Meltdown

When someone starts shouting in the Emergency Department, it’s never the happy shout of someone who’s, let’s say, just won the lottery or been happily reunited with a long lost relation. No, unfortunately, it’s usually a sign that a psych patient is about to launch himself into orbit. Or a patient has coded. Without thinking twice you run to the source of the noise, because one of your colleagues might be doing chest compressions and defibrillating while being pinned to the wall by the angry patient in the next bed whaling on a ventilator. You never know.

So I’m doing up the staff assignments yesterday — a charge nurse task, I am learning, requiring the skill, tact and cunning of  a wedding planner arranging the seating at the rehearsal dinner — when suddenly I hear a lot of yelling coming from the Resus Room. Naturally, I drop my pencil and race in, brandishing my lame-ankle cane. Get out of my way! Nurse in trouble!

It’s Beth, standing beside the patient in Bed 2. You’ve met her before. She’s tightly-wound at the best of times and she’s the one who’s all shouty. To no one in particular. “I’m so sick and tired of coming to do something,” she screams, “and nothing is ever set up properly, no one ever does this and never does that, and I’m the only one who actually makes sure everything is done and every else who works here is lazy and incompetent. . .”

“What?”

She turns and glares at me accusingly.

“Don’t you ever check to make sure equipment is where it should be?”

Beth, it seems, is having a wee moment. A postal moment.

I’m gob-smacked. Speechless, for once. Even the patient is staring in astonishment.

The trigger? The two Resus Room nurses were doing something or other with the patient in Bed 5, Beth wandered by and decided that Bed 2 had some upper airway secretions and needed a little suctioning. But the Yankauer suction handle was missing from the suction set up. Yes, before you ask, the Resus Room nurses are responsible for ensuring everything is in its place. But, one the other hand, it’s hardly a crisis: the patient’s airway is obviously not obstructed, I can plainly see another Yankauer on the suction set-up in the next bed, unused, and the supply cart is literally ten feet away from the patient.

Overreaction? You think?

Clearly there are other issues. But at the same time, it’s a nasty, busy day, Dr. Eagerpants is being a knob and pissing off both nurses in the Treatment rooms, two morphine 10 mg amps have gone AWOL, which will force me to do a lengthy search through old charts, and to whine just a little, my ankle hurts. I don’t have time to delve into the Tao of Beth. The best I can do is to is find a nurse to take Beth’s patients and send her off to break. My good friend Dianne peeks around Bed 5’s curtain, her rhinestone-edged reading glasses glinting. What the fuck?, she mouths. I shrug. Don’t know, and right now, don’t care.

Later, on my way home, I think about this a little. Beth is my age — somewhere between forty and death — married, a couple of kids, house in the ‘burbs, middle-class respectable  and so on. I don’t know her well: she’s a bit too driven, a little too unhappy, I think, to be really likeable. She married fairly young, and I gather the wedding was driven by hormones as much as anything else. Twenty years on, she’s driving a minivan with a DVD player in the back seat for the kids, hockey bags in the back, and the guy she married, who was so hot and so cool at the same time  — and the momentum of sex can drive a marriage for a long time — is suddenly looking like every other guy in her subdivision, who’s turned forty and flabby and dull, and also leaves skid marks. She’s stays, yes , for the kids, but also, because she can’t imagine what else she might do.

I think about what Beth said: “No one ever does this and never does that, and I’m the only one who actually makes sure everything is done.” I’m suddenly certain she’s said this to her husband. Repeatedly. I think of this, and I think of the elderly ladies who sometimes attend the demise of their husbands, and when their husbands finally die, their expression, after fifty or sixty years of marriage, is not one of grief, but of relief.

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  1. #1 by Jenn Jilks on Wednesday 21 April 2010 - 0849

    You are very wise, E.R.N. Yes, we often have displaced anger. Issues at home displaced to work, and vice versa. Nurses, too, are human, a good lesson you’ve learned.

    This happened to me when I was going through an expensive divorce. My temper was short with my young students, complicated by many issues. I went through EAP, found a counsellor. I took a couple of weeks off, spent the time in my garden and felt better.

    Staff assignments, yes. How to please everyone and piss off no one! I have the utmost respect for you. Take care of that ankle!

  2. #2 by wilomis on Wednesday 21 April 2010 - 2137

    Forty and death… haha… well defined

  3. #3 by Maha on Wednesday 21 April 2010 - 2303

    Feeling stuck is a horrible feeling. I still feel like that sometimes but I pretty much let my feelings gather into a ball of rage/melancholy in the pit of my stomach. I can empathize with Beth but I know I would have a very hard time working with someone like her. Outbursts by both patients and staff can send my blood pressure sky rocketing and make my heart beat in my neck. Not a good feeling.

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