Slow Your Roll

Oh hey, welcome to Hood Hospital triage! Let me just stop you right there. A few things:

-Hi! Nice to see you again! Oh yeah, I do remember you from last time, seeing as how you're here on a weekly basis. You presented about the same way last time too- tearful, dramatic, allergic to numerous non narcotic pain medicines and with crappy looking vitals because you just don't take your medications we continue to refill. You seemed to do fine that time, so you can just wait to get triaged like everyone else. Sending your boyfriend up to swear at me is a new approach, and I applaud you for your creativity, but the Dilaudid fountain still hasn't been installed up here and the triage desk so I still can't really pour you a refreshing Dilaudid-rita just yet. I'm real sorry.

-Hey, wait a sec. That's the hospital pen. You know, the one all these patients with coochie rashes and sepsis and yellow fever or whatever have been touching? Yeaaahh. I wouldn't put THAT in my mouth if I were you. I usually have a pretty good poker face up here, but I'm not even gonna attempt to hide my disgust that you just did that. Also, after doing that, you're going to put your baby's pacifier in your same mouth that JUST held the MDRO pen and then give it to your baby! No ma'am. Fail. The complaint you brought him in for is foolish but it's about to be legit. Too legit to quit.

-Yuop. I know Flubber is on in the waiting room right now so it's probably hard to concentrate, but if you look up there right above the desk there is a giant sign that says in big black letters that patients in the emergency room are seen based on acuity and not on a first come first serve basis. So needless to say that when we try to call to triage you for very emergent toe pain while you are in the bathroom, and during that time someone comes in for chest pain with low O2 sats, you sure did get skipped and your toe pain is gonna have to wait 5 minutes longer. What's cussing at me and making threats gonna do to change that? Well, not much, other than let you head back on out there to the waiting area to finish watching Flubber instead of going back to a room. Yes sir. Be nice to your nurse.

-FYI- Nurses cannot order tests, meds or admissions, but especially not urinary tract x-rays (very sensitive test) and admit orders for UTI pain for a grown woman who has not taken any of the prescribed medication from when your were treated at the hospital for the same problem literally 3 hours ago. Bringing your mother in to demand these things at the top of her lungs on your behalf despite the fact that you are perfectly capable of speaking for yourself and providing your own medical history will not change this fact.

I swear. I hate triage. I feel like I'm in the movie clerks. This scene, to be specific.

Chief Complaint of the Night x 2

Let me just preface this story by saying 1.Both of the young ladies in the stories I am about to relate to you seemed relatively articulate and well dressed, like normal people you would see anywhere. 2. The wait last night was average, about 3 and a half hours.

Okay, so the first chick checks in at the height of all the craziness and looks completely fine, so I ask what she's here for and she points to this red zit on her cheek. She tells me it hurt before it popped up last night and it hadn't come to a head yet so she thought it might need to get lanced. Mmkay. Is there a triage code below a 5? Next, please.

So about an hour or two later another girl comes in for a cold sore she's had on her lip for a week. Really.

WHY? You are young women, with lives and friends I'm sure. Even if you aren't paying for your ER visit, isn't the 5-6 hours total you will surely spend here from check in to discharge worth the price of some abreva? People perplex the shit out of me.

Efficient Fuckery

Hood Hospital. EMS patient with 10/10 chest pain s/p smoking too much crack. ER doc fed up at foolishness capacity for the evening. Deliriously tired ER nurses. These are their stories.
Hood nurse: M'am, do you have any medical problems?
Pt: Quit asking me fucking questions. I just came here cuz my chest pain and my headache and I been pissin all over the place and I'm outta hydros. Don't none of that shit matter. Look it up in my records.
Hood nurse: Ma'am. I can't start treating your condition until I have some basic information about you.
ER doctor: Ma'am, you know I'm not going to give you any narcotics this visit.
Pt: Fine, fuck you then doctor, I'll just go to another doctor to get some more hydro. I'll buy it on the street with some more crack. I'll go to another hospital, I got that Medicaid. Fuck all of you, I hate hood hospital, I just came up here for my blood pressure and that ambulance fix it.
Hood nurse: So do are you saying you wanna leave then?
ER doctor: Yeah, you just have to sign this form.
Pt: Yeah. You motherfuckers can't make me stay here (DC'ing own EMS line, the single one this crew has started in the last 2 years).
And this took all of about 8 minutes. The one thing you can say about crackheads, at least they don't waste any time.

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.

Hell Yeah

I continue to reign supreme at the blood ETOH game! I need to take this shit on the road. It'd be like the fair where they do guess my weight, only it would be guess how drunk I am, and I'd be making the big bucks.

My internship full of drunken foolishness (patients, not my own, at least on the clock) taught me one thing- guess low for the young folks.

Usually. At least guess low for people who pull total noob moves like passing out in public places and puking all over themselves. Bonus lightweight points when their poor parents get dragged into the madness. No cash prize for me today, just the sweet glory of victory.

Chief Complaint of the Night

Young lady presents with cute, chubby baby playing with her stuffed toy in no distress.

Hood Nurse: Hi! What an adorable baby! What's going on tonight, guys?

Baby's Mama: Uh, hey. Yeah, so I brought my baby in here basically cause I just don't know what's wrong with her. She just keeps whining. I don't know why. Maybe she's just bratty. I don't know what her problem is.

Hood Nurse: Okay. Well. I mean, how long has this been going on? Has she been running fever? Pulling at her ears? Eating less?

Baby Mama:No. None of that. She's just whiny. She's been whiny for two weeks now. I'm getting really tired of it. Do you think you guys can figure out why she's whiny?

Hood Nurse: Uh. Maybe. I really don't know.

Baby Mama: Do you guys see a lot of stuff like this?

Hood Nurse: No. Not really.

Baby Mama: Oh. Well, I guess I just pay more attention than most parents.

Birds of a Feather

Hood Hospital triage, 3 AM- two young ladies check in together. Both young ladies, I would say would probably wear about a size 14, but insist on wearing what I can only assume is about a size 8. Muffin top abound. I proceed to triage girl 1.

Hood nurse: Hi there ma'am! What's going on today? What brought you to the ER?

Girl 1: Hi, hi ma'am. Um, well, you see, I came in today because I, I have pain in my kidney, I have kidney problems, and like, I'm here because I was like, just at County Hospital, like just there, and my ovaries hurt, and you see they did the tests and they put the thing in me and they started this IV, see, right here, and they were gonna do a CAT scan but then they didn't and no one told me what was wrong and my kidneys are like really really hurting and they gave me some Morphine but I think it's starting to wear off and it's starting to hurt again and I don't know what's wrong and I'm really reallly scared, ma'am-

Hood nurse: Wait. Hold up. You were seen for this same thing at County Hospital and they did a full work up but you don't know what any of the results are? Did they not give you any discharge paperwork?

Girl 1:Well, no, because, see, I had to sign do the AMA and I told them I didn't want to do the AMA but my friend, she had her gallbladder taken out there, and I had mine taken out too, but they like, just did hers but she had to go but they still gave me this Morphine but I think it's wearing off, but my grandma gave me some of here Hydrocodone the other day and it helped and I could clean my house, and also, I don't know if this matters but I had Gonorrhea and Chlamydia but I took that medicine but I never went to see if it was better but I took all of it so it should be fine right? But now miss it really really hurts right here (grabbing suprapubic area)

Hood nurse: Okay ma'am, well, we'll get that checked out for you. Can you tell me if you have any medical problems?

Girl 1: Well I go to the mental health clinic and they say I have bipolar and ADHD and I take that Trazadone and Xanax but I'm out of Xanax and basically I'm just crazy I guess.

So, out to the waiting room she goes, and her friend comes into the triage booth:

Girl 2: Please be nice, not like at County Hospital, they suck.

Hood Nurse: Um, sure. What's going on today?

Girl 2: Well my legs hurt and all down here and it just really really hurts and I went to County Hospital and they were like really mean and I like just had my gallbladder taken out there last month, but it still really hurts, yo. And so I was in there and I kept asking them for pain medicine and they kept getting mad because I kept coming up and asking them and they weren't giving me any and then they were finally gonna give me some and then this man came and asked me if I needed help and I told him no I didn't need help and then the lady said that was rude and she called security and they made me leave and didn't even give me any pain medicine. Hood nurse: I see. Well. Are you mostly here for leg pain or abdominal pain then?

Girl 2: Well my legs hurt but also this still really hurts (pointing to incision site) and also it's hard and I think somethings in there or it's infected inside.

Hood nurse: Okay, yeah. What kind of medical problems do you have?

Girl 2- I got that Bipolar and ADHD.

Hood nurse: Realllyyy. Cool. Well go ahead and have a seat out there for me and they'll call you back there when they get a room open.

Surprisingly, it wasn't the girl who had just been kicked out of the other hospital that gave us hell. About an hour later, I took a couple of people back to rooms that had been waiting longer than Girl 1 back to rooms, so naturally, she thought it would be a good time to tell me a was a stupid bitch for not calling her name. So, after calling everyone before AND after her (to be fair, she was asleep when I called everyone after her, but still be nice to your triage nurse) she went back to a room and got her exams done. She was revealed to have numerous STDs, and nothing else, so she was sent home with multiple antibiotics. When she figured out she wasn't getting Vicodin, she tore up the prescription for the Flagyl and the Doxycyline while screaming, "Fuck all of you bitches! You just like sticking things in people's pussies and not giving them any pain medicine! Tell that motherfucking doctor lady to come back in here and I'll put that thing in HER and see how SHE likes it!" By then, her friend had been discharged without incident and they both strolled out of the ER to wherever the hell they came from.

Classy broads, these two. Whenever I deal with people like this in pairs, I always just wonder where they hooked up. Do you think it was another ER waiting room? I'd say it's about a 50% chance.