Human Piggy Bank

I really thought it was an April Fools joke.

The father of an 18 month old in triage stated his child had swallowed a coin.

18 month old promptly vomits 28 cents. One quarter and three pennies.

"I feel all better. Can I hab gum now?"

Would You Like Some Cheese With Your Whine?

As the acuity in the waiting room plummets, the drama factor rises exponentially. There must be an equation for this; please post it if you can think of it. Whine, whine, whine, that's all I heard today. What is wrong with these people? I spent eight hours in my beloved triage box, and it was one bonehead after the other. A number of people presented with cold symptoms. Has there been some new ad in Good Housekeeping that encourages people to go directly to the nearest ER with a runny nose lasting more that 2 days? There were quite a few with vomiting. Tough call on vomiting and when it is appropriate to go to the ER, but I will say that nausea and vomiting x 1 before heading out will bump you down the acuity list. It will further be downgraded if you are asking for change for the snack machine or eating Cheetoh's.

It is a sad commentary on the art of triage that one's flair for drama sometimes gets a bed before others when all else is of equal (and low) acuity. By far the Academy Award went to a young woman who moaned, groaned, wailed, cried, carried on as if an alien baby was about to burst forth from her chest. I guess vomiting for 5 months will do that to a person. Her enabler / mouthpiece husband was right there to lend support and advocacy. Although she had normal vital signs, I had to get her out of the waiting room because she was Causing a Scene. Later I found out that she Caused a Scene about being discharged, and was admitted with an order for NO NARCOTICS OR BENZOS, and a psych consult. Good, I am glad her problems will be addressed and that she wasn't just kicked to the curb with more pain meds.

Dream Sign for Triage (well, it IS customer service, isn't it?)

Heh, heh. I had to chuckle at Girlvet's triage warfare.

Here is my dream sign for triage:

1. Please do not ask how long the wait is. We are doing our best to serve you.

2. Patients are seen in the order of severity of illness or injury, not "first come, first served"

3. Lack of planning on your part does not constitute an emergency. If you need a prescription refilled or have a chronic problem, please see your PCP.

4. Triage is not a popularity contest, nor does the person who wails the loudest automatically get in ahead of someone who is legitimately ill or just very quietly suffering.

5. Save the drama for your Mama. See #3.

6. If this is your third or more visit with the same non-urgent complaint this week and you have not followed any of your discharge instructions from your previous visits, we probably can't do anything more for you. Most of our advice is based on common sense, and there is no prescription for a congenital absence thereof.

7. If you are checking in with abdominal pain or vomiting, please do not avail yourself of the delicious snacks in the vending machine. For that matter, please do not eat the Big Mac you have brought with you.

8. Please be courteous to the staff and others who share the waiting area; screaming and using foul language only serves to piss us off, and Pseudocity Police station have way less comfy beds in their holding cells. And your bail will be more than your co-pay. Not that you'd pay it anyway.

9. Please do not inquire as to why someone has been brought in to be seen ahead of you. The triage nurse is very experienced, and if she thought you were as sick as you think you are, you would be in a bed too. Besides, it is none of your business and privacy laws exist to protect, well, privacy.

10. If your condition has changed or become worse, please do let us know and we will be happy to reassess you. Please be aware that the decision of the triage nurse is final, and faking a seizure is not cool.

11. Please watch your own children and be responsible for their needs. We cannot give everyone a turkey sandwich. Your medical care may be paid for by the government, but if you can afford cigarettes, a cell phone, and a videogame for each of your 5 children, you are expected to feed them.

12. "Pregnancy test" is really not a reason to come to the ER.

Operators Are Standing By....

We get lots and lots of calls from people who are looking for advice, as I'm sure most ER's do. Here is today's top ten:




10. "How long is the wait?"

9. "If I took Tylenol at 2 hours ago, how soon can I take Motrin?"

8. "How long is the wait?"

7. "I cut my finger with an Exacto knife, do I need stitches?"

6. "I saw Dr. Dewshe Bagghe last week for my back, and my prescription for Percocet ran out, can he just call me in a script for more?"

5. "What are the symptoms of food poisoning?"

4. "Should I bring in my 2 year old for a high fever? It's 100 degrees"

3. "Can you talk to my husband and convince him to call an ambulance? He twisted his ankle yesterday and it's swollen and black and blue. Yes, I have a car, what does that have to do with it?"

2. "Can I make an appointment?"

1. "If I can't make an appointment, can I put my name on the list so I don't have to wait so long? Like at Chilli's?"

I Guess It Takes a Full Year For Some People to Feel Friendly

Wow, Hell has frozen over and I'm expecting the sun to rise in the west tomorrow. Dr. Dewshe Bagghe has condescended to make eye contact and engage me in actual human conversation. Will wonders never cease?

Aww, are you feeling all left out an lonely because I ignore you?

I'm sure.

Must be you are all impressed with what an AWESOME job I am doing as admissions coordinator. If not, see above image and follow these directions:

"First shalt thou take out the Holy Pin. Then, shalt thou count to three, no more, no less. Three shalt be the number thou shalt count, and the number of the counting shalt be three. Four shalt thou not count, neither count thou two, excepting that thou then proceed to three. Five is right out! Once the number three, being the third number be reached, then lobbest thou thy Holy Hand Grenade of Antioch towards thou foe, who, being naughty in my sight, shall snuff it." (Idea shamelessly stolen from Monkey Girl--I love Monty Python!)