Sunday, September 28, 2008

Charlie Tuna says no...

Had a disgustingly busy weekend in the ER this week.  And so many of the people really needed attention, unlike a lot of our "Santa Monica wounded" who could wait a day or two to see their doctors.  We had our share of abscesses, broken bones, lacerations, and abdominal pains.

The worst thing I had to witness this weekend was horrible parenting skills.  I know, I know, I am not a parent and shouldn't tell people how it should be done.  But, I saw some horrible behaviors from children and their parents and I saw some incredible kids with their equally incredible moms and dads.  Whenever I see children panicking and scared, I always try to imagine what it would be like for me to bring in my nieces with a deformed arm or a gash on their lips.  I would be super protective (what I call the mama-bear or papa-bear syndrome), so I allow people to be upset and cry if they need to.  I even allow people to be rude and aggressive, to a point, because they are just trying to protect the little people that they love so fiercely.  But, there is a point where I draw the line...

A 4 1/2 year old was brought in by his dad and grandmother.  He ran into a coffee table and had a gash on his forehead.  It definitely needed stitches if it was going to heal properly.  Sometimes we can use tissue glue but only for superficial cuts and the outcome is not as "aesthetically pleasing" as stitches.  And when it is on your face, well, most parents reluctantly agree to the stitches.  Yes, kids are scared.  Yes, they cry and try to bargain their way out of it.  And yes, we put them in a papoose, hold their head still, and try to console and distract them while the doctor pokes their "owie" with a needle.  It totally sucks for the kid and us.  We hate it but as adults our brains can process the fact that sometimes it hurts more to make us better in the end.  Kids can't think this way.  They are terrified.    

Anyway, the dad of this poor kid prefaces this encounter by telling us that his wife is a psychotherapist and grandma is a behavioral therapist and they want this to go as smoothly as possible so that their kid "doesn't hate hospitals as an adult".  What a way to set yourself up for failure.  It seems that the thing parents fear the most for the kid seems to happen.  Little Johnny (that's what I will call him) was obviously used to running the show.  The dad had requested that the wound be closed by a plastic surgeon.  One was actually already on his way because this little old lady across the hallway had partially amputated her finger.  (More on this story later.)  When the plastic surgeon showed up, he decided to sew the kid first and get it out of the way, so that he could spend more time re-attaching the finger.  He also had the OR waiting on another partially amputated finger in the ER.  I go in to assist and Little Johnny is throwing a huge temper tantrum.  Again, nothing I haven't seen before.  But what I didn't count on was the dad and grandma allowing him to kick and scream and threaten to bite us.  The plastic surgeon finally told the dad that he refused to sew up Little Johnny.  This was a first for me.  (The plastic surgeon told me later that he could not, in good conscience, waste any time (while dad and grandma tried to placate and bribe) on a non-emergency while he knew two fingers could be lost).  The dad and grandma decided to start blaming me and the rest of the ER staff for causing Little Johnny's behavior because we "made him wait so long".  Awesome.  Now it's our fault for him being out of control.  The ER doctor finally made the decision to sew him up herself on two conditons:  grandma left the room and dad allowed us to hold Little Johnny still.  About 10 minutes later, using three staff members to subdue Little Johnny while ER MD sewed, we finished the job.  Little Johnny, with five stitches in his head, bragged to us how brave he was and high-fived all of us that he had kicked and threatened to bite.

Little old lady across the hall, meanwhile, finally had her finger reattached successfully!  Yeah!

About an hour later, a two year old came in who had fallen and had a deep laceration inside her lip.  You know the piece of skin attaching your upper gums to your upper lip?  Yeah, needed stitches.  She sat quietly, while her parents sang to her, and the ER MD held her lip up and put in four stitches.  Wow!  I don't know many adults who would do that.

Later on, a 3 1/2 year old presented with a cut on his eyebrow.  His name was Charles and his mom told us we could call him Charlie Tuna.  We needed to stitch him but Charlie Tuna wasn't having it.  He fought, he kicked, he screamed.  That's okay.  We put him in a papoose and started our work.  He called us "jerks" and "fat assess".  His parents giggled nervously and told us they let him watch Family Guy.  "I thought it was just a cartoon!", mom explains.  Charlie Tuna continued to launch his verbal abuse throughout the procedure.  Again, totally okay with me.  The little guy is scared.  But just as the doc is about to finish, Charlie Tuna starts yelling "No more!  No more!" and mom says to us: "The doctor needs to stop now because Charlie Tuna says no".  I almost blew snot out of my nose trying to hold in my laughter.  Not to sound harsh but I don't give a f*ck what Charlie Tuna does or doesn't want to do.  He's three!!!  Keep in mind that these are the same parents that seem shocked when we tell them that, yes, there will be a scar.  That's what happens when flesh is torn apart.  It's never quite the same.  

I hope I didn't sound too cynical.  I get that way on my hard days...   


Leah Perlingieri said...

i am simutaneously crying and laughing. i know it all too well. dealing with scared and hurt children is incredibly difficult and also where the relationship of the parent and child really comes to the surface. i think kids need a strong, calm and lovingly authoratative parent in that position. i can appreciate fear, and offer compasison and empathy, but for my children i won't tolerate rudeness or violence on those that are there to assist. my fear is us raising a nation of entitled softies...which is too bad b/c americans used to be pretty badass.

(and why do so many psychotherapists have such effed up families? *dodging tomatoes*)

sounds like a very, very trying are our #1 nurse!! yay nurse rosen!!!!

LA RN said...

I love the term "entitled softies". Noah and I call that the "I'm a good person!" syndrome... (i.e. Why did I get cut from American Idol? I'm a good person!) As if no one else around them is also "good" and deserving.

And I've noticed, (dodging tomatoes) that psychotherapists and others in related fields are often messed up themselves. I suppose it is why they got into the field to begin with.