Friday.... bought Buffett's new CD (Encores.... its fucking fabulous), dropped the top in the Jeep and cruised into work happy as a parrothead can be, minus the margarita and cute boy that is. Walked in and found I was in charge in Green. Grrr... but its ok, we are gonna be fine. Not even sitting down before the psych OD in the unmonitored, padded room yacks her charcoal and Seraquel/Xanax/Ativan/Percocet combo all over the room and goes unresponsive. A little musical chairs and she is moved to a monitored room, intubated, OG'd, tied down and ICU called. Did I mention that we already had CPAP on an asthma patient in one zone, a 600 pounder (minus boobs.... mastectomy) next door and a new chest pain who was 400lbs, contracted from being bedbound and had crotch-rot from hell? YEAH!!
We decided that it must be dumb-bitch night. Every one who came through our door to be treated was a dumb bitch of some kind. Lots of drunks, some under arrest, some given the jail vs hospital option. Guy spent his dilantin money on booze and heroin and seized. We loaded him up and sent him home. He went home, accused his son of stealing his wallet and tried to kick his butt. The son beat the shit out of dad and back he comes in PD custody.
The WBL was in a zone and had a sick guy come in. AMS from drinking and upper/lower GI bleeds. She can't do shit with him. He seizes and she doesn't get the Ativan that the doc was screaming for. He does, however have all of his blood cultures sent. He has snoring respirations, she wipes his mouth and nose.... I throw in an oral airway and grab the O2. She was a damn mess all night.
The trauma room is getting destroyed. MVC's, GSW to the butt, assaults. You name it. Phone call that 4 more are coming and there are no rooms in Yellow for them to go.... so I get all 4 traumas (already worked up) down to green. WBL gets the ass shot who has a lactate of 16 (!) and needs a bicarb drip since he got contrast. We also got a drunk, high bipolar old lady who ran he car into a pole. She had already escaped the trauma room once. She ran out of the hospital naked and had to be brought back in. So she is tied down, screaming in the hall waiting for a ready bed. I looked up when the screaming stopped.... and she was GONE!
The cops with our drunk seizure guy saw her go through a door to another (closed) treatment area. She had gone into a bathroom, locked the door and turned out the lights. I pounded on the door, called my boss, the University Police and we tried every key we had. Nothing doing. 10 minutes of this crap. Lights intermittently being cut off and on, so we know she's alive in there. Finally, she flushes, and opens the door.... her excuse "I just had to go to the bathroom." OMFG!
Ended my night with a guy who got punched in the eye and had some facial and orbital fractures. He had been there 20 minutes and was demanding that we call the nursing director because he had been there an hour and this bitch (me) hadn't given him his pain medicine. Let me also mention that he pulled his IV's out, drank from the sink when I wouldn't give him a ginger ale and refused to stay on the monitor. He also kept going into other patients rooms looking for me so he could yell. Me 5'0, nose to ... well.... whatever with this evil drunk motherfucker. I didn't back down an inch and he went back to his room. Special forces medics were with us that night... they thought it was hysterical! Maybe I should have been a Drill Sgt!