DRAMA, life on the floor

Most weeks we have a few situations that are straight from the 10 o'clock news. This week, I could have watched most of my patients on TV. The recap:

My saddest case this week was a teenager riding in the car with his girlfriend. They got T-boned by a pickup on the drivers side. She was dead on the scene. This kid rolls up to the floor and the first thing he asks me is "have you heard what happened to my girlfriend? If you find out anything, please tell me". He didn't know. And his parent's asked me not to tell him. They wanted to do it the 'right way'. As much as I feel for them, after a few years in the trauma world you realize that the right way to tell someone that their loved one has died doesn't exist. However, the wrong way does. I was waiting for the trauma team to go in the room and for someone to offer their condolences, not realizing that this kid was still in the dark. This was such an ethical dilemma for me...on one hand, this patient is legally an adult. My obligation is to him, not his family. But who am I to decide what's right in such a complicated situation...not an easy day. For the record, the family sat down the next day and told him together before anyone accidentally let it slip.

So after all this drama, I'm feeling a little emotionally fragile. Which is why I had such clear feelings about our next trauma floor "issue". We had a prisoner patient who had been shot by the police after he open fired on 2 officers, wounding them both. He had a police guard at bedside, as is typical for anyone under arrest. After being shot a bunch of times, and only saved by his shiny gold grill that deflected the kill shot to his head, he was in pretty bad shape. Someone decided that it was a waste of time to sit by the bedside of someone trached and bedbound, so his officer was removed and we were told that someone would call daily to check on his condition. Several days later, the trach comes out, the patient stands at bedside, and we have heard nothing from the police. So we all sat around the lunch table, discussing if we should make a courtesy call to the police so they could come back. Personally, I was all for it. I don't think that people should get to shoot others and still have their annoying girlfriends sit at the bedside and feed them strawberries. So we came to an agreement: the nurse would call. And she did. A half hour later, SIX officers are on the floor. Apparently there had been a tip from a "reliable source" that someone planned on smuggling a weapon to the patient. They searched his room, placed him back in custody, and moved him. The next day, an officer came back to the floor with a fruit plate, a big tray of cookies, and a bunch of flowers for the nurse who called. Can I just say, I never realized that being a nurse carried the risk of getting shot at work? Apparently some people have no respect for the healthcare system.

So last night, after I dealt with the emotional toll of a grieving family and the anxiety of wondering if this prisoner's family was going to come back to the floor and shoot the place up, I was pretty much ready for an easy night. Not so much. I got a motorcycle accident as an admit from the ER. The guy was stable, considering that he hadn't been wearing a helmet. His wife, who was super nice, was at bedside with him. Turns out that this guy is in some sort of a motorcycle gang, complete with embroidered vest. I got report from the ER saying that his 40 motorcycle friends were down there, and everyone says that they're blood relatives, so I could expect a full house. Frankly, I wasn't looking forward to it, so was pretty relieved when the door opened and only one woman walked in. She sat herself down in the corner, and proceeded to ask the wife who she was. That was pretty awkward, so I was really surprised when, an hour later after my lunch, this woman was STILL sitting there. The wife pulled me outside and shared her concerns about this strange lady. I planned on asking her to step out for my assessment, but the wife beat me to it. I was standing outside the room doing my paperwork when the two women came out into the hallway. The wife very politely told this other woman that she wasn't comfortable with her being there, as she didn't know who she was. To which the other woman replies "I'm his baby momma". The wife clearly didn't know anything about this, and asked the lady how old her child was. "I'm pregnant" comes out of her mouth next. "With his twins". At this point, I'm realizing that I'm stuck between the wall and these women, and that I'm probably going to get hit by a person when one of these women starts swinging. I'm also calculating how long security will take to come up to the floor and how much damage these two are going to do before somebody rips them apart. But the baby momma just turned and walked away, and the wife stood there in the hall and burst into tears. So needless to say, it was a LONG night.

Yay for some time off. I'm going to need it to seek some mental help after this traumatic week.