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?
We have to page our RT during a code. But really, we start bagging a patient within seconds if they arrest anyway. So it isn't like we have lost any time while they get their machinery ready and bring it down.
I went to my parents house one Christmas Day and was met by my dad. "Take your sister to the ER. She is sick". Some type of bladder infection. I sat in the waiting room when a family came in. I knew I was in trouble when the oldest member of the family sat next to me. A whole empty waiting room and he sits next to me. He leans over and hands me a Christian tract and slurs "I want you to have this" WOOWEEE. He was tanked. Then he wants to witness to me. Finally, he gives up. Later, I hear one family member say "I didn't WANT to shoot him. He's my brother".
Uh-oh. Luckily, it was time to go.
As a nurse, I find it extremely difficult to find the words that will bring the most hope and comfort to someone whose loved one is brought to me on Christmas Eve or Christmas Day in critical condition. What can one say at such a time? Words fail. Sometimes the fear and sorrow is beyond expression, and words would poison the moment.
In those times, the best I can do is just be there, and to try to convey all the depth with which I care through the way that I provide care for the loved one and for them. I must confess that those are very sobering and uncomfortable times for me. I am reminded that for all my education, training, and experience, there is a time when a patient or family member will look at me for an answer, and I will have none.
You are now on the list. Thank you!
You are most welcome.
Your are now on the list. Here's hoping we never met on the job.
Please add me to your ping list. I am a medical transcriptionist, and I'm working tonight too. I'd also be in line to buy your book if you compile your stories.
You have proven your ability to be a safe and effective nurse to your school and to your state. You can do it! I'm rooting for you! -60
You are on the ER Nursing ping list. Thanks!
You're on the list, Vandy. Thank you!
I have just finished my first semester of nursing and look forward to many years of interesting adventures ahead.
If you have any questions or want to bounce any dilemmas off of me, feel free to freepmail me. I'll be happy to help. Are you in a BSN program or an ADN program?
Pray. Alot.
I almost choked when I read your rants about St. Nightingale. I would love to sit in on a semester of lectures from you, but will settle for the book we are all pushing you to write. So much of the education consists of "Kum-by-ya" training. I don't know how the guys stand it.
Thanks for the offer of help. When I read your profile I knew I had found a mentor (even if vicariously). I recognized many of your posts, but never realized the common author. You have a gift for writing, as well as healing.
I read your post in its entirety and have carefully weighed my response. I'm not going to answer insult with insult. I will, however, offer you the opportunity to elaborate on your comments regarding my character.
Hook 'em Horns!
My son and his family (five kids!) were visiting from Toronto for the Christmas/Chanukah weekend. Let me tell you that he has some very energetic kids! That's because I used to yell at him, "when you grow up, I hope you have kids just like you!"
My 2-year-old grandson managed to pinch his finger in a folding chair and a discussion ensued whether we should take him to the nearest emergency room, or take him across the border to Canada where my son has insurance.
My daughter-in-law started calling emergency rooms, beginning with the nearest one, and asked how long was the wait. They ended up taking him to the second closest ER where there was a 20-minute wait, the closest ER said there was a 2 hr wait!
The baby got 5 stitches on his booboo, he came home, got ice cream, and banged on the piano so there is still hope for his career in the Philharmonic.
Many is the night I've wished for a super-soaker full of haldol. I never thought of using the sprinkler system. Hmmm...
BTW, who's the moron, Global2010? Never been an ER nurse, I'd wager. Utterly clueless. If we got paid in how much the job took from us, emotionally, we'd be millionaires after the first year. Global2010, I cordially invite you to work a shift as an RN in a level 1 or 2 trauma center, then get back to me.
Please add me to your ping list.
You are on the list. Happy new year!
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