3 Kinds of Patients

    I noticed something about the E.R. There are 3 kinds of patients. I shall list them off for you. 

 Patient # 1 - The Baby 

       These patients have zero tolerance for pain. When you take their blood pressure, they scream as if you just chopped their head off with a power tool. The sight of a needle makes their face go like this. They complain about any symptom they have and exaggerate it to the point where it sounds fatal. Example: a young lady had flu-like symptoms and suddenly panicked and caused up a stir when she said her back was getting really warm. That'll happen when you have a fever mam. You're not about to spontaneously combust. 

   Patient # 2 - The Psych Patient 

          These patients will tell you they are Louis the XIV's grandson and that they just came back from the Vancouver Olympics winning a gold medal for Team Latvia. They are often very needy and love to ask the staff for any favor at any given moment. They get hostile, impatient, and incredibly hard to deal with. They are often a risk to you, themselves and others. The staff often has trouble looking past their actions and understanding they are truly ill and need our help. It is actually kind of tragic. 

   Patient # 3 - The True Patient 

       The people have serious concerns and deserve our beds in the E.R. Nonetheless, they probably account for 15% of the beds on any given day. 

 Here is a brief and rather unorganized synopsis of my day: Patient tried to kill himself with steak knife. Cut huge gash in wrist and stabbed himself all over the chest. Heard voices that told him to do so. Another patient is a cocaine addict who wasted our bed just to get free food and water. Doctor wanted her gone and complained he was forced to practice "defensive medicine" by not being able to discharge her. I did two IVs totally on my own with no help, learned how to do a blood transfusion, gave many meds, and further honed my interviewing skills. Great day!

 Drum roll........

 Lesson of the day: Wanna cut waste in our healthcare system? When you have a f**@ING cold, don't go to the E.R. 

  Thanks for reading. 

 

- Tommy 

   

     

Somber Sunday

   My first blog ridiculed the common perception that E.Rs are full of death and drama. Today I stand corrected. 

    My Sunday shift made the show E.R look like an episode of the Golden Girls.* It started off with a psych patient falling out of bed and screaming. This often tends to happen when people who are unable to walk try to anyway. 

    At around 11:00 AM, I am interviewing a patient. In the midst of my interview, a young woman walks in carrying her 4 year-old daughter and says "Please help my daughter, she is having trouble breathing." We quickly plop her daughter onto the bed, ask our old patient to go elsewhere, and we begin to try and rescue the little girl's airway. 

   

     Soon an entire team rushes in to help this girl out. They have me bag the girl, while countless nurses try to find IV lines and push medications to jump start her heart. Mom is outside crying and vomiting. The scene gets more chaotic as more and more people rush in to help. The girl's heart rate jumps to 200, and soon after it stops completely. CPR is begun, people are getting more frantic. 

    After 20 minutes of CPR Mom comes around and glances in. A female doctor puts her arm around Mom and says, "I don't think your daughter is going to make it." Mom collapses to the ground and screams at the top of her lungs. It was probably one of the worst scenes I have encountered in my entire life. 

       The trauma did not end there. Later on, a young guy came in after being hit in the head from a sporting injury. Unfortunately, he was hit in the part of the brain that controls his breathing. I don't know what came of him. I really hope he was revived.

 

       On the bright side, a doctor bought us all pizza....

  - Tommy

* The Golden Girls is a good show

E.R. BLOG 2

   

      People have very different ideas of what the word "emergency" means. Some come in hardly breathing. Others come in with bloody and broken jaws. Others walk in flicking their noses, as to displace a bugger that is about to make them sneeze. These are the patients nurses tend to have contempt for. 

    When meeting a patient, it is first important to ask them a set of questions involving their chief complaint. Seasoned nurses are experts at this. Nursing students are not. Here is a real-life example of that: 

Patient: I got this chest pain. It hurts so bad. 

  

Seasoned Nurse: What area of your chest hurts? Is it crushing, aching, or a sharp pain? How would you rate it? Does it radiate to other body parts or is it localized to your chest? 

Patient: I got chest pain. It hurts so bad. 

Tommy: Oh yeah? Where? Man I'm sorry. 

    Although a slight fabrication, my interview was about as effective as that. I am learning though, and in 130 hours from now, I will have this down. Moving along, I'd like to talk about some patient cases and what I've learned from them. 

Patient # 1  - Bites his fingernails. Bites the nail bed off, exposing him to infection. He gets infection. Swollen, puss-filled finger. Had to be drained. I'll stop. 

Patient # 2 - Cold. Sore throat. Convinced himself he couldn't swallow anything. For some reason this compelled him to spit up all the saliva within him. Hence a bucket of saliva by his bed. I'll stop. 

  Most other patients came in with chest pain, probably the most common of all chief complaints in the E.R. These are true emergencies, and so even the smallest amount of ridicule directed at them is unwarranted. They deserve our beds. 

  My favorite patient was a young woman who suffers from liver failure. Her skin was very yellow and her bone structure was akin to a skeleton. She could hardly stand without the help of me and my nurse holding her in place. She bruised so easily, that even pressing down on her skin for a handshake would likely turn it purple a few hours later. 

 Despite her utter right to be in low spirits and even a grouch, this patient was one of the sweetest ladies I've ever had. She was so soft spoken and polite, always complimenting me or the staff about something even though the focus should have been solely on herself. 

She loved Jeopardy, and so told me to come back at 3:30 when it aired, to play it with her. At 3:30 I looked at my watch, informed my nurse I was leaving, and walked in for the show! We both did quite well. She nailed the pop culture and the kitchen gadget categories, I nailed the state flags. I had a great time keeping her company.  

   Patients like that remind me exactly why I am pursuing this degree. 

 Thanks for reading. 

- Tommy

   

Day One

    Welcome to my ER BLOG! My goal is simple: to expose what E.R. life is like, and even share some medical knowledge with you. Enjoy! But first, read the disclaimer at the bottom of the page.

   Right as I step on the unit, I see 5 nurses sprinting down the hallway with oxygen masks. A few doctors are sprinting behind them with IV poles, tracheotomy tubes, and countless syringes stuffed in their pockets. Blood is splattered all over their clothing, and all I can hear are the words, "CODE BLUE. CODE BLUE. ROOM 710. CODE BLUE." The secretary was sobbing. The janitor stood helpless with a mop as he looked on in horror. All hell broke loose until I finally witness what had happened: A man's head fell off. 

  Okay, if you are expecting this blog to be as exciting as what you see on ER, House, or Grays Anatomy (all stupid shows except for ER and House), then you have come to the wrong place. That story was not true, but if you bought it at first, it simply highlights the prejudice you have about an E.R. My blog will work to erase that prejudice. 

    Day one was rather slow. I saw a false pregnancy, appendicitis, a stomach virus, high blood pressure, a lot of hypoxia, and way too many STDs before lunch break. None were serious cases, although if all in one patient, it would probably be a little serious. 

    The most remarkable patient was a 268 year old Native American dwarf (HIPPA can be fun see?) who came in thinking she was pregnant. The test was ordered and she was negative. Despite having serious symptoms of potentially fatal diseases, the patient refused any further treatment. She left AMA (against medical advice). Leaving AMA involves signing a bunch of papers and having the nurse basically say "when you drop dead, it ain't our fault." Case closed. I wish her well. 

    

Medical advice of the day: THE BRAT DIET. What is this? 

When you have the flu and are nauseous with diarrhea and a weak appetite, remember BRAT. 

Bananas 

Rice

Applesauce 

Toast 

  These foods are good for several reasons. One, they help solidify your poop because they are sticky and tend to absorb a lot of fluid. Also, they are bland and easy to eat, even when you feel like your stomach is about to explode. Personally I find the thought of eating rice when sick to be grotesque. That R needs a changing. Any ideas? Raisins? Ramon Soup? A ribeye? 

   This is the very beginning of a long, 160-hour journey (and hopefully a career) in emergency nursing blogs. Thank you for reading today. I appreciate your time. 

- Nurse Tommy

 

****As to comply with HIPPA (patient confidentiality rules) all names and ages of patients will be intentionally distorted.