I had a dear friend in the OR who left to become the new nurse manager of the ER. I kinda half-heartedly offered to “moonlight” for her if she “ever got in a crack.” Much to my schgrins, emergency rooms are always staffed the least on holidays… I can’t believe how easily I forget these things. I worked every Christmas, Thanksgiving, New Years eve, Fourth of July and Mardi Gras for the first five years of my ER experience. That was just the way it was (and still is for those poor souls who stake a claim as an ER nurse). Well, in my years of the OR, I’ve probably gotten soft. I checked in on July forth and there was indeed a serious need. I offered to do a night shift for overtime plus “critical need incentive pay”. (That’s overtime plus ten bucks an hour plus the six bucks for night shift differential. I thought “pretty sweet paycheck… if I live.” I thought I had forgotten a lot. Once I got over the “beginning shift jitters”, unfortunately, it was like I had never left.
My first patient of the night came in with nausea and vomiting. It was a patient in her thirties with a list of over fifteen allergies and another list of over 20 home meds for everything from diabetes and hypertension to IBS and fibromyalgia (of course). I didn’t ask, but I’m sure there is a psych history somewhere in there too. I know it’s probably stereotyping, but I’ll bet my paycheck that anyone with over 10 allergies plus fibromyalgia is certifiably crazy. All you have to do is strike up a conversation to find out, in the first five minutes, just how crazy.
I checked her in and took a history. The doctor asked me to get a shot of Promethizine for her nausea. I agreed and went out to the Pixys machine for a 25 mg amp of Phenergan. When I returned, the room was thick with the smell of fresh stool. I looked and saw wet poo, tarry black dripping off the stretcher to a growing puddle on the floor. She had it up to her wrists on both hands and was holding both side rails with poo dripping hands. I stopped at the door to catch a breath. She said, I am still feeling a little nausea… is that my shot? I immediately put an emesis basin to her mouth, thinking one horrible mess is still probably better than two. I got the hypo out and set it on the bedside table. The moment I looked back at my patient, she let out a three quart stream of emesis. (I didn’t get the exact measurement) The hot, thick, slightly beer and pizza flavored vomit shot out like a fire hose. The stream barely skimmed over the rim of the little emesis basin and hit me square in the chest. It was like a cow peeing on a flat rock. The spatter went everywhere and in every direction simultaneously. It was like a B-horror movie, with only a slight head turn and lip movements, she was able to nearly cover the entire room with only one short three second super-soaker burst.
Two of the “regular ER staff” came by to see what all the commotion was about. Apparently they could smell the smell, and hear the splashing from the other end of the department. They immediately threw me a towel and busted out as this was some huge joke. They both ran back to their rooms leaving me, the equipment, bed, walls, soaked in steaming bodily fluids from more than one orifice and only one dry towel. They were snikering like it was one big joke. Yea, hilarious… I can’t believe that I actually missed doing this kind of work. It’s like military men saying they miss getting shot at. I don’t care what they say, ER nurses still don’t get paid enough.