"Hey, he looks just like that Scorpions' album cover!"

I volunteer on Thursday nights at a little Emergency Room in my neighborhood. I started doing it just to get some clinical experience for my med school application, but I enjoy it so much that I am going to keep working there right up until I leave for NY. It's a small ER so we don't get major trauma like car accidents or gun shot wounds. Mostly we deal with sick babies, sprains and bone breaks, lacerations, that sort of stuff. We also have the usual drug seekers, hypochondriacs (called frequent flyers), and people who show up for things that don't really warrant a trip to the ER.

Carl is the triage nurse I work with most of the time. He's a young guy and is pretty cool. He's also a really good nurse, he got the "Nurse of the Year" award at the hospital where we work. Tonight we had this 4 year-old come in with a laceration on his forehead. The kid definitely needed stitches. The cut was about 1" long and so wide that you could actually see his little tyke skull. We get the kid into the triage area and get all his vitals taken and Carl looks at the cut and confirms that he needs stitches. He then begins to bandage the kid up with gauze and this non-sticky tape that holds it on. Imagine a disposable ACE bandage and you get an idea of what this tape looks like. As he's wrapping the kids head, another nurse comes over to talk to Carl about something and Carl kind of stops paying attention to his wrapping, but continues putting the tape on the kids head. About a minute later Carl looks down at the kid and bursts out laughing. He had wrapped the kids head from the top of his forehead all the way over his eyes. The poor little kid couldn't see and was groping around with his mouth open trying to find his mother. Carl looks over at me and says "Hey, he looks just like that Scorpions' album cover!" All I could do was shake my head and wonder aloud "How did you ever get to be our Nurse of the Year?"

Carl truly deserves his NOTY moniker:













I've only worked at the ER since February, but it's really shown me both the best and worst of human behavior. I've found that people who come to the ER can be split into 2 groups. Group A are the people who don't need to be at the ER, but are also the most demanding pains in the ass imaginable. Tonight a lady came in and filled out the little registration form and under Health Complaint wrote Need pregnancy test. You can buy a pregnancy test at any drug store for $3.99 and it takes you about 3 minutes to administer it yourself (maybe longer if you have to muster up some urine). So this lady trades that 3 min time investment for a 4 hour trip to the ER so she can find out if she's preggers or not. And right on cue, about 2 hours into her stay she starts complaining about how long it's taking for her to get an answer.

There are also the people who come in with the flu. I am talking about grown men and women who show up to the ER, write flu on their form, have temperatures less than 101, and no other complaint. We had a flu person in tonight who watched a man come into the ER via ambulance, being defibrillated (you know: CLEAR!!! shock charging...CLEAR!!!). The flu sufferer calls me to the little triage window and, I cannot fucking believe this, starts complaining that other patients who arrived at the ER after her were being seen before her.

"Are you talking about that guy just now?"
"Yeah, I was here waaaaayyy before him"
"The guy from the ambulance."
"Yeah the guy in the ambulance, maybe I should call an ambulance next time!"
"Let me ask you a question, are you breathing and is your heart beating?"
"What?"
"IS YOUR HEART BEATING?"
"Of course it is"
"Then you are in much better shape than the guy who just came in. So please go sit your no doctor-needin' welfare-receivin' no-compassion-feelin' ass down and we will get you in as soon as we can"

Yeah, I didn't actually say that last part out loud.

Now as much of a pain in the ass Group A is, Group B is much more frustrating. Group B people are truly ill. These are people with myocardial infarctions (aka heart attacks), out of control diabetes, people in kidney and liver failure. People in group B have severe lacerations or extremity injuries. These are people who need immediate and urgent care. It never fails that these are the same people who are quiet, never complain about waiting, understate their problem and are almost apologetic for being such an imposition on the ER Staff. Last week a lady came in and wrote Wheezing on her registration form. I asked her if she was having trouble breathing or feeling any tightness in her chest. "Oh no honey, just a little wheezing, nothing too bad." Carl was much more astute than I was and brought her back immediately. Her blood pressure was the highest I'd ever seen in the ER, her pulse was almost 200 beats per minute and her blood oxygen saturation was dangerously low. Carl goes "That woman would have waited forever and, without so much as a peep, died right in the waiting room."

There is alao a subset of Group B. I call them Group B juveniles. These are kids who come in and are calm, polite and don't cry. Tonight we had three. I told you about the Scorpion child already. He was covered in blood and clearly in pain, but never once cried or whined. We also had a 10 year-old who got his right middle finger caught in an automatic door at his father's work. He nearly severed his finger. As we took off the bandage his dad put on, it stuck to the wound and we had to kind of pick and pry to get it off. He gave a little "ah, ah" sound, but never more than that. Finally, a 3 year-old came in with a broken forearm. His little arm was clearly bent and deformed where the bone was broken. Not a wince, not a cry, not a complaint. He just sat there and let Carl get his vitals taken and then happily sauntered into the cast room.

Here are my rules for you to follow in a trip to the ER
1. Expect to be there at least 4 hours. Just accept it. If you see a lot of people arriving by ambulance on gurneys, get comfy.
2. Never, ever ever ever never ever ask the triage nurse "How much longer?" Ever. Just don't. First of all, the nurse doesn't know. Second of all, your chart will somehow get "accidently" misplaced for an hour and then, once found, will get put on the bottom of that huge stack of charts of patients waiting to be seen.
3. Be as specific as you can on the form. If you're having chest pains, write it down. If you are allergic to penicillin write it down. If you think that any medical condition you have could even remotely matter during your visit to the ER, WRITE IT DOWN!
4. Be as polite as possible to everyone you encounter in the ER. Pleasant patients get triaged, into a room, seen by a doc, treated and discharged so much faster than the rude ones.

Towards the end of the night it got a little slow and out of the blue, Carl looks at me and says "You know what dude? Beverages & More is my favorite store."

Amen brother.