Monday, October 17, 2011

Keep Honking, I'm Reloading

Many of the Really Sick walk in. That is what we are there for, we are the closest help for evaluation/treatment/stabilization and transfer to a tertiary care facility.  Sometimes, people who somehow manage to get themselves into a car will subsequently have difficulty getting out, due either to confusion or firmly held beliefs about when it is and is not appropriate to call 911. This is a behaviour peculiar to many an older adult, but is rampant among the Old Yankee population.  A penny saved is a penny earned; if I can breath, I can walk; if it ain't cut off, it's only a flesh wound. 

Sometimes family members will simply request a wheelchair.  Sometimes they will come in and calmly request assistance, and we will trudge into the parking lot regardless of rain, snow, sleet or dark of night.  But when there are only two of us nurses to tote that barge and lift that bale it can be a strain on the back; we are not superhuman.  And we are none of us spring chicks.  The youngest of us is 42.  The eldest is......well, me, with three of my colleagues within a couple of years.  Lab and xray on the evening shift?  Same boat.  The docs?  Again, same boat.  Gil already has a couple of stents, and though younger, Bobo is downright fragile.

 We used to have an elderly post stroke lady who could barely walk who would to beeeeeeeeeeeep her car horn incessantly so we could come out and drag inside her equally mobility-challenged and even older husband by wheelchair for a catheter change.  That was a treat.  I think that was Second in Commands doing: "Sure, just beep the horn!  We have curb service!".  Not.  I think he died or is in a nursing home. 

When patients comes into the ambulance bay laying on the horn, though, we pay attention.  Recent treks to the parking lot for assistance include:
"She's having a seizure"
"My husband has severe pain"
"My mother is short of breath"
"My daughter can't move her leg"

As for the above, none of them were exactly as advertised, and turned out to be more of a panic situation than anything life threatening.  Seizure?  Tremors in a Parkinson's patient who was either under-dosed or had missed their Sinemet.  Severe pain?  OK, that one was kidney stone, painful and scary;  way more painful in men than women.  Or more common anyway.  Short of breath?  COPD, always short of breath and still smokes.  Daughter who couldn't move her leg?  Soccer playing teenage girl.  Drama, drama, drama.  I usually make a bet that the teen will be on her cell phone within 5 minutes, and that at the conclusion of the visit she will hop up from her death bed and miraculously walk.  Nobody will take my bet anymore because I am always right.  The mechanism of injury is never commensurate with the level of disability portrayed.  Also, they are uniformly poor actresses.

People in an absolute panic get pissed when ER nurses don't exhibit the same level of panic.  They think that by remaining calm and in control we are complacent and uncaring.  Really?  Do do you think anything will get accomplished if I am jumping up and down screaming?  Seriously?  I will get out the Dope Slap machine and set it to stun if necessary.

And, although I operate on the principle that it is not time to panic until it's time to panic, once in a while someone will get my adrenaline pumping.


New Cathy and I beheld an enormous SUV, engine still running, stopped diagonally across our ambulance bay and blocking the parking lot entrance because it was attached to a large trailer.  The trailer was partially  in the street. The 70ish man in the driver's seat was pale and sweaty and breathing rapidly.  Wow, I thought.  He's having the Big One.  "Sir, what's  wrong?  Are you having pain?  Are you diabetic?"

"Call.  The police.  Secure.  The guns."

WTF?  Guns?

I reached in, put the car in park and turned off the engine lest we be run over.  New Cathy and I hauled him into the wheelchair (he could, fortunately, briefly stand).  All the while he muttered, "Secure.  The guns.  I.  Have a.  License.  Legal.  Need to.  Lock.  Them.  Up". 

He was diabetic, had a cardiac history, and was dehydrated having driven most of the day from some gun show.  He wasn't having the Big One that day, but he was admitted anyway. 

The guns?  All legal.  The local police came over to move the SUV and secure the weapons, locking them up at the station.  BEEEEEEEEEEEEEEEEEEEEEEEEEEP!!!!