It’s been a busy few days. I was at work one day last week, and we were simply overloaded with patients. In our 100 bed ED, we at one point had more than 220 patients. The waiting room saw every seat full, and some people were standing. Wait times were more than 6 hours for some people to even get a room inside of the department. I wound up working for 15 hours, and even then they asked if I could stay the rest of the night. When I pointed out that I still had to work the next morning, they asked if I could come in 4 hours early. I told them that I needed to get SOME sleep, so then they asked if I could come in 2 hours early. I agreed.
When I went in the next day, having only had time for 5 hours’ sleep, a shower, and a change of clothes, the backlog had been taken care of. My first patient of the day was a septic man who had a sore on his abdomen, and didn’t realize that he had a blood sugar of over 500. His A1C was 12.7, and he didn’t even know that he was diabetic.
My second patient was a 60 year old woman that had begun speaking gibberish the night before. The family let he go to bed. When she woke up the next morning and was still doing it, they decided that bringing her in was a good idea. We did all of the stroke assessments initially couldn’t find anything. Still, because of the delay, she was not a candidate for clot busters, so we did an angiogram of her head.
While we were waiting for the results, a new family member came in and began yelling at me, wanting to know why we weren’t doing a bunch of ridiculous stuff that she thought needed to be done. I guess her extensive Google search had recommended a bunch of things that she wanted us to do. I explained to her all of the things that we were doing, but she kept on making requests and went so far as to begin flagging down every hospital employee she saw to make these demands. She started getting really loud and mouthy. I finally had to tell her to wait in the patient’s room or I would have to call security. She came unglued at that point and said she wanted to speak to my supervisor so she could have me fired.
I know you would never guess that she was an Amish Canadian from Norway.
The patient eventually was transferred to another facility for brain surgery to fix the extensive blood clot that was found, but since the delay of over 12 hours meant that there was a lot of dead brain tissue there, her inability to walk or speak is likely permanent, and that’s on the family.
That mess was followed by a parade of people with sepsis, some diabetics, and a host of other issues. One diabetic had an A1C that was over 14, meaning that it was off the chart. He claimed to me that he always follows his diet and always takes his medication. Of course, he is lying. He doesn’t need to lie to me, it’s his feet, eyes, and life that he is playing with, not mine.
Every patient that I had wanted to argue and tell me that I didn’t know what I was talking about. Keep relying on doctor google and see what happens. As for me, all it does is keep me employed.
26 Comments
Elrod · December 16, 2024 at 8:30 am
“Everyone Knows More than I”
It’s a shame you are so ignorant; why does your hospital deny you the same access to Google your patients’ relatives have? So much more could be solved with all those miracle cures just a mouse click away….
Just out of curiosity, how many patients arrive with relatives/friends/etc. who ask how they may assist in the patient’s care without negatively impacting the process…..and then do just that? I’m betting it’s a pretty small percentage.
I’ve wondered if there is, anywhere, information on “how to be a good patient” and/or “how to assist your relative/friend/neighbor in receiving care.” If one is in the position of potentially being a caregiver, even an emergency or temporary one, such might be useful information. Exact procedures may vary somewhat between hospitals, but I’d guess that the human body is pretty well standardized by now so it probably doesn’t vary much.
Skyler the Weird · December 16, 2024 at 2:15 pm
They shouldn’t rely on Google. Everyone knows you use Tabers and the Merck manual to diagnose yourself and family members.
K9 Operator · December 16, 2024 at 9:10 am
Just wait until they can start putting their personal assessment of their symptoms into an AI bot and get Dr AI to tell them what you’re doing wrong.
JimmyPx · December 16, 2024 at 9:59 am
What gets me is “If you are such a Johnny Know It All and the doctors and nurses are incompetent then WHY did you go to the ER” ??
Knowledge is good and I research a lot about my medical conditions and the medications that I am taking. I then have a conversation with my doctor and I listen to what she says.
She’s cool with this as am I however this isn’t an Emergency situation in the ER.
Ms. Amish Know it All thinks she knows enough to argue with you but NOT enough to get her family member showing stroke symptoms to the hospital ASAP ?
NebraskaGuy · December 16, 2024 at 11:52 am
I use Dr. Google so I can ask informed questions or gain a better understanding of medical decisions. I do not ask a doctor / nurse for help and then try to tell them how they are going to help me. People in your profession have saved my 63 year old tail more than once. Thank you!
Chutes Magoo · December 16, 2024 at 11:53 am
Man, you have an tough job, I surely appreciate your dedication. When my mum was in the ol’ age home, I could see that the staff, at times, was overburdened so I made it clear to them that if mum had an episode of not knowing where she is and panicking that they could phone me regardless of the hour and I will talk her down to an calm state. The facility was an 2 hour drive away. Several of the staff let me know that I was one of the few people who actively made their job easier, and I’d like to think that’s why mum received such stellar care.
TRX · December 16, 2024 at 12:39 pm
A friend of mine left work in an ambulance after collapsing. His blood sugar was 480. He didn’t know he was diabetic.
He had been out of the USAF for seven months, and had a full physical on discharge, which somehow didn’t notice anything wrong, nor did any of his prior annual physicals.
JNorth · December 16, 2024 at 12:50 pm
Sepsis sucks, I’ve had that a few times. I have Primary (aka hereditary) Lymphedema so I’m super susceptible to Cellulitis which easily becomes septic. It’s been enough that the local ER docs recognize me and just get me admitted for a couple days of IV vancomycin then send me home with a weeks worth of doxycycline and cefalexin. The thing that blows me away though is the number of times doctors or nurses have expressed surprise that while in the hospital I’m doing what they tell me to do. That’s usually just something simple but slightly uncomfortable like keeping my leg on a big stack of pillows so it’s above my heart. Apparently it’s common for people to go to the hospital and then ignore the doctors and nurses, I don’t get it, if I’m not going to listen to you I’m not going to be in the hospital wasting all of our time.
Caren · December 16, 2024 at 3:28 pm
me at 46 in the ED: i am having a heart attack
ED: you are female and too young, its anxiety, here have a valium
Me grabbing the “how to recognize a heart attack booklet” from the wall and screaming in pain and panic: treat me now or i will sue
ED reluctantly performing the protocol: oops, gosh, you are right, we need to get into surgery right now
Your milage and point of view may vary
Aesop · December 16, 2024 at 9:33 pm
B.S. flag thrown.
“The protocol” for anyone presenting with chest pain in any U.S. ED, going back 40+ years (i.e. probably before you were born, and definitely before you were having a heart attack) is an immediate 12-lead EKG, and cardiac enzymes, along with a high index of suspicion that it’s always a heart attack until proven innocent, multiple times over a shift.
After that, yes, we’ll cheerfully tell you to take a chill pill.
Nobody I’ve ever seen in an entire career gets diagnosed with zero clinical investigation whatsoever, and anyone who does so is, by definition, a total medical moron, from tech to MD.
Not before.
So unless you were at an Doc-In-The-Box drive-thru Urgent Care, or a Zimbabwe ER, or this was 60 years ago, I smell fish.
It could have happened long ago in a galaxy far away, or you may have gotten seen by the last-place graduate MD from Whatsamatta U.’s Carribean School Of Medicine, with no board specialization credential but dermatology, (or you’re just a patient of Kaiser, or a country with socialized health care, which are almost the same thing), but otherwise the odds of what you claim are similar to winning the PowerBall anytime since about the 1980s in the U.S.
But feel free to fill in a few particulars and correct my misimpression.
I’ve had patients having a full-blown gonna-kill-you heart attack in their mid-30s (current record personally, 35).
It was also documented and diagnosed in about 3 minutes of hitting the front door, which is SOP.
The only people we routinely discount are teens and twenty-somethings, and even then only if they have no prior cardiac history, and they have a bog-normal EKG and a negative cardiac enzyme test, twice, and they’re also negative by lab test for cocaine, amphetamines, meth, and PCP..
You could have gone to an ED filled entirely with incompetent morons top to bottom, but the lawsuit industry tends to make that a very short-lived phenomenon. So hopefully you’ll understand the skepticism of that story as presented.
Do share more.
Divemedic · December 16, 2024 at 11:43 pm
What Aesop is saying is correct, even if he is a bit rough in saying it. The protocol set by CMS, which is the national standard, is for anyone who reports to the ED with chest pain to get an ECG within 10 minutes of arriving, followed by a chest x-ray and several repeat cardiac enzyme tests (at least two of them- one on arrival and one an hour later).
Any hospital who doesn’t do that is not following national guidelines as set by CMS.
Jason · December 17, 2024 at 12:12 am
Both of you gents are very correct. Way back around 1999 I was active duty and driving through the middle of Missouri (around 9 PM) when I started having some awful chest pains. I was near Whiteman AFB and asked the gate AP where the ER was. He told me they did not have one and used the hospital in Warrensburg. I showed up there about ten minutes later and upon hearing my complaint, they had my shirt off and were sticking a bunch of wires with sticky ends to my chest before I had a chance to wipe out my ID. I asked the doc what the deal was and he said that they do that for any person my age (41) having chest pains. The EKG was normal and a follow on exam a couple days later at Ft Campbell revealed that I had semi-chronic reflux condition. Very weird to say the least.
RayJ · December 16, 2024 at 3:31 pm
What is an “Amish Canadian from Norway”?
Haven’t heard that one before.
Dirty Dingus McGee · December 16, 2024 at 10:11 pm
In less civilized communities they are called NAPA’s.
North
American
Pavement
Apes
Wilson · December 16, 2024 at 3:57 pm
How many people were put on “resdeathisnear” , then put on a respirator to die?
Aesop · December 16, 2024 at 9:13 pm
People were put on respirators because they were in respiratory failure.
That is a non-recoverable problem that ends at the morgue, in 100% of cases.
This is because oxygenating your bloodstream is generally regarded as rather important.
But feel free to source your alternative protocol for that problem, hot-linked to any source dated prior to January 2020.
Bonus points for the medical research to back it up.
No points for citing your 20/20 hindsight, four years later.
JimmyPx · December 16, 2024 at 10:01 pm
Wilson, I work in a hospital and did during Covid. Indeed I caught it there and it almost killed me and did several coworkers.
The thing is that doctors and nurses can’t just “wing it” regarding treatment plans.
There are proscribed treatments for most conditions and to deviate can get you in serious trouble with the medical board and open you up to lawsuits.
I was there and the doctors and nurses did everything they could for their patients.
Blame the government agencies and medical boards for things like not allowing ivermectin to be prescribed.
Divemedic · December 16, 2024 at 11:44 pm
Ventilators are a hospital’s last ditch effort to save someone who is dying. In other words, they will die unless they are placed on one. Sometimes, they die anyhow. That’s how it goes- eventually, you lose every person because the chance of dying for any individual is exactly 100%.
JimmyPx · December 17, 2024 at 12:13 am
Regarding Covid and ventilators, while many people did sadly die there were a bunch who were on ventilators that ended up recovering.
At our hospital and many others we ran out of ventilators and actually hooked up CPAPs (usually used for sleep apnea) to the patients to keep them breathing and their oxygen levels up.
Covid was a horrible time and I know several doctors and nurses who at the end were burned out and retired from the field.
Skeptic · December 16, 2024 at 6:43 pm
To be fair, it can be quite hard knowing if a black is speaking different gibberish than their normal gibberish.
Dan D. · December 16, 2024 at 8:41 pm
The gibberish woman story is sad; how many people know that altered mentation is a sign of Something Really Bad? This is going to land hard on the 30s and 40s generation when they realize that all the TikTok videos on their phone just entertained them to death, literally.
Aesop · December 16, 2024 at 9:07 pm
Three kinds of people end up in the ED:
Smart people
Unlucky People
Stupid People
The exact ration of those, respectively, based on decades of first-hand observation, is 5:10:85.
I tell people I’m a life guard in the shallow end of the gene pool for one reason:
Because It’s True.
Low General IQ = Full Employment Until We Retire
Best Wishes during the holiday stupidity season.
Boneman · December 17, 2024 at 5:39 am
I’m still trying to wrap my head around Amish Canadian from Norway…..
First… I have extended family in Canada…. Second, I am of Norwegian decent. LOL… My observations have been that folks from those extreme cold areas, in order to prevent their blood from FREEZING must intake lots of ANTI-FREEZE (in the form of ETHANOL) and I think it tends to alter their thinking.
I know the feeling.
I am alarmed by the seemingly high amount of walk-in SEPSIS though….
Hang in there…. amazing the description of your typical “day”.
Divemedic · December 17, 2024 at 8:38 am
You are being far too literal.
Jay Bee · December 17, 2024 at 7:04 am
Lousy part: that family is going to forever blame your hospital, you as an individual, the other doctors/nurses/staff at that hospital, and probably the janitors, for the condition that their relative is in. They’ll tell everyone within earshot for the rest of their lives that it’s everyone’s fault but theirs.
McChuck · December 17, 2024 at 12:29 pm
Those sorts of people have been saying that about everything for their entire lives.
Comments are closed.