Thursday, May 21, 2009

Triagony

Once you get a little experience under your belt and prove you have some common sense the powers-that-be will ok you to go to triage. My hospital is so busy that on any given day (or night) we may have between 3-4 nurses doing triage at once... usually. When there is a call out or a hole, that's the first place that they rob Peter to pay Paul from.


So picture me.... 12 hours, stuck in the same little box room. I have been going fucking crazy! Oh, and lets not forget the little "thou shalt not play on the Internet" decree that was handed down a couple of months ago. Forgive me father, but I break that one EVERY night. What the hell else am I supposed to do??? I never stay put... I am always wondering into the back to check things out, or to the communications room where the paramedic gets all the incoming ambulance and helicopter calls. That room is closed off from the waiting room and those crazy fuckers can't get to me there!


Thus far in triage I have been chased, hit on, cursed to hell, looked at toilet paper with God-knows-what in it. I have wrestled drunk/high teenagers back into wheelchairs while convincing their equally dunk/high friends that they weren't dying... just drunk and high. We pull drive up traumas out of cars and (last night) dragged a heroin OD out of the driveway where his buddies (so kindly) dumped him.


Last night I had a IVDA (aka IV drug abuser) that was seen at an outside hospital for back pain, discharged with anti-inflammatories and was PISSED she didn't get narcotics. So she sat in a wheelchair in the middle of their ambulance drive and refused to leave until someone called an ambulance to take her to us. We, so kindly, pulled her off the ambulance, ran her through triage (not me!) and popped her ass in the waiting room. I did mention that the wait time was about 5 hours and she was unthrilled. She wanted us to bring her a cot, because the wheelchair was uncomfortable and she refused to sit in the hospital chairs.


Its sad... but we recognize a problem child when we see them!


5 minutes later patients started coming up to me to tell me that she was now laying on the floor, refusing to get up. We checked her out, determined it was status dramaticus, told the attending and hauled her off the floor back onto the chair. About 30 minutes later.... same shit. 15 more minutes that attending and clinical coordinator didn't care that she was on the floor. She had documented stable vitals and was no closer to the top of the list. On the floor she stayed. The visitors remained "concerned" and kept making sure I knew she was on the floor. A self-proclaimed doctor from John's Hopkins (that's what he told me) came to explain that I was not allowed to do that, he was a doctor and we were not treating her appropriately. He looked like a self-proclaimed jackass guido from Jersey to me (shirt open, bloodshot eyes, smell of etoh) so I ignored his threat to call 911. When the college popo showed he was nowhere to be found. Hey, at least the popo helped get the bitch back into the chair AGAIN!


Triage= A fun-filled trip to Adventureland or 12 hours of sheer HELL


Triagony it is!

I thnk I'm going to put this sign in our waiting room! JCAHO will love it!

2 Comments:

Blogger mojitogirl said...

So very true! Triage is the only place where I've been threatened to be beat up (by drunks, family members, angry boyfriends whose beat-up girlfriends were already inside!). Some drunken woman even came right up to me until she noticed in mid-swing that I was VERY pregnant--and she withdrew. It is the only place where off-duty police officers and State Troopers guard my door. It has been the only place where I've worked behind bullet-proof glass. Now we don't have a designated triage nurse, since we're only 6 beds--we all rotate if we're free. I could never go back to doing STRICTLY triage for hours on end.....talk about Dante's Inferno!

7:39 PM  
Blogger Grumpy, M.D. said...

Gotta agree with you. I'd have left Ms. Whiney Junkie on the floor after the 2nd time. She only gets one chance to be hauled back in her chair. Sounds like she needed some duct tape and slapping.

I got called in last week to see a guy in ER that was injured while trying to rob a store. By the time I got there he'd somehow escaped and the cops were looking for him. Love it.

You people who work ER have my respect and worship. You are the trench soldiers of this insane field.

Love the cockroach sign.

9:06 AM  

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