Triage Hell

Spent the last 12 hours in Triage. Definitely one of the worst days I've had out there. 

I clock in at 11a and we're holding 10 admitted patients because there are no beds upstairs, 3 transfer patients, rapidly transfusing blood on another, with several overdoses. We have a really high acuity going on (unusual that we have this many at one time).

We get word of an OD needs help out of a car.  We drag his strung out ass into a wheelchair with the help of security. As we take him to a room, security disappears.  The patient becomes combative and we end up calling a code gray (violent patient). Everyone shows up who is supposed to respond (security, maintenance, basically everyone available), and NOBODY helps. They stand outside the room listening to the patient ramble on about being raped by the person living in his head (I think that's called masturbation) and how he's travelling at the speed of light.  Homey is tripping on something.

As we deal with all this in the back, people continue to come in to the department, obviously we can't exactly close.  I end up with 23 people in the lobby with a 5 hour wait time just to get to a room.

One person waiting tries talking to me about how he doesn't understand how this hospital can handle an emergency when we can't even get patient's in the back to be seen.  This is the same fucker that eloped with his wife because they had been there 4 hours (she had an ulcer on her ass with an abscess starting to tunnel to another location, and it appeared necrotic) without an answer. 

I told him they had to wait because of the large number of traumas/overdoses/unresponsive patients. He didn't seem to happy but it shut him up.

After triaging a few other people, I marked 2 for the rapid medical side of the department.  One of the RNs working that unit called me to ask if we could bring them back.  Mind you, I'm still 20 deep and trying to get protocol orders completed and still triage the rest. She had 4 patients, one of whom was being admitted and the others nearing the end of their treatment.

I asked her to come out and grab the 2 extra patients.  She starts bitching about patient abandonment and how she is the ONLY one in that section (not true) and how she is leaving the provider without help (maybe true, but they don't need us to wipe their ass while working).  Instead of calling her out on her bullshit I decide to ignore her and hang up the phone.  A couple of minutes later she comes out and is still bitching about all the work she had to drop so she could get more patients for herself.  Again, instead of calling her out on her bullshit I ignore her (and so does the other triage nurse).

Basically she needs to get off her high horse and take one for the team. It's not like we have a lot of options.

The other triage nurse gets a call from home and her grandma is sick and she has to leave.  I'm then left alone for over 30 minutes trying to get everyone triaged (yes, still 20 deep, people still coming in).

I'm then told by the charge nurse to take a lunch break whenever because people are going to keep coming in.  I'm not the kind of guy to leave my coworker alone to triage 8 people in 30 minutes.  I opt to not take a lunch break unless someone comes to cover for me and help triage (never happened).

Towards the end of the night it FINALLY starts to slow down.  I'm finally in the single digits for people needing to be roomed/triaged.  Rooms are becoming more available. Someone checks in and reports leg pain. She is making such a big scene that her boyfriend goes up to the registration desk and asks for the patient to go back twice in 5 minutes.  I opt to triage another person in front of her (had been waiting for almost half an hour for the triage and palpitations come before leg pain anyway). She's making such a big stink about her pain that everyone in the waiting room was happy to see her go back to a room (turns out she was just drug seeking and she was escorted out by security. I'm SO shocked by this outcome).

Overall there were a lot of variables I couldn't control in the ED. I thank my coworkers for helping us all get through this without any real incidents.  Over the course of the 12 hours I had more people leave without being seen than I have in the 5 years I've worked in the department.  I don't blame them (other than they probably didn't need to be seen if they left).

At one point someone asked if I hated my job.  Honestly, even through all this shit today, I still like my job.