Tuesday, October 18, 2011

Ambulance To Triage

Sassy zero b.s. coworker of emesis bag fame has started acting as charge nurse, which, let me just say, is AWESOME. The one downside, I would have to say, at least as a triage nurse, is about 3 times the amount of ambulances in triage. Pretty much the criteria tonight was breathing and walking. Justifiably so, too, as there were several sick people out there for about 6 to 7 hours thanks to the clusterfuck we walked into.
Yup, the part of me that has a relatively low capacity for drama and conflict would really rather these people just go back to rooms so I don't have to deal with them. The other part of me that's a spiteful b kind of loves it.
Let me explain myself a little further lest I sound insanely hateful. I like it when entitlement and douchebaggery are punished. I'm not so much spiteful as I am the type of person who gets really pissed off when someone thinks they're above the rules. Like, I'm the one who always has to say something to the person who cuts in line or the able bodied princess with no tag that parks in the handicapped space. I'm the one telling the people in the movie theater who are talking to shut the eff up or pay me for my ticket. I know. World police, it's a character flaw. But as this type of person, I absolutely love the moment when the asshole who thought using the ambulance as a taxi realizes, "oh, wow, I'm gonna have to follow the rules and wait like everyone else." LOVE IT.
Anyway. We had one last night who thought he'd come in on an ambulance and get seen sooner for his back pain x 2 days. Nope! To triage you go, sir. Now before anybody with a back pain history decides we're douchebags, not only were there much sicker folks in the waiting room, but homeboy also got Fentanyl IV thanks to the extra generous EMS crew, so he should have pretty much been good to go. But no. He screamed and carried on and acted dramatic- when that didn't work, he told me he felt like he was going to pass out from the pain (I have yet to see that happen in the waiting room. You aren't getting your leg amputated, bro), so I told him to sit down and I would come recheck his vitals. Which were of course fine. But he took that time with me to express how the pain medicine didn't do anything and it was already wearing off. I explained that Fentanyl usually stayed in the body longer that 40 minutes, to which he responded by yelling at me, " This is RIDICULOUS! I shouldn't. Even. Be. Out here. I came in an AMBULANCE!"
I decided at that point to explain to him, loudly, that your mode of transit does not factor into your acuity level. If you're dying, you get seen quickly. If you don't, you wait. I wish more people understood this. It would save tax payers so much money.


  1. WTF is it with the Fentanyl IV lately for atraumatic "back pain"? I've only been seeing that this year. I don't really care if it's for elderly people, but for Crackhead Jones down the street? Really?

    PS If I send someone to triage who arrives by ambulance with an IV and they're shady and not sick, first thing I do is pull the IV. Sinks the message in, and doesn't pre-dispose the doctors into thinking this person needs IV That D Medicine.

  2. "World Police, it's a character flaw" LMAO. I can SO relate. And I love you even more because of it! People like you are the only thing keeping the douche bags from a total takeover.

  3. @K- Oh hell yeah. That shit's coming out before they get off the stretcher, every time.
    @Becky- I don't know if it phases them, but it at least creates awkward and embarrassing situations for them. My poor husband has to preemptively be like, "um, please don't get in a fight with anyone over this today, thanks."

  4. lmao world police- excellent

    I am too waiting for the day when people realize that the emergency department is for EMERGENCIES. Any day now...

  5. I am waiting for the day we can tell these idiots....you really thought this was an emergency??? And if you ever figure out how to speak stupid to make them understand that your back pain is not an emergency please teach it to me...cause the ones that come in my ER are pretty stupid...grr
    btw had one come by ambulance for a broken pinky toe...really???

  6. I'm jealous! In our ER if they come with a line they can't go to triage...so to a hallway stretcher they go.

  7. As a seasoned ER nurse, I would suggest that you need to go work in the newborn nursery. You are way too bitter way too early to be providing emergent care, whether or not your ego finds it so.

  8. Douchebaggery occurs in the newborn nursery as well, plus 20+ babies crying at the same time ain't no picnic. You go on with your bad self Hoodnurse, tell it like it is, I love you for it!