Holy Mary, Mother of God.
It's been a week.
I've been playing catch up from my six days off at Christmas, and since I didn't want to take any vacation time, I've ended up working six of the last eight days. Three on, two off, three on. Tiring enough under normal circumstances, doubly difficult with a diva ankle. We've been out of town, had my folks in town, had a major "first divorce" holiday and the entry of my middlest into teenager-hood. I'm normally moderately high energy, but I have to admit that this week I've been dragging my derriere. I'm tired. And I'm going to admit something here that I will not cop to at work. I really hurt. You can stabilize my ankle all day long, but if I still feel it shooting to my knee every time I put my foot down in a twelve hour shift, it makes for a long day. Or three.
But today was my last day before three days off. Before my schedule opened back up again into the lovely schedule I'm used to. Before I rejoined the Land of the Living - doing something more than eating, sleeping and working. I breezed into work this morning groggy, but already looking twelve hours into the future. I could do this. Right? How bad could it be?
Holy Mary, Mother of God. It was insanity.
And as usual for me lately, it started with triage.
I talk about triage a lot, but am not sure I've ever really explained it to the non-nursing types. The triage nurse is the one you see as soon as you hit the ER, the one who decides how urgent your state is, and how quickly you need to be seen. This initial assessment, and the priority assigned to it, dictates your entire ER visit. Triage can be tricky. You're expected to be able to decide in about thirty seconds if someone needs to go back to a room immediately (chest pain, can't breathe, suicidal/homicidal, overdoses) or if they need to go back fast (severe abdominal pain, kidney stones, allergic reactions, open fractures) or if they can wait a while (back pain,sprained ankles, headache, nausea/vomiting) or if they can wait forever (drug seeking, dental pain, ingrown toenails, big zits).
Triage is intense. Patients get all pissy with you, you have to drag unconscious people out of cars, and most of all, you never ever EVER know what is going to walk in the door in the next blink of an eye. Triage is so stressful that the day is broken into three four hour blocks. Four hours is about all you can stand. Even that is pushing it some days.
I triage a lot. Call it what you will, but I've ticked someone off enough that they keep sticking me out there. And I've been on a hell of a run. I'm not exaggerating. When I go out to triage lately, there is a collective intake of breath among my co-workers. I can take a unit that is running quite smoothly and turn it into a screaming, overhead code blaring mess in about four minutes flat. I can go from a peaceful, calm day to every bed filled and helicopters landing in no time. Want eight year olds brought in by the cops in handcuffs and car engines exploding in people's faces? Put me in triage. There's a phrase for this.
Hi. My name is RC and I'm a Shit Magnet.
And this is my tally today.
Eleven - yes, eleven - chest pains in a twenty minute period. I'm expected to deal with chest pain ASAP - get them to a room, on the monitor, EKG, IV, register them in the computer, blah blah blah - this takes about ten minutes per patient in a best case scenario. Can I just tell you that this wasn't a best case scenario?
The patient we had to pull out of a car who proceeded to have one seizure after another on my feet. It's very hard to hold someone upright when they're having a grand mal seizure. And it's impossible to move when they're seizing on your ankle immobilizer.
The trauma victim who wandered in with his severed finger in a soft drink cup, leaving a trail of blood behind him.
The drunken, homeless patient who appeared as I was getting a chest pain settled in a room. Our tech called my charge nurse, who was in the cafeteria getting her lunch, and told her someone was unresponsive in the driveway. She threw her food and some money to a co-worker and bolted for the parking lot. Imagine her dismay when her "unresponsive" patient turned out to be one of our nastiest, foulest frequent fliers, with routine blood alcohol levels that would be lethal in a mere mortal, and a disgusting mouth to match. That, compounded with my staggering number of chest pain admits, had her threatening me with an intimate acquaintance of her shoe - as it met my intestinal tract.
But even so, the day was still salvageable. Hell, for that matter so was the week. I could forget the flesh eating bacteria wound that I had had to culture - before we knew what it was. I could forget the homicidal nine year old who made me go in the break room and cry. I could forget the blatant drug seeking drama queen from the day before who made me seriously consider a change in careers. I could even forget my charge nurse, since she's one of my better friends at work and I knew she didn't really want to put her foot in my ass. It's her own fault, truly. She keeps putting me in triage, even knowing what has been happening when she does.
No, this all changed when I took our foul smelling drunken frequent flier to his room. This is where the fun really started. We were wicked busy, and normally I would have had someone with me to get him from the wheelchair to the bed. But there was no one to get. They were all dealing with my chest pains and so forth. For better or worse, I was on my own.
And this guy was big. And really, really gross. Smelly and filthy and drunk off his ass. A mouth full of half-rotted teeth. Clothes that may or may not have been changed in the last calendar year. Prince Charming - not.
I got him out of his wheelchair and went to help him into the bed. As I was doing this he stumbled. I was expecting this, and braced myself for it, but then he twisted sideways and I had to make a grab for him to keep him from hitting the floor. He knocked me off balance, and I fell across the bed in the room.
The thought crossed my mind - oh, for the love of god. Could this get any worse?
And then he fell across me. And pinned me on the bed. Underneath him. Yes. Yes, it could get worse. And it did. In a big way.
I'm at home now, and have had a seven hour shower. I've gargled with bleach and scrubbed my entire body with a Brillo pad. I wasn't sure if he actually touched my head, so I just shaved it to be safe. I've reflected on the comments of my co-workers, ranging from "well, hell, if you needed some action..." (males) to "oh, my god, I think I'm going to be sick". (females)
I know just how they feel. I don't feel so good myself.