I woke up today and my stomach is a mess. I'm not surprised though, because it was when I went to bed last night too. Cramping, pain, bloating. I spose I need to get into the Dr and get it checked out, but I just can't seem to find time. We are going away this weekend to see some friends which means that I won't be able to spend any time with the boy. So I feel like I should spend my days off next week with him instead of in the Drs office. I bought some OTC ibs medicine that I've been taking. I thought it was helping. I didn't have time to take it regularly yesterday though, so hopefully if I get back on it today it will clear me up. I took the max dose this morning.
I had a pretty stressful day at work yesterday. I think there must be a bad batch of drugs out there because I have been running a TON of patients who are out of their minds, angry and violent. Twice in the last 2 weeks I have been afraid. I don't remember ever being this afraid for my personal safety. We got called out yesterday for a guy who had been missing from his job for the last few days but decided to show up yesterday. His employers called police out because he would not leave their lobby and was not making any sense, talking like he was out of his mind were their exact words. Of course I'm up. It's always my turn to do patient care when we get the difficult patients. So we walk in, and it takes me about 5 seconds to figure out who the patient is. There are 3 pd officers in the office and 3 lay people. So I make eye contact, walk towards the patient and ask him what is going on. He looks into my eyes, but doesn't say a word. He starts balling up his fists and his face and eyes are just full of rage. Minutes passed before he finally spoke. He said very few words, but it was apparent that he wasn't a part of our reality. He thought that my uniform was fake and didn't trust me. He got more and more aggressive, so I backed away and pd moved in closer. A few more words were spoken and he tried to dart into an office. Pd followed him, took him down and put him in handcuffs. And then pd tells me "will you transport him, because if we do he will just kick our windows out". I agreed as long as they will help secure him to the cot. There really is no "securing" a sweaty, stimulant strength person to the cot. They may appear secure, but in my mind, they are always just a quick second away from slipping out. It didn't take long before this gentleman figured out how to pull the velcro on our four point restraints. I was terrified. I decided that it was time for some chemical assistance. Our protocols allow us to give haloperidol and midazolam. The drs and my partner get upset when I sedate with midazolam. It is the most effective, and has more of a rapid onset than haldol. But I knew that haldol would be the path of least resistance. So I pulled it up and injected it into his bicep. Which just pissed him off more and added to his paranoia. Meanwhile, he is picking at the velcro on the restraint on his right hand. I just knew that he was going to find a way out. And the look on his face and the things he was yelling left no doubt in my mind that if he got free, I would be lucky if all he did was hurt me. So I grabbed some coban and wrapped it around the velcro so he couldn't get to it. It took some doing and some time. I had to lean over him to do it, because there was no way that I was letting him get between me and a door. So leaning in that awkward position, trying not to get bit, trying to weave a roll of coban in and out of a 1 inch space while my partner was throwing me all over the truck with his driving was the best I could manage. Thank God we finally got to the hospital. Security and pd were waiting for us when we arrived. The patient continued to thrash and be nasty and scary. I have never been so glad to turn over patient care. I later found out that it was meth that the patient was on. I had been guessing k2. I also found out that he became "nice" and cooperative later. So I'm sure this patient was cut loose from the hospital. I decided that I am never going to do this again. My words can in no way describe what it was like. I am going to use the damned midazolam in the future. Drs and partner can kiss my ass. My personal safety is #1 priority. Not to mention the future of the patient. I'm not going to try and "tough it out" anymore. This behavior emergency protocol is in place for a reason. Situations like this are going to get people hurt, if not killed.
This meth stuff is nasty. My first call of the day was meth related too. My first call was a person who I have run multiple times. This person always eats meth. I think he was smoking it this time too. Add that to paranoid schizophrenia and you get a helluva good time. (Note the sarcasm). This patient is probably the most paranoid person I have ever seen. He spent the entire ambulance ride looking out the window, turning around looking behind him, trying to get off the cot. Pd was on scene before us. They actually patted him down, but during transport he pulled his keys out of his pocket, put them in his hand and put one key between each finger and balled up his fists. I saw him do this, said NO, and took them away from him. He was easy because he didn't resist. He just let me take them. But this is just another example of how I'm gonna wind up dead. Lol.
So my last call of the day, like all of the others, couldn't be easy or simple either. It was in a decent neighborhood. I'd just woke up from a short nap. I had stuff that I should have been doing between calls, but I felt like shit. My stomach hurt and I was so weak. So I'm kind of still waking up. The call came out as chest pain. We get there and I see a little chihuahua behind their fence just barking like crazy. It makes me giggle, because of my chihuahua. I love those little dogs. We get inside and fd is there too. I walk in with my monitor and approach the patient, and fd says, "it's not a chest pain!". The patient says I am having cramps. He is grabbing his leg and is extremely restless. The patients wife is also there and says that he was hospitalized several years ago for heat exhaustion and heat cramps. This is a 50 y/o male, tall, in extremely good shape. He is muscular. A black man, with some gold teeth. He is very impatient. We are trying to take vital signs and get the whole story. Turns out he had been working out in the heat, and has drank a ton of water....8-9 glasses he says. So I think that his electrolytes are probably all messed up. So I try to get an ekg. He won't sit still thought. He stands up but keeps pulling the leads off. Fd was acting irritated, so I let them go. I ask the patient what hospital he wants to go to, and he says that he doesn't want to go if he doesn't have to. He says that he took an aspirin (like dispatch instructed because of the chest pain). He blames the cramps getting worse on the aspirin. I told him that I needed to check his vital signs but that there's nothing that I can do immediately for his cramps without assessing him. He decides that he wants to go to the hospital now but won't let me do an ekg. He starts walking towards the door, so I have my partner break down our cot as quick as he can. (Unfasten seatbelts, lower it, etc). We get the patient on the cot, and he is sweating profusely. Which concerns me. He is in great shape, so I am thinking that this may be more than just cramps. The patient is extremely agitated and keeps yelling at us to get him out of this heat. I told him that we were moving as fast as we could. We get him in the truck and he yells at me to get going. I explained to him that my partner was getting the rest of our equipment put back into the truck, that we were moving as fast as we could. I get the ac going and pointing at him and get the bp cuff on and the monitor put on. I am finally able to get an ekg...and guess what? Acute MI suspected. Stemi. Yep. So I holler at my partner to call a stemi alert (alerting the hospital that they need to reserve the cath lab, expedite everything), I get aspirin down him (because he isn't sure if he had a baby or adult aspirin prior to our arrival), get the fast patches on him (because people like to go into scary rhythms who are having a stemi) and get an IV started, bag of fluid, nitro and fentanyl for his pain. I explain to him what is going on, and he says "well the cramp on the left side of my chest is the worst". I'm not sure if he is really having a stemi or if his electrolytes are just off, or if maybe the heat caused an mi. It's not my job to determine this, so I just treat for the worst and hope for the best. He remained stable throughout his time with me...thank God. We got him to the hospital and the Dr decided to not send him up for a heart cath until he got a few more ekgs. We had to leave before I found out what happened with him.
So we are trying to get back to post, as it's 15 minutes before our shift is supposed to end. The city is blowing up. There are calls coming out on all sides of our area. We got stuck at a stoplight. Sitting ducks. A call came out that was kind of on the line. It could easily be ours or the truck in the area next to us. My partner is driving and hears this, and turns west quickly...lol. We take the side streets back to post. Which avoided lots of traffic, but also put is further away from the questionable call. Lol. I'm furiously working on patient care reports while he is driving. I'm getting carsick from not watching the road. I am hot as hell, dripping sweat and hoping that we get back to post before we get tagged on another call. We have gotten caught on late calls for the last 3 shifts. Just once I would like to get off after 12 hours. Luck is with us, as we made it. Our relief was there, so we didn't have to go on a late call, but wound up staying a little late to finish paperwork.
Now I'm home trying to prepare for our weekend out of town. Hubby is playing video games with the boy. I'm enjoying one cup of coffee before I get started cleaning up the kitchen from the last two days of the dishes piling up from when I was at work. Laundry, etc. I don't mind though. Nobody is trying to kill me while I'm doing dishes or laundry. It may sound like I'm complaining about it all. And I am. But I wouldn't have it any other way. No other job in the world would allow me to see and learn so much about so many different areas of medicine. My only regret is the time this life takes me away from my family. I also wish that I would have started this when I was younger. A medical career really isn't conducive to family life. Well, let me rephrase that....an exciting medical career really isn't conducive to family life. I could go to nursing school. Be a school nurse. Or work in a Drs office. Yawn.
My anxiety has been thriving lately. I think it's because of some bad things that are happening to a good friend. My friend's husband was recently diagnosed with esophageal cancer. Stage IV. He is in his 40s, she is in her 30s. A few weeks before that, an acquaintance's husband was diagnosed with a stage IV brain tumor. He was given 6 mos. to live. His wife had just had reconstructive surgery due to breast cancer. I know that the nitrates in our water are off the charts. It's not safe to drink. But it seems that the rate of people getting cancer in our little town are way out of proportion with the population here. There aren't that many people who live here. Everyone is getting sick. I get anxious about being away with my son. If I find out that my stomach issues are some horrible terminal cancer, am I going to feel guilty about all the time I spend away from him and he is alone? I miss him as it is. Hubby has been having a lot of belly pain lately. What if it's his tumor coming back? My new Dr is a dick. I find myself avoiding seeing her because of this. Putting off concerns like this won't do any good I know. Anyway, just more stuff to worry about.
Work, family, health, money, unfinished things. That's life right? And that's just the stuff that I can mention here.
No comments:
Post a Comment