Tales from the ER...

Ugh! It was a long week at work. The last night was the worst...it started with toilet paper and balls, and ended with toilet paper and balls. Not fun! Here's how it went...
We have frequent fliers in the ER. People who call 911 for the most ridiculous reasons, drunks who come in all the time. For whatever reason, they are there almost as much as we are. So we have this patient, I'll call him T.T., I worked 3 days in a row this week, he was there three days in a row. Sometimes twice a day. He's a drunk, he passes out on the street and some good samaritan sees him and calls 911, so they bring him to us. Or he gets drunk and doesn't want to pass out on the street so he calls 911 himself and claims chest pain. Either way, they bring him in, almost every day. So anyway the first night I worked he was there, with a blood alcohol level of .347 (legally drunk is .08). So we let him sleep there all night, sober up and sent him home in the morning. I came back the next night and he was there again, with a blood alcohol level of .361.
So I come in the third night and this is how it goes...
First thing I see as I walk into the nursing station is another one of our frequent fliers walking back to his bed from the bathroom. It was a typical TV hospital moment...gown wide open in the back, nothing but his birthday suit on underneath. The whole ER got a nice view of his butt, with a toilet paper trail hanging out from between his cheeks. He climbed into his bed, and we all saw the "full monty". Toilet paper and balls!
So I take a look around the ER, bed 1 is another one of our frequent fliers, who this time is actually sick. He's a little agitated and keeps getting out of bed. Bed 9 is T.T., back again for the third night. Passed out and snoring on the gurney, this time with a blood alcohol level of .317. The night was pretty calm at first, we got bed 1 admitted and up to the fourth floor, TT eloped about nine o'clock. It was peaceful. About 11 o'clock, we hear code gray paged over head. Code gray means a patient is combative, fighting. It was our guy from bed 1. So Alex and I head up to the fourth floor to see what was going on. We see 6 guys standing there, but no patient. They had let him get away. We knew he was still in the hospital because his tele monitor was still picking up, so we were scouring the hospital but couldn't find him. It was like a game of hide and seek. The next thing we hear is the emergency exit door alarm. He had headed outside. We followed him out, but lost him. He was gone, with his IV still in and his tele box, so we had to call the police and let them know he was missing.
Alex and I headed back to the ER and the phone rang, it was the medics bringing in another patient. They showed up and guess who it was....TT! He had left the hospital and headed straight to wherever he goes to get his drink on. This time his BAC was .401. We got him settled and I headed to see what was going on with my new patient.
She was paying a visit with a complaint of vaginal discharge. We get alot of people coming in with complaints of these kinds of issues. I like to call them dirty snatch disease, or stinky winky disease, depending on the gender. So anyway she's complaining of vaginal discharge that had been going on for about a week. So the doctor gets ready to do a pelvic exam. I was standing by to chaperone. As soon as we get her up in the stirrups there is this foul, foul odor. I hear the doc say "what is that?" (Never, ever a good thing to hear during a pelvic exam.) And he pulls out this horrible smelling, grayish colored blob of something. Turns out it was a tampon she forgot was in there. And her last period ended a week ago, so it had been in there that long. The smell was horrific, the best part was the doctors face as he was trying to hold his breath and not gag. Classic!
About this time the ambulance door open up and it was our guy from bed 1 who had run away earlier. They had found him passed out in the empty field next door. He was covered in mud. Because he had left, we can't just send him back up to his bed, we have to start all over again, who knows what he did while he was out there. This time he was even more agitated, and still kept trying to get out of bed. We medicated him to try and sedate him but nothing worked. We gave him enough medicine to take down a horse but nothing was working. We ended up restraining him, but even then, he kept trying to sit up and get out of bed.
While that was going on, I get another new patient, this one was complaining that her intestines were falling out her rectum. (It can happen, its called a prolapsed bowel, and it can happen if people strain too hard to have a BM, or people with some chronic conditions, but it's really rare.) So the doc and I head in to see what was going on. The doc goes in for a rectal exam, spreads her cheeks, and out comes a large wad of toilet paper. Apparently she had been wiping really hard and leaving pieces of toilet paper in there and it had just built up between her cheeks and she thought it was her intestines coming out. It was a disgusting mess, and had another not-so-nice odor about it.
I sent her on her way, and went back to help out with the guy in bed 1 again. He was still so agitated, and we needed to do some exams, so we ended up intubating him so we could really sedate him. We gave him some good meds and he was pretty sedated. The last thing I do before I leave is put a catheter in him. Kim was helping me and as I sticking the catheter in, Kim says "What a night, we started with balls, and we're ending with balls."
My reply was "Toilet paper and balls."
Sometimes we just don't get paid enough, but at least we get good laughs about it later.