Wednesday, July 13, 2005

Laughing at the pain of others

Just finished a row of afternoons in the ED (And thanks to several of you for your very welcome comments - should be able to post something more individual tonight). And to my lasting shame I must admit that I spent a fair amount of yesterday laughing at the pain of others.

When you book into our ED this is the process - the first person you see is the triage nurse. The triage nurse gets the story and allocates you a priority out of five (priority one is to be seen immediately, priority two is "within ten minutes", etc., all the way down to priority five. Theoretically priority fives should be seen within two hours. In reality priority fours can often wait eight hours and priority fives usually leave "against medical advice", i.e.: before seeing a doctor). The triage nurse also takes a few lines of the story explaining why you are here, so that we can get an idea of what the next patient is. The brief history and the priority rating goes onto our computer screens out the back, and also onto a piece of paper they bring around, and then as soon as we can we pick up the bit of paper and see the patient.

Well, here's a few of yesterday's brief histories, with their priority ratings:

Priority 4: 23 y/o male, ten pin bowling, bowling ball got stuck on finger, swung up and hit patient on head, patient fell to ground and bowling ball hit patient on head again. No loss of consciousness.

Priority 5: Attacked by pet goldfish while feeding. Small bite to finger, no tendon damage.

Priority 3: Changing television antenna on roof during thunderstorm, fell from house roof onto car roof, then into fishpond. Appears heavily intoxicated.

Priority 4: Hand stuck in cheesegrater.

And then there was the hand-written note which several of us read as "Caught finger in dick chain", which turned out to refer to an accident with a deck chair.

So, not exactly "previously on ER...".

I remember this recent meeting we had where someone brought up some of the recent events in triage. My opinion is that the triage nurse is the worst nursing job in the hospital - a lot of people focus on the nurse as the cause of their (understandable) frustration at ridiculously long waitng times. But then, some people just like to complain. One of the nurses told me the following from a few years back when she was on triage:

A teenage girl presented to the triage desk and siad "I get this funny feeling just before I'm going to have a seizure, and I've got that funny feeling now". The nurse opened her mouth to say something and the patient went into a full seizure. She hurled herself to the ground, stopped breathing and lashed about on the floor, smashing her face repeatedly on the skirting board. The triage nurse called a code blue, every man and his dog ran out from the ED, there was blood and various other fluids everywhere, some woman had hysterics in the waiting room, babies crying, doctors and nurses clustered around this seriously fitting girl, people waving big needles and someone trying to make sure she kept breathing, and after a few seconds we finally got lines into her and wrestled her still-jerking body around the back.

And this woman stalked up to the triage desk and actually said "I was here before her! How come she jumped the queue?"

Can't please all the people. it is from events like this that I have formed the belief (and it has served me well) that if you ever hear something, and you can't believe it, but the only reason you can't believe it is that you think "Nobody could be that stupid", or "Nobody could be that cruel"... then what you heard is probably true.


Blogger Benedict 16th said...

So does your ED have an Ass box?

9:12 PM  
Blogger Chade said...

I was once one of those stories, I think. i went in to Emergency wanting to get a splinter removed. I was placed in a cue and waited four hours (It was a slow day) Then the splinter was probed and proded for a while before the nurse had to go get a doctor. The splinter was located in the cluster of nerves, tendons, and other lovely things at the ankle. I still laugh at it.

8:30 AM  
Blogger Bronze John said...

No ass box.

By the way, I was told in my youth that "donkey" and "rooster" are two words invented by the Puritans, who coudn't endure referring to the traditional words (cocks and asses).

I remember getting this "splinter" out of a girls face last year, where we stuck the anaesthetic in and I wriggled and jiggled at this tiny bit of wood protruding from her cheek - and finally pulled out almost four centimetres of wood stuck over he cheekbone.

6:43 PM  

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