Patient Overload

Standard

“Beeeeppp…..Medic 8….” “F***!” George kept up a steady torrent of swearing as we drove out of the ER ambulance bay. I snapped the chart I’d been working on shut and started scribbling the information down. George was still swearing as he flicked on the lights and gave the siren a few quick shrieks to get us out of the parking lot and into traffic. I waited for a pause in profanity to key up, “Medic 8 is in service and in route from Cape Fear!” I let my voice rise at the end, embuing as much cheer as I could into the radio. The dispatchers voice came back deadpan as he gave us our times and a brief description of the scenario. “Pt states she smoked crack and is sad now.”
George jerked his hands up and slammed them on the steering wheel, rolling his eyes and then glaring at the radio. “You have GOT to be f*cking kidding me!” It was our sixth call of the evening, including two codes, and it was only a little past 2am. We maybe had one chart finished between us and 12 lead strips were scattered across the front of the cab with hastily scribbled medication lists and patient information on the backs. Neither of us had eaten more than a bag of chips and George was hurting for a cigarette. I shook my head. I could either get pissed about it, or let it roll. Some nights were just like this, and at least with the call volume we were rapidly hashing out our roles on the ambulance.

I pulled up a new chart on the laptop and started entering information. George drove a rather lazy emergency traffic to our supposed “6 D difficulty breathing” which was apparently a crack addict regretting her life choices. It gave me time to put a couple more notes in the chart of my last patient before we arrived on scene. We pulled up to a gas station where a lone cop car was parked around the side and the officer was talking to a woman who could’ve been anywhere from 20-60 years old sat hunched on the sidewalk. George parked us close and I hopped out. “Hey! I’m Sarah-what’s going on tonight?” I gave a quick smile to the officer but then attempted to make eye contact with the patient. “I don’t know, ma’am, I don’t know. I’m so messed up, you know, and it just hurts. It hurts so much-”
“Her name is M— K—— and we’ve picked her up before. She’s not violent, and she’s drunk and who knows what else. She called saying she couldn’t breathe because she was so sad-” The officer spoke quietly to my partner as I wrapped the blood pressure cuff around the woman’s arm.
“Now, they said you were having trouble breathing?”
“Yes ma’am, I’m just so sad. I used to be pretty like you, and now I’m a mess. And I swore I’d never do it again, I’m just a mess.”
Her hair was stringy and dirty, eyes bloodshot, and what teeth left were rotting. Crack clearly wasn’t the only drug she had used.
“Mind if I listen to your lungs real quick?”
“Do what you gotta do, ma’am. I’m such a mess.” And she started crying, digging the base of her hands into her eyes.
Her lungs were clear, her vitals completely stable. I went ahead and hooked her up and printed a strip just to be thorough. The only difficulty in breathing she was experiencing was from the snot running down her face.
“Would you like to go to the hospital with us?” I kept my voice calm and as sympathetic as possible, all the while fervently hoping she’d refuse.
“Do my lungs sound ok?” She sniffled, making eye contact for the first time since I sat down by her.
“Yes, ma’am, they’re clear as a bell.”
“Then I think I’ll just stay here. My buddy Roy will come pick me up.” Her eyes were shifting from the officer to the ambulance to me and then to the ground. “Do you mind if I ask you a few questions?-” I opened up the laptop and proceeded to gather all the pertinent information for the chart.
Ten minutes later, after reassuring us that she wasn’t suicidal, we left the patient in the disgruntled care of the police officer who would wait for the friend to come pick her up. I managed to finish the chart just as we cleared the scene. Reluctantly, George checked us back in service.
“No more stupid shit like that tonight. She just said she couldn’t breathe because she thought the cop was going to arrest her.” “Yup.” I nodded, rapidly typing away at one of previous charts.
We actually made it to the fire station we were assigned for only the second time that evening. George immediately got out to smoke and I triumphantly finished one more chart before reaching for my lunch box.
“So how long have you been a medic?” I asked George through the open window. He blew smoke away from the ambulance.
“Going on eight years and I worked as a basic for three years before that. Long enough to be tired of shitty calls like that one.”
“Mmm.”
“D’you graduate with the May class or June?” He asked me.
“May. Em was my FTO on days. I switched to nights last week. I like nights better.”
It was his turn to make a noncommmital filler noise. “Well. If there is anything you need to know or want to learn more about you can ask. I won’t pretend to know everything like some medics do, but I’ve got some experience.”
I laughed, “I’d say. There are medics with half your experience that believe they know twice as much.”
He grinned. “I’m not naming any names…”
The conversation flowed easily from there…for about five minutes when the tones went off again and cut it short.

We had three more calls that night, no more codes thank goodness, but there was an accident with two patients fully c-spined. Otherwise the charts were easy and we somehow managed to get the previous charts finished before fueling up at the end of shift. It had been a long night and I yawned as I threw my bag into the back of the car. A long night, but all things considered it had been a good one. I was rather glad it had been so busy. There had been no time to be nervous around George once I was elbow deep in patient BS and charting. I backed out of my parking spot and headed home, thinking of nothing but how nice it would feel to climb into bed.

“Bravo dear! Last night was perfection. I couldn’t’ve done it better myself.”
I slammed on the brakes and almost took out a light pole.
“You should pay better attention.” Mrs Murphy admonished, primly clutching her purse in her lap in the passenger seat of my car. Her bangles were different, I noticed distractedly. A few neon greens and pinks were sprinkled amongst the plastic animal prints.
I couldn’t think of anything to say.
She arched a thin eyebrow. “I thought you’d appreciate a little encouragement. You know, some appreciation for your work and all. The way you handled all those calls the first night with your new partner was excellent.” She sniffed, as if I were being rude.
I still couldn’t think of anything pertinent, so I eased back into traffic still mute.
“Well, you aren’t much company. I suppose I’ll talk to you later when you aren’t so out of it.” And with one last disdainful sniff she dissappeared with a pop.
I had just managed to stop shaking by the time I pulled into the driveway. It was a good thing I didn’t work this coming night, I didn’t think I could sleep.

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