[batgirl]

Double whammy for today

One of the best parts of my job is that I always get something new. Sure, I have repeat patients, but even after 6 years doing this, I still haven't seen everything.

The elderly and I have a bond

We get a call to take a man home to his residence. Residences are a bit iffy, and I dislike them greatly for 2 reasons:

1- There are usually stairs, making us need to lift the patient on the stretcher (which itself weighs 110) up said stairs.

2- More often than not, the amount of stairs are lied about. The page will say "male, 200lbs, 2 steps" but once we get to the house, surprise surprise, there are 6 steps, making my job that much harder.

The patient we were sent to pick up was 230lbs and was going to a house in Queens, far in Queens. We meet the family and thank god, there's no steps. I find out that the poor man has advanced dementia, and really only has very brief lucid moments. I talk to him for a little while, and he seems to be doing ok. His daughters say their goodbyes to him until they meet us at their house and we begin our journey. As we start driving I notice that the man is lying slightly to the side. Now our stretchers are not made for comfort, but I'd like to think that I do my best to make my patients as comfy as possible. I ask the man if he was comfortable and he says yes.

Me: "Ok, but if you're not, just let me know and I'll do what I can."
Man: "Would you like me to make love to you?"

And then he grabs his junk. Yay.


Sometimes I get calls that are really just ridiculous. They make me wonder why the hell some people have gone into the health field the way they treat patients.

WARNING: GRAPHIC

Are you retarded?

My partner and I get a call today for shortness of breath. No biggie, so we head out to a nursing home that is notorious for being full of bullshit. We arrive on the floor and I go see the nurse. She explains to me that the patient in question vomited coffee grounds (iron oxidized blood so it looks black and like coffee) last night and today had an oxygen saturation (how much air you're taking in) of 83% (normal healthy people hover around 97-100%) and was congested. They think he might have aspirated (emesis/vomit or fluids entering the lungs) and he's getting worse. This was not bullshit.

Now, I can hear what you're thinking: But Batgirl, why didn't they call the ambulance last night when he was clearly vomiting blood? Well my good friends, I'll tell you: I have no fucking clue. Maybe there was only 1 or 2 nurses on the night shift and they didn't check on him afterward, maybe they didn't want to fill out paperwork, maybe they just wanted to leave it for the morning nurses, maybe they just didn't give a shit.

I leave the nursing station and as I get closer to the room, I hear gurgling and wheezing. Audible gurgling and wheezing. Without my stethoscope. Outside the room and down the hall. As I enter the room, I see a man with a small nasal cannula in his nose on 4 measly liters of oxygen. Big fucking help that'll do. He's kind of thrashing around and is turning purple. I grab a nonrebreather mask and pump my oxygen up to 15 liters, throwing the mask on him. I debating calling for a paramedic, but the odds of one being in the area were almost zero, so my partner and I grabbed the man onto the stretcher and flew.

In the truck, the man was asking for water, which is putting salt in the wound. No need for more fluid to go into the lungs, but he was so confused he didn't get what I was saying. All I could do for him was take a blood pressure, keep the oxygen flowing and hope he didn't die on me. He had a DNR, but I'm not one for having corpses in my truck. His pressure is dropping (114/41), but we make it to the hospital. I grab the nearest nurse and explain the situation while we move the man over and start going over medical history (lung cancer, another clue to send him out last night, dear nursing home?) allergies and medications. The nurse puts him on a monitor and gets another blood pressure: 78/26. Oh shit.

She dials up respiratory therapy to bring a BIPAP (Bilevel Positive Airway Pressure) machine (a machine that regulates and helps breathing) and they start to try and get IVs in. The man is resisting, so I hold his arms down so they can get an IV in both, one arm and one hand. They get an EKG going and start a dopamine drip.

After 50 minutes in the ER, I manage to toss my gloves and get a signature for my report. I grab a soda and stagger over to the truck, feeling numb, the rush of adrenaline and tunnel vision I get with serious calls draining from me. The absolute disregard for that man's well being by the nursing home was overwhelming me. I've seen it before, too many times. This was a bit different though. If they would have left him for 30 more minutes the way he was, he would have died, easily. And they showed almost no concern, like it was not a big deal to them. They're nurses too, same training as ER nurses, and they just didn't seem to grasp the seriousness of that call.

I know that even though the part I played in that call was minute. I couldn't do much other than monitoring his vitals and keeping his oxygen going, but I know I did all I could. They can't say the same, and I hope to god they find out what happened to that man (I doubt he'll make it through the night) and that they lose a hell of a lot of sleep over it.