The last 2 shifts I worked I've managed to end up in fast track and triage- good lord. People are absolutely batshit crazy. I know I sound like a broken record, but I don't understand these people's reasoning. Like at all.
Night before last, 2 early 20 something girls check in together, both with their various vagoo problems- girl 1 thinks she has a yeast infection, but "wants to get a good exam" because she had a baby 11 months ago and it's been a while since anyone looked at her cat, so 2 AM on a Monday in the ER is a good time to do that, I guess. Her friend, girl 2, wants some bullshit low abdominal pain checked out and oh, by the way, she also hasn't had a period in a few months and might be pregnant. Shocker- she is- also she is my age and is on pregnancy number 4, ladies and gentleman. So they both get in line for their respective hoo-hoo exams- at this point girl 1 is only complaining of "slight vaginal itching"- I go in to bring her to the exam room and she's snoring. I try to wake her up. Nothing doing- not a surprise, as she wouldn't stay awake through the nurse or the NP assessment to provide her own damn medical info, either. So, we skip her ass and go to girl 2. She gets her business done, as well as some blood work, and chills in the room. I go back in and give girl 1 a second chance- after shaking her a couple times, she finally asks if she can "pass" on the pelvic exam. Um. Sure. I tell the NP, who tells me she can't just write her a prescription without the test, that she needs to sign out AMA.
I go in and tell the patient this and she totally loses her shit. I am legitamately confused at this point. I ask her what she wants, and whether she understands that she can buy Monostat over the counter- she becomes indignant and informs me that shit doesn't work and she has to be at school tomorrow and her friend is probably already discharged because she just came to see how long she had been pregnant-girl 2 apparently knew she was, but lied about it because she wanted a sonogram. Girl 1 takes an angry lap around the ER and comes back to her friends room, where the NP is talking to her about her bloodwork. I go in to discharge girl 2 five minutes later and the two of them are screaming at the top of their lungs at one another- they are arguing about what STDs the ER will test for, and what you have to tell them so that they will run the tests you want them to run. I wrote the number for planned parenthood and the hospital clinic down for both of them and got the hell out of there before someone's weave got torn out. Holy shit.
So after that lovely patient encounter, I go up to triage for the last 4 hours of my shift, where a patient who was treated earlier checks in AGAIN for the same thing. She's got a legit history- gastroparesis with diabetes, which can make for some sick ass patients, but MAN. She is acting a fool. She starts out with her earlier straight-back-to-a-room worthy performance by rolling around on the floor of my triage booth, literally. I, like the compassionate nurse I am, continue writing and tell her to please get up and sit in the chair so I can take her vital signs. Bitch, please. You drove here and walked in here, don't try to act like you can't sit in a chair. She finally sits down- before I can even ask her any questions, she asks if she has to go back to the waiting room. Yup, but I'll get you some Zofran first. I don't have any rooms with nurses to cover them in back at the moment. At that point she tells me she has chest pain. It just keeps getting better! Any time I ask her questions she doesn't want to answer, she starts to gag and wretch and then forces herself to vomit. She then pants and looks to me for a reaction. At this point I go back to get her a Zofran but also to ask around about her earlier visit. I talk to the nurse who took care of her- apparently, she did the same performance earlier, for which the doctor planned on giving her a full cardiac and abdominal workup, and probably an admission. However- as soon as she got the Dilaudid, she asked the doctor to cancel the tests, and he obliged. Now she's back for round 2! No ma'am. I gave her the medicine and tried to throw her ass out in the waiting room- except by the time I got a blood sugar (400 oh no!) and tried to load her up in a wheelchair since now she became "lightheaded", the day shift triage nurse came in and bought the act, upped her acuity level and then brought her back to a room immediately (because what does the dumbass night shift nurse know? Nothing!). I made sure to tell her about the visit history when she returned from saving this girl from her critical vomiting- congrats, you just filled your last room with that crap. I'm gonna go home and drink a beer now, later.
Fast forward to last night, where I was apparently smoking the wrong stuff and agreed to pick up and extra shift. I naturally ended back up in fast track, where I immediately as given the gift of the husband who thinks his grown ass wife with a fever and a headache was extremely critical. The NP does a CT scan and gives her a pill. She calls a little later saying she's still in pain- no problem- I let them know that I have to get vitals first so we know what kind of pain meds I can give. I'm putting the blood pressure cuff on the lady's arm literally 10 seconds later and he tells me "She's hurting really bad. She needs something for pain. NOW." I let him know I'm taking her vital signs NOW and then we can give something for pain, like I said, 10 seconds ago, damn it. He then proceeds to tell me she needs a shot (the lady has an IV already) and then turns around and scolds his wife about how she needs to demand I give her a shot. She points at the IV and stares at him. I walk out in disgust. He continues this foolishness through the whole night, while his wife, who's actually very sweet, hangs out quietly. Then I get her discharge instructions- as expected, she has a virus, but her urine test also tell us she has Trichamonas- an STD. Ruh roh. If that isn't bad enough, his mom is in the room when we have to explain that one of them went and picked up an STD. By her reaction, I'm guessing it was him. Yikes. I would have liked to have seen that car ride home. Akward.
Wow. I'm really hope I get back to the critical area this weekend. Something about people who are actually at risk of being sick or dying makes for a lot less drama, surprisingly. I guess they don't have time for it.