Saturday night must have been a blowout around here, because come Sunday morning we had a unit full of (pick at least one) intoxicated/suicidal/arrested people getting treated. The psych rooms were full and there were numerous other SIL (sleeping it off) patients.
How you get treated in a situation like this really depends on the circumstances. If you do something illegal while you're drunk you're going to wake up with a blue uniform next to you, and as soon as you're medically able you'll be off to the big house. If you come in with no legal issues (let's just say your frat boy friends got a little concerned when you fell down three flights of stairs), as soon as we finish treating your injuries and rehydrating you, we'll discharge your hungover butt and send you on your way. The treatment of choice is something we call a Banana Bag,which is a yellowish fluid composed of normal saline and a whole pile of vitamins and electrolytes that clearly need to be replaced. Think of it as IV gatorade.
The tricky ones are the Psych cases, the people who have at some point in this whole process been obviously intoxicated, but in that time have expressed any kind of desire whatsoever to harm themselves. This is when it gets difficult. All we can do is let them sleep it off, with a nurse or law enforcement person there with them at all times. These one on ones can be awful when the unit is packed and all you can do is sit there and constantly keep one eye on your still passed out patient. The other nurses glare at you as they race by, but every single one of us would rather be too busy than flipping through a four year old copy of Fisherman's Weekly, bored out of our minds, wondering when the hell our patient is going to finally wake up so we can get on with things. While they're sleeping we continue to draw blood for labs, because the next step in the process is to get a mental health screener in to determine what happens next. Are they really suicidal or was their friend Bud doing the talking? Do they need detox? The catch is that the patient can't still be drunk when this screening is going on, so we draw serial alcohol levels to know when they're sober enough to be evaluated. It's a frustrating time, especially when they wake up belligerent and hung over or still drunk off their tails and mean about it. However frustrating it is though, it's never dull. And it's often hilarious.
I had one guy, in the space of thirty seconds, tell me I was the most beautiful (and only) girl in the room and ask me a) if I was pregnant (what??), b) if I had grandkids (WHAT??), and c) if I could find him a shot of vodka somewhere, before he started singing "Somewhere, over the rainbow..." at the top of his lungs. He looked a little like the Cowardly Lion just to add to the whole scene.
The kid who got to me was just a plain old "too much partying" case. But when he woke up he was scared, he was embarrassed and in his own words, he felt like he was going to die. I'm quite sure that seemed like a distinct possibility. I was closest guess in his alcohol level pool and all I got as a prize was some other fool singing Judy Garland at me. Anyway, this kid is very anxious and heading straight south toward hysterical when his brother and his girlfriend get there to take him home. And as I'm standing about ten feet away pulling meds I can hear them all talking and do you know what the girlfriend is doing?
She's breaking up with him. Right there by the bed. He's standing stiffly with yellow fluid that looks like pee still running into him and a nasty hospital gown flapping in the back and she's telling him that they don't have anything in common anymore and their relationship has just run it's course and they need to see other people, yada yada yada. And he starts crying. Right there by the bed. And do you know what I did?
I threw her out. She said fine, gave him a little wave and, like Elvis, left the building. The patient and his brother looked at each other. The brother was clearly at a loss for words. And do you know what the brother finally said?
"Dude. Sucks to be you. You wanna go get a beer?"