Thursday, November 15, 2018

Lake-sword autocracy vs. autonomous collective

My ER did some remodeling and created a locked area  for dedicated psych hold beds.  Now, because the patients have a nice, warm, safe, cushy bed with a TV, they wait much longer for a commitment bed.  'Cause, you know, they are in a safe place.  I refuse to work there.  The days holding routinely number in double digits. Weeks.

Two of our old psych rooms were turned into medical rooms.  There was no increase in staff to reflect the increased acuity.  The assistants are routinely taken off the floor to watch the suicidals which are now in overflow hallway beds with the drunks, and the beds are always filled.  We have more psych patients than before.  Many.

Sometimes it gets loud there, in the hallway, what with people trying to walk, steer stretchers, move X-ray machines, stuff like that.  There are 10 computers at that end of the ER.  It is loud.  Phones are constantly ringing, alarms always dinging. There is no privacy for the patients, and no privacy for us.  People are always hanging on the desk asking for things.  You can barely hear yourself think.

Often, the patients talk to each other, complain to each other, and get each other all ramped up and agitated.

One night was particularly wretched.  The patients were heckling, actually heckling, security, nurses, docs, anyone who walked the gauntlet of hallway dwellers.

Security and the assistants were beside themselves trying to keep things calm, but they had a job of it.

After a couple of hours I went out to dwell in triage, happy to get away from the cacophony.

One of my zone mates had PTSD from the events of the remainder of the shift.  She was wild-eyed, her usually flawless bob sticking out all over from many frustrated passes.

"It was awful.  It was really hard trying to take care of actual sick people, they just wouldn't shut up, they kept at it and at it.  "Nurse! Nurse!  I need, water, I need food, this sucks, I want to see my lawyer".  They were all trying to outdo each other in the asshole department.  Then they started to organize themselves.  They had a list of demands!  They were there so long they established their own form of government and elected a representative.   Possibly a king!”

Happy I am closer to retirement with each passing day.

Supreme executive power derives from a mandate from the masses, not some farcical aquatic ceremony.