Wednesday, May 25, 2011

Effin' Gasto

Dudddee. It's gastroenteritis season apparently, and I am already FINISHED with this shit. Every third patient I triaged this week seemed to have nausea, vomiting and diarrhea. And for some reason it's also causing paralysis, because they all need freaking wheelchairs. Seriously.
Now I completely understand this phenomenon among the elderly or chronically ill, whose fluid balance already kind of blows anyway, especially if their symptoms have been going on a couple of days. But if you're younger than me- No ma'am. I expect you to walk, that is ridiculous.
We actually had a chick come in last night- and by came in, I mean she was dragged in by a dude on either side followed by three other concerned gentlemen. As to minimize the scene in the waiting room and to see what was going on, I went and got a chair and wheeled her back to the triage booth. Yeah. Homegirl had no medical history and had been vomiting x 3 hours. She wouldn't answer any questions directly- I would ask, she would whisper the answer to her entourage, and they would tell me in a grown up voice. None of these guys were her relatives, so she had to sign her own consents before we brought her back. So she whispers to her posse that she was too weak to sign. Girl, please. I couldn't even handle it anymore. I straight up told her, "Ma'am, seriously. You've been vomiting for three hours. There is absolutely no medical reason you cannot pick up a pen and sign your name, and you have to do it before we can treat you legally, so just figure it out please." She sure did make one of the dudes hold her hand and trace write her name. Hoolly balls.
This is not at all atypical of the gastroenteritis presentation. I know it sucks. I never thought I would consider linoleum floor with bathmats a comfy bed, but it's happened. So just compared to my own experience, I seriously have to ask:
1. Why can't anyone walk across the room? No one's asking you to do a 5K in this state.
2. Does moaning and screaming really help? Really?
3. Do IV narcotics really help? I thought they were supposed to make you more nauseated.
4. Do people really ever think eating solid food when they're like this is a good idea? And after you've puked the solid food 6 or so times, why wouldn't you stop trying?
5. The really important one- how do you hold your poo long enough to even drive to the ER? I'm serious. Diapers? Butt plugs? Please advise.


  1. "Does moaning and screaming really help? Really?"

    Sometimes these two do. However, there are also times that they help to heighten the pain. Too many patients in pain do this because they think that this could help. It's a matter of perspectives, I guess. Though, there are really patients who are overreacting, eh.

  2. girl today kept saying she's nauseous, all while she's eating everything. so while she's gone, doc says: oh so&so says shes nauseous n vomiting, and im like: oh, but she was just munchin on some pretzels. btw best part was the doc says: well maybe you shouldnt be eating mcdonalds and hotdogs when you feel like youre gunna throw up.

  3. Just reading your blog for the first time but had to share a ER gastro story with you... 20 something girl with diarrhea has a room next to the bathroom which she has been using regularly calls me into the room because she has shit herself.
    Me (RN): Oh Im sorry honey, couldn't make it to the bathroom?
    Her: I just was tired of getting up, so i just went, but nurses take care of that, right?
    Me: We do, here is a basin, washcloth and some fresh sheets. Have at it.


  4. WHAT THE HELL! I just don't understand people, really. Who wants a stranger to wipe their ass? Who? WHY?
    We had this dude during my internship in his early 20s with gastro one day who kept shitting on himself and his mother was cleaning him up. My preceptor, who was totally awesome and called shit how she saw it, came into the room while it was happening at one point and pretty much read the lady the riot act about how fucked up it was that she was cleaning diarrhea off her grown son's balls. It was amazing.

  5. I caught the bad gastro from one of the lovely clientele this past winter. I vomited my guts up the entire night every 15 minutes, I shit you not. I tried OTD zofran. It didn't work. The next day, I was so weak I made it down the stairs but couldn't make it back up. I slid up them at night. I barely could hold down sips of fluid for 5 days. Good thing I was off for a stretch. I did not call in sick. I had epigastric pain for 2 weeks. I lost 10 pounds. I did not check into the ED. I did not call my family and moan and scream. I laid on the couch and watched court tv. I have no sympathy for the moaner/screamers/wheelchair bound 20/30/40 yr olds with n/v x 2 hours who come in with their mommy's. In fact, I can't even look at them. I know they don't have appendicitis or any other crap. America is full of nothing but a bunch of pussies and free loaders. I need a vacation.