Wednesday, February 16, 2011

"You're my valentine"

So, February has been as usual, a brutal beating in terms patient acuity and staffing ratios. This year, we seemed to have added to the mix a whole mess of cray crays, so not only is 3/4 of the ER full of hold patients that have been down there for two days, but hold patients that bite and scream and pull out their own foleys with their toes while in 4 point restraints (yes really).

It all came to a head Valentine's day when I was given the hold nurse assignment by a charge nurse who clearly hates me and wants me to die. So, they throw me back there and immediately give me report on 4 patients with out of control blood pressures and various other issues, then bring me two psych patients that are angry and have been admitted in the waiting room for 6 hours without having anything done. They force some poor floor nurse who has never been oriented to our unit to come down to help me- she's totally overwhelmed and has no clue how to use our computer system or our paper charting, so my manager is there trying to orient her while simultaneously interrupting my IV starts to ask me shit like whether she can put my name on the patient assignment boards. Seriously, woman, I don't care. You could put my name as Tits McGee on the patient assignment board and I probably wouldn't notice. Go home.
So, I explain to the first angry psych patient that no, we aren't going to give you Dilaudid, Phenergan and IV Benadryl for your pain you have in your abscesses that you got from shooting heroin, since you're at the hospital for opiate withdrawals and it seems counterproductive to give you a whole mess of opiates. Yeah, I know you're allergic to Zofran and that's what the doctor usually gives you, but he sure won't give it to you this time. Yup, I talked to him about this when I had the 2o minute conversation with him about how you needed to go for PICC line placement in the morning because you done killed all your veins, and the ER doctor who never saw you and did not admit you was not going to start a central line on you no matter how much he insisted. He didn't seem to get it but at least we got a 24 gauge in your earlobe in case we need to push code drugs. Yeah, here's a Vicodin, though.
My second angry psych patient can't move his arms due to a nasty episode of gout, so I hang upside down from the IV pole like Batman to start a line on him, get him medicated, happy, and upstairs- I sit down to chart and help the floor nurse with putting in orders and meds. I'm rethinking my choice of careers and feeling pretty much spent at this point. I 'm sick of working this hard and dealing with nothing but hateful people.

As soon as gouty man's room gets cleaned, they bring me a little old lady with Alzheimer's- it seems her son dropped her off for some little complaint and left, I kind of suspect to get a break from her. All her stuff was done, but she was quite the handful. If she wasn't screaming for me to come in the room for something, she was trying to wander the halls with a very unsteady gait. She eventually got discharged and her son came to get her- I got her dressed and helped her to the bathroom before she went home. She was a little bigger than me but I was able to scoot her toward the toilet and she put her arms around my neck while I lowered her down. As I was lowering her, she kissed me on the top of the head and told me, "Thank you sweetheart. You've been so kind. You're my valentine."
Yeah, I started crying. That little gesture after all the foolishness was all I needed to remind me why I do what I do. I still could use a vacation, though.


  1. How cute, I absolutely love it. Right when you think you can't take one more problem, you're sent a little bit of love to help get you through. I would've cried too after having a day like that.

  2. Bless her sweet little heart :-)

  3. Hopefully on the press ganey survey scores the hospital sends out, her son wrote "My mom loved Tits McGee, she was the best!"

  4. Oh Rachedy, how I love you. I think I just peed my pants a little.

  5. You probably need a vaccination...not a vacation....after being kissed by a GOMER

    ER Doc