Beer meter: 0 again!
Last night when I got to the E.D. the entire place was packed. I've come to learn that we actually have about 33 beds in the E.D. plus about 6 more in the Fast Track area. Last night, every single one was full and there were about 10 people waiting in the Waiting Area. We were officially on diversion.
Diversion means that walk-in patients can still come in and wait their turn as they are triaged. All ambulance traffic gets "diverted" to another facility. Also, since we are one of the larger hospitals in the area, we get admissions from surrounding smaller hospitals when they encounter a patient that needs a higher level of care. So, we "divert" those patients as well. Actually, they were all getting sent to E.C.M.C, so their E.D. was packed as well, but I digress.
I jumped right in and started seeing patients. I can't believe the volume of chest and abdominal pains I see. Also, SOB's. (Again, shortness of breath not a comment on the patients themselves.) So everything is becoming garden variety in this the start of my fourth week here.
Some standouts from last night:
I have no problems giving lots of narcotic medications to people with legitimate medical conditions. Cancer patients get all they want. Pancreatitis people who aren't raging alcoholics get a good amount. Drug seekers who try to scam me out of oxycodones by telling me that they're allergic to everything else and are in sooo much pain they can't do anything because of the pain get none.
If you followed the link I wrote about previously, you will understand when I say that no one can have 10/10 pain. One of my colleagues said 10/10 pain is being hit with your own amputated leg. Seriously. I think almost all of my patients tonight described 10/10 pain. If you have that much pain you should be screaming at the top of your lungs, writhing in bed, and nothing short of being knocked unconscious should relieve it.
We had things under control by about 2 in the morning. At that point we only had about 4 patients on the board and no new patients coming in. We opened to ambulance traffic again and had a few come in over the next couple of hours. We left 5 people on the board at sign-out. I don't mind, I have one night of nights left then it's back to the day shift to finish out the weekend and my rotation.
For the next 2 weeks, I have "Flat Adrian" visiting as part of a school project. So I will be showing what he's up to here. If you are not familiar with the story of "Flat Stanley" google it for an excerpt and links to the Flat Stanley Official Website.
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