Tuesday, February 5, 2008
Patients of the Week
Last night was rough. We had almost 70 patients in the ER at 7pm, all waiting to be worked up. You have to know that on a night like this, the weirdos and crazies are going to crawl out of their dwellings to make their appearances. Here are a couple from last night, for your entertainment. (Names have been changed to protect the innocent...er, guilty.)
-A woman brings her child in for a fever of 104 at home and a cough. What else do you do with a child with a fever except bring him to the ER!? Give him Tylenol? What are you thinking? Bring that kid to the ER! Now, when there are 70 people waiting to be seen, you can imagine the wait time is long. Last night was no exception. This lady waited 6 hours in the waiting room with this 9 month old. She finally gets to come back to a private room with a stretcher and a television. The kid gets a chest x-ray and plays in the room, smiling, laughing, drooling. Less than an hour and a half later she's up at the nurse's desk (we've addressed this previously--google "use of call light"). This is how the conversation goes:
Mom: We're gonna leave and I'm just gonna take him to his doctor in the morning.
Me: Yes ma'am, I know you've waited a really long time, but you're the next person the doctor is coming to see. It will only be a moment before he will be in your room.
Mom: No. I'm tired. I think we're gonna go on home.
Me: Ma'am I just looked at his chest xray and the radiologist commented that he has bronchitis and possible pneumonia. If he does have pneumonia, he could need blood work, IV antibiotics, or at least a prescription.
Mom: I'll just take him to the pediatrician's office in the morning. (Wondering if she just heard what I said about her son having pneumonia.)
Me: Are you sure because you've been waiting 7 1/2 hours and it's FINALLY your turn.
Mom: I just wanna sign the paperwork and leave.
Me: Alright. I'll get it for you. Let's go ahead and give him this Tylenol I was drawing up for his fever.
Mom: No thanks. I'll give him some at home. (Right...just like what totally slipped your mind when he originally had fever.)
And she left. After waiting all that time when she was next up in line and I informed her of how sick her child could be. I'm voting her mom of the year.
I'm voting this guy "most likely to live with his mom his entire life." (Warning: It's long, gross, and you'll be amazed).
Ambulances are rolling in. We have zero beds. Heck, we don't even have any chairs. "No rooms at the inn!" should be flashing outside. The next emergent dude rolls in (31 years old) with his wife and mother at his side, looking intensely worried. Nausea, vomiting, diarrhea for 3 hours. He called 911 for this instead of asking his wife to drive him. I'm sure he thought he was going to need life support before he could get here. Guess what? Inn's still booked. Out to the waiting room. 2 hours later I'm bringing him back to a room. Granted, at this time he's a little clammy, pale, and throwing up a little bit of clear liquid. He needs some fluids. He gets some and after the second bag and some phenergan and pain medicine, is looking much better. When we all started saying how much better he looked, I think it upset him. Now is when I name him Titty Baby. I understand that men are bad sickly people. I do. But this guy took it to the extreme. Check this out:
He says he has to have diarrhea. I say we'll walk him across the hall (approx 15 steps from his bed) to the bathroom. He says he can't make it because he's too weak to walk and needs a bedpan. What? You're a big healthy (albeit probably a LITTLE weak from vomiting) 31 year old horse of a man! So, abandoning my best instincts, I get the man a bedpan thinking 1) after the first bout of diarrhea in a bedpan, he won't need to do this again cause he'll have his strength back and 2) what 31 year old man would actually use a bedpan if he had two working feet?! He proceeds to use the bedpan (after he had ME put it under him) with his wife, mother, and I all part of the audience. Sound effects and all. The orchestra was in full force. He then says he can't pull it out. So I, nice nurse, pull it out. I now have to obtain a stool specimen of the most disgusting smelling diarrhea ever. And it's not in chunks so it can't be "scooped" out. It must be poured...over a toilet, preferably. So I walk it 1/2 mile to the closest bathroom and obtain said specimen. Ew. I go back into the room, and you will not believe this---
His wife is wiping his butt with the baby wipes I'd given him. This grown man, fully capable of sticking his hand in between his own two legs was being wiped by his diligent, enabling wife. This happened multiple times.
You would think with such great "cleaning service" you wouldn't miss the opportunity to catch your output in a bucket. No so for Titty Baby. He has diarrhea in his bed....THREE TIMES. Diligent wife changes his sheets for him every single time and piles them in the floor. I guess having his butt wiped by someone else just wasn't cutting it anymore.
On top of this he: 1) couldn't lift his arm to get the blood pressure cuff around it 2) pretended to talk out of his head (blaming it on the phenergan he'd received 5 hours prior--yeah right), 3) acted like he couldn't speak at all, and then mumbled when he did so no one could understand him, and 4) acted like he couldn't hear a word I was saying and was "asleep" 5 seconds after telling his wife how much he hurt all over.
People, I had had it. This was the biggest man baby known in all of history. He took "Most Amazing Patient of the Week" home in a wrapped package. And the wife? Seriously? My husband would have to be in pretty bad shape for me to wipe his butt...and I think I can speak on behalf of my husband and say he wouldn't WANT me wiping his butt unless he had no hands!
Anyone wanna work for me Wednesday night? It'll probably be lots of the same.
(p.s. Please excuse any grammatical errors in this post. I'm exhausted and don't want to proofread it.)