Working the ED, obviously, means you learn a lot about Crazy. More so than being a psych nurse, actually; and I did that for five years. There's enough of it to turn you into her.
However, I digress.
I think there are shades of crazy. First there's, say, the Old Lady who's just a little batty, wears very strange clothes, makes random statements at inopportune moments, embarrasses her grandchildren, is quite sure men didn't really land on the moon and that W is an awesome president, and is, in short, Not Quite Right. But definitely lovable. She's what I call a yellow.
I really like HER, actually.
Then we'll move up to the fellow who's brought in because bystanders found him a bit frightening at the gas station, what with that rambling on and on about all the guns he has and how we just need to wipe out all the hippy/commie/pinko/liberal/fags. He knows where he is and where he's at, what day it is, and he's usually pleasant enough if you're nice to him. You really don't want to get on his bad side, though, and for heaven's sake don't tell him about that C.O.N. (the commitment paper) the doctor's signed sending him to the local mental health facility until the police are standing outside the door. Let's call him anorange.
Finally we have The Real Deal- the one six police officers literally drag in handcuffed kicking, screaming, cursing, and foaming at the mouth. He's just killed his dog and now he wants you. (This actually happened last week) They toss him in the seclusion room and lock the door; where he proceeds to bang on it, shriek the filthiest words imaginable at the top of his lungs while the patients in nearby rooms are hiding under their beds in horror and the security guards are flipping a coin to see Who's Gonna Open the Door and put him in those leather restraints. This happy camper is what I think of as a red.
ER nursing is by far the most dangerous of all nursing occupations; luckily, however, I am fearless. Except when it comes to dentists. And tunnels. And oversized anythings. (such as a twenty foot giant cow in front of a steakhouse) I guess my worst nightmare would be my car being blocked inside a tunnel by an oversized statue of a dentist with a drill in his hand. Now THAT'S scary.
Monday, October 27, 2008
Tuesday, October 21, 2008
Funny Hats
Guess who showed up the other morning? I'll give you a hint.
It was really good timing. We had a very long and horrible Thursday night and it was going on Hour Fourteen (about 9 am) and I'm trying to catch up on charting when Paul, the cheerful registration dude, stumbles out of the registration room laughing hysterically and desperately motioning for me to get in there NOW. Paul is generally a laconic sort of fellow, so I was interested enough to go and look. Signing in at the registration desk was the Unicorn Man, wearing what has to be the World's Funniest Hat- a tall stovepipe red-and-green striped Dr. Seuss hat with a pink plastic bill- apparently two hats put together. Don't ask me how he did this (we're hoping the owners of the two hats aren't buried somewhere in his backyard)but Unicorn Man always has great hats. Outfits, too. One night he was wearing camoflauge pants, a pink sateen ladies' blouse, a flat wool cap with a big green bown wrapped around it, and knee-high yellow rubber boots. I guess those were for wading around in unicorn doo-doo when he's cleaning it up.
Anyway, Paul and I were trying to figure out how to take his picture on Paul's camera phone without, you know, getting fired or going to jail. Not that Unicorn Man would care; he'd have been thrilled if we asked to take his picture, and probably struck a pose for us; but it Isn't Allowed. Privacy, you know, what's that about? So Paul took a picture of "me" with Unicorn Man just happening to be in the background, but it didn't turn out very well. We were very disappointed. It was a sad ending to a dreadful night. But the hat was great.
I want my niece, Rachel, who loves funny hats, to meet Unicorn Man. We could invite him to my sister Cyndi's house for that card game where everybody wears funny hats. It was a great game. What's the name of it, Jessi? Liz says you brought it home from college.
It's the little things that keep you going.
It was really good timing. We had a very long and horrible Thursday night and it was going on Hour Fourteen (about 9 am) and I'm trying to catch up on charting when Paul, the cheerful registration dude, stumbles out of the registration room laughing hysterically and desperately motioning for me to get in there NOW. Paul is generally a laconic sort of fellow, so I was interested enough to go and look. Signing in at the registration desk was the Unicorn Man, wearing what has to be the World's Funniest Hat- a tall stovepipe red-and-green striped Dr. Seuss hat with a pink plastic bill- apparently two hats put together. Don't ask me how he did this (we're hoping the owners of the two hats aren't buried somewhere in his backyard)but Unicorn Man always has great hats. Outfits, too. One night he was wearing camoflauge pants, a pink sateen ladies' blouse, a flat wool cap with a big green bown wrapped around it, and knee-high yellow rubber boots. I guess those were for wading around in unicorn doo-doo when he's cleaning it up.
Anyway, Paul and I were trying to figure out how to take his picture on Paul's camera phone without, you know, getting fired or going to jail. Not that Unicorn Man would care; he'd have been thrilled if we asked to take his picture, and probably struck a pose for us; but it Isn't Allowed. Privacy, you know, what's that about? So Paul took a picture of "me" with Unicorn Man just happening to be in the background, but it didn't turn out very well. We were very disappointed. It was a sad ending to a dreadful night. But the hat was great.
I want my niece, Rachel, who loves funny hats, to meet Unicorn Man. We could invite him to my sister Cyndi's house for that card game where everybody wears funny hats. It was a great game. What's the name of it, Jessi? Liz says you brought it home from college.
It's the little things that keep you going.
Monday, October 6, 2008
ER Nurses Can Be Stupid....at least, if they're me
You may have surmised from any previous postings that ER nurses think we know it all. Well, that's just because we do. Actually it might be a nurse thing....or maybe just a female thing? I think it's because you're only new in the ER for about six months, and then you've either a)run screaming out the back ambulance doors, never to return, or b)figured this shit out.
Anyway, since I like to tell amusing tales mocking other people, I thought it would be good to add one about myself.
(a few days ago)
Me (picks up cell phone and hears this message from my aunt, Shirley Bu) "Hi Cheri! I meant to say Carey in my blue tooth and I said Cheri! Oh well, I love you!"
Me (to husband): "This is the strangest message EVER. Aunt Bu said something about saying my name into a tooth."
Husband (who is watching football) "mmm....hmmmm."
Me: (worriedly) "This message doesn't make ANY SENSE. Why would she be talking into her teeth? What if she has early Alzheimer's? Some people get it in their forties! Who's going to take care of her? Do you think we should clean out a guest room?
Husband (sighs, gives up on game for a moment) "What did she say?"
Me: "She said something about SAYING MY NAME INTO A TOOTH and then her PHONE CALLED ME!"
Husband (laughing): "Was she drinking?"
Me (aggravated) "NO, she DOESN'T DRINK. I wish she WAS. I know it's early Alzheimer's! This is terrible!"
Husband (patiently, as he is the patient one) "What EXACTLY did she say?"
Me: "She SAID 'Hi Cheri I said Carey into my BLUE TOOTH And it called you!"
Husband begins laughing.
Me: (irritably) What? This ISN'T FUNNY!
Husband: BLUE TOOTH. That's that thing you talk into when you have the phone in your ear, you know like Celia has?
Me; (sheepishly) "ohhhhhhhh."
Duh-uh-uh. Well, now I know the name of those things I hate. I always just called it "that stupid thing Celia puts in her ear" because I hate them. People are wearing them and they just start talking, so you think they're talking to YOU, and you respond- and then feel very foolish and aggravated when you realize they weren't talking to you AT ALL but to some disembodied person.
Whatever happened to phones on the wall?
Anyway, since I like to tell amusing tales mocking other people, I thought it would be good to add one about myself.
(a few days ago)
Me (picks up cell phone and hears this message from my aunt, Shirley Bu) "Hi Cheri! I meant to say Carey in my blue tooth and I said Cheri! Oh well, I love you!"
Me (to husband): "This is the strangest message EVER. Aunt Bu said something about saying my name into a tooth."
Husband (who is watching football) "mmm....hmmmm."
Me: (worriedly) "This message doesn't make ANY SENSE. Why would she be talking into her teeth? What if she has early Alzheimer's? Some people get it in their forties! Who's going to take care of her? Do you think we should clean out a guest room?
Husband (sighs, gives up on game for a moment) "What did she say?"
Me: "She said something about SAYING MY NAME INTO A TOOTH and then her PHONE CALLED ME!"
Husband (laughing): "Was she drinking?"
Me (aggravated) "NO, she DOESN'T DRINK. I wish she WAS. I know it's early Alzheimer's! This is terrible!"
Husband (patiently, as he is the patient one) "What EXACTLY did she say?"
Me: "She SAID 'Hi Cheri I said Carey into my BLUE TOOTH And it called you!"
Husband begins laughing.
Me: (irritably) What? This ISN'T FUNNY!
Husband: BLUE TOOTH. That's that thing you talk into when you have the phone in your ear, you know like Celia has?
Me; (sheepishly) "ohhhhhhhh."
Duh-uh-uh. Well, now I know the name of those things I hate. I always just called it "that stupid thing Celia puts in her ear" because I hate them. People are wearing them and they just start talking, so you think they're talking to YOU, and you respond- and then feel very foolish and aggravated when you realize they weren't talking to you AT ALL but to some disembodied person.
Whatever happened to phones on the wall?
The Good, The Bad, and The Dead
The Good, The Bad, and the Dead
Since last night started with a dead patient and ended with a dead patient (same room, too- not a good night fto be inoT-6) I thought I would jot down a few thoughts on dead patients.
Pros:
1. The patient will not put on the call light thirty-eight times in one hour like my other patients are doing.
2. The patient will not attempt to hit, bite, or otherwise molest me.
3. In fact, the patient will not annoy me in any way. It's nice to have one that doesn't whine for a change.
4. I can talk about the patient in front of them and they don't mind.
5. There's no need to do all those admission or transfer papers.6. The patient will not have to get up to the commode; necessitating a ten-minute-search for the portable potty, a twenty-minute search for the toilet paper, a lower back strain while attempting to hold onto grandma as she pivots her enormous behind from bed to potty, and the cleaning of the portable commode.
Now, if you're thinking a dead patient is pretty much a perfect patient- it would seem that way, wouldn't it? However, there are the Cons.
Cons:
1. The patient will have no identification anywhere on their body. If the patient is female, her purse will contain only candy, cigarettes, lighter, unlabeled pills, hairbrush/comb and makeup bag. If the patient is male, his wallet will contain only: five unused condoms and one that I'd rather not guess; various court citations in which his name is smeared illegibly as if it's been dropped in the toilet one too many times; a few one dollar bills, a pound of change- which will fall all over the floor in the room- a phone number for Bubba (there's always a Bubba) and a pocketknife.
2. Three hours later five family members/friends/live-ins will come into the lobby and start screaming that no one called them. If you call Bubba, he'll sound very panicked and say he doesn't know anybody that could possibly be dead. Bubba doesn't want to give his last name, either.
3. Family members/friends/live-ins will begin to argue over the dead body as to who's fault it is that they're dead and bring up every past grievance they have ever held against the other person. Attempts to redirect their "misplaced grief" (we're hoping that's what it is) will result in said family members/friends/live-ins informing you that they've been through this before and don't need your advice, thank you very much
.4. The Organ Donors must be called. They must. It's a State Law. No matter how long you put it off, eventually you must call them. They will put you on hold for twenty minutes while your other three patients are 1)pulling out their IVs 2)screaming for their pain medicine 3)vomiting in the hallways and 4)getting more short of breath. If you hang up and call back, they'll put you on hold longer. Once they answer, they will ask you five hundred and eighty six questions about the dead person's medical history, medicines, lifestyle, sexual preferences, etc., of which you have absolutely no idea. You're lucky if you get a correctly spelled name out of the family members/friends/live-ins. They will argue with each other over the patient's age, and nobody has a clue as to the birthday. The organ donors will make you go ask the family/friends/live-ins all their questions, and they will shriek at you that they do not know either and is this any time to be asking questions? Because, you know, they're busy fighting with each other.
5. Someone must decide where the body will be sent. In theory this is very simple. "What funeral home do you choose?" "Oh- mother has prior arrangements at Such and Such." This happens once in a freaking blue moon. Or maybe I just don't get those patients. My asking about the funeral home always results in the person asked giving me a horrified look and yelling, "I'M NOT PAYING FOR ANYTHING!" Nobody wants to pay for the funeral, so nobody's picking a funeral home that might possibly expect payment- and NOBODY is going to sign the paper releasing the body. Never, ever, ever.
6. Family/friends/live-ins will begin wandering around the unit, chatting with other patients, bumming cigarettes and coffee, and when asked to remain in their assigned area, will state they are too upset to sit down.
7. The funeral homes take turns accepting bodies that have no responsible person (i.e., the nobodys-paying-the-bills, which is most of them) They are not thrilled when you call them at 3 am and inform them you have such a client and would they please get out of bed and come cart their dead ass away? They do not show up for three hours. When they do, they are very surly. By this time, the patient, who was found down in a field and had probably been dead five hours anyway- (but must be heroically coded for forty-five minutes and brought to the ED to be pronounced- i.e., dumped on us)- has been dead twelve hours and They Don't Look So Good. Dead trauma patients aren't necessarily the most gruesome; although I suppose if severed body parts or gaping holes or brains hanging out bothers you they might be- I vote for the Drowning Victim. They Look Bad. All bloated up and no place to go. It won't keep me from my sphaghetti and meatballs lunch break, though, if said break time ever occurs (generally at the end of thirteen hours)
Every now and then there is that rare exception- an upstanding citizen who actually has a driver's license and a working cell phone; actual grieving relatives, etc. This is not fun because it's very sad. If it's a young person, it's horrible and you don't ever get used to it. Fortunately, most of our deceased fall into the above category.
My Favorite After Death Scene: Momma, in her early fifties, falls off porch and breaks her hip. Momma vomits during surgery, aspirates it into her lungs, codes and dies. Momma's children come in and promptly begin screaming at each other in the waiting room over who is going to get Momma's black-and-white TV, her Frigidaire, and the money she has in her underwear drawer. This is an absolute true story. The 6 foot tall sister has her much smaller brother pinned up against the wall by the time security comes. When the surgeon arrives to try and apologize his way out of a lawsuit, they punch him.
Labels: death, ER
posted by cherigrace 6:03 PM
1 Comments:
Liz said...
I like all the different categories of dead people, haha. People need to be told to keep ID on them so they won't be a burden to Bubba or the ER staff. :)
8:55 AM
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Tuesday, September 30, 2008
Halloween in the ER
Since the first post was met with an inordinate amount of enthusiasm, (I wasn't expecting ANY posts- well, maybe from my daughter, cuz she's sweet like that) I've put my mind to pondering other interesting/bizarre/totally insane ER incidents and patients. The werewolf story made me think of last Halloween, which was definitely the weirdest and funniest night we had all year.
12 MN- Werewolf-bitten patient arrives, is escorted into Exam Room 5.
12:30 MN-1:00 AM EMS recieves a call from dispatch that a 66 year old woman states she "ate a bad piece of Halloween candy and now my kidneys have shut down." They bring in said woman, who promptly takes off her gown and begins to dance in the hall. Security is called. Werewolf bitten patient is interested.
1:00 AM EMS recieves a call from dispatch (you KNOW they aren't getting any sleep tonight) stating a 42 year old man has an earache. They HAVE to go pick up every patient who calls. It's the law. I'm not even kidding you-wish I were. We've had people call EMS for, and I quote, "constipation" "scabies" and my all-time favorite "I was cold." (when I asked the patient why he didn't get another blanket, he said "It was all the way downstairs. The phone was next to my bed so I just called 911.") The 42 year old Ear Pain man is placed in the EENT room to await the doc, who is treating an Actual. Sick. Patient. Not that he cares. He wants a doctor in there RIGHT NOW.
1:30 AM- Crazy kidney lady rushes out to the nurse's station without her gown (security being otherwise occupied, as you'll soon hear) squats behind the physician and secretary and pees on the floor. The doc, who is our most dry, sarcastic, and professional pf physicians, turns to her and says: "Well. Apparently your kidney problem has resolved, ma'm. Perhaps you could return to your room and dress." Crazy kidney lady is not impressed, and shrieks: "THAT DIDN'T COME FROM MY KIDNEYS! IT CAME FROM MY STOMACH! WHAT KIND OF DOCTOR ARE YOU?" Dr. H does not even bother to respond.
1:30 AM- (all of this occurred simultaneously, which is one reason it was so funny) Ear Ache Man- who has been talking on his cell phone, mumbling about wanting a cigarette, and generally appearing in no distress- comes out to the desk, leans over, and begins screaming profanity at the physician who is attempting to chart on an Actual. Sick. Person. Security is called.
1:32 AM- We have a square shaped area of exam rooms (the "E" side) in front of the nurse's desk, and trailing back behind it in a line are the more acute/trauma rooms (the "T" side). Ear pain guy is being chased around the square of exam rooms by the two security guards, one of whom is, ummm, a bit overweight. Ear pain guy flies past, security guards go by. Ear pain guy comes around, security guys come around. Ear pain guy comes by, security guard- huffing and puffing- stops at desk and says he feels short of breath and could Respiratory Therapy come give him a treatment? His partner comes up behind him and they begin to argue. Meanwhile Ear Pain Guy stomps out into the lobby, shouting.
1:33 AM- An actual sick old woman, who is also a crazy drug addict (sometimes the two go together, oddly enough) starts screaming from T-7 that if she doesn't get something for pain NOW she is going to "eat every hydro I've got in my purse." ER doc starts banging his head on the desk.
1:33 AM- Ear Pain Guy runs into the triage room, where a nurse is triaging an already-frightened 5 year old girl, and utterly terrifies her when he begins screaming that he hasn't seen a doctor and he's been here twenty-five minutes and his f**king ear hurts. Local police are called. We do NOT put up with patients that frighten small children.
1:33 AM- Crazy kidney lady rolls up her gown and stuffs it into the commode of the communal E area bathroom. Toilet overflows. 80 year old lady who came in for hip pain and is patiently waiting to be seen goes to use the bathroom, slips on the water, and breaks her hip. This is Not Good. Lots of paperwork.
1:34 AM- Since one security guy is getting a breathing treatment and the other is trying to break up a fight in the lobby; I go into T-7 and try to wrestle the purse away from Crazy Old Sick Lady who reeeeeeeally doesn't need to eat all 120 of her hydros at one time. (Hydrocodone, aka Vicodin or Lortab, our region's Most Popular Drug) She's gotten about five of them down but hasn't anything to drink; so she's climbed over the side rail and has her face in the faucet. I grab the purse, she grabs the purse, and hydros fall everywhere. It's like Hydro Heaven. If only Ear Pain Guy had run in here, he'd have been a happy camper.
1:35 AM EMS had earlier been dispatched to a local plant for a "worker who is coughing up bright red blood" I triage this fellow and there's just something Not Right about his story. It's the ER animal-instinct thing we all develop to survive. Finally I call his supervisor, who states the fellows in the assembly line swear they've been with him for the last four hours and he hasn't coughed up any secretions of any sort. Good to know. He's quite agitated and hyperverbal, so my differential diagnosis is Crackhead at Work who decides he'd Rather Leave. This proves to be correct when he climbs into the large sink/basins we have in the T rooms and tells me he isn't getting out until the doctor gives him something for pain. I ask him where he's hurting and he thinks about this for awhile and states, "My ass hurts." I tell him that's probably because he's wedged himself into a 4 X 4 porcelain sink, and he's about 5'10, 180 pounds. I mean, he's crunched up in a little ball- up until this incident, I never knew an adult could fit into one of those sinks. That's the other good thing about the ER- you're constantly learning.
1:36 AM- Crazy sick lady who wants to eat all the hydros runs out the back of the ambulance doors. Nobody chases her.
1:37 AM- Guy In Sink begins loudly cursing and shouting. I make the mistake of looking in to see why; and he's talking on his cell phone to his (God bless her soul) wife. He finally screams his last bit of vulgarity and slings the phone across the room where it promptly breaks into two pieces. He looks at me and says, "You're paying for that phone."
1:39 AM Crazy Sick Lady comes back IN the ambulance doors and announces she's suing all of us. No one responds.
1:39 AM Crazy Kidney lady starts going into other people's rooms (mercifully, two other nurses have wrapped two gowns- one front, one back- around her in such a fashion she can't figure out how to get them off) and telling them that tainted candy shut down her kidneys. They all begin frantically phoning every friend and loved one they know to inform that that they're probably all going to have kidney failure and die if they ate any Halloween candy, and they'd better call 911 if they did.
1:40 AM- Local police tase cursing and screaming Ear Guy who's still in the lobby frightening small children and isn't going quietly. Everyone in the lobby applauds. Six year old girl with a cough shrieks, "THIS IS BETTER THAN COPS!"
1:41 AM- Crazy Sick Lady goes back into her same room, gets down on her hands and knees, and starts looking under the stretcher for the hydros, which housekeeping has already swept up and tossed. She starts yelling what I call: "The Five Things Every Drunk/Drugged-Up/Crazy Person tells you when they come to the ER." These are:
1. I have rights, man. (These rights, according to the patient, include the right to verbally and physically assault anyone who annoys them; act in extremely inappropriate ways towards other innocent patients without any attempt by staff to stop them; and to recieve whatever pain medication they demand in the dosage, form, and strength they demand it)
2. I'm gonna sue you. (This is always said by the person who hasn't money for a cab ride home, can't afford his four dollar Walmart prescription, and spends every last dime on cigarettes- but apparently can afford a high-powered attorney)
3. I need something for pain RIGHT NOW. (see number One. Oh, and it doesn't matter if there's a code going on, or a baby is in distress, or you've just gotten in three multiple trauma victims- you'd still better drop everything, chase the doc down with a flying leap, and throttle him until he gasps out the Desired Order for the Desired Drug. I mean, they have rights, dude.)
4. I need a cigarette. (And if I don't have one, can you lend me one?)
5. You DON'T UNDERSTAND, man! (The problem is we actually do)
1:42 AM- Guy in Sink repeatedly screams he will not leave said sink until I bring him some Demerol. At this point I'm getting a little irritable, because I really want to eat SOMETHING during my thirteen hour shift, and he's basically on my very last nerve. So I tell him "You can sit there as long as you want. I get off at seven whether you're in that sink or not." This, of course, is not the therapeutic communication we were taught in nursing school; but it does shut him up. For a few minutes.
1:44 AM- All EMS trucks (eight total) are out on calls for people who've been food poisoned by tainted candy that shuts down the kidneys.
It's a 27 bed ER, so there was quite a lot more than THAT going on- those are just the parts that stand out. Anyway, to sum it all up- since I know you've come to love these people by now- Crazy Kidney Lady is discharged after absolutely nothing is found wrong with her; but has no way to get home (and EMS is not required to take them BACK unless there is a medical necessity per the physician- which there wasn't) so she sits out in the lobby telling everyone who comes in how horrible we are until my shift ends. (I don't know what happens after that. I can't honestly say I lost any sleep over How She Got Home that day.)
Crazy Ear Guy is released from the pokey on bail and shows back up in the ER six hours later complaining of lower back pain. Via ambulance, of course. Oh, and if you're wondering who pays for all these ambulance rides for these people with no insurance- the answer is YOU.
Crazy Sick Lady is admitted to the floor where we apologize profusely to the nurse we hand her off to. She tells the nurse we've stolen all her drugs, she's going to sue us, and she really needs a cigarette. Apparently we don't understand she has rights.
Guy In Sink begins yelling again because his wife won't come pick him up (after he's discharged because there is Nothing Wrong With Him) and I sigh and say, "Maybe she's tired of you taking all the drugs." (His urine drug screen was- what a shocker- positive for cocaine, ampethamines, opiods, and barbiturates) He gives me an odd look and says: "She hasn't had to come get me from a hospital in OVER A WEEK!" Honestly, I don't know what's wrong with that bitch.
The six year old with a cough gets a sucker, a coloring book and crayons, and announces this was the best Halloween ever when she's discharged home. I think she'll make a good ER nurse one day.
The physician (who's the only doc on duty) finally snaps at 4:30 am and tells me to go to the local gas station and buy a pack of cigarettes for a drunk who keeps yelling for one. This rather suprises me (not that I'd do it anyway) until he adds: "Put a nonrebreather mask on him, turn up the oxygen, light up the cigarette, and stuff it through the vent hole in the side."
Yeah, I didn't do that either. I need my job.
12 MN- Werewolf-bitten patient arrives, is escorted into Exam Room 5.
12:30 MN-1:00 AM EMS recieves a call from dispatch that a 66 year old woman states she "ate a bad piece of Halloween candy and now my kidneys have shut down." They bring in said woman, who promptly takes off her gown and begins to dance in the hall. Security is called. Werewolf bitten patient is interested.
1:00 AM EMS recieves a call from dispatch (you KNOW they aren't getting any sleep tonight) stating a 42 year old man has an earache. They HAVE to go pick up every patient who calls. It's the law. I'm not even kidding you-wish I were. We've had people call EMS for, and I quote, "constipation" "scabies" and my all-time favorite "I was cold." (when I asked the patient why he didn't get another blanket, he said "It was all the way downstairs. The phone was next to my bed so I just called 911.") The 42 year old Ear Pain man is placed in the EENT room to await the doc, who is treating an Actual. Sick. Patient. Not that he cares. He wants a doctor in there RIGHT NOW.
1:30 AM- Crazy kidney lady rushes out to the nurse's station without her gown (security being otherwise occupied, as you'll soon hear) squats behind the physician and secretary and pees on the floor. The doc, who is our most dry, sarcastic, and professional pf physicians, turns to her and says: "Well. Apparently your kidney problem has resolved, ma'm. Perhaps you could return to your room and dress." Crazy kidney lady is not impressed, and shrieks: "THAT DIDN'T COME FROM MY KIDNEYS! IT CAME FROM MY STOMACH! WHAT KIND OF DOCTOR ARE YOU?" Dr. H does not even bother to respond.
1:30 AM- (all of this occurred simultaneously, which is one reason it was so funny) Ear Ache Man- who has been talking on his cell phone, mumbling about wanting a cigarette, and generally appearing in no distress- comes out to the desk, leans over, and begins screaming profanity at the physician who is attempting to chart on an Actual. Sick. Person. Security is called.
1:32 AM- We have a square shaped area of exam rooms (the "E" side) in front of the nurse's desk, and trailing back behind it in a line are the more acute/trauma rooms (the "T" side). Ear pain guy is being chased around the square of exam rooms by the two security guards, one of whom is, ummm, a bit overweight. Ear pain guy flies past, security guards go by. Ear pain guy comes around, security guys come around. Ear pain guy comes by, security guard- huffing and puffing- stops at desk and says he feels short of breath and could Respiratory Therapy come give him a treatment? His partner comes up behind him and they begin to argue. Meanwhile Ear Pain Guy stomps out into the lobby, shouting.
1:33 AM- An actual sick old woman, who is also a crazy drug addict (sometimes the two go together, oddly enough) starts screaming from T-7 that if she doesn't get something for pain NOW she is going to "eat every hydro I've got in my purse." ER doc starts banging his head on the desk.
1:33 AM- Ear Pain Guy runs into the triage room, where a nurse is triaging an already-frightened 5 year old girl, and utterly terrifies her when he begins screaming that he hasn't seen a doctor and he's been here twenty-five minutes and his f**king ear hurts. Local police are called. We do NOT put up with patients that frighten small children.
1:33 AM- Crazy kidney lady rolls up her gown and stuffs it into the commode of the communal E area bathroom. Toilet overflows. 80 year old lady who came in for hip pain and is patiently waiting to be seen goes to use the bathroom, slips on the water, and breaks her hip. This is Not Good. Lots of paperwork.
1:34 AM- Since one security guy is getting a breathing treatment and the other is trying to break up a fight in the lobby; I go into T-7 and try to wrestle the purse away from Crazy Old Sick Lady who reeeeeeeally doesn't need to eat all 120 of her hydros at one time. (Hydrocodone, aka Vicodin or Lortab, our region's Most Popular Drug) She's gotten about five of them down but hasn't anything to drink; so she's climbed over the side rail and has her face in the faucet. I grab the purse, she grabs the purse, and hydros fall everywhere. It's like Hydro Heaven. If only Ear Pain Guy had run in here, he'd have been a happy camper.
1:35 AM EMS had earlier been dispatched to a local plant for a "worker who is coughing up bright red blood" I triage this fellow and there's just something Not Right about his story. It's the ER animal-instinct thing we all develop to survive. Finally I call his supervisor, who states the fellows in the assembly line swear they've been with him for the last four hours and he hasn't coughed up any secretions of any sort. Good to know. He's quite agitated and hyperverbal, so my differential diagnosis is Crackhead at Work who decides he'd Rather Leave. This proves to be correct when he climbs into the large sink/basins we have in the T rooms and tells me he isn't getting out until the doctor gives him something for pain. I ask him where he's hurting and he thinks about this for awhile and states, "My ass hurts." I tell him that's probably because he's wedged himself into a 4 X 4 porcelain sink, and he's about 5'10, 180 pounds. I mean, he's crunched up in a little ball- up until this incident, I never knew an adult could fit into one of those sinks. That's the other good thing about the ER- you're constantly learning.
1:36 AM- Crazy sick lady who wants to eat all the hydros runs out the back of the ambulance doors. Nobody chases her.
1:37 AM- Guy In Sink begins loudly cursing and shouting. I make the mistake of looking in to see why; and he's talking on his cell phone to his (God bless her soul) wife. He finally screams his last bit of vulgarity and slings the phone across the room where it promptly breaks into two pieces. He looks at me and says, "You're paying for that phone."
1:39 AM Crazy Sick Lady comes back IN the ambulance doors and announces she's suing all of us. No one responds.
1:39 AM Crazy Kidney lady starts going into other people's rooms (mercifully, two other nurses have wrapped two gowns- one front, one back- around her in such a fashion she can't figure out how to get them off) and telling them that tainted candy shut down her kidneys. They all begin frantically phoning every friend and loved one they know to inform that that they're probably all going to have kidney failure and die if they ate any Halloween candy, and they'd better call 911 if they did.
1:40 AM- Local police tase cursing and screaming Ear Guy who's still in the lobby frightening small children and isn't going quietly. Everyone in the lobby applauds. Six year old girl with a cough shrieks, "THIS IS BETTER THAN COPS!"
1:41 AM- Crazy Sick Lady goes back into her same room, gets down on her hands and knees, and starts looking under the stretcher for the hydros, which housekeeping has already swept up and tossed. She starts yelling what I call: "The Five Things Every Drunk/Drugged-Up/Crazy Person tells you when they come to the ER." These are:
1. I have rights, man. (These rights, according to the patient, include the right to verbally and physically assault anyone who annoys them; act in extremely inappropriate ways towards other innocent patients without any attempt by staff to stop them; and to recieve whatever pain medication they demand in the dosage, form, and strength they demand it)
2. I'm gonna sue you. (This is always said by the person who hasn't money for a cab ride home, can't afford his four dollar Walmart prescription, and spends every last dime on cigarettes- but apparently can afford a high-powered attorney)
3. I need something for pain RIGHT NOW. (see number One. Oh, and it doesn't matter if there's a code going on, or a baby is in distress, or you've just gotten in three multiple trauma victims- you'd still better drop everything, chase the doc down with a flying leap, and throttle him until he gasps out the Desired Order for the Desired Drug. I mean, they have rights, dude.)
4. I need a cigarette. (And if I don't have one, can you lend me one?)
5. You DON'T UNDERSTAND, man! (The problem is we actually do)
1:42 AM- Guy in Sink repeatedly screams he will not leave said sink until I bring him some Demerol. At this point I'm getting a little irritable, because I really want to eat SOMETHING during my thirteen hour shift, and he's basically on my very last nerve. So I tell him "You can sit there as long as you want. I get off at seven whether you're in that sink or not." This, of course, is not the therapeutic communication we were taught in nursing school; but it does shut him up. For a few minutes.
1:44 AM- All EMS trucks (eight total) are out on calls for people who've been food poisoned by tainted candy that shuts down the kidneys.
It's a 27 bed ER, so there was quite a lot more than THAT going on- those are just the parts that stand out. Anyway, to sum it all up- since I know you've come to love these people by now- Crazy Kidney Lady is discharged after absolutely nothing is found wrong with her; but has no way to get home (and EMS is not required to take them BACK unless there is a medical necessity per the physician- which there wasn't) so she sits out in the lobby telling everyone who comes in how horrible we are until my shift ends. (I don't know what happens after that. I can't honestly say I lost any sleep over How She Got Home that day.)
Crazy Ear Guy is released from the pokey on bail and shows back up in the ER six hours later complaining of lower back pain. Via ambulance, of course. Oh, and if you're wondering who pays for all these ambulance rides for these people with no insurance- the answer is YOU.
Crazy Sick Lady is admitted to the floor where we apologize profusely to the nurse we hand her off to. She tells the nurse we've stolen all her drugs, she's going to sue us, and she really needs a cigarette. Apparently we don't understand she has rights.
Guy In Sink begins yelling again because his wife won't come pick him up (after he's discharged because there is Nothing Wrong With Him) and I sigh and say, "Maybe she's tired of you taking all the drugs." (His urine drug screen was- what a shocker- positive for cocaine, ampethamines, opiods, and barbiturates) He gives me an odd look and says: "She hasn't had to come get me from a hospital in OVER A WEEK!" Honestly, I don't know what's wrong with that bitch.
The six year old with a cough gets a sucker, a coloring book and crayons, and announces this was the best Halloween ever when she's discharged home. I think she'll make a good ER nurse one day.
The physician (who's the only doc on duty) finally snaps at 4:30 am and tells me to go to the local gas station and buy a pack of cigarettes for a drunk who keeps yelling for one. This rather suprises me (not that I'd do it anyway) until he adds: "Put a nonrebreather mask on him, turn up the oxygen, light up the cigarette, and stuff it through the vent hole in the side."
Yeah, I didn't do that either. I need my job.
Nobody can make this stuff up
I'm an ER nurse- a member of that elite group of society that may be saving a life one minute and trying to explain to an aggravated drunk why it really isn't a concern that they "don't want to be treated in a square room."
I love what I do because people are fascinating. There are people that need comfort; people that need help; people that desperately need psychiatric care and....people that really, really just ought to go home.
I thought I'd start a blog of some of my favorite ER encounters- things I'll forget about but will remember with a smile later. I've thought of doing this before, but decided no one but other ER personnel would believe the stories. Lately, though, I've decided that no one can make this shit up.
Case in point: It's Halloween. I'm sitting in triage and a large fat man walks in naked. He sits down in the triage room. This doesn't surprise or startle me at all, which is a sad comment on the state of my psyche and/or an indication I've worked ER too long. I ask the fellow what's going on tonight- no need to mention the lack of clothes, since I don't especially want to know- and he announces that he's been bitten by a werewolf and asks if we have an antidote. I solemnly inform him that yes, we do, and he's quite relieved. I'm not lying, either- the Haldol worked really well.
A few weeks ago an elderly man, otherwise completely alert and oriented, entered with a goose-egg hematoma (bruise) on his forehead. He cheerfully tells me that he has a unicorn- a very pretty white unicorn, with a fluffy pink mane- and she's awfully sweet, but now and again her temper flares up and she's poked him in the head. He says quite seriously "Now, honey, I'm not crazy. I know you all aren't a veterinary hospital. But what I really need is a sedative for my unicorn. I don't want her getting put down." Unicorn man, as we've come to call him, has been in and out several times since- once with non-unicorn-related injuries (his wife had smacked him- probably because she's tired of hearing about the nonexistent unicorn) and several times with scraps and scratches from falling off the unicorn.
This one wins the prize for the What-do-you-say-to-that-statement category. Thirtyish white male enters triage room looking nervous and schizoaffective. Sits very stiffly on the chair. Stares at me and announces, "My brain wave has changed." Now, there are some stock responses to the chief complaint, such as- when did this begin? What other symptoms are you having? Have you started any new medicines? etc., etc. I really couldn't come up with a response for that one for at least a minute. Finally I said, "And how can we help you with this today?" and he replies, "I want that doctor to change it back."
Brain-wave dude (as he is now known- don't ask me why he's dude and unicorn man is man- just accept reality, people) then started coming in almost every night with different delusional complaints until he was finally C.O.N'ed to the local mental health facility, for that whopping three days of treatment. The other night one of our older and generally non-humorous nurses answers the phone and starts falling over laughing. She puts the caller on hold, hands me the phone and says "You gotta here this." (this is not a good sign) I pick up the phone and it's brain wave man, who is playing the funeral march on an organ in the background. He tells me that his brain wave was acting up again, but he fixed it himself this time- only when he fixed it, he lost his voice. HE TELLS ME THIS. Hmm. So I say, (because we're on a first name basis with brain-wave-dude by now, and I know exactly who it is) "But Jason- you're talking to me. Your voice IS working." He replies with a disgruntled sigh, "That's what you know." and plays even louder. I kind of want to keep him on the phone because this is the most fun I've had all night; so I mention that I didn't know he played the organ. He gloomily responds "I used to play in church. But they asked me not to come back." How crazy do you have to be before a CHURCH tells you not to come back?
Here's our last-but-not-least. Young twentyish female (all young females are known to ERs for fits of histrionics, Drama Queen impressions to get Boyfriend Attention, and fake seizures) calls EMS for "uncontrollable shaking" They bring her in and she's got her elbows folded and is flapping her arms in a seal-like fashion, while scissoring her legs madly and shrieking: "I NEED SOMETHING TO STOP THIS!" (the something was her Xanax, which she'd taken all of in a week and was now withdrawing from) Our laconic male physician says in his professional-yet-stern voice, "Ma'm. These movements are voluntary." She stops the scissoring, quites the flapping, points her finger directly in his face and screams: "NO, THEY ARE NOT!"
All of this leads me to ask someone at least once a day....What is wrong with these people?
Then said drama queen dramatically announces "I'm going out....I'm going out...." and pretends to fall unconcious. Now, here's a tip if you're ever of the mindset to fake syncope (fainting) to get Boyfriend Attention or whatever. People who actually faint DO NOT announce it before they do so. You're just drawing grandma's blood and, BANG! grandson standing behind you hits the floor. Drama Queens of the World always announce it (at least twice, maybe three times) in sepulchral tones and with much rolling of the eyes and twitching of the limbs.
There's a really common cure, however. Start cutting off the clothes (which you would do to an actual unconcious person, to examine them for injuries). Said Drama Queen will then begin shrieking about Her-Favorite-Bra-That-You-Are-Gonna-Pay-For and will not be at all embarrassed when you inform her that wow, she isn't unconcious at all.
Anyway, because to the girl with the arm-flapping and leg-scissoring. She continues this business, along with the intermittent "fainting" spells; and one of our very sly and funny nurses takes her cell phone and calls the doc and tells him in a low, gloomy voice: "This...is...Doctor...Chin....neurologist. You have...(gives patient's name) as...your....patient." Doc is rather baffled, states, I'm sorry? She continues: "The...patient...is...suffering...from...an acute case of Flaptarditis....for which, there is no known cure."
She then hangs up the phone and shrieks with laughter; we all fall over on the floor, and doc himself is quite amused. Better Flaptarditis than Retarditis, I guess, although it was meant to be a combination of both.
well, that's enough for today. I'll keep you posted on who wanders in next.
I love what I do because people are fascinating. There are people that need comfort; people that need help; people that desperately need psychiatric care and....people that really, really just ought to go home.
I thought I'd start a blog of some of my favorite ER encounters- things I'll forget about but will remember with a smile later. I've thought of doing this before, but decided no one but other ER personnel would believe the stories. Lately, though, I've decided that no one can make this shit up.
Case in point: It's Halloween. I'm sitting in triage and a large fat man walks in naked. He sits down in the triage room. This doesn't surprise or startle me at all, which is a sad comment on the state of my psyche and/or an indication I've worked ER too long. I ask the fellow what's going on tonight- no need to mention the lack of clothes, since I don't especially want to know- and he announces that he's been bitten by a werewolf and asks if we have an antidote. I solemnly inform him that yes, we do, and he's quite relieved. I'm not lying, either- the Haldol worked really well.
A few weeks ago an elderly man, otherwise completely alert and oriented, entered with a goose-egg hematoma (bruise) on his forehead. He cheerfully tells me that he has a unicorn- a very pretty white unicorn, with a fluffy pink mane- and she's awfully sweet, but now and again her temper flares up and she's poked him in the head. He says quite seriously "Now, honey, I'm not crazy. I know you all aren't a veterinary hospital. But what I really need is a sedative for my unicorn. I don't want her getting put down." Unicorn man, as we've come to call him, has been in and out several times since- once with non-unicorn-related injuries (his wife had smacked him- probably because she's tired of hearing about the nonexistent unicorn) and several times with scraps and scratches from falling off the unicorn.
This one wins the prize for the What-do-you-say-to-that-statement category. Thirtyish white male enters triage room looking nervous and schizoaffective. Sits very stiffly on the chair. Stares at me and announces, "My brain wave has changed." Now, there are some stock responses to the chief complaint, such as- when did this begin? What other symptoms are you having? Have you started any new medicines? etc., etc. I really couldn't come up with a response for that one for at least a minute. Finally I said, "And how can we help you with this today?" and he replies, "I want that doctor to change it back."
Brain-wave dude (as he is now known- don't ask me why he's dude and unicorn man is man- just accept reality, people) then started coming in almost every night with different delusional complaints until he was finally C.O.N'ed to the local mental health facility, for that whopping three days of treatment. The other night one of our older and generally non-humorous nurses answers the phone and starts falling over laughing. She puts the caller on hold, hands me the phone and says "You gotta here this." (this is not a good sign) I pick up the phone and it's brain wave man, who is playing the funeral march on an organ in the background. He tells me that his brain wave was acting up again, but he fixed it himself this time- only when he fixed it, he lost his voice. HE TELLS ME THIS. Hmm. So I say, (because we're on a first name basis with brain-wave-dude by now, and I know exactly who it is) "But Jason- you're talking to me. Your voice IS working." He replies with a disgruntled sigh, "That's what you know." and plays even louder. I kind of want to keep him on the phone because this is the most fun I've had all night; so I mention that I didn't know he played the organ. He gloomily responds "I used to play in church. But they asked me not to come back." How crazy do you have to be before a CHURCH tells you not to come back?
Here's our last-but-not-least. Young twentyish female (all young females are known to ERs for fits of histrionics, Drama Queen impressions to get Boyfriend Attention, and fake seizures) calls EMS for "uncontrollable shaking" They bring her in and she's got her elbows folded and is flapping her arms in a seal-like fashion, while scissoring her legs madly and shrieking: "I NEED SOMETHING TO STOP THIS!" (the something was her Xanax, which she'd taken all of in a week and was now withdrawing from) Our laconic male physician says in his professional-yet-stern voice, "Ma'm. These movements are voluntary." She stops the scissoring, quites the flapping, points her finger directly in his face and screams: "NO, THEY ARE NOT!"
All of this leads me to ask someone at least once a day....What is wrong with these people?
Then said drama queen dramatically announces "I'm going out....I'm going out...." and pretends to fall unconcious. Now, here's a tip if you're ever of the mindset to fake syncope (fainting) to get Boyfriend Attention or whatever. People who actually faint DO NOT announce it before they do so. You're just drawing grandma's blood and, BANG! grandson standing behind you hits the floor. Drama Queens of the World always announce it (at least twice, maybe three times) in sepulchral tones and with much rolling of the eyes and twitching of the limbs.
There's a really common cure, however. Start cutting off the clothes (which you would do to an actual unconcious person, to examine them for injuries). Said Drama Queen will then begin shrieking about Her-Favorite-Bra-That-You-Are-Gonna-Pay-For and will not be at all embarrassed when you inform her that wow, she isn't unconcious at all.
Anyway, because to the girl with the arm-flapping and leg-scissoring. She continues this business, along with the intermittent "fainting" spells; and one of our very sly and funny nurses takes her cell phone and calls the doc and tells him in a low, gloomy voice: "This...is...Doctor...Chin....neurologist. You have...(gives patient's name) as...your....patient." Doc is rather baffled, states, I'm sorry? She continues: "The...patient...is...suffering...from...an acute case of Flaptarditis....for which, there is no known cure."
She then hangs up the phone and shrieks with laughter; we all fall over on the floor, and doc himself is quite amused. Better Flaptarditis than Retarditis, I guess, although it was meant to be a combination of both.
well, that's enough for today. I'll keep you posted on who wanders in next.
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