Hello! I'm back! It's closing in on a year since
I updated this blog! So much has happened in life and in the ER since I last
wrote, I hardly know where or how to start...
Of
course, the Covid saga rolls on but, on the bright side, we are seeing WAY less
positive cases these days. The Covid units are now integrating non-Covid
patients and the makeshift plastic negative pressure rooms are completely gone from
the ER. We still wear surgical masks daily, much to my chagrin, but I haven’t broken out the N95
mask in months. Some people have asked if the Covid vaccine is mandatory at my
hospital, and, no, it’s not. I chose not to get the vaccine and have had no
negative feedback at all! Several of the nurses I work with opted out while
many chose to get it. People have varying opinions on the Covid vaccine, and everyone is
entitled to their opinion, however, for me personally, having already had the
Covid in December and not knowing the long-term side effects and length of
immunity, it didn’t seem necessary.
One thing I love about working in
the ER is the unexpected people. I encounter a lot of so-called "urban
survivalists," aka, homeless people, but I met one such lady a few months
ago that I will always remember with a smile. I came into work one morning and
the night shift nurse told me that my patient in ER 23 was a B&B. That
means that the patient is intoxicated and needs sober up before discharge. I
glanced in the room and noted that my patient was snoring softly and was
vitally stable on the monitor. Moving on to my other patients, I basically
forgot about her for a while. Sometime later, I heard strange noises coming
from ER 23 and went to investigate. My patient was awake, out of bed, and
taking herself off the monitor, talking loudly in some language I did not
understand. She was obviously of African descent, all of about 5 feet tall,
with a close-shaved head and a particular "smoky" body odor that
immediately took me back to my days in Africa. She had obviously decided it was
time to see what lay outside of ER room 23, and she couldn't understand what I
was saying when I said slowly, loudly, and with lots of expression, that,
"No, we don't allow people to roam in the hallways naked." The whole
episode was getting the attention of my fellow nurses and they were coming to
lend a hand. Marissa, a feisty redhead from the Midwest, said, "Oh, I know
what she's saying! That is Swahili!" So, while I watched (and made a
mental note to ask Marissa how IN THE WORLD she knew Swahili), she and my drunk
little patient started an animated conversation. Soon, both of them started
singing and chanting in Swahili and dancing!... Clapping and stomping in true
African fashion, my patient and Marissa and a few other happy nurses danced and
sang all the way around the ER! The doc looked on warily and decided that if
our little friend was sober enough to dance on one foot, she was sober enough
to be discharged. I helped her pack her clothes into a tight little bundle
which she immediately settled on the top of her head in true African style as
she sang all the way out the door. I couldn't help but feel such an odd sense
of de' ja' vu as I watched her go and remembered my time spent in Africa years
ago. I learned later that my little African lady had been killed when she
stepped in to a road way in one of her drunken rambles, such an unfortunate
ending for such a fun little person.
In
September, Hurricane Sally made her way through the area, being far more
destructive than many residents anticipated. As a result, I had some
interesting days in the ER. I particularly remember an elderly couple who had
set up their generator inside the house. They were both unresponsive and
hypoxic when they were found by their daughter who called 911. The EMS crew had
been successful at reviving them with oxygen but brought them to us for further
evaluation and monitoring. I had one of them as a patient and the other was
directly across the hall, so I spent a lot of my time relaying messages back
and forth. The poor old gentleman was so worried about his bride and was so
angry with himself for causing the whole situation. He had set the generator by
the back door and left the door open for ventilation. Unfortunately, the
generator was on the ground floor and the couple was on the third floor, so
obviously the fumes must have traveled up and not out. Both made full
recoveries and were discharged home. While they were fortunate, some people
were not. Many people who relied on home medical equipment such as oxygen
condensers or IV pumps ended up in the hospital due to the power outage that
lasted for the better part of a week in parts of our city. This situation stressed
our already crowded hospital to the absolute max. Holding unit patients in the
ER for days became a reality. In an unprecedented move, our director lined up
ambulances and shipped patients over to our sister hospital across the bay.
It’s
pretty common to hear a call come over our radios for “assistance to the
ambulance bay, please!” and most of us like to go check it out if we aren’t too
busy, because you never know what you might find. Most of the time, the call is
just for someone that needs help getting out of a vehicle, but occasionally, it
is a little more entertaining. Several months ago, security called for help in
the ambulance bay, and this time, there was a SITUATION… A big blue pickup and
trailer had stopped just short of coming through the glass doors and was
smoking rather ominously. There were numerous bullet holes down the side of the
truck and the glass was shot out of the driver’s side. A young African American
male was sitting almost in the middle of the truck with blood oozing from
multiple gunshot wounds to his chest and abdomen. The ER team sprang into
action and he was soon lying on a stretcher and on his way to a trauma room.
The ambulance bay became a crime scene and was taped off for hours. The ER went
on lock down as law enforcement hunted for the shooter. I never found out with
100% certainty, but we were left with the understanding that the patient had possibly stolen the truck as a get-away vehicle and ended up in a shoot-out.
How
many of you enjoy cheese pizza? The cheesier, the better, right? We had a
patient the other day who was found in the bathroom by her husband,
unresponsive. Panicked, he called 911 but by the time the EMS crew arrived, she
was responding and vitally stable. By the time she reached the ER, she was very
awake and lying in the bed screaming “I have to POOOOOP!!! Get me a bedpan! I
got to POOOP!!!! Ross, her nurse, put her on a bedpan which she promptly
filled, completely... But the patient wasn’t finished, so Ross thought the
easiest thing to do would be to put her on the toilet and let her finish her
business. A few seconds after he got her on the toilet, she turned gray and
became unresponsive! He pulled the bathroom call light and I happened to be the
closest nurse, so I walk in the room to see Ross holding this lady onto the toilet,
covered in poo and vomit and looking rather dead, to be honest. I quickly hit
the code button and the calvary arrived a second later. The patient was quickly
lifted into the bed, not an easy task since she was stripped naked and covered
in slippery substances! We were checking for a pulse and about two chest
compressions in when she started waking up… Hours later, she kept saying, “It’s
all because of a cheese pizza… I ate the whole cheese pizza!” When I left work
a couple hours later, she was still pooping! That must have been one LARGE
cheese pizza…
One morning this week, I had 3 stable patients and was waiting on doctor orders when I heard an EMS report come over the radio; the crew was coming in “emergent” with a “large laceration.” I decided to step into the trauma room to help when the patient first arrived so I could see what this “large laceration” was all about. Soon the EMS crew rolls in with a 300+ lb gentleman on the stretcher… one paramedic holding pressure with gauze on the right flank and lots of bloody gauze on the stretcher. After we successfully transferred the patient from the EMS stretcher to ours, (not an easy task, even with 5 people) we pulled back the gauze for a peek. The large laceration appeared to be maybe 5 inches long and 3 inches wide with visible subcutaneous tissue, not exactly a “large laceration” but, ok, it did look rather deep… initially, the bleeding was controlled but after a minute started to stream blood again. I put a pressure bandage back on the wound and the doctor finished his initial exam and began to ask the patient questions. The patient, who liked to talk about himself in third person as “Daddy,” stated that he had gotten out of bed to use the bathroom and upon return, had tried to “line up with his bed” but ended up sitting down on his glass night stand instead, ending up a large glass shard stabbing him on the flank. When the Dr. told the patient that we would be taking him to CT to check his internal organs, the patient replied, “Oh no, you aren’t! Daddy don’t go in one of them things!”
Also, this week, my patience and PR skills were put to the test when I had a patient who was intoxicated, rich, and extremely rude. She was well into middle age with obvious signs of Botox and carrying a Burberry bag. The EMS crew that dropped her off in my room looked frustrated and kept rolling their eyes at me over the patient’s head. It was soon obvious why. The patient obviously believed that we were her slaves and that we should act accordingly or else she was “going to administration.” I had the unfortunate position as her primary nurse, so I had to get my face right each time before I went into her room and faced the music. During triage, she proudly told me that she had lied to the paramedics, saying that she was going to kill herself, but that, really, she wasn’t feeling at all suicidal… she had just said she was to get EMS to take her to the hospital. She stated that she was there for detox from alcohol and that she needed a room and food now! Also I needed to get her a phone charger immediately because “all hospitals should have one.” I felt rather vindicated when the doctor came in and told her that there were no “detox” beds available and that she was going to be discharged with follow-up instructions. Boy, was she livid! She proceeded to curse at all of us before taking out her own IV and leaving. The next day, she was back, still drunk, still belligerent, and ended up winning a spot in the behavioral med unit for a mandatory 3 day stay. Thankfully, I was not her nurse this time! This lady really made me thankful for my normal ole’ poor people, even the smelly ones!
Every day in the ER is an adventure, to be sure, but, I find that my days start to run together sometimes and situations that I may find remarkable one day I often forget the next. One of my aunts recently asked me, “Vanessa, do you ever feel honored to be there when people die and are having the worst day of their lives?” I’ve thought about that question a lot since then, and, yes, I do! I feel so blessed to have a job that I love and a supportive husband and family. I feel honored and humbled to be called to this crazy mission field we call nursing!
