Sunday, August 17, 2008

Allah will get me, apparently

So we get a call to go into the psychiatric inpatient ward to deal with an unruly patient. When we get up there, the nurses brief us on the situation in their office. One of the nurses tells me "she's highly psychotic and a very devout muslim," and tells me that previously she had objected to bloodwork being taken by a male because "males aren't allowed to see her skin." We agree that it would probably be best if we maintained a low profile while dealing with her, if possible.

We enter her room, and she starts arguing with the nurses. She refuses to take the meds in pill form, so the nurses decide to go hands on and instruct us to hold her down so they can deliver the meds via IM. She objects, saying that males aren't allowed to see her skin because it "angers Allah," to which the nurses respond "well tough shit, you should have just taken the pills instead." When we're rolling her over onto her side, she starts screaming "Allah will get you for this!" The nurses inject her up the ass, and we disengage. Later when we're debriefing inside the nurses' office, she comes back up and starts screaming at us "you guys are idiots! Can't you see how they're using you as pawns in their cruel game?" We 'escort' her back to her room, and by now the meds have started to kick in so she's out like a light.

Apparently she's seriously mentally ill, and refused treatment until her husband basically ordered her to go for treatment and she's since been certified. I don't condone the kind of family unit that her home clearly operates under, but in this case her husband's ability to order her to do something was probably best for her in the long run.

Monday, June 30, 2008

It's Called the Emergency Room For a Reason!

Okay, so I work security at a metro Vancouver area hospital (which one is unimportant) and it never ceases to amaze me how many people bring themselves, family members, or friends into the Emergency Room without genuine medical emergencies. I would go so far as to say that at least 80% of people who are admitted through the triage area are wasting valuable healthcare resources, as they have problems that could be far more effectively dealt with by scheduling an appointment with their family doctors in a day or two.

A few nights ago, at around three in the morning, I'm playing solitaire and listening to 80s music in the office, and a middle aged Asian woman rushes up to the door carrying her small child. I buzz her in, and she runs to me with a frantic look on her face. I ask her the same question I ask every other person who comes in through the ER triage area: "are you here to see a doctor?" She says that she is, and I instruct her to sit down in the waiting room like every other patient and wait for the nurse to begin the admitting process. Because there was no one else in the triage area so early in the morning, they saw the triage nurse straight away. Since my office is right next to the nursing station, I had to struggle not to laugh my ass off as I overheard the mother describe her son's scraped knee to the nurse, followed by the nurse repeating over and over that this was not the kind of thing you visit the hospital for.

The nurse couldn't just send them home, as any refusal of healthcare, no matter how absurd the problem, is illegal. I can only imagine how angry the mother would have been had she brought her son in during the day with a papercut only to wait twelve hours until all patients with real health problems were done with.

Such an extreme example of wasting healthcare resources (and by extension, my tax dollars) is relatively rare. More typical wastes of our time constitute things such as a fever, flu, minor skin irritations, one or two instances of vomiting in a 24 hour period, etc. And then these people sometimes get angry when they're bumped down the queue by someone brought in with an actual, real medical emergency. I've even seen triage patients with non-emergencies get pissed off when staff were called away to deal with an episode of cardiac arrest in the ER itself (don't worry, the guy lived). Do these genuises not understand the concept of a triage?

Remember what it's called? The Emergency Room. Based on that label, I'm going to let you figure out what it's supposed to be for.

If this is the kind of shit we have to deal with at my hospital, I can only imagine what those poor people at Vancouver General go through every night.