Tales from the ER....

So it's been awhile since I've done one of these, but I just had to share my story with you...

Last night, I pull up to work and there's one ambulance, one fire truck, and five police cars outside the ER door. Now the ambulance and fire truck are nothing, but the five police cars, that's a bit unusual. I walk in and hear someone screaming and yelling, not unusual. So I peek my head into the room to see what was going on. I see a black woman lying on the bed, in four-point restraints (both wrists and ankles.) Alex, our tech, and 5 or 6 officers were in the room with her. I went to go see if any patients were in triage and then came back to watch the show. That was when Alex grabbed me and told me she needed help. Apparently the woman was half dressed and because all the officers were male, we needed to get her covered up. So we walk into the room and this is what happens....

The woman is lying on the bed with her shorts around her ankles. We didn't bother trying to get her shorts up, we were more concerned with just covering her up and decided to throw a sheet on her. But she kept twisting around so the sheet would fall off. (I need to insert here that the woman was clearly homeless, and a drug addict. She was dirty and stinky. Emphasis on stinky!) So Alex and I kept trying to tuck the sheet under her, but somehow she managed to keep taking it off. She kept saying "My p---y is sweaty! My p---y is sweaty!" We finally got her covered up and I left to find out from the officers what the story was.
Apparently, the woman was a lady of the night. She was found riding on the roof of the car of her john, naked, down Beach Blvd. The story was that he had picked her up in a neighboring county 10 hours earlier, they had spent the day together doing what they do. Then she freaked out on him, kicked out his car windows and climbed on top of his car, while he was still driving. He just kept driving with her screaming and yelling, naked on top of the car. Good samaritans called 911.

We had a good laugh, picturing that, and wondering what kind of guy wants to get his next to hers. So the police keep interviewing her and it comes out that she's got a crack pipe stashed in a very intimate spot. Because the police are taking her to jail, we've gotta get that out. So I went to tell the doctor the good news. He tried to get me to do it, but I told him because he's got the fancy degree he gets the pleasure. So Alex, the doctor and I walk into the room. He tells the lady of the night what he going to do and she yells out, as loud as she can, "Oh no you ain't! My p---y is sore! Too much been goin' on down there already today. You ain't doin' nothin'! My p---y hurts!"

Since the patient refused we can't do anything about it. Because the police need her clothes for evidence, we've got to strip her down, and since all the officers are guys, Alex and I get the pleasure of doing it. So we strip her down, stick her in a biohazard suit and send her out with the officers. And thank the ER gods that they didn't decide to just leave her with us all night.

About 4 or 5 hours later, I get a text message from one of the officers...the crack pipe had just fallen out onto the jail floor. In the cell next to her was the john, I'll let you figure out how the crack pipe fell out!

Sometimes, if I didn't experience these nights first hand, I wouldn't even believe it was real.

Tales from the ER...

Just a quick one here....

My patient last night tried to kill himself. (And don't get all outraged, I'm not making fun of people who try to commit suicide, only those who are bad at it! Ok, ok, that's not funny either! Sorry!) Anyway he tried to hang himself. He said that he is on narcotic pain meds for chronic back pain, but that they are weaning him off the meds. So he usually takes one half of a pill every day. Well last night he wanted another half pill, but since his wife wouldn't give it to him he decided to hang himself. He went out to the garage, climbed up on the counter, and put an electrical cord around his neck. He tied the cord to a pipe running over head and jumped off the counter. The problem? He's 6' 7'' and the cord was too long. So the police arrived and he was just standing there, with the cord around his neck. The police cut the cord, but he started fighting with them, so they tazed him.
Then they brought him into the ER. After the police left him there, he became aggressive and started yelling and swinging at people. So we tied him down, and then we gave him meds to sedate him.
So, he failed at trying to kill himself, got tazed, got tied to the bed, and got a catheter. And still didn't get his other half of the pain pill! And you thought you had a bad day!

Tales from the ER....

Last night I had a patient who was 34 years old and a quadripalegic. He had been in an accident and broke his neck a few years ago. At the time he was married with small kids. He is now living in a nursing home. He breaths thru a tracheostomy (a hole in his neck) and requires a ventilator to breathe. He is in diapers and totally dependant on others. He cannot speak, but communicates by mouthing words. I had never had him as a patient before, but apparently he frequents our hospital often. He was just there the end of last year for over a month with pneumonia.
When I saw him, I thought to myself, if I was like that, I'd rather be dead. I would not want to live like that. However, he had a different perspective. The ICU nurse that I gave report to told me that he was her absolute favorite patient. She said that he is always happy, he never complains. She said that he told her, he thanks God every day that he is alive. He said he is truly blessed because he gets to live to see his kids grow up!
That really put me in my place. Next time I complain that my life sucks, I'll remember him, and remember that it's all about perspective.

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.

Tales from the ER

A note to my patient last night....

Because I know you don't remember what you did, allow me to refresh your memory. You are a young girl, probably very pretty, but it is hard to tell, because I have only seen you covered in your own vomit. The police brought you in, hog-tied because you kicked out the police car window, and your face, hair, and clothes were soaked in vomit. The police said that you had taken a bunch of tylenol trying to kill yourself, and yup, there was evidence of partially digested pills in your vomitus.

I'm sure you are wondering why you are so sore this morning. Well that is because we had to tie you to the bed. You were kicking and swinging at us, and we just can't have that now. We tried to tell you to lay still, but you just wouldn't listen. When we tied your hands and legs you were laying on your back, but somehow you managed to twist yourself around so you were laying on your stomach, I'm sure you're feeling that pain in your shoulders today. Oops. Next time listen when we say lay still.

The pain in your throat is from the large tube we had to stick down there to wash out your stomach. Let me tell you that was an adventure. It took two cops, two nurses, and a tech to hold you down enough to get that done. I was the lucky one who got to shove the tube in your throat, and had to hold it at the lip while another nurse dumped a bunch of fluids into your stomach. The unfortunate result of dumping all those fluids in, is that they must come back out. So, while we were trying to suck them back out, I guess we weren't fast enough for you, because you promptly vomited again. And because I was the lucky one holding the tube, you vomited all over my hands. Good thing I was wearing gloves.

I'm sure you're also wondering why you have blood around your nose. Well that is your own fault. After we took the tube out of your mouth, we had to stick another one into your nose that goes down into your stomach. (The tube in your mouth can't stay in, this one can, so thats why we had to do both.) Anyway we got the tube in, and gave you the charcoal (more on that later), but when we had to untie your hand to move you, you immediately yanked that tube out. Again, we told you not to do it, but you just didn't listen. We told you it would hurt, but I guess you're just one of those people who have to see for yourself.

So back to the charcoal. What people don't know, is that tylenol is one of the worst drugs to overdose on, it won't kill you, but it will ruin your liver. Seriously. So we had to give you charcoal, it binds with any undigested pills and prevents them from being absorbed into your system. This was given via the tube in your nose. Charcoal is thick, black and nasty. Not fun to give. But you took it like a champ. Of course you didn't have a choice, because, again we gave it via the tube. The unfortunate side effect of charcoal though, is it makes you really sick to your stomach. About half hour after you yanked out the NG tube, you started to vomit that charcoal back out. You were laying on your right side at this time, so there wasn't much risk of aspirating. After you vomited, you laid your head right back down into it. We tried to tell you not too, but again you didn't listen. And this time you fought back a bit. You rolled around in that nasty stuff and got it all over you, so we moved you to a clean bed, but you vomited all over again. This time it was projectile. It splattered everywhere, including on me. Now my cute green scrub pants are permanently stained with your charcoal vomit. Thanks for that. So anyway you kept rolling around in this nasty stuff. And the thing is, charcoal vomit is horrible. It is black and chalky, and well, it stains. I'm sure you would be aware of this, if you could get to a mirror, but I know you can't so allow me to tell you what you look like. Your face, arms, chest (yes, your chest, you wouldn't keep your clothes on either) are smeared in black. Your pasty white face, looks like an african american. And it's in your hair too, mixed with the vomit from earlier. If I were you, I'd plan on getting a haircut when I left the hospital. You'll never get the black stains out from your blonde hair.

Anyway, the main point of this letter is to let you know, that while we were doing all of this to try to save your life, and your liver (although you'll probably kill that by drinking, the police said they found you in a room littered with beer bottles), YOU BIT ME!!! Yes, you read that right, you bit me. So I just wanted to know if your vaccinations are up to date, or do I need to get a rabies shot?

Thanks.
And by the way, you're welcome for saving your life.

Tales from the ER....

It was another one of those nights at work. It started out innocently enough, nothing too exciting until about midnight.
We got an ambulance run with a patient who called 911 because he stubbed his toe. Yup, he stubbed his toe. I'm sure it was really life threatening and worthy of that 911 call. Anyway we xrayed his toe, nothing was broken so it was time to send him home. He sat there and said he wasn't going. His exact words were "You can't make me." So we called the police. Before the police got there tho, he got into a yelling match with the one male nurse we have on nights. So the patient gets up and is yelling "You wanna take this outside?" So our nurse says yeah, opens the doors to the ambulance bay and the patient walks out ahead of him. Our nurse quick closed the doors. That got rid of that patient. Ha, dummy. Next time don't threaten to go outside, when that is all we want from you. Stupid.
Then I got a patient, a girl in her early 20's who mom brought in because she was acting weird. So we get her in the gurney and sent mom back outside because the patient didn't want her back there. So we're asking her what is going on, why she's acting weird and she keeps saying "my mom is the culprit" So of course I ask her, "What did she do?" The patients response "I told you she's the culprit. She's been culpriting." When I asked her again, I got the same response "She's been culpriting"
Nice, so I can see where not going to get anywhere here. So we get her undressed and into a gown and of course she takes the gown right off. So then she's sitting there nekkid and yelling that she wants "my Jeffrey, bring me my Jeffrey." Yelling, at the top of her lungs. We finally get blood drawn and IV infusing and she promptly rips it out. So then I'm pissed. We ended up medicating her 3 times, and each time I used a bigger needle than the last. (That'll teach her this afternoon when she feels those bruises.)
So anyway even after all this medication she's still screaming and yelling, trying to undress herself, and trying to throw punches. So we got out the restraints and tied her arms down. She immediately tried to kick me in the head, luckily her aim was a little off. So anyway, we all walk away and just wait for the meds to kick in, and she's still screaming. "Get me out of here, I hate you all." They she says "Hey I know how to sing" and so the next hour or so goes like this...
"I HATE YOU....think of me, think of me fondly....GET ME THE F*CK OUT OF HERE....think of me.....WHERE IS JEFFREY......think of me fondly.....I WANNA GO HOME....think of me....GET ME Out of heee...."
The meds had finally kicked in. Thank goodness. Then she slept for the next 4 hours, and I got to go home and pass her off to day shift. Yay for me. Unfortunately, I really like Phantom of the Opera, and that song will never be the same for me again. :)

Tales from the ER...

I just have to share my night at work with you. Seriously I wish you all could have been flies on the wall, because unless you saw it you will not truly comprehend the majesty that was the ER Friday night.
So my night starts like this, I get report from the day shift nurse and she tells me to watch out for bed 5 because he's been hypersexual and hitting on everyone and making inappropriate comments. So I avoided going into the room for a good hour, but then I had to. I wish I had the words to describe this guy to you. Picture one of the Hansen boys, with a long scraggly bowl haircut, in the gurney with just his pants on, he took the gown off to show off his manly (or not) chest, sunglasses on. Trying to be cool. So I walk in all no nonsense and thinking I'm gonna be all firm with him. Unfortunately I was walking in to get a urine sample from him so I'm sure that just played to his fantasies. I ended up sending the one male nurse we have in to try to get it from him and I overhear the patient asking the nurse "Do I look buff to you? I mean do I have a nice body? Good muscles? Do I intimidate you?" It was all I could do to keep from laughing. A little bit later I go in the room to tell him he is going to be admitted and he asks me if I'm mad at him. Then he tells me that I "put the naughty in naughty nurse" and asks me if I'm gonna be his nurse for the rest of the night. Five minutes later, I have to go in the room again, as I'm approaching the curtain I hear some strange noise coming from inside the room. I rip back the curtain and find him pleasuring himself. I yell that he needs to stop that immediately which of course draws the attention of the family member in the room next to him. The look on that guys face was classic!
So I finally get this guy upstairs and the next patient in that bed wasn't much better, although much more harmless. He kept asking me if he had nice muscles, and when I had to give him a shot in the butt he said it was ok because "your cute and I have a nice butt"!!!! What the hello?!?! If he only knew how many butts I've seen, trust me his wasn't that impressive!
The most fun part of the night however was the drunk lady that came in a few hours later. Luckily she wasn't my patient, but in the spirit of teamwork I decided to help a fellow nurse out. So this chic rolls in via the paramedics, she had been drinking in downtown HB and apparently passed out or something like that. So she comes in covered in vomit and stinking to high heaven. So Heather, Kelly, and I go into the room to get her triaged and situated. We had to gown up with masks and all cuz it stunk so bad. She's in these tiny painted on skinny jeans that are covered in vomit. Heather and I just wanted to cut them off, but Kelly insisted on taking them off. So she starts pulling the jeans off and notices something dark in them.
Kelly says "Uh I think she started her period"
Heather and I: "Um no Kelly, that's poop!" She had crapped her pants. The smell was so awful Kelly almost puked right then and there.
So the patient meantime, is so freaking drunk she's like a ragdoll. She keeps trying to sit up but just keeps flopping around. She's spitting at us so we threw a sheet over her head. Then she sits up like she's gonna puke, Heather grabs a bucket and holds it under her mouth, the patient puked in it, then immediately flopped down into the bucket face first. So we just left her like that, face down in a vomit filled bucket. She wakes up a minute later and starts flopping around again, picture a fish out of water. She's spitting at us again and shaking her finger at us like she's really gonna do something, she ralphs again.
So by this time we're trying to start an IV and were playing everyone's favorite guessing game...what did she eat for dinner? The conclusion, reached by looking at her vomit, was seafood. So we clean her up, throw her vomit, poop and pee soaked clothes into a bag and set them outside to save for her. She wakes up a few hours later and asks for her clothes, so we give them to her. She opens the bag, in which the clothes have now been fermenting in all those bodily fluids for hours, takes a nice big whiff of the smell and pukes again!
I wish to goodness that I had videotaped this night, words just can't do it justice. But now when you all complain about your jobs, just picture me playing what was for dinner, and it probably won't seem so bad!

Tales from the ER

At work last night we got a full arrest (for the non medical personnel out there, that means someone who is not breathing and without pulses). So anyway there we were waiting for the medics to come in with the patient and I noticed something. We were all standing around the bed talking, not about the patient or what was coming, but laughing and joking. Telling inappropriate stories, insulting each other, just being obnoxious in general. And I realized that this is not unusual. Every full arrest I've ever been a part of has been like this. And in the NICU when we would go for a critical delivery it would be the same thing. The doctor, the respiratory therapist and the nurse would be standing around the warmer waiting for the baby to come out, and just making the most inappropriate jokes, quietly, of course, so the family and patient wouldn't hear, but not very nice in any way. I don't know what this phenomenon is. Call it gallows humor I guess. I suppose its our way of taking the tension out of the situation. Maybe subconsciously we know that in a few minutes we will literally be trying to pry someone away from death's door and its how we relax. It's also weird that after the arrest is called and the patient pronounced, we all just go on like nothing has changed, most of the time. There are the unusual cases that really affect us...kids, young people, mostly. Those stick around for awhile. But in most cases we just go back to business as usual. I guess maybe its a way of coping.

Tales from the ER

I posted this awhile ago on myspace, but thought I'd share it here. I have some great stories from work and will be sharing them periodically. Enjoy...

So last night I worked...it was Super Bowl Sunday which in the ER means it will be slow during the game but busy afterwards when all the drunks come out to play. Well it wasn't. It was crazy busy all damn night. So I was wondering why people are so stupid. And what makes them think their stupid behavior is ok. I had a patient who had too much to drink and so decided to call 911. She came in screaming and yelling that she didn't want to be there. Hellooo you called 911 not me, now you can't leave and we're both miserable. But that doesn't mean you get to spit at me when I call security and tie you down, or call me a whore and cu**. And then we had another patient, who was also drunk, who, literally, chewed through her IV tubing and climb out of bed while still attached to blood pressure cuff which was attached to the wall and lay on the floor yelling "they're trying to kill me" while we tried to drag her back to her bed. Oh did I mention she had shit her pants and literally had poop covering her from crotch to shoulders. Yeah she did. As did 2 other patients at that time. Needless to say the ER was a smelly place. When I drove home in the morning, I had that stinky smell stuck in my nose. So now I am exhausted. I've been spit upon, almost bitten and had to clean stanky shit off the drunk who tried to bite me. I've been called a cu** and a whore and told I'd better watch out when I walk to my car in the morning cuz I'm gonna get my ass kicked. And I get to go back tonight and do it all over again...Some one tell me why I chose this profession...