Expert Level Tomfoolery

Okay, let me give you some background information first so you can really understand exactly how ridiculous this whole situation is. I know you're probably over me being all, "guys, Hood Hospital really blows right now", but no, truly, it does this time. All I'm saying is, when your ER is functionally shut down from 50 beds to 8 beds because all your beds are full of holds and 10 of them are ICU but there's still ambulances coming and 200 people a day are still checking in at the front being the triage nurse is terrible. Anyone's who isn't actively dying or on fire is sitting in the waiting room with double digit wait times, even the ones that came in via ambulance and need to be assisted to the bathroom. Every time they need to be assisted to the bathroom, you have to leave your little collection of patients you've started treating and monitoring in triage because there's no beds, hope they don't die, and then enter the waiting room to be cussed out by all the people that have been waiting since before your shift started.

So in the midst of all this, enter dramatic med seeker. He runs in in dramatic fashion complaining of some chronic extremity pain, which naturally, is 10/10. He is asked politely to be seated and wait for triage, to which he responds by not only adding chest pain to his complaint but by yelling at the top of his lungs for all the waiting room to hear "I'm having a heart attack!" Well played. Clearly we have a formidable opponent. Okay, let's get this emergent normal sinus rhythm EKG dance over with, shall we?

So as I'm hooking up the leads, homeboy starts in on how he took a cab here and didn't have money to pay the cab driver and how he was going to come in a get a voucher from us. WTF? I try to explain to him that we don't pay for people to bring us patients, but every time I open my mouth, he screams louder "I'M HAVING A HEART ATTACK!!!" Wow. At about that time the cab driver shows up with one of our police officers- apparently when the cab driver questioned his reverse voucher scenario, he threw his dollar store jewelry on the floor of the cab as "payment" and just ran into the waiting room, hence the emergent need to be triaged. Normal EKG notwithstanding, this guy continues to act a fool and scream at the officer to get the cab driver away from him because he's having a heart attack.

I assure all of them this is not happening, charges are pressed for theft of service, and in the process of all the drama and arguing, our officer finally asks this dude the million dollar question- why didn't he call an ambulance if the really thought he was dying? Uh, yeah, turns out he was right outside another hospital who wasn't giving him Dilaudid wasn't doing anything to help him. Rad.

Savvy master of free transport is then directed to the waiting room, at which time he adds on a few more complaints that change nothing. Once he figures out this isn't getting him anywhere, he throws the last hail mary out there- suicidal thoughts. Huh? My hearing is damaged from all these patients yelling obscenities at me all night. What, you're going to repeat that statement to anyone in the waiting room that will listen? Great, sit down in this chair right by the triage desk and this here nurse is now also your sitter. Hope you weren't planning on using those Camels in your pocket, sir, because that isn't part of suicide precautions. If you thought he was finished NOW, you underestimate him, because he then started screaming, having fake auditory hallucinations (while still able to request an Ativan shot to "calm him down ") that spontaneously resolved when he was told the police officer would be coming back to see him if he didn't stop making a scene. Seriously?

I've seen a lot of strategies employed by fools to get ahead of legitimately sick people in the ER but I think this is the most I've ever seen used at once. I really think the only option he didn't exhaust was faking a seizure. Maybe he was saving it for day shift.