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#emergency department
mdrambles · 1 year
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you are waiting
and i see you
and i recognize that you are suffering--
whether it is worry,
hopelessness,
or pain,
i see you
and i am sorry
because right now you are suffering,
but my first priority must be to save
and if you are not dying right now
i am needed elsewhere.
perhaps the biggest misconception of medicine
i had when i began
was that my career in aiming to heal others
would mean that i would always be driven to lessen suffering
(even in some small way)--
now i realize
that because this system cares not
for what truly constitutes
suffering
my hands will always be tied
to those who are most immediately threatened
and not those whose suffering is the greatest.
i see you
and i am sorry
that i am only one person
(because, yes, underneath this yellow gown
and this mask
and this title of ‘doctor’
i am only a person--
a small,
frightfully human
person.)
i see you
and i hear you--
you call us callous and heartless and, sometimes, evil
and you say we cannot do our jobs;
and sometimes,
because i am only a person,
i believe you.
(thoughts from the front lines, 2023)
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defleftist · 9 months
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Last week I had to go to the ER due to an unfortunate run in with a bat and worries about potential exposure to rabies. This trip to the ER was a fascinating anthropological study of human behavior while under stress. Maybe the most noteworthy thing I noticed was a man sat near me in the waiting room who brought with him a book called Classical Christianity. He read the book briefly before casting it aside to watch videos on his phone. After an hour or so of waiting (it was a very busy night in the ER we all had to wait a long time) he jumped up, book in tow, and went up to the front desk where he proceeded to yell and flip off the front desk worker before storming out of the ER in a huff. Just saying, that didn’t seem like very classical Christian behavior my dude. But hey, I’m just a godless heathen who would never dare to treat overworked and underpaid healthcare workers like that.
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boulderingbarista · 8 months
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Cannot stress enough that people will absolutely die because of this. Especially if they have already waited several hours for an ambulance too.
The system is falling apart, and it's easy to ignore until you need it.
So you had better make sure you don't need it...
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faofinn · 11 months
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Day 7 - First Night in Hospital
@mediwhumpmay
Part 1 | Part 2 | Part 3 - A continuation of a prompt from Whumptober, which in itself is a continuation of a Sicktember prompt 😅
“Stay put for a minute, I need to organise a space for him. One minute, alright?”
"Just getting everything organised." He reassured. "Thank you for taking us seriously."
“I’m sorry it’s taken this long for someone to take you seriously. We’ll get this sorted now.”
"Thank you."       
Harrison turned to his husband, stroking through his son’s hair.  "I knew he wasn't well, Tai."
Tai sighed. “He’s being looked after now.”
"What if they left it too long?" He whispered over Kieran's head.
“They’ll get it sorted.”
"Yeah."
Kieran gave a quiet whine, his hands over his stomach again. He curled into his dad, trying to seek some relief. 
"You gonna be sick again, Kit?"
He nodded, his eyes wide. “My tummy hurts.”
Harrison's heart broke further, and from the look he exchanged with Tai, he wasn't alone. His husband shoved the empty bowl at them, pressing the call bell for some more. 
One of the nurses appeared a short while later. “Sorry it took so long, can I help you- oh. You poor thing. I’ll go and grab you some more bowls, two seconds.”
"Thanks." Harrison was beyond stressed, rubbing Kieran's back and muttering soft encouragement between bouts. "You're alright, Kit. It's better out than in, right?"
The nurse appeared moments later with more bowls and tissue. “Here, and let me get rid of some of these used ones, yeah?”
Kieran roughly wiped his mouth, though immediately vomited again. He made a small noise, a brief frown appearing on his face before everything happened at once. The bowl fell from his hands, tipping into his lap and he seemed to just crumple. Harrison was immediate to support him, but the worry and fear was so clear in his tone. 
"Kieran? Kit? Kit, open your eyes, please, Kit."
Tai’s stomach dropped, the fear rising. He darted for the curtains, looking around for someone to help just add the nurse reappeared. 
“I’m going to get a doctor, alright? Hold on for me.” She told them, pressing the alarm. 
Harrison kept Kieran on his side, though he was still curled into him. Kieran was still stubbornly unconscious, everything becoming so much worse as he started vomiting again. 
"Shit." Harrison whispered under his breath, shifting Kieran further over. He wiped his sons mouth, trying to clear as much as he could. This wasn't supposed to happen. Not to their family. 
When the doctor appeared, his decision was easy. “We’re going to resus now, alright?”
Harrison glanced up. "On the bed?"
“Yeah. Let’s go.”
Steve had heard the alarm, had seen it was his grandkid's room, and rushed over, meeting them as they were wheeling Kieran out. Harrison was balanced on the bed, supporting a very clearly unconscious Kieran, the pair covered in vomit. Tai was white, far clear in his face, and even the doctor's face was guarded. 
"What happened?"
Tai gravitated towards Steve, relieved to see someone else. “I don’t know. He was sick, and then sick again, and then he just went.”
"Kids can do that." He tried to convince, wrapping an arm around Tai. "It should be just a faint, just a response to all the vomiting."
“And Hars just… is Hars. He knows what he’s doing.” He mumbled, leaning against him. 
"They're looking after him. He's gonna be okay."
“Finally.” He hated this. Hated thinking about the what ifs. Hated thinking his son was stuck with the same, miserable disease he was stuck with. 
Steve pulled him in for a hug, holding him tight. "He's got all of us in his corner."
“He has. I’m just worried about him.”
As they pushed the bed into the bay, Kieran began crying, deep, whimpering sobs. Harrison's heart broke again, wrapping himself around his son, brushing through his hair.
"You're okay, it’s okay. You’re safe, dad's here, you’re okay."
Tai moved closer to his husband and his son. “We’ve got you, it’s going to be okay.”
"Daddy?" He asked quietly, whimpers breaking through. "I don't feel very well."
“I know, Kit. It’s okay, the doctors are looking after you. You’re going to be okay.”
"I want Alfie."
“He’ll come and see you later.” Tai said gently. “He’s looking after Levi now.”
"Oh. What about me?"
“We’re looking after you now.”
"But I want Alfie too."
“You can see him soon.”
Harrison hummed, his hand still in Kieran's hair. "Kit? Why don't we swap your pjs for some hospital ones? Get you nice and clean again, yeah? And they're gonna want to stick some stickers on you too."
“You’ll feel much better in clean clothes.” Tai told him gently. “Dad and I will help you, yeah?”
Kieran didn't have the energy to argue, letting them help. It didn’t stop the embarrassment though, his cheeks flushing red as he saw the mess he'd made. The panic had started to overwhelm him again, worried he'd be more than a little told off for the mess. Of course, nobody cared about it. It had been an accident and everyone knew that; it wasn't as if Kieran had asked to be that poorly. After plenty of reassurance, he was settled on the clean bed once more, leads and wires attached everywhere. 
At some point, Tai had taken a photo, dropping it in the group chat to keep everyone updated. As sick as he was, he was settled. There were a few more tears as he was cannulated, the plan to sedate and insert more stable caths when he was ready. He was started on fluids, his blood pressure so low even for a kid. Insulin eventually too, a desperate attempt to start shifting things in the right direction - he'd worsened dramatically even since they'd first been seen. 
While it was the middle of the night and he was bound to be tired, he'd only become more drowsy and irritable, and unfortunately for him, hadn't managed to entirely stop being sick.
With the help of a little sedation, they ended up getting more access, and passed an NG. He needed cranial imaging, and it was easier to manage when he was clinically as stable as he could be. And, with as much access as possible, just in case anything went south. 
It seemed to be an age, but the scans came back clear and he was on his way to the PICU. Steve followed them, and while Kieran wasn't 100% with it, he felt better for having his grandad there too.
Kieran somewhat changed his mind once they'd transferred him, calling out for Tai. In the end, he hopped up on the bed with him, hiding his fear of all the needles and wires and machines and - everything. He wasn’t there for him, Kieran needed him. With a happy noise, Kieran snuggled closer, his head on his dad's chest, his favourite place to be, listening to the beats of his heart. He was quiet for a long while, and Tai was almost certain he'd fallen asleep amidst the low hum of Harrison and Steve’s conversation. 
"Dad?"
"Mm? You alright, Kit?"
He gave a long sigh, still apparently feeling the sedation too. "Are we the same now?"
"What do you mean?"
"Because you have to take your…your antisugars."
He smiled. "My insulin, yeah. That's what's in that bag there, too. I think it's nearly 100% that we will match, though, so I'll be able to help with every single thing you need, and you can ask me anything at all."
"Promise?"
"Of course, Kit." He sighed past the lump in his throat. "You know how Daddy is a super doctor too?"
He nodded, looking up at Tai. 
"Well, when I got diagnosed with 'di-ah-bee-teas'," he sounded it out properly for Kieran. "Daddy made sure to teach me everything. Sometimes he would even do my checks for me because I was a bit of a scaredy cat! But if you need me to help, or even daddy to help too, all you're gonna have to do is ask. I'm sure even grandad Steve would do it for you, too, if you asked nicely."
Kieran managed a laugh, snuggling closer. Tai's murmuring reverberated through his chest, and the circles he was drawing on his son’s back didn’t help keep the tiredness away. It didn’t take long for him to slip into sleep, content on Tai, and protected by his entire family. 
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a-moment-captured · 3 months
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People, if you are sick, stay the fuck home!
Stop spreading your flu and covid germs everywhere!
Not only do I have covid but my sister and brother in law do as well.
Now they are at the emergency department with my 6 month old niece who has a 103.4 fever, pulse ox was 88, and she was basically panting like a dog.
I can’t even go in because I’m sick! I hate this! I’ve seen so many babies and children come in on the weekends I work that have the flu, RSV, or covid. @heavyhitterheaux can tell you, it’s awful lately!
I see so many “adults” send their kids to school sick because they don’t want to deal with them (their words on Facebook because you know they think teachers are babysitters).
If you are sick, keep your ass at home!
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macgyvermedical · 2 years
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Hi. I promise I'm not trying to be antagonistic so I apologize if anything in this ask comes off ass aggressive, I really don't intend intend to be.
In 2022, how should one expect to be treated if one goes into the ER feeling suicidal?
Chronic pain nonsense has had me longing for death more days than not. It got to a really bad point where I was strongly considering plans every single day...and the hospital completely blew me off.
Uhm, is this... typical? Should I expect that ER services are no longer able to handle situations where folks are considering suicide?
To be overly frank, I'm not opposed to the idea of suicide but I don't want to hurt others. I went for the sake of concern for those who love me. I'm not afraid to die if there were no consequences of it. Are there still resources for those experiencing feelings like mine, or should I seek anything else?
I don't have any sort of health insurance and I've been denied medicaid despite supposedly qualifying for it. I'm at my wits end and struggling to find what the hell I can even do anymore.
I'm sorry this happened to you, anon.
The ED works on a screening tool- if you score high enough, you should be able to get some level of care, even if it is just speaking with a psychiatrist (in a larger medical center, at least, in a smaller one it's probably going to be whatever doc is there). Typically self harm or suicidal ideation without defined plan or means will not be enough to "count" as needing emergency care (and tbh, if you got sent to the hospital every time you had suicidal ideation, you'd never be able to tell a counselor or work on those things). Just saying "I'm thinking about suicide" will most likely get a "yeah you and everyone else here buddy".
If you know you really need care and can't get it elsewhere- and as a med pro I hate to say this- exaggerate just slightly. Some things that will boost your score include reporting a defined plan with a timeline in the very near future and reporting access to your chosen means of harm. Make the triage nurse feel like you might die right in front of them, because to be perfectly honest, they're completely desensitized to everything else (and honestly probably a little bit desensitized to that too).
The nice thing is, if you do get admitted, the hospital wants to be able to recoup some of the cost and will do everything they can to help to get you on medicaid. This is also not a particularly crazy amount of help because let's face it, the social work department is understaffed too, but hopefully having that leg up with work in your favor.
If you then have medicaid, you'll generally have more options for mental health care. I would recommend starting by getting a primary care doctor instead of trying for a psychiatrist off the bat. It might take a while for a new-patient appointment, but primary care (especially those with a residency- look for offices with a strangely large number of providers or ask if the office is a residency/training clinic) can handle a lot of psych problems internally and can refer you to an outside psychiatrist if they can't help you adequately. Some family med and internal med offices even have their own social workers, psychiatrists and/or psychologists who can help on the spot.
If you do get a bill and don't make more than about 4 times the poverty line, you can call the financial assistance office, report your inability to pay, and ask about how much they can reduce your bill. For a lot of people living around or below the poverty line, they can reduce your bill to zero. For higher amounts of income, you can still expect a substantial reduction and a willingness to work toward a payment plan.
I know none of this is great news, but as far as I am aware this would be a good path forward for someone who needs access to the currently extremely stretched services of the US healthcare system and who doesn't currently have insurance.
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queern-bn · 9 months
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"There have been times over the last two years where I'm standing in our waiting room with many patients waiting to be seen, many of whom are uncomfortable and sick, where you want to sort of shout at the rooftops and say, 'This is what a health-care system in collapse looks like.”
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crystallllines · 1 year
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aw nice we got the sweet older irish lady who knows nora!
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A while back there was a patient in the ED.
He presented with a grand mal seizure, brought in by the ambulance from a public park.
Homeless.
19.
I wasn't the one treating him, I just saw him in our obs unit before he left AMA (against medical advice).
I still think about him sometimes. I couldn't meet his eyes. I wanted to talk to him, but couldn't bring myself to. What could I say?
A veritable child. Living on the streets. What could I possibly say, knowing that we,
as a society,
we'd failed him?
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weirdponytail · 1 year
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Oh my god I almost forgot.
I was getting stitched up by the emergancy medicine lady and this happened:
Me: so I know it’s kinda taboo to ask but I have to at this point. What’s the weirdest thing you’ve pulled out of someone?*
Doc: …do you mean me, or the whole department?
Me: hm, well, either! Both! Yeah both!
Doc: (knots off a stitch) a full sized cooking whisk.
Yeah we had a good laugh at that.
*I was asking like pulled out of anywhere. Out of a wound, a nose, butt, anywhere.
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mdrambles · 2 years
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I had one of the weirdest calls into the emerg the other day. Our business clerk looks up from the phone with a perplexed expression and I happened to be writing a note, so I asked her what was going on. She said, “There’s a pediatrician on the phone with a question I’m not sure how to answer.”
Hm, that’s already odd. Usually if it’s a definitely medical issue our clerks are really efficient at getting one of the doctors on the line to deal with it, and anything else they’re awesome at connecting to the right places.
“Okay, would you like me to talk to them?”
(Warning: under the cut is mostly just ranting and venting and an example of how our system is so thoroughly broken that doctors cannot even seem to help each other out or treat each other with common courtesy.)
The clerk made an expression that I can only describe as, “This-person-was-very-rude-to-me-and-now-I-feel-bad-about-making-you-speak-to-them-when-I’m-not-sure-if-you-even-need-to-speak-to-them”, but, y’know, as a facial expression. With just her eyes and eyebrows, since we’re all still wearing PPE to combat the latest wave of COVID brought upon us by increased international travel and overly-relaxed public health recommendations (lmao in our region they just removed the isolation period post-positive COVID test because they want people to go back to work sooner... well, this means every child ever is going to have had COVID by Halloween 🙃).
“I’m really sorry,” the clerk said, “I just really don’t know what to do. Thanks for taking this call.”
“I’m happy to help out,” I reassured her, “and you have nothing to be sorry about! People are weird sometimes, that’s not YOUR fault.”
Once the line connected, the conversation went something like this:
Me: Hello, this is Dr. [Sabrina] from the [children’s hospital] emergency department, who am I speaking with?
Dr: I’m Dr. X. I need you to tell me where I can get a COVID PCR.
Me: Sorry, Dr. X, we don’t do tests on adults--
Dr: No, not for me! Ugh, for a patient. I just said this to whoever was on the phone before.
Me: Oh, my apologies Dr. X. Can you tell me more about your patient’s situation?
Dr: I just--fine. My patient is a x-year-old with [chronic disease] who needs a COVID PCR.
Me: Ah, I understand that with this diagnosis, you would be concerned about COVID. What is the reason you think this patient requires a test?
Dr: I just said, they have [chronic disease]! If you’d just let me finish, I’d give you the whole history!
Me: Sorry, please continue. 
(I was very confused, since I had not, at any point, cut this person off on the phone. What did they mean by “if you’d just let me finish?” Hm. I will never know.)
Dr: So my grandson has [chronic disease] and his mother just tested positive for COVID.
Me: Uh, wait, sorry Dr. X, is this a patient you’re calling about? You just said your grandson?
(Context: where I practice, you shouldn’t be treating your family or friends, so this is... inappropriate.)
Dr: Yes, this is a patient. But I just need a COVID PCR so that we can get Paxlovid.
Me: Well, then, Dr. X, it would be most appropriate to ask the physician who would get the Paxlovid to order the PCR test for your patient.
Dr: No! I can get the Paxlovid to clinic, that’s not a problem. What I need is the PCR! I just said that!
(Okay, this is not really adding up? If you can get the Paxlovid, you can order a PCR. WTF is happening here?)
Me: Is your patient feeling very unwell?
Dr: No, he’s just got a sore throat.
Me: Is your patient requiring any changes to their baseline respiratory support or experiencing any new respiratory symptoms?
Dr: No! I just said--ugh. You’re wasting my time here. I need a PCR.
Me: Sorry, Dr. X, but you’ve called the emergency department. Based on what you’ve described, your patient doesn’t require an emergency department visit, so--
Dr: Yes! I know that! I don’t want to go to the ER, I just want a PCR!
Me: Okay... well then I would suggest that your patient attends their nearest COVID testing centre.
Dr: Where is that?
Me: The testing centres are all listed on the government website. You can search for the nearest one based on your patient’s region or postal code.
Dr: So where’s the clinic then?
Me: ...as I said, you can use the website--
Dr: Just tell me where the clinic is!
Me: ...Okay, so can I confirm that this is the patient’s postal code? *types in Google, then website* Yeah, using the government website, there are X clinics nearby. All of them say they’ll take a patient 2yo or older, and will test symptomatic patients, based on the information on the website.
Dr: But will they do a PCR?
Me: (truly just baffled at this point) They should?
Dr: Listen, I don’t wanna show up and they only do rapid tests. Where can I get a PCR?
Me: Okay, Dr. X. Here are the phone numbers for your patient’s regional COVID testing centres on the government website. I’d suggest you give them a call to confirm their tests are PCR, though none of the testing centres have been using rapid tests for a while.
Dr: Fine. Thanks. *hangs up*
Of course, this was a very strange interaction (seriously... does this person just... not know how to use a computer or the internet? They could’ve done this from their phone in less than the time they took talking to me. Good thing I had a bunch of trainees on with me seeing patients for the 15 minutes of MY TIME that this person wasted... God forbid patients wait in the EMERGENCY DEPARTMENT because some snarky person couldn’t be bothered to USE GOOGLE and instead had to be rude to my business clerk and snappy with me. Honestly, I could’ve just continued to push them to use the internet (or have someone in their clinic do it), but I thought I’d do them a favour since it sounded like their patient/family member (🤷🏻‍♀️) would’ve suffered if they didn’t get some sort of answer.
Later, one of the nurses passed by and asked me what was up with this encounter, because they reviewed the note I wrote documenting it (essentially because I had to medicolegally justify why the heck I was on the phone with this doctor for 15 minutes when there were patients to be seen in the department). I explained and they laughed, “Wow, Sabrina, I remembered when only a few months ago, as a fellow, you were so sweet and meek, and now you’re calling people out on their 💩!”
While I appreciated that they found this humorous, I was actually a bit disheartened to hear that I’ve changed so much since the beginning of fellowship. The burnout has obviously affected me in noticeable ways and I’m really anxious that it may negatively impact my interactions with my colleagues and my patients. I think the fact that I’m starting to care less and less about how parents specifically perceive me is a symptom of said burnout; I am losing my sympathy for the parents who loudly complain about wait times in the ED, and I no longer have patience for the parents who verbally abuse me or my colleagues for all this garbage that’s out of our control. If you’re mad that your family doctor couldn’t see you today, I’m sorry that you had that experience, but I’m here to try to help you now, so maybe try not to be a huge a**hole to me and everyone else just trying to help? We might not be able to solve things for you but we’re doing our best with what we’ve got.
This whole stupid conversation was just an example of the kind of dumb s*** that we deal with in the emergency department, but because we literally cannot turn people away or hang up on people asking for help (even if “help” is more of a technological than medical issue...), people will wait. I’m sorry if you’re one of the people waiting, but we’re all just doing our best. Dunno if you heard, but there are not that many of us left. I work in a large urban centre, but wouldn’t be surprised anymore if our department ended up closing due to staffing issues similar to our rural communities. Many of my colleagues are fed up. They’re leaving. Those of us that are left are working exponentially harder to make up for the losses. 
Eventually, we may leave too. I don’t know if anyone will ever care beyond cursing us all out for “being selfish” and “quitting when the going started to get a little rough”, because “[we] signed up for this when [we] decided to work in healthcare”.
No, probably not. No one seems to have cared for the past 3 years, I’m not sure why I’d ever expect anything different now.
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During a procedure in the ER
10 year old patient to provider:
You look like the type of person that makes TikTok’s while you do surgery
Nurse (assisting provider) to patient:
Not her. She can barely turn her phone on.
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boulderingbarista · 1 year
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🫀🫀🫀
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theangelblood · 2 months
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Sitting in the ER after getting hit by a car. I feel really awkward scrolling through tumblr, but I really need a puck me up and tumblr is that for sure.
Been hit by a car twice now. Both times not my fault. Guess I'm just lucky like that🤷🏽
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comicabrasions · 3 months
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Jesus Christ on a cracker
They didn’t even do shit. Kept me for 4 hours and told me I’m good.
I started feeling faint at work and then my body kind of went numb, my hands started shaking so they wheeled me into the ED
Well next time just let me be and throw some cold water on me maybe 🥲🥲
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