Hard and Fast - That Emergency Life

The last post dangled a part two. I don't have the energy for it. That shift was the only shift I've ever cried after work. Work has never made me cry. I've been doing this since August 2002. I've never cried. That shift was emotionally and mentally brutal. Colleagues told me it was painful to watch. It was that bad. Instead, I thought I'd show you the "fun" side of things. Procedures.  In the ED we do all kinds of procedures. We remove objects from places they don't belong, we splint, we intubate, we put back together... just to name a few. The downside is that procedures take time. We live in a society that has put gold medals on throughput, how quickly you can get a patient out. Therefore, procedures can really mess up your flow. Sad, right? Here's a recent one I did.   As we age, our skin naturally thins. There are other reasons, like some medications, that can also contribute to this. It is not uncommon for elderly people to have thin skin and...

 Yesterday, volume was relatively low. Stress was relatively high. My shift was 7 am - 5 pm. I run my side mostly by myself until the next NP or PA comes in at 10 am. For the first part of my shift, I had a pretty good MD attending who trusts my medical judgement and leaves me alone to do the right thing. He's available when I need assistance; otherwise, he's hands off. The first half of my shift, while balancing all other patients, this is what I did: I had an actively miscarrying young mother whose husband wasn't allowed in due to covid. Actually, she miscarried about 3 weeks previously at 9 weeks gestation. She was scheduled for a D&C yesterday, at a different facility, because even though she miscarried her body did not expel it. The night prior, she started having bleeding and cramping. She bled heavy through the night. She came in by ambulance. The charge nurse never triaged her or took her vitals. She put her in a room and left it for another nurse to do. Fortuna...