In the Resus Room the other night, working my second-to-last night shift. EMS brings us a 24 year-old female — I’m going to call her Lovely Girl — who’s had a few beers, five or six shooters, and then progressed to vodka shots and maybe some extra-legal intoxicants as well.
It’s been quite the night for Lovely Girl: she’s well lit. She’s been kicking in plate-glass windows, has a few nasty lacs on her ankles; a fist fight happened somewhere along the way, her face is contused, so she’ll need a CT at some point to rule out cerebral bleeding.
Almost needless to say, Lovely Girl is in police custody, for public mischief and assault.
Lovely Girl is a piece of work.
She reeks of vomit and beer.
She’s cursing, spitting like a Bactrian camel, scratching, biting and flailing around on the ambulance gurney so hard she’s in danger of capsizing. We need to restrain her — and contrary to popular belief, we don’t restrain people willingly.
So we put her in four-point restraints, tying her down to the emerg stretcher. The police help to hold her down.
“I have to piss,” she wails.
Fine, we tell her. We can’t get you up (or even get a bed pan under you) till you start to cooperate, because you’re a danger to us and yourself. Spitting in our faces is a fairly clear indication that you’re not ready to help us help you.
Do you want a foley? someone asks. (This is really inept. You don’t play the foley catheter card until you’re out of options.) And Lovely Girl’s evidently been down this road before. She doesn’t react well to this suggestion.
“No fuckin’ catheter!”
Without any further discussion or debate she urinates in the bed. Not a dribble, mind you, but a veritable of lake of straw-coloured urine, so voluminous it overflows the stretcher and drains to the floor. We stare amazed. What does she have, a basketball for a bladder?
It’s unfortunate, but we can’t leave Lovely Girl in her own urine. Theoretically and officially, this is a patient-comfort measure. A patient left laying in their own urine will suffer skin irritation and breakdown. Practically speaking, Lovely Girl is going to stink (worse) in very short order.
I sigh. I tell Lovely Girl we need to get her undressed. I tell her we’re going to be taking off her restraints, one at a time. I state as factually as possible that one false move will result in the restraints being replaced faster than you can say Jack Daniels. I tell her that if she so much as twitches she can marinate in her own urine till she’s sober enough to leave.
She grunts understanding.
We banish the police to behind the curtain. One restraint off, then the other arm — Lovely Girl is oddly and suddenly docile and calm. We sit her up. We pull at her clothes, get her piss-soaked t-shirt off. I start to unhook her bra —
Lovely Girl plows me in the left lower jaw, and knocks me off my feet. I go sailing backwards into the Resus Room ventilator, and end up in a heap on the floor, stunned.
I actually see stars. Like a cartoon character.
All hell breaks loose. I really don’t remember a lot of it. Someone calls a Code White*. Suddenly a million people are in the Resus Room. I’m helped into a stretcher and taken to the Observation Room for assessment.
The police come in after I’m examined. They take a statement, promise Lovely Girl will be charged with assault. Later, they cart her off in her skanky, filthy clothes.
Call me jaded, but I don’t really believe them. To my knowledge, people who assault nurses are never actually charged, much less prosecuted. To much hassle and paperwork, I guess. And we’re just nurses, after all. All part of the job. But I’ll let you know if I can justify my cynicism.