Yesterday was my penultimate shift in the ER...and medical school. I walk into the unit and the first thing I hear was "She's trying to start a fire with her cigarette!" Welcome to work!!! This was a very challenging patient! She had been brought in the ambulance, for a reason we weren't sure because the report had the wrong name, ethnicity, and date of birth on it, so we couldn't trust it. As soon as she got put in the room she decided she wanted to leave, so she lit a cigarette and tried to set her bed on fire. Her mood depended on the moment. She could be very nice and cooperative or completely belligerent. She hated blacks and Filipinos, but being gay was ok as long as it was your business. Her family had all been murdered by doctors. Her mother had been beaten to death at a nursing home. She was an atheist. Then she wanted her Bible and was going to forgive everyone because she was a Christian and would forgive. She was verbally abusive the entire.night.
We had another patient who came in because she was experiencing seizures. She was telling us that "I'm having one right now." While she's wide awake and walking. A quick check to her record reveals a diagnosis of paranoid schizophrenia. She was also a real pain in the ass. She was belligerent until the nurses made it clear that she was not going to be allowed to be disruptive. Sometimes dealing with these patients is like dealing with a six year-old.
Most of our patients that night were serious. Which is a bit out of the ordinary. In the ER a lot of the patients really don't have emergencies. Mexican moms in particular bring their kid to the ER every time they throw up. This is not an emergency. Kids get sick, and they throw up every once in a while. If it does not stop or is accompanied by a very high fever, and cough, or the vomit looks weird, that's different. But one episode of vomiting does not an emergency make.
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