the agony and the ecstasy

I'd almost forgotten what a 12 hour shift in the middle of the night feels like. It started off like any first shift at a new job, although it's nice that I know the employees, and the equipment, and the layout of most of the rooms. But just enough has changed that I feel I'm in some slightly skewed alternate ER- the beds have been renumbered, the crash carts have been reorganized, the charts have been shuffled. At first I contributed my mild confusion to the early a.m. pre-coffee haze, but then realized that this time, it wasn't entirely me.

first IV of the day is an EJ. No, I didn't get to do it, although I could have- the patient had ropes for veins. With the EJ came a marriage proposal from the patient, my first of two for the shift. DeepThroat, my Medic trainer, teases me a little. I tell him it's a little different in the back of an ambulance, where it's just me, the patient, and a bunch of 14 g needles. That combination tends to curb the flirtation a bit.

With DT hovering over my attempts on the next several patients, I botch 4 out of 5 IVs. Grrrr. Granted, I haven't started an IV in a couple of months, and each patient greeted me with "I'm a tough stick," but still. After lunch, DT decided to leave me be, and hovered outside the room instead of over my shoulder and- ba da bing ba da boom- I'm 7 for 7 the rest of the shift, with only one AC. Hallelujah, the tingle is back in the fingertips.

The cops showed up in the early a.m. with a meth head. The guy had been pounding on his sister/cousin/girlfriend's car at 5 a.m (he wasn't terribly clear on this, so take your pick- although since this is meth central, one person could actually be all three). The guy is barefoot, dirty and bloodstained, with blackened burn blisters at both corners of his mouth from sucking on a hot pipe. He is also about 6 feet of wirey, sinewy muscle. Not an ounce of fat on this guy. The night nurses give him Haldol and Ativan, and we calm him enough to get him to a bed. He's definitely high as a kite, but I think he was less violent than terrified of the cuffs, the bright lights, the restraints in the back of the cop car.

Later in the day, an ambo brings in a homeless guy who is somewhat disagreeable. He was drunk, and got in a fight, and doesn't really want to be here. I am amazed at the disgust his nurse shows him, how rude she is. DT says she's old school, and doesn't like change. Whatever. I can understand getting burned out and sick of the so-called human trash- I live in the middle of it. But I also know that most humans, if given the opportunity, will rise to the occasion when treated like humans instead of pond scum. The guy was lying on the bed, shivering, soaked through from the rain, and his nurse hadn't even given him a sheet. I put my hand on his shoulder, introduced myself. He lowered his arm from his eyes, told me his name. Smiled. I covered him with a couple of dry, warm blankets. He thanked me. The doc shows up, gives the guy a once over, orders dinner for him. Treats him like a human being. Thank god for that doc. I wanted to fwap the nurse over the head with a purple nitrile glove- fwap fwap fwap. But that may not have been my most excellent idea, considering it was only my first day.

I can't think of one employee that I don't actually like at Meth Central ER. Most are good people with high standards and excellent training. The nurses generally fall into one of three categories- the ones who appreciate the medics and view us as colleagues, the ones who view us as nothing more than housekeeping with IV skills, and the ones who resent the hell out of us. Luckily, the nurses in the first category far outnumber the other two, but I am only now realizing the intricacies of politics in the hospital setting- the docs are treated with kid gloves, but nudged along by the nurses, who seem to think the docs have no idea what they're doing. The docs tolerate this because, well, it's best to humor the nurses, don't you think?