire.
Nursing is very tough. My wife is an RN at our only hospital. The 12 hour shifts are a killer for both of us. We have a few kids so when she goes to work, its like me going to work. 7AM to 7PM. Weekends are the worst, because it's like I have no days off. I'm not going to complain beyond that. She works very hard and loves what she does. It also pays very well.
"So glad he got enough years in to retire."
Amen!
Two words.
Thank you!
Could you add me to your ping list please? I try to avoid the ER like the plague but have had to make a few visits. Some have been more (mentally) painful than others.
Please add me to your ping list, too. I am a new nurse, and absolutely love your posts. Thanks for taking the time to write them!
*Ping*
Having been married to a nurse,I learned quickly that it is very hard work and for little thanks.Apparently they take it for granted that it is your job and a simple thank you is not required.I remember one instance passed on to me by the wife.She was working the late shift in upstate NY,when a man came in very sick.It was in the middle of a very bad snowstorm.and no one came or went.The patient was extremely rude and obnoxious no matter how hard the staff tried to comfort him.It put the whole staff on edge.Sometime during the night,he passed away.The nurses aides folded his arms across his chest and made the middle fingers on his hands stick out.The next day,after rigor set in,all hell broke loose.If I recall,a few workers lost their jobs.I think they may have done it out of frustration.
Please add me to your Ping List.
Thanx
Please add me to your ping list. Thanks
I hope that you are putting these memories in some sort of format for publication. They are incredible--I still remember the one about the Kindegarden teacher with a .400 (?) BAC. I look forward to your posts and honestly thank you for what you do. When I go to the ER, I appreciate the kind nurses more than the doctors. They are the ones that care and watch over the patients.
Please add me to a ping list. I have just finished my first semester of nursing and look forward to many years of interesting adventures ahead. Thanks for the "warnings" and may you be blessed for your work.
You both shame me in your ethics and self loathing and pride.
I am an advocate for skipping the local hosp. and getting transport to keep the patient once stable out of Hospitals with policy that you must work under.
I can't say how disgusted I was by your latest pen to net...
I hope none of those who truly needed passion, compassion, or some one to hold their hand that Christmas Night ever reads this.
Sir you leave me speechless in your antics of the ER...
Maybe it is time to find your passion in life...
BTW Don't even respond....
Ping!
Amen to that! Right now, I CAN at least outrun her! LOL!
bttt
lol.....good job completely missing the message and not understanding the tough real world of health care - it was funny to read - in it's ignorance....I have held many hands, dried tears, saved lives - and diligently looked over my patient and cared for them to give them another day to live - just enough for that loved one to make it across the country via plane to say goodbye....
nothing surprises me - don't bother responding.
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