Ok. Read the title, scratch your head, and let your imagination take you where I am certainly going.
A few weeks ago I was working overnight, again on a weekend. This particular Saturday night seemed a bit slow; however content made up for lack of bodies walking through those automatic doors. As a triage nurse, you are the first person to see the patient, determine the 'emergence' of the emergency and place the patient into the appropriate room. For example, a twenty-five year old rosy cheeked frat boy saunters in with alcohol on his breath and glazed over eyes, complaining of severe abdominal pain while making jokes about how nurses used to be in tight little short dress uniforms and rolled up stockings is not something one would consider emergent. Well, not unless he was doubled over and the tears were streaming mid joke. That versus a thirty year old woman accidentally hit by her husband backing out of the driveway (he was talking on the cell phone while backing the car, obviously a very important boy, errr, man) and rolling through the doors with a visible bone or two. Bones are not supposed to be visible, thus creating an 'emergent' emergency. Frat boy will just have to wait 'til the alcohol wears off.
This particular night was relatively interesting. After years of seeing just about everything, this was a first. A man in his mid forties or so was brought in by the police; always a joy. He was hyper, no, more than hyper...my initial guess was methamphetamine. Low and behold I was correct about that part, go figure. The triage process when people are brought in by ambulance or cop is different than the primary tell-me-your-problem triage process. It entails the patient being brought directly back into a room, in this case in handcuffs. From there we go to work trying to find out what happened so we can determine how to treat. Unfortunately there are some docs and nurses that use this time to determine what type of treatment would best fit the type of patient. Yes, even we objective medical professionals are subject to a bit of prejudicial thinking. It comes from day after day of watching perfectly healthy people destroy a body that was perfect upon birth, just for fun.
Methamphetamines usually make people undesirably strong. A small and frail looking 120 pound woman could fight off eight huge security guards with her pinky finger if the situation arose. So then, with the meth guy we were cautious...He didn't look to be in the best of moods anyway. He was having delusions and talking to a lady that none of us could see. It doesn't mean she wasn't there sitting next to him, it means we couldn't see her. He thought we were all out to get him, a normal paranoia with meth. But then something crazy happened. The cuffs came off and he fell silent. We all just stood there, on guard and waiting for him to start bending the side rails of the bed or threatening to snap our little legs in two. He look up at me and with tears in his eyes he said, "It was Stetson."
At first I thought, a delusion, I look like a bottle of Stetson. My thoughts vaguely wandered back to high school, I think that is what my old boyfriend used to wear a ton of. I snapped back to his mumblings and the "not right" feeling came over me. This is when things look ok, and they sound ok, but there is just that little something sitting on your shoulder that forces your senses to understand that something is not right. At this point I start digging, crossing my fingers that he would at least be able to tell me the truth about exactly what happened. Remember, my foremost fear is that someone will keel over and stop breathing, forcing us to intubate and keep them alive. The paperwork is a mess. My primary goal was to figure this out and get him up to psych, after all my 2 a.m. episode of Cops was about to come on.
The blurry eyed man just kept staring at me with his mouth cracked open. Then he slurred, "I wanted to die, then I changed my mind but I had already taken the Stetson..." And the mumbles continued without any sense to them. By this time the necessary steps had been taken to look at a urine drug screen and a blood alcohol level, both not looking very pretty. We will call him "D". "D" looked at me again and decided it was time to leave, grabbed the side rail and started proving his strength by bending it to try and get out. I suppose the thought of just jumping over the rail didn't occur to him. We medicated and in fifteen minutes he was snoring with a pile of blankets and the lights dimmed. Reminded me of a trip to the Marriott with my husband one year.
Come to find out, when all were sober this is what actually happened. "D"s girlfriend broke up with him and he decided he couldn't live without her. They had been doing meth all night and he was cranked. He drove to a part of town where there were train tracks. He had no idea that those tracks had not been used for over fifteen years. After lying on the tracks for hours waiting to die, he got impatient. He was diabetic, and went to the trunk to get his diabetes syringes and medication, with the intention of injecting all of the insulin and ending it that way. Looking through his supplies he realized he had forgotten the insulin, but still had the syringes. Go figure. Frantically searching his car for something lethal to inject, he found a bottle of Stetson in the glove compartment and took it out. (You know where this is going) At this point "D" was frantic. He quickly drew up one syringe full of Stetson and found a large vein in the anticubital space, inserted the needle and shot the cologne into his arm. Once the stinging subsided in his vein the meth took over and he got scared, decided she wasn't worth dying for and called the police threatening suicide and spouting the events of his last few hours.
This is the point when medical personnel make choices. Do we make him comfy or do we allow him to feel like he is truly dying, just for the effect. This is certainly better than my episode of Cops. Hell, it is the episode! As I was leaving to go home that morning I thought about how I would "go out" if I were in his situation and had limited resources. I think I would have not used Stetson. If I'm going I would like to go out in style; who wants to be remembered as the Stetson man? The least he could have done was steal some Armani or Dolce and Cabana and go out in style. But now as I think about it I would have had to change the title of this story and it wouldn't sound as interesting. Thanks "D", for making my a.m. ramblings something of a pleasantry.
"D" lived and vowed never to do Stetson again. The frat boy sobered up and his buddies took him home. The lady with visible bones was transferred to a "more suitable" hospital; we don't do that here.
Saturday, November 26, 2005
Tuesday, October 18, 2005
Blonde Vs. Um...
In response to Teh Blogfather wanting a picture of a more appropriate nurse (as opposed to a blonde, which there seems to be way too many of - what should that tell you about walking into the ER, Hmmm? Don't Go.)
BRUNETTE, I PROMISE...
There are no clean Brunette nurse pictures because we all are out having too much fun.
Sunday, October 16, 2005
The Star Strangled Banner
The small sip of soda a few hours ago certainly wasn’t enough to sustain Tara’s craving for sustenance. As her stomach gurgled and howled, the inebriated fifty-three year old man chuckled and started singing the Star Spangled Banner. All she could do was cringe and hope that his family would come get him and soon. It was 2 a.m. early Saturday morning and she just didn’t have the compassion that most nurses would normally have for wounded patients. Of course, that would be determined by how one would define the terms “wounded” and “compassion”, but in any case she was ready to kick him in the shins just too really give him something to howl about.
And the rocket’s red glare…the bomb’s bursting in air…
That was it. Tara tightened the strap of the wrist restraint just enough to get an “Ouch lady!” She looked at Mr. Truman and said with an annoyed tone, “I’ll be back in a bit.” As she turned to walk off and ignore the verbal knives thrown at her from behind, she winked at the guard and demanded in a whispered voice, “Just keep him on the gurney for ten minutes!” A bee-line was made first for the little girls room, then the kitchen, or as she liked to call it, the Petri-dish. Her pet name for the break room referred to the never ending amount of bacteria and fungus one had to pilfer through jus to get a “clean” fork, thanks to the day shift of course for never cleaning up their crap. Emergency room employee kitchens were exceptions to the rule of standard good hygiene, a true test of human immune response. As Tara kicked her feet up and turned her focus to a silent television screen, her mind wandered to the social activities of what few friends she had on the outside.
The searing pain felt from a bump in her knee alerted Tara that she had fallen asleep and one of the passive aggressive interns needed her to diagnose and propose treatment for yet another one of his patients. It was old hat for the fresh interns to look to the nurses for help before they attempted to kill someone, hoping they would find a nurse competent and not as equally passive aggressive. “At least they try to save’em before they try to kill’em”, Tara thought sarcastically. But in her mind she knew that she was one of “the chosen”, and as much as she sometimes hated it, it made her feel good to know there was a little faith in her medical capabilities. However, she couldn’t decide if that request,coming from a new intern, was faith or fear of the inability to fluff their chest after choosing act on her treatment plan.
Gave truth to the light…that our flag was still there…
“Oh good God in Heaven” she thought as she ditched the intern to get to her minimally restrained patient. The security guard shot her a glaring look as Tara’s eyes followed the slurred singing. When she pulled back the curtain to the see the singing “banner man”, her first inclination was to puke and just go home. As she stood in horror trying to process the view, the singing stopped and a very foul smelling laughter filled the room while banner man rolled around as much as he could, his hands turning purple from the wrist restraints. There was a woman, equally as drunk and half naked (not the better half, if there would have been one) sitting right on top of him, bobbing up and down like one of those little red fishing bobbers during a nibble.
She decided not to puke, and instead shot a help-me and a how-could-you-let-this-happen glance at the six foot two guard. Together, Tara and the guard named Chuck strategically removed the woman from the room and covered her obese, slithering body, somehow disallowing the public from seeing what should never again be seen by the human race. “Well,” she thought, “at least the singing has stopped.” She turned back to Mr. Truman and covered his ‘working parts’ with a sheet, deciding he needed a brief cooling off period before getting the one inch laceration to the back of his head stitched. “After all,” she justified to herself, “I believe the book says that we have around eight hours from the time of injury to get that thing sown up.” With that she returned to the nurse’s station and grabbed the top record of the stack of twenty, and trudged to the waiting room to call her next victim...
And the rocket’s red glare…the bomb’s bursting in air…
That was it. Tara tightened the strap of the wrist restraint just enough to get an “Ouch lady!” She looked at Mr. Truman and said with an annoyed tone, “I’ll be back in a bit.” As she turned to walk off and ignore the verbal knives thrown at her from behind, she winked at the guard and demanded in a whispered voice, “Just keep him on the gurney for ten minutes!” A bee-line was made first for the little girls room, then the kitchen, or as she liked to call it, the Petri-dish. Her pet name for the break room referred to the never ending amount of bacteria and fungus one had to pilfer through jus to get a “clean” fork, thanks to the day shift of course for never cleaning up their crap. Emergency room employee kitchens were exceptions to the rule of standard good hygiene, a true test of human immune response. As Tara kicked her feet up and turned her focus to a silent television screen, her mind wandered to the social activities of what few friends she had on the outside.
The searing pain felt from a bump in her knee alerted Tara that she had fallen asleep and one of the passive aggressive interns needed her to diagnose and propose treatment for yet another one of his patients. It was old hat for the fresh interns to look to the nurses for help before they attempted to kill someone, hoping they would find a nurse competent and not as equally passive aggressive. “At least they try to save’em before they try to kill’em”, Tara thought sarcastically. But in her mind she knew that she was one of “the chosen”, and as much as she sometimes hated it, it made her feel good to know there was a little faith in her medical capabilities. However, she couldn’t decide if that request,coming from a new intern, was faith or fear of the inability to fluff their chest after choosing act on her treatment plan.
Gave truth to the light…that our flag was still there…
“Oh good God in Heaven” she thought as she ditched the intern to get to her minimally restrained patient. The security guard shot her a glaring look as Tara’s eyes followed the slurred singing. When she pulled back the curtain to the see the singing “banner man”, her first inclination was to puke and just go home. As she stood in horror trying to process the view, the singing stopped and a very foul smelling laughter filled the room while banner man rolled around as much as he could, his hands turning purple from the wrist restraints. There was a woman, equally as drunk and half naked (not the better half, if there would have been one) sitting right on top of him, bobbing up and down like one of those little red fishing bobbers during a nibble.
She decided not to puke, and instead shot a help-me and a how-could-you-let-this-happen glance at the six foot two guard. Together, Tara and the guard named Chuck strategically removed the woman from the room and covered her obese, slithering body, somehow disallowing the public from seeing what should never again be seen by the human race. “Well,” she thought, “at least the singing has stopped.” She turned back to Mr. Truman and covered his ‘working parts’ with a sheet, deciding he needed a brief cooling off period before getting the one inch laceration to the back of his head stitched. “After all,” she justified to herself, “I believe the book says that we have around eight hours from the time of injury to get that thing sown up.” With that she returned to the nurse’s station and grabbed the top record of the stack of twenty, and trudged to the waiting room to call her next victim...
Tuesday, October 11, 2005
What's your sign?
It seems that when people start talking "Zodiac" all reasonable thought flies right out the window - especially for men. Yes, we've all heard the old 70's line of "What's your sign, baby?" and a ghastly picture of a toupe`, mustache and a baby blue polyester suit comes to mind. Ick.
What I'm talking about are the lawyers, doctors, nurses - the professionals that actually lose it when reading the back of Cosmo during their birthday month. You know one of those people don't you? Of course! Next time you are shopping for groceries, strategically place your cart behind a 40-something rather unkept mother with her three screaming children (all under the age of five). You will notice a wishful look on her face (probably wishing she would have had her tubes tied after kid #1) and I promise you she will be flipping to the back of a magazine looking for her "most compatible" mystery man. It obviously was not the father of her children or she would be at the salon and he would be shopping with the kids. The woman will be eagerly searching for her birth sign and trying to find something in the words to giver her some hope for the future. Good grief. This woman (or man, with obviously a bit of a feminish side) is a real life professional. The one that figures out how to keep you breathing in the emergency room, or handle your traffic tickets. You don't recognize her because on the weekends she just doesn't care...And make-up does wonders on a weekday!
Aries, Libra, Taurus, Pisces. I could go on but I fear I would start a chant that would never get resolved and I will have it singing in my head depriving me of sleep I need to put you back together after your car accident this evening while you were driving just barely over the legal alcohol limit yet not slurring bad enough to scream in agony. Believe it or not I actually talk in long exaggerated sentences like that. Regardless of your injury I really do not like people and frankly am so caught up in the fact that my horoscope said I was going to be recognized as a successful writer that I'm buzzed and unless you are turning blue I'm going to continue reading the back of my Cosmo magazine.
Hello. My name is Katie and I'm a registered nurse. An emergency room nurse. An Aries/Pisces depending on where the moon is and whether I am on my period or not or whatever that crap is supposed to say. The sign of a Boar according to people in other countries that do not eat them.
This blog is to tell crazy stories of life in my emergency department. Things that will make you throw up, laugh, gasp, chuckle and all with the point of steering you away from my path when you wake up at 3 am and decide you have a toothache (that has been acting up for a few months now) and you're bored, so you get dressed and come visit me in the ER hoping I will give you some sort of relief...or company. Nope. Two aspirin and a coke will do ya' just fine.
Stay tuned to some of my gruesome yet somehow funny adventures. It's never boring.
What I'm talking about are the lawyers, doctors, nurses - the professionals that actually lose it when reading the back of Cosmo during their birthday month. You know one of those people don't you? Of course! Next time you are shopping for groceries, strategically place your cart behind a 40-something rather unkept mother with her three screaming children (all under the age of five). You will notice a wishful look on her face (probably wishing she would have had her tubes tied after kid #1) and I promise you she will be flipping to the back of a magazine looking for her "most compatible" mystery man. It obviously was not the father of her children or she would be at the salon and he would be shopping with the kids. The woman will be eagerly searching for her birth sign and trying to find something in the words to giver her some hope for the future. Good grief. This woman (or man, with obviously a bit of a feminish side) is a real life professional. The one that figures out how to keep you breathing in the emergency room, or handle your traffic tickets. You don't recognize her because on the weekends she just doesn't care...And make-up does wonders on a weekday!
Aries, Libra, Taurus, Pisces. I could go on but I fear I would start a chant that would never get resolved and I will have it singing in my head depriving me of sleep I need to put you back together after your car accident this evening while you were driving just barely over the legal alcohol limit yet not slurring bad enough to scream in agony. Believe it or not I actually talk in long exaggerated sentences like that. Regardless of your injury I really do not like people and frankly am so caught up in the fact that my horoscope said I was going to be recognized as a successful writer that I'm buzzed and unless you are turning blue I'm going to continue reading the back of my Cosmo magazine.
Hello. My name is Katie and I'm a registered nurse. An emergency room nurse. An Aries/Pisces depending on where the moon is and whether I am on my period or not or whatever that crap is supposed to say. The sign of a Boar according to people in other countries that do not eat them.
This blog is to tell crazy stories of life in my emergency department. Things that will make you throw up, laugh, gasp, chuckle and all with the point of steering you away from my path when you wake up at 3 am and decide you have a toothache (that has been acting up for a few months now) and you're bored, so you get dressed and come visit me in the ER hoping I will give you some sort of relief...or company. Nope. Two aspirin and a coke will do ya' just fine.
Stay tuned to some of my gruesome yet somehow funny adventures. It's never boring.
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