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.

Categories: Me


Steve · December 28, 2022 at 11:39 am

Worked ER back in Maine from mid-‘70’s to 1994 full time nights, then one day a week as OT until around 2004. Nights were staffed with three RN’s, usually all men, and I was the smallest. The two (big men) city cops would haul the out-of-control person in, my two bigger coworkers would pile on, and it was my job to inject the Haldol into the vastus lateralis asap, right through whatever winter clothing they were wearing. My coworker Hal Dol kept the patient under control while we found a judge to sign the ‘blue paper’ and get the detainee off to a 72hr hold.
Times gone by….

MN Steel · December 28, 2022 at 1:05 pm

Monday my work supervisor’s ex-wife with no family history was found in a laundromat after a heart attack, ~47YO, on the cooling rack with no MRI done yet.

Global Warming pounces with no warning, beware.

GuardDuck · December 28, 2022 at 4:26 pm

Used to work hospital security. Some Docs you knew were going to make you use physical restraints. Others were chomping to use ‘chemical restraints’.

Wife is working in ED today. Said she showed up this morning to 32 patients being boarded in the ER….

Crazy way to run a hospital.

Rod · December 28, 2022 at 4:49 pm

Thanks for the real world posts. When I’m short on time to spend reading blogs, there are two that I don’t miss. Yours is one of them.

BobF · December 29, 2022 at 4:23 am

And here I thought you were relaxing in a lounge chair with a number of Mai Tais all that time… 🙂

May your new beginning be better than the old ending.

Aesop · December 29, 2022 at 9:53 am

Feelin’ your pain, man. I did three nights out of four last week through Monday, with only Christmas Eve off.
We’ve seen maybe three COVID patients since 4th of July, and the ones we’re getting now are fine with O2 sats.

But the damnedest thing: every one of my vaxxed co-workers has gotten sick since Labor Day, mostly with COVID, and they have a cough that lasts for weeks and weeks.

None of the unvaxxed fraction have had any such problems.

Yet again, I suspect Suddenly™ will be discovered as the culprit.

Somehow, I suspect that if we’d all gotten smallpox and polio five times after we got those vaccines, the jig would’ve been up, and torches and pitchforks would have made an appearance outside several large corporations’ HQ.

Comments are closed.