Saving Lives

I've been working the past two months in the ER at Virginia Hospital Center with the official job title as "Scribe". My job is to do whatever the doctor needs me to do to help them see more patients in a more efficient and timely manner. So I take the chart into the room and chart the patient history and complaints, gather and record labs, page other doctors, or get juice or a warm blanket for the patient, or whatever else the doctor can think of that they need help with.

That is my job in a nutshell. I work the evening shift usually from 3:30pm-1am ish 2-4 days a week while going to school during the day. I need to unwind after tonight so I thought I'd share some of the craziness that is my job. I get to the ER, and as the doctor I am working with is waiting for the other doctor to sign out their patients to us, a nurse comes out of a room saying this patient needs to be seen STAT. He was brought in by the paramedics in a mild coma. So we ran tests trying to figure out what was wrong since he was non-responsive, but stable. Turns out he was a diabetic on dialysis and with a blood sugar of 1225!!! So we have to admitted him to the ICU and got him on some insulin. Patient number 1.

We then saw an 86 year old man who tripped in the hospital parking lot while leaving after having a procedure done and fell and broke his nose and was really beat up with abrasions above the eyes and the lips who needed to be sutured up. He decided to make a scene and kept coming out of his room demanding the doctor so he could ask him about his regular medications. So we had to go into the room numerous times to calm him down. Then the son showed up who also decided to make a scene and got upset about the abrasions on his fathers hand and kept making a big deal of everything. Then we lost the father momentarily while reassuring the son, because he went off someone to find a place to put his pants back on. Patient number 2.

Then an elderly woman brought her husband in because he was suffering from depression and was suicidal and she normally takes care of him even though she herself is in her 80s. But she brought him in because he was "belligerent" and "aggressive" and even tried to run out the front door in his underwear, and then after his wife locked the door, he tried to escape out the second story window. You get the picture. Patient number 3.

Then we have the Paramedics bring in a patient who was in the middle of a heart attack. Long story short we were able to save his life. Literally. And the ER was so busy with all the rooms full and 8 patients in the hallway with 10 more to come back from the waiting room, that the doctor, the nurse and I had to bring the patient up to the Cath Lab where they were going to put in a stint. Seriously, whenever have you heard of a doctor transporting a patient up to another floor? Patient number 4.

Keep in mind that we also got 7 patients from the previous doctor and so all during the time we were saving this man's life, all the patients, except for the man in the coma, were having a fit that they needed to be seen and get out of the ER. Now this is about 2 hours into the 10 hour shift.

With so many people waiting for rooms we tried to discharge a patient who came in refusing to speak, except that he had to stay for a week. So we ran the work up on him since we didn't have any complaints, and everything came back negative. So we tell him he needs to go home and he continues to pretend he is asleep. He "wakes up" when we ask him if a meal would help him feel better. So he eats and when he is done we tell him he has to leave since all of his tests came back negative and we need his bed for patients in the waiting room, and that we are not a hotel. He refuses to get out of the bed, let alone sit up. The nurses try, the doctors try, he just keeps saying he needs to stay in the hospital for a week. So we call security and go through an entire ordeal trying to get this man out of the ER. Finally they wheel him in a wheel chair to the front door when he gets up and starts going crazy and running around the ER being chased by security. The police come and the man runs out the front door into the rain with the police chasing after him. We still don't know if they ever found him. And I felt bad because he ended up being a homeless man who just wanted a place to sleep and a meal. We tried to find a place for him, but he ran off too quickly. But still it was pretty funny to see, and took about 45 min to get everything resolved.

Needless to say that the night continues to go on in this manner. All the patients we saw after that had every complaints you could think of, all of which had been going on for at least 3 months, some for a few years. Note to all future people who read this: the ER is not a place where you go when you have a chronic illness that needs tests and someone to follow up with. We will not figure out the cure to your abdominal pain and dizziness that you've been having for 9 months in one visit. See a primary care. It is a waste of your time and your money. They will run a Chest xray, CT, get CBC, CMP, and a urine and when it all comes back negative they will just tell you to follow up with your primary care physician and go home, after you waited 3 hours for all the labs to come back.

And to top this all off, the doctor I was working with is a very nice man, and I'll be working with him a lot in the future, but this was my first shift with him and I almost went nuts. I spent half the night trying to find him or trying to get him to focus and read the labs and xrays so the next patient could go home. Granted it didn't help that he was exhausted after dealing with everything, but he was just all over the place!! And he even admitted that he would not have made it through this shift with his sanity still in tack without his trusty scribe. Haha. Lets just hope that I can figure out how to keep better tabs on him and get him to focus a little better next time.