Christmas day saw me work 13 hours in the emergency department. It was a fairly quiet day. Then came the 26th. Things were pretty quiet until 3 in the afternoon or so, then all hell broke loose. We had drunks and crazies galore.
One guy came in as a Baker Act*. He was screaming that he was a CIA trained assassin and said he was going to kill (pointing at four of us, me included) those guys as soon as EMS let him off the stretcher. My manager was standing next to me. The same manager that had to tell me that I had been suspended for the last time I had to wrestle a patient. Next to that manager were two of our doctors.
Sotto voce (so the patient couldn’t hear) I said, “How good of an assassin could you be? Killing yourself even seemed to be beyond your capabilities.” Coffee immediately shot out of the doctor’s nose. My manager said, so let’s let him off the stretcher and see what happens. I said, “Do you really want to do that? Last time that shit happened, you suspended me for a week.” The manager even laughed. We gave him some Haldol and some Benadryl, which did wonders for his attitude. After an hour or so, he was telling me that I was the smartest man he had ever met. Love that Haldol.
We also worked four codes, some other kidney and blood sugar problems, half a dozen sepsis alerts, and a stroke alert or two. We are also seeing a lot of flu and COVID. We actually had our first COVID death in quite a while. It was legit. He came in complaining of shortness of breath and had an O2 saturation of 65% and a blood pressure of 70/40. We did all we could, and even managed to get his O2 up into the 90’s with some BIPAP, but even Levophed couldn’t keep his BP up. He died about an hour after we sent him upstairs to the ICU.
Yesterday was no better. We had all sorts of craziness. A homeless woman who wanted to fight, three codes, and a dislocated hip. Conscious sedation, one nurse leaning on his pelvis, me pushing on the hip joint, and the doctor up on the bed with the patient’s knee on his shoulder, pulling. We pulled several times, then a loud pop. Nope, didn’t realign. Instead, the hip fractured. So now he’s off to ortho for surgery. Another patient had been prescribed Januvia and Novolog and the combination meant that we couldn’t keep her blood sugar up without a constant D10 drip.
Thus ends my work year for 2022. Now I don’t work again until a few days into 2023. I worked 38 hours in three days, which is why there hasn’t been any posting here to speak of.
A Baker Act is a law in Florida that says a person can be held under involuntary psychiatric observation for up to 72 hours, if a Law Enforcement Officer or Physician feels that the person presents an immediate threat of death or serious bodily harm to themselves or others. It’s generally used when a person either attempts or threatens suicide. Every state in the US has a similar law.