Sunday, December 23, 2007

death at the ER door

the holidays are the worst for the ER. every one that i've worked in becomes over crowded and understaffed right around Christmas time, it's utterly ridiculous.
today was just one of "those" days. there is a full moon out, we were understaffed and i knew before going in to expect the worst since christmas is right around the corner. it wasn't bad at first, lots of crazy people though. i had the ROOM 1, the heart attack/stroke/crazy/seizure room. i also had room 6 and 7, just regular rooms (although any of the above can go in there, just not heart attacks, those are reserved for rooms 1 and 2. at 7pm i was surprised that we had 2 patients in the whole er, i was hoping it maybe would stay that way. I was wrong. way wrong.
at 8pm the bus unloaded and migraines, chest pains, difficulty breathing and crazy were all on it.
at 11pm i inherited another room since we were down a nurse and the second room (room 2) is our OTHER cardiac/stroke/crazy/seizure/any-thing-remotely-serious requiring a second crash cart, a pediatric crash cart and a neonatal warmer room, it was also expecting an ambulance.
this blog isn't intended to be my vent system but today i need it, so i'm going for it.
he was in his 50's with a history of asthma, he complained of stomach pain to his wife a couple of hours earlier and when she went to check on him at one point he was face down on the floor and blue, like not breathing blue. his wife FREAKED out (as any right person in their mind would) and called 911. she said it took forever for them to get there.
he arrived in the ER unconscious and being bagged (not breathing on his own) because he was so "tight", his lungs weren't able to get oxygen because all the airways were so small due to his asthma. the doctor quickly intubated him and we started him on medications to keep him sedated and comfortable. he had also lost bowel and bladder control so he was soiled and in need of a good cleaning (which was obviously my last priority but still a priority). i never left his room except to accompany him to CT to make sure it wasn't a stroke and then at 2am i took him to his ICU room, he was still dirty.
let's talk about being in a room with someone who's blood pressure is 220/130 and almost waking up, trying to pull out their breathing tube, listening to the alarms tell me he needed something stronger, listening to his wife ask me a million and fifteen questions and all the while inhaling the smell of liquid poo leaking from his rectum, which was soaking up the sheets. it's 4:50am and my stomach still hurts. i know his wife was concerned but i almost couldn't take it. at one point i turned to her and looked her in the eye and said "hon i know you're freaked out and you have every right to be. hell if i were in your position, even as a nurse, i'd be scared, but you have to believe me when i tell you that i am doing everything i can to make sure he's comfortable. i know it's scary but i need you to calm down". it lasted for 2 minutes and then she started in again.
i'm glad the night is over and that i have off today/tonight/Sunday. i work again monday, tuesday and wednesday which now seem like any other day but i know it's Christmas eve and Christmas day i'll spend with coworkers. but it's a day i chose to be there, unlike my friend in ICU room 2 that was admitted.
lets not forget there are people out there who will spend their christmas staring at a hospital wall with horrible cafeteria food. we should all be so lucky to spend it choosing whatever it is we want to do, alive and well.

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