Last night I had quite an array of patients. First I had a patient who relapsed on IV cocaine (which I don’t get, but hey, I’m clean!) 4 weeks ago. 3 weeks ago he developed severe back pain which had only gotten worse. He came in today at the beckoning of his primary. We found a epidural abscess on his spine which can be nearly fatal if it ruptures. He was so upset when the doctor told him. I assured him that yes, it is from your relapse. No, it is not as bad as it sounds. It can be fatal, but since he came in when he did, IV antibiotics should clear it up. If not, the hospital is exactly where he wants to be. I also made sure to tell him that he is taking huge steps to get clean. It is not a easy process, but he is doing a great job. This is just a little bump in the road. He was so freaking polite and nice. I really hope he makes it and continues with his own road to clean living.
I then got a patient with a .583 BAC. He was 48 and talking about Vietnam…yeah…He is a frequent flier who is terrible depressed. He is also pretty non-compliant with detox. He was so freaking polite as well. Yes, I do flirt quite openly with most of my drunk patients, but I also have the least amount of outbursts from my drunk patients :D The poor guy kept telling me how scared he is and how terrified he is of everything. I felt so bad for him, but I also know how much has been done to try to help him.
Another patient I got was a little 25 year-old who was attacked with a knife. When I asked him if he knew who attacked him, he said, “umm…kind of…” Again, he was very polite, so I decided not to ask anymore about that as the police would be there shortly. This poor little guy had a 2-3 inch lac on his forehead that he was holding pressure on. It was clearly bleeding a lot as there was blood all down his body. I had him sit down, asked how he was feeling, making sure he wasn’t nauseated. Then one of the nurses I was working with smugly said, “Oh, you won’t need tele.” Seriously?! Can I make a freaking call with MY patient?! Put the pulse ox on the guy and his heart rate is 150…yeah, I’m going to need tele. I look at his lac, it is pulsating…yeah, I’m going to need a doctor, IVs and some fluids…idiot…
Again, the patient could not have been more polite. We got some fluids in him, got him sutured up which took some careful, skillful work from one of my favorite doctors who is one hell of a kick-ass woman. (Even when pregnant! I had my first code with her and her lovely belly. Watching a pregnant woman intubate someone is pretty cool.) After some fluids, fentynal, and TLC, his heart rate came back down to the 80s, and he could go home. Later, one of the policemen told me that the person who attacked him was someone he used to sell drugs to. It doesn’t make a difference to me. Everyone deserves respect even if they are into some questionable things. If they are polite to others, they deserve politeness back.
Remember that stupid, entitled people who think they deserve all the attention in the world! A little respect goes a long way in the ER. I don’t have time to smooth your feathers when I DID NOTHING TO PISS YOU OFF!! But I will definitely spend my precious time with the drunk guy crying about a war he was a pre-teen in than making you feel entitled again.