Category Archives: Nurse Stories

Entertaining Angels – Part Two

Be not forgetful to entertain strangers: for thereby some have entertained angels unawares.  

Hebrew 13:2 KJV

After spending what I’m sure was a wonderful week or more in California, I hit the road back to Colorado, this time taking the southern route through Arizona.  Despite being late September, it was a brutally hot day as I drove towards Phoenix.  Along the 10 freeway in this part of Arizona, there are few exits, and even fewer places to stop for gas, food, or the bathroom.

As happened on the way to California in my previous post “Entertaining Angels – Part One”, I saw a figure walking in the distance along side the freeway.  And I knew.  I’d be picking this person up, too.  Only he wasn’t hitchhiking.  He was trodging, head down.  And he was in trouble.  Even though the temperature was pushing 110 degrees, as I pulled up next to him I could see that he wasn’t sweating.  He was beet red and he was panting and he had no belongings, no water.  He was wearing probably all the clothes he owned, including a heavy jacket.  The sign for the next place where there were “services” indicated it was 10 miles down the road.  I drove along side him with the window open telling him he needed to get in so I could get him cooled off.  He was muttering to himself.  I finally drove a little in front of him, got out and opened the car door telling him to get in.  He did but he told me it wasn’t a good idea.  I was busy wetting down a towel and some fast food napkins and putting them all over him, so I didn’t care if it wasn’t a good idea.  I made him drink water.  With all my years of experience as a nurse to help me, it wasn’t hard to determine two sobering things.  One, this man was less than an hour from death and would not make it to the next gas station.  And two, he was deep in the throes of paranoid schizophrenia.

I wasted no time in getting back on the road with the AC cranked to maximum and heading for that exit while the man sitting beside me had a conversation with someone unseen about how no, he wasn’t going to hurt me, because I was helping him.  I sped up.  He was rocking back and forth telling me to hurry because he didn’t want to hurt me.  I kept encouraging him to hang in there, that it would just be a few more minutes, and told him to keep drinking water.  Man, I was nervous.  I was just praying that if I had to die that it would be quick and painless, but asked if I was going to get a prayer answered, let it be that I could just get the guy out of my car and to safety in time.

That was probably the longest six minutes of my life.  But we made it.  He had started to sweat by then (as had I) and wasn’t nearly as red, and he jumped out of my car as soon as we hit the gas station.  I gave him some money.  And I got the heck out of there.

No deep spiritual lesson in this one.  Just that sometimes doing the things the Lord wants you to make you reeeeeally uncomfortable.  I don’t know if either of these men I stopped to help ever made it to their final destinations, but I do know that both of them helped me along my way to mine.

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Why I Didn’t Answer The Door

About 20 years ago, I returned home from my noon to midnight shift at a hospital emergency room.  It was close to 1:00 in the morning.  I parked my car behind the rear unit of the tri-plex in which I lived.  The back door and front door were both on the same side of the house, about 25 feet apart.  It was a very dark night.  I had not left my porch light, which actually was pretty much my custom until this night.  But even in the near pitch darkness, I could still see something on my front porch, and that something looked an awful lot like a dead body.

I quickly let myself in the back door as I didn’t have a good feeling about “this”.

I switched on the front porch light and peeked out the small peep door in the front door.  Sure enough, there was a “dead guy” on my porch!  But I was suspicious.  I grabbed the phone and called 911.  I hollered out the peep hole to the dead guy that I had called for help for him if he was the one needing it, and for me, if I was the one needing it.  My landlord was a cop whose mother lived in the front unit, so let’s just say this…the response time was like lightening.  Despite that, once I informed the dead guy that help was on the way, I heard him get up and bolt away down the front path.  The police showed up just moments later.

And they told me it was a good thing I hadn’t gone right to him to see if he needed help, because there’d been a series of crimes against health care workers recently…seems we have this desire to want to help people that sometimes causes us to make decisions that might not be the smartest when it comes to our own safety.  This guy would pretend to be having a medical emergency on the porches of female healthcare workers in order to lure them into “helping” him.  He would apparently scope out potential victims who worked odd shifts and returned in the wee hours.

Fortunately I am worst case scenario girl, or I could have been one of his victims.

So, whoever it was who rang my doorbell at 1:00 THIS morning, that is one reason why I didn’t answer the door.

The other reason is that I have a friend who has a totally cray cray stalker who has been escalating their stalker activities, and I have fallen into the circle of destruction.  I don’t know if they know where I live, but I am not taking any undue chances.

No way I was gonna answer that door.


“Screaming Mary Jesus” – Not a Religious Post

The first time I heard this phrase I was working in an Emergency Department in Los Angeles.

Me:  “You brought your child here because you think she might have whaaaat?”

Mother:  “I think she might have screaming mary jesus.”

(Yes, that’s what I THOUGHT I heard her say!)

Once I determined WHY she thought her daughter had what she thought her daughter had, I put the pieces of the puzzle together and the light went on.

Spinal Meningitis.  She thought her daughter had spinal meningitis!  Hard to maintain one’s composure and not LOL at something like that!!!!

Over my tenure in the ED I was exposed to lots of cases of meningitis requiring that I (and everyone else exposed) be treated with Cipro (a powerful broad spectrum antibiotic) in order to protect from contracting the disease.  Being exposed to infectious diseases on a daily basis was one thing I wasn’t going to miss about being in the ED when I left it.

Segue to today….

Today, while working in the MRI suite, a man was brought over from the Emergency Department for a brain scan.  The chief complaint for this patient was “altered level of consciousness”.  It was believed he might have had a stroke due to his atrial fibrillation (an irregular and less effective heart rhythm which can lead to the formation of clots in the heart which can then be shed up into the brain – a stroke).  In chatting with the nurse, it seemed to me like he had something possibly very different.  He had an altered level of consciousness, yes.  But he hadn’t been feeling well for a number of days.  He was running an elevated temperature, and he had been up vomiting in the night before his altered mental status became apparent to his wife.  When she helped him back to bed she noticed purple dots on his legs.  All of these things, to me, added up to “maybe we should be suspicious that he has meningitis”.

Which he did.

FORTUNATELY the patient was intubated, thus greatly reducing the potential for the introduction of bacteria into the air as meningitis is spread by contact with nasal and oral secretions.

UNFORTUNATELY the ventilator did NOT have a filter, therefore increasing the potential for the introduction of bacteria into the air.

So, all those people in the ED who had contact with this patient would be getting Cipro to protect themselves (nurses, doctors, EMTs, RTs, phlebotomists, Rad Techs, etc.)  And off to the Workman’s Comp clinic for the three of us imaging employees who were exposed.  More Cipro for me!  Yay!!!  Only two doses though.  No big deal.  I just thought those days were behind me…

AND I have missed the last two Photo Fridays.  Dang.  I need to manage my time better!


You Might Be a Nurse If….

Every once in awhile a list of things which, if they apply to you, might mean you are a nurse, gets circulated around.  Each time it comes around, there is usually a new addition, or more, to the list.  Some of them are perennial favorites of mine, like:

You might be a nurse if you recognize you can’t cure stupid.

Or…

You might be a nurse if you consider a tongue depressor an eating utinsel.

Or…

You might be a nurse if eating popcorn out of a clean bedpan is a completely natural thing to do.

Or…

You might be a nurse if you’ve ever heard someone with a nose ring, a brow ring, 12 earrings and sleeve tattoos say “I’m afraid of shots”.

Or…

You might be a nurse if your friends and family hate to watch medical sitcoms and dramas with you because you spend the whole time pointing out errors and upside-down X-rays.

I could go on.

But there was a new one on the latest list sent around to me and it cracked me up cuz it’s sooooo true!!!!!

You might be a nurse if you wash your hands BEFORE you go to the bathroom!!!

Still crackin’ up at that one!


“My Mom Is Having a Stroke!”

My first nursing job was on an orthopedic unit in a Los Angeles hospital.  A large percentage of the patients admitted there had undergone hip and knee replacements.  The nature of this type of surgery and the populations in which it is generally performed means that there can be significant post-operative complications.  These patients are especially vulnerable in the first few days following surgery.

But I was taken by surprise when the daughter of one elderly patient, who was nearly ready to be discharged home and who had been doing remarkably well up until that morning, came running to the nurses station shouting that her mom was having a stroke.  I rushed into the room, not exactly certain what to expect.

There my patient sat, in her chair, her mouth very twisted, drooling.  She was having terrible difficulties with speech, but seemed mentally clear and was able to follow all instructions.  Her hand grips were equal and strong, she denied having a headache, she denied any numbness or weakness anywhere and was able to take steps normally, she had no vision changes.  I asked her to smile to check on the symmetry of her mouth, but she struggled to do this and was unable to despite repeated attempts.  I didn’t think she was having a stroke, but clearly something WAS horribly wrong.  The symptoms seemed to come on suddenly, out of the blue, and there was no progression.  Her vitals were fine.  I was a new nurse, and I kind of wanted to panic, but the family was all staring at me, counting on me to handle the situation professionally.

Resisting the urge to call for help at this point as I WAS the help, and before sending out the alarm, I decided to calmly ask a few more questions.  The answer that sent a bell off in my head was that the symptoms exactly coincided with the insertion of her dentures.  I asked her to take them out.

When she popped the top denture out we all broke out laughing.  She had put her dentures in upside down!  The twisting of her mouth, the inablity to speak or smile, and the drooling was due to the fight she was having to keep the dentures from falling out!

Boy, would I have been embarrassed to have sent up flares and had a doctor come in only to discover the same thing.

This is one of those patient stories you remember forever!  Don’t have any idea why I was thinking of her particulary today, but just thought I would share that little story.  Moral?  Always take the time to evaluate a situation before panicking!  🙂


Claustrophobia

One of the aspects of one of my jobs is to give sedation (either oral or intravenous) to clients who need MRIs but who suffer from claustrophobia (fear of being in enclosed spaces) and need the bravery that the meds can give them.  Some folks break into a sweat just looking at the “tube” and imagining being in it.  Others are fine until they are slid inside.  Some are so freaked out once they get inside that they Houdini themselves out before we can get to them to help them out!  Despite reassurances that they can’t help the irrational fight or flight response that has been elicited, they often they voice embarassment at their inability to control the fear that wells up inside of them.

Before their exam, I usually ask them if they know why they have claustrophobia.  Oddly, it is the rare woman who knows the reason.  Much more often men can pinpoint the genesis of their fear of being in the MRI “tube” to a particular event.  (Of note, people will sometimes not know that they have claustrophobia until they try to have an MRI and fail!)

Here are some of the stories I have heard from male patients.

One was nearly suffocated by his brother when he was a child.  They were playing with pillows and the brother held one over his face for a little too long.

A few were “tunnel rats” in Viet Nam.  One had been trapped in a fox hole by exploded debris in WWII.

One was buried by sand in a cave-in at dig at work.  He had the quickness of mind to pull his hardhat over his face thus creating a small air pocket which helped to keep him alive until he was dug out from under the ten feet of debris over him.

Most recently I had a gentlemen who was very hesitant to share his story.  With some gentle encouragement, I asked him if he wouldn’t share with me what happened.  He was held prisoner of war for 17 days in a Viet Cong prison camp.  For seven of those days he was sealed in a 50 gallon drum and the drum was beat on from the outside by his captors.  All this had come flooding back to him in a palpable way when he had an MRI done on his neck.  You see, MRI tubes are about the circumference of a 50 gallon drum, and the machine makes banging sounds when scans are being taken.  Despite this, when he found out that the MRI he was going to be having done this time would require him to enter the tube feet first and that his head would be near the opening of the machine, he said “oh, I can do this without any help from medicine”, and he did.  Later his wife told me that although they’d been married shortly after his return from the war, he only recently shared the story of his seven days in the drum.

There is one elderly woman’s story that has stuck with me as well.  She was a Jew who had fled Nazi Germany to England and was buried for many days in the pitch dark under the house in which she was living when it was bombed and collapsed.  She survived but was never again able to be enclosed in a small space of any type. 

Imagine trying to put any of these horrifying things behind you when they spring out at you whenever the walls are too close.

These are stories I will never forget.  And even though I’m not in the ER anymore taking part in life saving activities, these are the patients that bring me satisfaction.


I Heard the Pharmacist Laughing…

I have recently found a couple of blogs that are absolute gems.  They are written by emergency nurses.  I used to be one of those.  It’s not a job I’d wish on my worst enemy, and yet it can be the most rewarding job EVER.  This is the strange paradox of working in an emergency department.  I had been thinking of writing about more of my experiences, but I tellya, these nurses live the same life I did.  They have many of the same stories.  So similar in fact, I wonder if I, in a fugue state, have started these blogs myself and write all these posts and have no memory of having done so when I come back into my own senses.  Because it reflects SO much of my experiences, I have added the blog ERNursey to my blogroll.  Anyhow, I thought I would share a funny little tale that happened years ago when I first worked in an ED.

Drug addicted patients will often go to great lengths to feed their addictions and they will often end up the ED where the overworked physicians who don’t know them might, just to be expedient, write them a script to get them out of the ED .  The stories these folks tell are sometimes so amazingly complex and creative that you almost want to just give them however many Vicodin their little hearts desire simply because they’ve put so much work into trying to get them. 

And then there’s the patient who does absolutely nothing in the way of research…

Case in point…Phone rings.  I answer.  Pharmacist on the other end tells me he’s calling to verify a prescription with me.  Asks if he can fax it over to verify it’s authenticity (yes, some patients actually STEAL prescriptions, or alter the ones they are given).  Sure.  Fax it over.  The fax maching rings.  I pull the fax off the machine and start to howl.  I call back the pharmacist, who, when he hears it is me on the phone also starts to laugh in the background!  Clearly I didn’t have to verify the authenticity of the script, but the pharmacist wanted to bring a little levity to my day.  The script read thusly…

“Mofeen 10 pounds”

The doctor’s signature was forged.  I told the pharmacist to call the police on this one. 

Good grief.  Mofeen.


U (vula) Got To Be Kidding…

Okay, so I wouldn’t have believed this either, but I was working in the ER the day THIS guy came in….

He was about 20, and he was FREAKING out when he arrived.  Crying.  In a shaky voice he reported that he had a weird thing growing in his throat and that it was making it difficult to breathe.  And he was there with his twin brother who had similar complaints.  The one twin reportedly looked in his mouth and saw the growth just prior to rushing into the ER.  Before he left the house he called to his brother to have him see it, and his brother looked in his OWN mouth and saw that he had the same growth!  It was then that the difficulties with breathing started, and they high tailed it in to get emergency care.  They reported that they figured that they had both developed these growths in the same place because they were identical twins.

The nurse that triaged them could hardly contain herself.  When she had calmed them down long enough to be able to look in the throat of the first twin, this is what he cried…

“Can you see it?!!!  Can you see that red thing hanging down in the back of my mouth?”… 

!!!

Yes, she could.  And as the title of this post would suggest, these twins were all upset over discovering their uvulas.

Again, don’t people have ANY awareness of their bodies???

I guess not.


“Swollen Veins”

Now, mind you, this is a REAL true story of the ER!

A patient  presents themselves at the admitting window and checks in.  They give their chief complaint to the clerk who writes their name and complaint on a nurses’ note and gives it to the nurses who then go and “triage” the patient.  Triage is a process in which background and related information to the complaint is obtained, and the patient is evaluated for severity of symptoms and the level of urgency or emergency is determined.  For example, does this person need to come back immediately, or can they wait their turn in the waiting room?

This particular man came in with a chief complaint of “swollen veins”.  Gosh, that sounded interesting.  In my mind I was thinking maybe he had a varicose vein or a blood clot or maybe phlebitis or something like that, that was bothering him.

Not exactly.

Turns out he was concerned because he noticed when his hands were hanging at his sides the veins on his hands and arms bulged and “got swollen.” 

This guy was in his forties.  How is it possible he missed the effect that gravity took on his veins for that many years?  Had he never looked down until that day???

But trust me, this is not the only person who, it would seem, had never even taken a rudimentary look at their body and got freaked out by something.  I’ve got another one for you tomorrow!


Amies et Chiens

I had breakfast today with my friends Susan and Brian.  She’s a nurse.  He’s a paramedic.  We went to a little french bistro and ate outside.  I had a lovely little tomato, swiss, and avocado omelette with baby greens and a baguette.

We shared lots of stories.  Got all caught up on life.

“I told you about when Cole went into full arrest, didn’t I?”, Susan asked?

No!  She hadn’t.  Cole is one of her two adorable Shih tzus (Allie is the other, and they are sisters).  Here’s how the story went….

“The girls” as S and B call them, were spayed.  No problems with the surgeries.  They brought them home.  Each of them sported a Fentanyl patch (that’s a narcotic, in the codeine and Vicodin and heroin family) for post-operative pain management.  Susan recalls that she commented that she wondered if the dosage seemed high for a six pound dog (remember, she’s a nurse).  But Cole did fine for the next three days and the patch was subsequently removed.  Later that night, Brian picked her up and she was breathing really fast and really shallow with her tongue way out of her mouth.  He brought the dog’s condition to Susan’s attention, and they immediately headed out to the nearest 24 hour vet.  It was past 10:00 pm.  They didn’t get far.  Before reaching the car Cole stopped breathing.  Susan started rescue breathing and while she was holding Cole, she felt the heart stop beating.  The nearest vet was now too far away.  So Susan made the decision to take the dog to her work which was only a mile or so away.  Susan works in the emergency department.  She ran up the ambulance entrance, put in the emergency code for the door, and took the dog into “Room One”, which is the big resuscitation room.  She screamed for the nurses and asked that Dr. “S” be sent in right now.  Dr. “S” is a lover of dogs, and had no problem with trying to revive her.  Susan had already determined that Cole was suffering from a narcotic overdose, probably from licking the skin where the drug patch had been applied.  The nurses grabbed Narcan (a medicine that reverses the effects of narcotics) and gave Cole a shot.  Within moments, her heart began to beat, she started to breathe, and she looked up at Susan just like nothing had ever happened!  Though she was clinically dead for nearly 10 minutes, she suffers no long term impairment.  That must have been some gooooood CPR Susan gave her.

This is not a story I tell you to encourage that pets “in extremis” be taken to the local emergency department.  Your animal will not be seen, evaluated, or treated there unless you are lucky enough to work there.

But it’s a great story, doncha think?  One that should be retold in TLC’s “Untold Stories of the ER“! 


Don’t Have a Cow

My sister Whitney reminded me about this emergency roomism in a comment to my posting "The Casket". 

More than one patient has asked me about whether they should "sit on the guernsey, or lie down".  I chuckle to myself and think, "if you can lie down on a cow, more power to ya".  But whatever you do, you'll be riding that cow down to X-ray, so make yourself comfortable…

***Emergency Roomism:  Guernsey

Guernsey = gurney


The Casket

My first job in an emergency department was in a hospital in the south central area of Los Angeles.  It is a predominantly black neighborhood.  And I am a very white girl.  At the time, I was about 30, but looked all of about 18.  In fact, it was extremely usual for people to ask me if I was even old enough to be a nurse.  (This seemingly pointless background information will come into play as I tell more stories about my experiences at this particular hospital, I promise!)  I had long blond hair and a baby face, so I don't really blame them for thinking I was a kid.  Once we got to talking, however, people would recognize that I was a grown up and a capable nurse.  For the most part I had excellent rapport with my patients.  I especially loved the older patients.

One day a very congenial, and verrrry old (if I remember correctly, he was closer to 100 than he was to 90) gentleman came in for treatment.  His chief complaint was that of an extremely sore right wrist and arm.  As I looked at it, it appeared to be much thinner and even a shade or two lighter in color than his left. 

I asked him why he thought his arm might be sore.  And he matter of factly told me….

"Well, miss, I broke this arm about six weeks ago.  The doctor wasn't done treatin' me, but I couldn't stand one more day of draggin' that casket around on my arm, so I made him take it off yesterday.  And it's been sore ever since."

The visual I got, watching this old gray haired sparkly eyed man dragging his arm around with a big casket attached to it was almost too much for me.

***Emergency Roomism for the day:

Casket – a cast


Disappearing Denise

The posting of this story was made because of a special request from my sister, Diane, as noted in the comment section of “Restraint.”  It was originally “published” as an e-mail to the Christian Girls Choir over a year ago.  The “choir” will be blogged on a later date.  If any of the choir is reading, they surely remember this story.  It is another story about a day in that crazy emergency department:

We all thought this couldn’t possibly have ever happened before, but in retelling the story at the change of shift, we found others who had a similar story to tell.  But to all of us in the ER today…it was a definite first!

Denise was brought in by the police as an “okay to book”.  “Okay to books” are people who have been taken into custody, but then come up with a physical complaint to get out of going to jail (“I can’t breathe”, “I’m having chest pain”, “My arm hurts” -duh, you’re in cuffs-, “I have a rash”, etc…)  In these situations, these people are brought to the ER still in custody to be evaluated by a physician and deemed “okay to book”.  Most of the time these people are making up their complaints.  For a few it pays off; it’s not worth the time to the police to stay in the ER waiting for this process and they are released.  But for Denise, this was not the case.  She was felonious!  And felonious individuals just don’t get let off that easily.

Let me interject with another related story about an “okay to book”.  This young man was brought in with a chief complaint of having an asthma attack.  And he was.  He really did need to be treated before getting booked.  But his story has another twist to it.  The “victim mentality” twist.  Once he was cuffed to the gurney, I asked the police to step out so that I could talk to the patient privately.  Patients will tell nurses pretty much anything because we are so trustworthy in their eyes.  So this guy was quick to tell me that he had been caught in the act of robbing a house, and was chased by the police.  He had a crack habit and smoked regularly.  He had smoked it that morning.  He wasn’t really a thief, he had to steal to pay for his drugs.  And he told me that he was going to sue the police for making him sick.  He was sincere.  He believed he’d been victimized by the police.  Yes, a guy who KNOWS he has asthma, and smokes crack anyway, and steals to pay for it, and gets caught in the act of robbing…and because the police CHASED him, and the exertion caused an asthma attack, he was going to sue.  Poor little victim.  I leaned into him and patted his arm and said, quite sincerely to him, “if you think you are going to win a suit against the LAPD with a tale of woe like that, then you have worse problems than being a crack addict with a robbery problem.”  And I popped the nebulizer over his nose and mouth.

Back to Denise. She was to be processed for felony robbery.  She shoplifted cheese (yup, cheese – we asked what kind, but just got strange looks from both the cops and the patient), but in doing so, she assaulted the store clerk.  Heroin was involved.  Her complaint was nausea and vomiting.  She was probably in need of a fix, but she wasn’t sick.  Being a little bitty thing (about 85 pounds and 5’2”) the police stood watch outside her door and took her out of the handcuffs.  They could easily handle her!!  (These “in custody” patients are generally cuffed to the gurney).  There was a seasoned officer and his rookie partner doing duty on Denise.  And they never left their post. 

So it came as quite a shock to discover that, after a couple of hours in the ER, Denise’s room was empty!  Mind you, there was no way out of that room except that door.  AND Denise’s clothing was missing.  The rookie ran to and fro like a Keystone Cop, not knowing what to do and looking like he was either going to pass out or puke.  Hospital security was notified and before long the ER was swarming with our guards and about a dozen cops.  A quick search of the ER, the hospital, and its environs yielded nothing.  If we couldn’t find Denise, these two cops were going to be in for the ribbing of their lives from the rest of the force!

Denise’s nurse had a lightening bolt of an idea.  Which for this nurse, usually meant something stupid.  Let’s just say, he’s not the sharpest knife in the drawer.  Almost as dumb as a box of rocks.  His idea?  Maybe she was in the ceiling.  We all thought this was a ridiculous theory, UNTIL, on inspection, a small triangle of hospital gown was seen protruding between the drop ceiling tiles!!  In order to flush her out, this nurse (jokingly, mind you) loudly said “She’s in the ceiling, use your gun!”  While the rookie comes running WITH HIS HAND ON HIS GUN (unbelievable), a plaintive voice was heard from above crying “Don’t shoot me” as another nurse intercepts the rookie, and quickly informs him that a firearm wasn’t going to be necessary!  The ceiling vent tile was removed and two sooty arms reached down around the ventilation hose.  In a half whining, half panicked voice, Denise cried “I DON’T WANT TO BE UP HERE!!”  It was pitiful.

The seasoned cop grabbed her roughly by the arms and pulled her down, headfirst, into the exam room catching her by the waist halfway down, while the rookie tells Denise that she is “in SOOO much trouble!” in a voice reminiscent of an “I’m going to tell Dad” moment from childhood.   We had all lined up at the doorway, heads at varying heights extending back 15 feet, to watch the spectacle.  All of us dying of laughter.  Denise had managed to get her clothes, climb up on the counter, and use the cabinet shelves as steps to reach the celing, remove a ceiling tile, get into the ceiling, replace the tile, and get dressed, leaving just enough gown trapped to give her away.  All without making a sound.  She couldn’t get far though, all the walls to her room were load bearing and extended to the roof.  She had been trapped up there.

It wasn’t until she had been led out, scuffing along in her bare feet, hands now back in cuffs, and taken away that her shoes were found by the maintenance crew checking for damage, still up in the ceiling! 

She never did vomit.  But I bet once those cops got back to the precinct and started getting’ razzed by their fellow officers THEY just might have!

***Emergency roomism:  An emergency roomism is a word that “sounds” like what a patient/family member/visitor THINKS they’ve heard something called, but it isn’t exactly right. 

Emergency roomism for the day:  Q-Ticks

Some need translation.  Does this one need an explanation????  If it does, those are Q-Tips.


Restraint

Time for something humorous, doncha think??

One of my favorite quotable T-shirts is the one that says "some days it's just not worth chewing through the restraints".  I can totally relate to this!  I am, or was until last July, an emergency department nurse.  Working in the ED you get to see just about everything if you work there long enough.

For the past six years I worked in a smaller, but hellaciously busy, community hospital ED.  It is sandwiched between posh Marina Del Rey and the more artsy and homelessy Venice Beach.  So it sees an extremely bizarre cross section of society.  Actors, sports figures, producers, and other "upper crusty" people are treated along side the homeless, the drunks, the drug addicted, and the INSANE.  And when I say INSANE, I mean clinically and sometimes homicidally INSANE.  But this isn't a story about insanity.  I'll save insanity for later.  Today, children, we are going to talk about DRUNKS.

Some EDs are famous for their care of neurological injuries, some for pediatrics, some for cardiac emergencies.  Well, one of the things "my" ED specializes in is drunks.  We had (I only say "had" because I don't work there anymore, so I am switching to past tense) many "frequent fliers" who came to stay with us.  These chronically drunk individuals did not find their own way to the hospital.  Most of them weren't happy about being there.  But because they passed out on someone's porch, or peed in somebody's trashcan, 911 was called.  And because somebody died in custody years ago from alcohol related events, these publically drunken and often disorderly individuals become patients instead of inmates.  Whatever happened to drunk tanks?  Bring them back!

Hey, I said this was going to be funny.  I'll soapbox on the "social problem of alcohol" in the future.

This post is about, well, I'm going to call her Suzanne.  If I told you her real name, I'd be in violation of federal HIPAA laws.  Suzanne was one of our irregularly regular drunks.  Which was unusual, because most of the chronic drunks who end up in the ED are men and homeless.  But Suzanne was neither a man, nor was she homeless.  What she was, was a mean, mean drunk.  So she'd get brought in for one kind of disturbance or another.  She would attack her husband, or scream at her neighbors.  She scared people.  She would binge in a cycle.  Sometimes we'd see her frequently (like more than once a day), sometimes it would be months between her "visits".

At the time this story takes place we were under renovation and were running our department out of the very inconvenient and crowded back area of the department.  It was awful, but that's another story as well.

Suzanne was brought in wild eyed and screaming at the top of her lungs…."YOU'RE KILLING MEEEEEEE!  YOU BLEEPING THIS AND THAT!!!!", etc.  Criteria for discharge of a drunk is ability to ambulate independently and to make arrangements to get home if you can't walk there.  Suzanne was so out of her mind, that, although she could walk and probably even get a cab under her own power, we had to keep her until she sobered up enough to calm down.  And because of the ferocity with which she struck out at the staff on this occasion, once she was undressed and put in a hospital gown, little miss Suzanne got put into four point (soft, not leather!) restraints (that means arms and legs).   

And she got "chemically restrained" as well.  Which means she was given meds to knock her out until she sobered up.  We all hunkered down for a long day of Suzanne intermittantly hollering from the very farthest back room about needing this and needing that, and how we're killing her, and how we are this or that expletive deleted. 

After about an hour of this auditory assault, she quieted down.  We went to check on her, to make sure she was breathing and just sleeping, which she was.  So we exhaled a collective sigh of relief at the now "relatively" quiet state our department was in.  Once she was asleep, we relaxed.  Have you ever heard the adage, "let sleeping dogs lie"?  We expand that in the emergency setting to "let sleeping dogs and drunks lie".  So we let Suzanne lie.  We'd intermittantly listen next to the door for her breathing, but did nothing that would prematurely awaken her.

Another hour or so of this quiet (as it relates to Suzanne) had passed, when a thin, attractive blond lady approached the nurses station.  She was asking where she could find the bathroom.  Believing the woman to be a visitor, the secretary pointed through the exit door and told the woman that the bathroom was in the waiting room.

WAIT!!! The nurses practically yelled when they saw who was being given access to the "real world"!  It was Suzanne, looking very much like your average well-kept Marina Del Rey wife.  She was quickly corraled and led to an interior bathroom.  You can't just let patients under treatment walk out because they think they're ready to go, or even because they want to go.

One of the nurses quickly ran back to the room where Suzanne had been.  Wrapped up nicely into four little packages in the trash were Suzanne's restraints!  And they held clear evidence of the sharpness of Suzanne's ingenuity, as well as the sharpness of her teeth!  Not only had she chewed her way through the restraints, she then went through the trouble to untie them from the gurney, and neatly wrap them up before getting dressed, brushing her hair, and applying make-up, and heading out to the nursing station a new woman.  A clear message was sent to the staff that day!  Just try it!

Some days it IS worth chewing through the restraints.  Ask Suzanne.  We let her go after exhibiting such amazing problem solving techniques and dexterity! 

But she'd be back.  They all, almost always, come back. 


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