Pre Planning Your Scene

Small Town Hospital Fun And Games

 

TINS. TIWFDASL in a small rural ER somewhere, and the local EMS had brought in Sumdood who had sustained some sort of injury, that necessitated placing him on a long backboard, and cutting off his clothing. Said Dood subsequently, and contrary to my exhortations, removed his backboard straps, ripped out his IV, exited the cot, and started trying to assault another patient. I overhead paged “security stat to ER” (try not to hurt yourselves laughing), and the reporting officer ran back in, and took down my crazy, naked, lunatic wannabe fellow patient assailant.

Mr Naked was trying to cold cock the cop, the cop was trying to cuff Mr. Naked, and it looked to me as if more hands were needed, on The Good Guy’s side. I grabbed Mr. Naked’s off hand, and it was on.

So, the three of us were rolling around on the floor. Neither the officer nor I was making much progress, because Mr. Naked was sweaty and (shockingly enough) uncooperative. In addition, and simply making my day so very much better, he was bleeding enthusiastically from the site from which he had ripped his IV. Nice.

One of the nurse aides came over, and asked, “Is there something I can do to help?”

I replied: “Go over to the phone, dial 9 to get an outside line, dial 911, and tell the nice dispatcher that you are at Rural Community Hospital ED, and you have an officer in trouble. Repeat that, over and over, without stopping, until you hear the sirens. Now. Now would be very, very good!”

Long about this time, one of the (male) floor nurses, having determined from the overhead page that This Was Likely To Be Bad, had gotten another floor nurse to watch his patients, and trotted into the fun and games. So, by the time that the first backup officer had arrived, there were FOUR of us rolling around on the floor. In the blood. And sweat. And, every bit as much fun as it sounds to those of us who really, really do not like to exchange bodily fluids in the middle of the ER. On the floor.

Well, it soon developed into a Public Safety Roll Call. Every officer in our rural county screeched to a stop in our parking lot. There were city cops, there were county deputies, State Police officers rolled in. I even think that the county’s Department Of Natural Resources officer joined in the festivities. EMS showed up, firefighters clumped in.

Mr Naked was subdued, and cuffed. The offices went to pick him up by his cuffs and feet, and I suggested that they were much less likely to hurt their backs, should our friends from EMS place him on a backboard, and transport him to the pokey in their truck.

On the way out of the door, the ER physician asked the medics to pause a moment, and the doc asked the patient if he, the patient, desired to be evaluated for any injury or illness. Mr. Naked responded with an oration on the peculiar mating habits of the physician’s mother. We took that to mean, “Why, Doctor, how thoughtful! No, thank you very much, but these nice officers and I have made other arrangements! Y’all have a nice evening!” (or, something like that)

I retired to the nursing station, to write a nursing note that looked like a Take Home Essay Final on “Emergency Nursing in The 20th Century: Issues and Answers”. It ran on the order of 2500 words, and I made certain that this narrative was filed where I could find it should the need arise.

So, out of the blue, maybe 5 years later, I received a phone call from the Prosecutor’s Office for Rural County. I was asked if I remembered Mr. Naked Guy. I replied that I did, indeed, remember Mr. Naked Guy. I was asked if I could recall the events that I just finished recounting, in slightly altered fashion, above. Why, yes, I replied, I certainly could.

She continued. It seemed that Mr. Naked Guy was now out of jail, and was alleging that the responding officers had employed excessive force in subduing him. Did I recall anything that might relate to Mr. Naked Guy’s allegations?

I asked her if she had read my nursing notes? She had not.

“Ma’am, why don’t you read my nurse’s notes, and, if you have any more questions after that, call me back.”

She told me that she would do so.

I never heard another word.

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Fun With Suits! · Sometimes You Get to Think That You Have Accomplished Something!

Teamwork!

This one time, after departing Da City’s employ, I worked for a hospital in Da City. After several adventures as a staff nurse, I was promoted to supervisor.

The way things worked, was the staff nurses attempted to untangle the problems that developed,and then punted the resistant ones to me. So, one evening I received a phone call from one of the floor nurses, relating that Mr. Man was due some coumadin (a blood thinner, used post blood clot, among other indications), and she had none in her medication drawer to administer to him.

Thinking, “This is why I get the big buck!”, I asked her, “Have you looked on the counter, and checked the medication record?”

Yes to both, no accounting for the coumadin either place.

“Did you call pharmacy, and request that they run some up to you?”

Again, yes, she had. Her explanation of why Our Friends In Pharmacy had not delivered the medication, was intriguing. “They said that it had been in the drawer when they swapped them out this morning, and they were not going to send any more up, until tomorrow.”

Puzzled, I asked, “Did they explain how your patient was going to get his medication in that circumstance?”

“Nope, simply said that they would not deliver any more.”

“Let me look around. I’ll be right up!”

I arrived on the floor, and, sure enough, no lonely coumadin on the counter in the med room, nor on the counter in the nursing station.

I called Our Friends in Pharmacy, and asked the pharmacist about the missing coumadin.

“It was there this morning, I’m not gonna send any more. Everybody knows that the nurses take meds from the drawer, I’m tired of it!”

It had been a kind of grueling night for me, and I was not in the mood. “So, let me see if I’m hearing you correctly: you are telling me that you have personal knowledge of nurses diverting medication from patients for personal use, did I hear that right?”

His reply? “Yeah, everybody knows it. It goes on all the time!”

I set my trap. “So, what have you done about this information?”

“Nothing. Everybody knows about it, nobody’s gonna do anything!”

“So, you are telling me that you have personal knowledge of medication diversions, and you have done nothing about this knowledge, did I get that right?”

“Yeah, nobody’s gonna do anything about it, so, yeah, right.”

“What do you suppose the Board of Pharmacy would think of this revelation? Tell you what, why don’t I write them a letter, documenting this conversation, and you can find out, in person, what they think of a pharmacist who has personal knowledge of medication diversion, and takes no action to end it. That ought to be very educational, don’t you think? In fact, if you are here, with the needed coumadin, before I finish that letter, perhaps I will not have to send it at all! Maybe, I could write a letter telling the hospital administrator how wonderful it is to work with pharmacists who are so very, very collegial. Bye-bye, now!”

I asked the nurse, standing next to me, if I could borrow her pen and have a sheet of paper. “What for?”

“Got a letter to write!”

“What sort of letter?”

I told her, “That depends on whether or not we see your favorite pharmacist up here with your coumadin in the next few minutes, or not!”

I heard the pounding of footsteps on the stairs, and heard his wheezing before he even reached the stairway door.

I love it when we all work together to help our patients!

Fun And Games Off Duty · guns · Having A Good Partner Is Very Important! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

I Hate Late Night Phone Calls

Many years ago, I was working midnights in a small ER in northern Michigan. One night, around 0300, the phone rang. I answered it to find my wife on the other end. Her opening conversational gambit certainly caught my attention.

“Honey, it’s me. Don’t panic.”

Sounded like good advice to me. “OK, I’m not panicking. What might make me consider panicking?”

“Well, when you hear on the scanner that the sheriff is sending a car out here, I thought you’d get worried.”

Hmmm, the hospital still has coffee. Why would the sheriff send a car out to my home, populated by my wife and (presumably) sleeping children? I asked, “Why is the sheriff on the way out there?”

She responded, as if telling me about the dog getting into the trash, “There is a guy on the porch.”

Remember the guy-on-the-porch story I told y’all recently? Yeah, I certainly did. I was beginning to very much NOT like the direction this conversation was taking, so I asked her, “What gun do you have?”

“I don’t.”

This required remedy. “I’ll wait while you fix that.”

My normally clear thinking bride seemed somewhat slow this morning. “Huh?”

“Go get a gun, right now. I’ll wait.”

“What? Why would I get a gun?”

“Because I think it would be a good thing if you had something more compelling than your girlish good looks and winning personality should Mr. Porch decide that now was the time to enter, and lay hands on you and the children. Go. Now.”

Evidently Mr. Porch had decided that he did not, really, need to enter THIS house on THIS night, because this porch guy had elected to wander off before the sheriff’s deputy arrived, and before The Darling Wife felt the need for a little show-and-tell. No loud noises, nobody got hurt, Score! Score, and SCORE!

Fun And Games Off Duty · Pre Planning Your Scene

My Youngest Son Gets Dunked (or) Why I Will Never Be Constipated

We were living in An Un-Named Bedroom Suburb of Cohoville, and discovered Road End Parks. This capitalizes upon the fact that the county/township right of way extends into the lake bed, and therefore, an area roughly 25-50 feet wide continued along the roadway into the lake, and belonged to the township/county. When you have some property that wide, you can park a couple of vehicles at “the curb”, and fence off maybe 50-75 feet of the easement, and you have a nice little parklet, which the fudgies are unlikely to know about. If your idea of summer fun does not run to drunken aquatic revelry, well, you are all set.

I was working nights at Erewhon Community Hospital (“Both Nowhere, AND Backwards!”), years and years ago. The Plaintiff, in her pre-Plaintiff days, worked days. Therefore, summer days provided an opportunity for me to Be The Dad, and bundle our brood off to the lake for fun and sun.

If you have read my tales of rollicking good times, you know that I have plenty of experience with The Prophet Murphy, and his laws. Having worked the street,  I  feel well prepared for minor childhood misfortunes. Before setting out on our beach trip, I had carefully checked the contents of my personal medic bag, placed a lifeguard style whistle on a lanyard around my neck, set my truck’s amateur radio to readily access the local 911 center (this was in pre-cell-phone days), and waited the usual complete hour after lunch.

Arriving at the beach, we reviewed the McFee Family Immediate Action Drills, carried picnic gear and loads of whatnot to the beach, and so began our casual, layback day of fun and sun in beautiful Northern Michigan. The big kids played in the water, keeping well within earshot, and the little boys had big fun scooping sand and splashing away.

This worked out alright, at first, as the older kids waded some distance out into the lake, and the little boys stayed within ten feet of the beach. I settled there, toes in the sand, camouflaged with a book that I really had no intention of even looking at. I even began to relax. BIG mistake.

The local lake, in Michigan’s Northern Lower Peninsula, is not really deep in any meaningful sense of the word for quite some distance out from the shore. I had assumed that, keeping eagle eyed watch from the beach, nothing could develop that I couldn’t handle. Two year old David, Number Three Son, was having Big Fun with his brothers and sister, navigating just fine in the knee deep (to him) water. Next thing I knew, a wavelet from a distant boat lapped at his knees, and he fell, face first, into the water.

He immediately came back up, only to go back, face first, into the lake.

Police officers who have been in exchanges of gunfire report that time slows way down in life or death situations. Boy, have they got that business right! One second, I’m fat, dumb, and happy, soaking up sun at the beach, the next second my two-year-old son is floating inert, face down in the lake. The second immediately following found me with my feet wet, almost before I became aware of Number One Son, 11 year old Adam, at arms length from David, calling “Dave? Dave? Dave?!?”

Adam knew this was not right, but had not yet sufficiently organized himself to act upon this insight. I directed him to “PICK DAVE UP!” all the while reviewing these sort of videotapes running in my head. First Edition, I would pick David from Adam’s hands, race to my truck, call the Paramedics (“Paramedics? I want a Freaking Helicopter!”) on my Ham radio, while beginning resuscitation of my youngest son there on my truck’s front seat. Second Edition, I would snatch David from Adam’s hands, begin resuscitation right there on the beach, call EMS from my handheld radio (“Where are the goddam first responders?”), while directing Adam to collect the other children, and send eight year old Beverly to retrieve my medic bag from my truck LIKE RIGHT FREAKING NOW!

That day, Adam excelled in Listening To and Following Directions (Thank you, Adam!). The “light bulb” went on over his head: he picked his little brother out of the water, and handed him to me after a few steps. The “videos” went on playing in my head, as I weighed the efficiency of each action alternative, and quickly evaluated improvements to each generation of The Plan. I sat Dave down next to me, back on the beach, and began to ask him “Dave, are you alright? Dave? Dave?…”

Once Adam had picked him up, Dave began to look around with this sort of “Whoa! Way Cool!” look on his face. After I had asked him if he was alright for the hundredth (well, okay: maybe only the seventh) time, he looked at me as if I had lost my mind, and said those magic words: “Yeah, Dad. I okay.”

Tapes stop. Breathe again. Tremble. Call in other children. Closer look at Dave. Realize that I will, never in life, require therapy for constipation. Acknowledge the Attentions of a Merciful God. Request no lapses, again, in His attention like unto that just completed.