Nursing, Mental Health Consults, Trauma, and Life After Dark
Good Morning Folks, I had the night off, and today until 7p off, which is refreshing after working three nights in-a-row. I haven't really been fair to you, the reader of House Calls, about the work I've done in the Emergency Room. There are 2 types of patients for me (it took awhile to classify them this way): those who are going home, and those who are being admitted to the hospital or mental health facility.

Admissions
These are patients critical enough to warrant sending them upstairs where more tests are run, or else they need to be observed for a few days. When all the rooms are filled, admission patients stay in the ER and rot, er, I mean, rest. The big problem is with all the orders scribbled down by the admitting doctors, or docs for short. The phone number to question them in case I can't read the scribbling is also illegible. And that makes me ill tempered about the whole admitting process.

Mental Health
These patients usually get transported off fairly quickly, but they still scare the heck out of me. We recently got out of the restraining business, and use chemicals instead. Sometimes that doesn't work either. I've talked to truly weird folks that see visions, talk in strange sentences, and ask me to pray for them (I do). The 2 seclusion rooms have a funk to them that smells like a combination of sweat, urine, and cigarettes from the last 10 years all rolled into one nostril-turning blast each time I walk in there.

Trauma
Lately, I've been getting patients who are post-trauma incident, usually car wrecks (MVCs). But one woman broke her leg while vacuuming, somehow. Stepped on a seashell. All traumas get x-rays and CT scans, and typically go home after a short stay in the ER. Plus I get bullet or stab wound patients after their initial trip to the trauma bay. With me, they get sewed up, patched up, and sent home. Serious cases go straight to the OR.

Good Patients
Good patients are the ones who come in with some true signs or symptoms, but it ends up being nothing wrong with 'em. I type up discharge instructions and escort them to the front door. One older fellow was cussing under his breath when we wouldn't let him stay and sleep until morning. As if we were a Motel 6 or sump'n. Good patients go home quick.

My Niche
I like to listen to patients tell their story, no matter how crazy it seems. One woman had seven children, got drunk, and fell down 15 fifteen concrete steps leading up to her front door, but not necessarily in that order. She had some nasty roadrash on her scalp, but was otherwise okay and went home after a few hours. Believe me, I had her tell me that story over and over, and sometimes I would ask variant questions to see if she could keep her story straight. She did.