Wednesday, April 4, 2012

Like Moths to the Flame...

Some days the E.D. is just like this...

I was signed out a patient that was waiting for a simple blood test.  The blood test came back slightly abnormal so I called the patient's private physician, and we made some medication adjustments and the patient was discharged back to their senior living facility.

I spent 20 minutes wrestling with a 4 year old who was bitten in the face by the family dog and needed just one stitch to hold his lip together.  And then, I got several more patients that were "verticals" meaning patients that had simple clinical problems: uti's, colds, etc.  Quick see, write a script, discharge.  Then I got my next patient.

He was convinced that a sexual encounter he had over 30 years ago is still causing multiple medical symptoms that have to be checked out a couple of times a year.  He couldn't answer any of my questions with anything more than a grunt or a yes or no.  For every question about his condition he kept telling me, "It's in your computer somewhere."  Very frustrating.  I ordered some simple things and got him some medications for his symptoms and then discharged him.

No sooner had we cleared out the room, then there was a banging on the triage window.  A patient was having chest pain after an assault.  His face was beaten, he had a cut lip.  He said he felt pressure in his chest after the assault but managed to go to the police station to file a report, and then to the optometrist to get his glasses fixed.  The optometrist told him he didn't look so good and maybe he should go to the E.R.  By the time he got to us, his chest pain was pretty severe, and his EKG confirmed a STEMI.

We went into overdrive to meet our goal of sending this patient to our sister hospital to the get to the cath lab.  At some point in the middle of this flurry of activity, there was a large BOOM!  It was thunder.  Then suddenly, hail the size of ping pong balls started falling.  Within a few minutes, the ground was white.  We all looked at each other thinking, "Oh, &*^%$!"

Sure enough, the tone out signaled an ambulance call to a multi-vehicle accident.  Then a second ambulance was called out to the same accident.  Then another tone out for a another accident.  About this time, my husband texted that one of our new goats had jumped the fence that he had put up in the barn.  And another tone out sounded for the patient we had sent out earlier in the morning.  And another tone out for a frequent flyer who was "lethargic."

While we waited for ambulances to start arriving, I saw another couple of "verticals."  Another patient showed up with a possible ectopic pregnancy, but she signed out AMA because she had to "go pick up my other kid from school."  I explained the risks of everything from worsened pain to bleeding to death, and the patient left.

We got the "lethargic" patient in.  The STEMI got shipped out (did I mention he had his service dog with him? A large German shepherd that went with him in the ambulance).  And then three patients all came in at the same time from the car accident.  While I got them all seen and orders written, we got another couple of "verticals" through the triage window.  I quickly saw them, and we seemed to be on a roll.

Then a mother brought her son in for an evaluation.  He'd fallen on his back and hit his head while playing basketball out in the rain.  She wanted to make sure he was ok since he had "hit his head on the side where his brain was."  I kept a straight face while she said this.  The patient in the other bed on the other side of the curtain giggled somewhat loudly.  I politely explained that the brain filled the whole skull and didn't just sit on one side.  I could still hear giggling as I walked out of the room.

My car crash victims were all discharged and a new round of ambulance patients filled the rooms.  My "lethargic" was transferred to the sister hospital since her cardiologist was there.  I admitted a very sick patient with heart failure.  I sent home an elderly gentleman who kept falling, most likely because he was over-sedated by all the medications his physician had him on.  I signed out an elderly lady with broken ribs from her recent fall and came home.

My hubby reported that the wayward goat jumped every barrier my husband set up, so our barn now looks like Fort Knox.  One of my cats caught a mole and decided to play with it in the kitchen while my husband was having lunch.  At one point, the cat tossed the mole up in the air and it landed in my husband's boot.  So that's how his day went. 

Seriously, you can't make this stuff up.


betty said...

LOL on your last line, I had just read to my hubby about the lady with the boy and the brain comment and had just said to him "you can't make this stuff up" and then I saw your last line. LOL about the mole and the cat and the boot.

Oh my gosh Veronica, what a day! definitely one you don't want to repeat any time soon!


Lori said...

What a day for both of you. I'm not sure if your husband's barrier-jumping goat and mole-flinging cat can trump your side-of-the-head-his-brain-was-on or not!

Elizabeth h said...

Don't you love your job? I didn't know about the Mom's brain statement, that's awesome! But, you should feel proud that you helped keep that day flowing, because even with the crazy, it didn't feel like overwhelming least for the nurses... :)

Claudia said...

I think the first guy needs a psych person to diagnose his guilt and then refer him to a priest to hear his confession and absolve him.

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