Wednesday, December 19, 2007

LA living...

It rained all day in Los Angeles today. That doesn't happen often. The ER was pretty slow, people don't like to come in when the weather is crummy (although I like it!), so only REAL patients came in.

A patient came in who had been visiting someone at the hospital. He dropped his car off at the valet (yes, a hospital with a valet) and decided to grab something out of the back seat. The valet driver was unaware of this and started to pull away, thereby running over the (now) patient's foot. Luckily it wasn't broken and the horrified valet driver came in to check on the patient. "Where'd you learn to drive? Britney Spears?" I asked him when we knew the patient was okay. Luckily, he thought that was funny, too.

A gentlemen in his 60's was brought in complaining of elbow and hip pain after a traffic accident. It seems this guy was on his motorcycle (imagine white haired, overweight dude finally living the dream of his youth) and had pulled into a parking lot. He came to a stop behind another car that had stopped as well. He looked behind him and saw an SUV pulling in behind him. He realized that the driver of the SUV was on her cell phone and was not looking his way. He panicked and tried to pull away but she hit him anyway and he "spilled" his bike and landed hard on the pavement. We discovered he had broken his elbow AND his pelvis! Ouch! The woman that hit him? Three words: Hit and Run. She took off without even bothering to see if he was okay. He was so shaken he didn't even have time to get her license plate. Puh-lease, people! If you drive an SUV, I'm sure you have insurance! Where is your regard for other humans??

Another young man came in after being in a four car pile up on the 405 freeway at rush hour. (Rush "hour" is from 4 to 7pm.) He told us that he had been in the fast lane going about 20mph (hee hee!) when the accident happened. No one was seriously hurt so all the drivers did the responsible thing and pulled off the freeway (instead of snarling up traffic while waiting for the cops to show up). They exchanged numbers and info and went their separate ways. For our patient, this meant calling a tow truck since his car was barely drivable. His friend drove him to a nearby police station so he could file a report. The police told him they would not take a report since he "could be filing a false report to scam his insurance company". Okay, okay, I'm sure many people have done this before (!). By now he is feeling the consequences of the impact and comes to us to inventory his bodily damage. We hear his story and immediately get on the phone to file a report to the police. Now, obviously, in LA, there are many different jurisdictions. The first number I call is to the West LAPD. They tell me that because he was on the actual freeway and not on an exit it is not their jurisdiction. They tell me to call the CHP (CHiPs, as in Ponch and John), otherwise known as the California Highway Patrol. I call the number and get a recording saying that if I have an emergency I should call 911, otherwise, have a nice day. The phone disconnects. What? So I call West LAPD again and tell the front desk officer what happened. He tells me, "The CHP hold banker's hours. They're closed by now". What? This officer was nice enough though and promised to call me back with another number. Fifteen minutes later he calls and gives me a new number. I dial it and it rings.. and rings.. and rings. No answer, no recording, nothing. What? I call back and someone finally answers. She sounds stressed and pissed. I explain the situation and she lets out a big sigh and asks, "They didn't call the police when it happened?". I tell her why they didn't and she takes my number and says she will call me back. She never called back. Luckily, this guy was not seriously hurt. A little whip lash of course. We discharged him with the number I had been given by West LAPD. I hope he was finally able to file a report. Having trouble getting a hold of the police is nothing new here. I've had several people tell me that when they dialed 911 they got a busy signal!

A young man came in after falling while walking dogs. (His profession!). His middle and ring fingers of his right hand were severely deformed. His fingers were dislocated. Imagine your fingers, in their normal position, and then twist the middle knuckles to exactly the opposite of where they should be. It's hard for me to explain without a picture. Look at your fingers on your right hand now and try to imagine the middle and ring fingers pointing 45 degrees to the right. Grossly out of place. Amazingly, this man was in good spirits, although complaining of pain. He received morphine intramuscularly and the physician's assistant did a nerve block before she "reduced" the dislocation. The funny thing is that he and his companion smelt overpoweringly of really good marijuana. Probably the reason why he was not freaked out. A good bong hit can make any major body deformity seem not so bad. I remarked to the physician that we should ask him where he got his supply because it was "the dank".

A young woman came in complaining of severe chest and back pain for the last two months. She had been seen by a GI (gastroenterologist) who prescribed her medications for gastric reflux with no relief. This girl was sick, you could just tell. (Before I had met her I happened to be walking behind her in the hallway and thought she was an old woman, the way she was hunched over.) Once she was in our exam room I hurried in to start an IV after the doc had seen her. Her husband was at the bedside, very nice people. She was in obvious distress. I started a 20 gauge in her arm and drew blood samples. I started an IV drip and gave her anti nausea meds and morphine. She was finally able to relax enough to lean back on the gurney. I was gathering up all my garbage and was headed out the door with her blood samples when my foot shot forward and I almost fell. I looked down and realized I had just skidded through a big pile of vomit! I have slipped in urine, blood, and shit so this only completed my nursing resume. Always the professional, I quickly recovered and, after disinfecting my nurse shoes and calling a janitor, I sent her blood specimens to the lab. Meanwhile, I'm laughing because it is pretty funny. After several more tests we finally discovered she was passing gall stones. Very painful! At this point, she was comfortable and ready to be sent home. As I was taking out her IV, I told her what had happened. She was embarrassed until I told her, what was only the truth, "Don't feel bad. It was the biggest laugh of my day!".

I love my job the most when people who are truly in need of medical help come in to the ER. I'm frustrated by bullshit complaints. It's hard to take someone seriously when they ask for a handicap sign (to hang in your car to be eligible to park in a handicap spot) for a broken toe. I sometimes wonder if some people have never been injured before. I try not to be hard hearted. I know a lot of emergency room workers have a reputation for being callous. But, I'm sorry, a broken pinky toe, while painful, should not warrant the request of a handicap placard. But, some people think it is necessary, or owed to them.
It's probably not just LA, but I know we have a special group of people here that expect (demand) a certain type of service. For me, the more you expect special treatment, the less likely you are going to get it (unless you are TRULY sick or hurt).

Rainy day in LA. Valet parking, hit and runs, 911 busy signals...everything you have heard about LA and more...


DBN said...

I love reading your blog! A little over a year ago I developed idiopathic anaphylaxsis (fun times) and had never really been to an ER before. Oh my. Oh my oh my. Its hard to be sympathetic to someone's cold when your throat is closing up!
Glad you had a slow day yesterday!

Mrs. G. said...

What a great post. You are so right. I find myself bristling at people who just EXPECT that they are entitled to, well, everything.

Also, I don't know if it's just me, but I had a lot of difficulty reading this because the type is so light. I had to put my face close and squint. Now I'm old but not THAT old.

I wanted to let you know that I'm throwing you on my blogroll. I'm sorry it took me so long. Love your blog.

LA RN said...

Thank you mrs.g! I, myself, had wondered why my blog seemed too soft, too whispery. A simple font color change was in order!

Thanks for the blogroll add! I am truly honored coming from someone like you!