I'm an ER nurse, who works in a deadly city, AMA

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hahah depending how nice you are... turkey sandwich and apple juice. (cranberry, wow thats exotic).. but go see you PCP... we tried sry

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Hey your right.. I don't understand how bad the pain is. absolutely right. But i understand to get through an addiction takes pain, struggle and mostly support. At my job I can put my orders in before a even doc sees them.. Yea morphine dilaudid ativen versed u name it. I don't do nursing plans in the ER. I take on medical emergencies. don't yell at me for pain medication... ur not dying just going through hell going through shit.. those medications are a brief relief no help to the real problem..

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y?

You sir, are an ungrateful douchebag.

what do you mean by that...cuz I am not

So how is Detroit tonight?

Never been

what is the craziest thing you have seen there.... something that instantly comes to your head as something you will never forget?

Easily one comes to me. An ambulance brings in a pt. They say they found the pt in an abandoned apartment basement on a couch. The the basement was covered with cockroaches, no lights. They must have been down their for so long, their skin fused to the couch. Their legs were so contracted,their feet could touch the back of their head. When the pt first came in, it looked like they had no legs and part of the couch came with them. Their eyes were literally sealed shut with eye gunk and dirt. The pt had an old peg tube site. When trying to assess it. Bugs came out. So the pt had a mental retardation and whoever was their caretaker at some point just left them. This person looked crazy. Almost dead, but made it out of the ER and was admitted.

wait... that patient is still alive? How!?

idk they were breathing and had a heart rate when they left... actually not dead

As an emergency services worker in a large city who occasionally ends up seeing awful things like this, I'm curious as to why EMS would bring the patient to the hospital. In obvious cases like this we can pronounce the patient and immediately call the coroner. What good is it to bring a patient in this obvious state of decay/death to hospital?

Also thank you very much for what you guys do. It takes a special person.

Edit: I'm a dummy, I didn't read your full story and assumed, based on your description that the patient was obviously very dead. My apologies.

yea alive. but thank you.. love when you line and lab them... must be hard in a moving vehicle. but spot on good work... so no thank you

Well I shouldn't take any credit for doing any lining! I'm a firefighter. I've helped but the paramedics but I've never done it.

hahaha personally I think you guys are bad ass. We have had firefighter come in in pretty bad shape doing their job. It's a dangerous job. bad ass but stay safe

Was this one person or two? You keep shifting between "The pt" and "their"/"they". Not being grammar nazi, just curious.

I will say this. As a student I did math and science. English fuck it. When it comes to ER nursing documentation is almost click screen, at least at my hospital. I can't possibly write a nursing note one a pt that is dies and i am sticking with needles and administering medication... Not good with english and words...like to think I'm good at saving lives... ooh i type with two fingers. when I type when i'm on reddit

For what it's worth, you were fine alternating between they/their and "pt." - they/their is perfectly acceptable for referring to one person, especially if you want to avoid specific gender pronouns (him or her).

:)

you are mega right..can't spell grammar sucks... o well... damn English

My aunt is an ER nurse in Detroit, and she always has interesting stories about work too. Ex: She became attached with one hooker who was beaten up by her pimp. Later that day the pimp brought a gun in to finish off his hoe in the ICU. That's something she'll never forget.

What is one story from work you'll never forget?

We have had to take guns off pts when they come in the trauma bay, But if pts come in any other way, they are searched there are metal detectors everything. A story that kind of relates to the story you told... I like to remember when a pt threatened a cop. The pt was in their make shift room. In our ER we don't really have rooms. Well the cop tells the pt if he doesn't sit down and shut up he was going to have use his taser. Pt punches the cop in the face. Cop then uses his taser gun jumps on the pts back uses the taser gun some more and handcuffs him. Pt cried like a baby handcuffed to the bed the rest of his stay. Discharged to jail

Do the patients get their guns back? Or are they handed over to police as a 3rd party/make sure they didn't do anything illegal with them, or their allowed to posses weapons.

idk... when i comes to guns and if you have a license. knifes, razors, lighters are gone and thrown away

Is that policy just for the area's you work in or do you think that it would apply to most other hospitals as well? I usually walk around with a pocket knife and even sometimes OC and if i were to ever be hospitalized and lost either because of it i'd be very upset..

no just hospitals that deal with in house violence. docs and nurses have been attacked. its a federal crime. we try to maintain a safe environment. If you came into our hospital, it would be gone.. for the sake of the staff. It sucks for you but, for us, better to be safe than sorry

Do you have repeat visitors that know you by name because they come in so often? Are they mainly seeking drugs, clumsy, or gang affiliated?

ooooooo yes. Mostly drug seeking pts, drunks and people that continue to overdose. We know many pts by name. Its not surprising to see the same pt twice in a 12 hour shift

I assume pt means patient? I keep going "point or points are looking for drugs?"

yup patient.

This comes from my wife: Why do you guys always send the pt's up to the ICU covered in shit? (she's somewhat being sarcastic)

Gosh, I hear these kinds of stories ALLLLLL DAY!

Ha. it true to some point. Is she an ICU nurse? It always comes down to whats happening in the ER. If my ICU patient is now as stable as stable can be and then I get a GSW or another critical pt in another room of mine, my attention goes their. I work to get that pt stable. In the mean time, my ICU is still stable( as stable as stable can be) and gets a bed to go up stairs, I am pressured, very pressured by the high ups to send that pt up as quickly as possible to open a new bed up. So i send them up. Being covered in poop or piss wont kill them. Not having a bed for a pt that comes in coding is a problem. Personally, when I go up and the ICU nurse is also having a rough night, I have no problem turning, cleaning and settling the pt as quickly and as best as possible. Someone has to do it. If everyone is having a busy night is sucks, but thats how it is.

She basically said the same thing. :) She is an ICU nurse. Currently doing contract nursing and not enjoying a single moment of it. She'd rather be back down in the ghetto working with pt's that have more interesting things going on.

Here in the 'burbs, people drive their Porches to the valet of the ER... you can only guess how they are when they walk through those doors.

Thats funny. I have only worked at this hospital. And I always imagined working at a hospital in a beautiful neighborhood with I guess non ghetto ppl. But I have heard from nurses that I have worked with, who have worked at many hospitals, those pts can be bad if not worse(personalty wise) Props to her for being a nurse. It's tough. I myself, am contemplating travel nursing to hawaii or san diego but idk. Ha (I myself) I like that.

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Clam shell thoracotomy are always crazy. Basically you open up the chest like a clam shell. At that point, doctors can massage the heart, administer drugs directly to the heart. It crazy looking. Only done in the trauma bay then sent to the OR..if the pt is still living.... usually not tho

ooo wound sry. didnt answer the questions. GSWs to the head are pretty graphic. Brain material can come out the nose and even mouth if bad enough. If they are in the ER long enough, their eyes can bulge and look like their pooping out due to increased swelling and presser in the head.

haha - I was just reading your previous reply to my wife and she was like, "That's not a wound!" Then read your next reply! :D

she is right... hahaha my bad...wife 1 me 0

What is a GSW?

goneshot wound

What would you say is the most rewarding part of your job?

going home and having a drink hahaha... But I would say easily saving lives. Sound unoriginal but on a crazy day and with little help, when you go home and realized you had a huge part in saving the life in one, two or even three critical pts..its a good feeling. The drink tastes better too.

What happens when people can't pay?

By law we have to take care of everyone. My hospital, due to poverty, gets money from the state. The majority of our pts have no insurance and can't pay. Im sure we all know how much medical bills can be. Soo they can't pay.Still have to provide care.

Any patients that you've bonded with?

No. This is question is interesting because I work in an ER. But to explain my answer briefly. The pts that come in that are nice and grateful are in the ER get admitted or discharged and are not seen for months or years. Most of the pts that come in are frequent flyers, drunks, drugs, want food, mental illness...etc. Or the pts that are shot, stabbed, burned, hit by a car...etc Ha.. most of the people I take care of nice or not cool or uncool, I only take care for a shot perioed of time . Pts need to be admitted or discharged quickly because there are another 40 people in the waiting room that need to be seen. So little time for bonding, usually running around all the time. HAHAHA not so brief, hard to explain tho

What's the best excuse you've ever heard for someone being shot?

one that comes to my head... A guy came in and was shot in his penis and thigh. He said his girlfriend shot him because he wouldn't by her a new outfit. A couple hours later, she comes in to the hospital escorted by police bruised and messed up. She presses charges saying she was physically abused for years.

How bad was the guy hurt? My friend recently got robbed in Atlanta, and was shot with a .45. His bone shattered and collapsed a lung before going into his stomach. I imagine that a bullet to his penis be a big mess.

the pt wasn't serious.. not dying. went to the OR. don't know if his main man still worked tho

I've always wondered what is the grossest thing you have removed from the anus. I've heard rumors but nothing from the source.

Shot glasses with women. Beer bottles with men. Nothing like super crazy like at animal or anything.

Shot glasses with women. Beer bottles with men.

you say this like it's a general rule. i'm intrigued.

Guys like to take shots out of women's buttonholes. Curious or gay guys like long objects in their anus. duhh haha. I guess.

Got any good stories of bringing people back from death?

we had a young pt go into cardiac arrest in front of out eyes. coded the pt mean cpr and administering life saving drugs. after a minute or two the attending punched or hit, however you want to put it, the pt in the chest, the pt actually like woke up a minute later, and was like " who the fuck punched me in the chest" haha he didn't know he was dead and dying. pericardial thump

How do you cope with all the death you see?

Not to sound like a dick, but I see death so much, it's to big deal

Ever caught two of your co-workers doing it in the janitors room etc?

yup. I don't say nothin. good for them

Were they a couple or was it just random?

Idk good for.. good stress relief

have you ever had to save a friend/family member?

I had to take a friend to the ER. he was walking through a bad neighborhood and was hit over the head with a brick. he got 6 or 7 or idk stables to his scalp. never a family member

Do you like dubstep?

I hate dubstep. I like chemical brothers. But dub step...no

Thanks for the AMA!

I'm thinking of going into emergency medicine/trauma as a specialty, and I was wondering what the best ER doctors have in terms of qualities.

Also, a piece of advice many of my friends in nursing drive into my head is to "Never, ever piss off your nurses." How do I avoid being the annoying doctor who everyone can't deal with?

so ur going to be an ER that awesome, love the ER. best quality "relax". like any work these are your co-workers you are gunna make friends and you are are not. yelling, screaming freaking out, as a nurse I think ur incompetent, as an attending i'm sure(fact i know) they think ur incompetent and wont make it. Every nurse wants to work with a doctor they consider a friend. Just be you... work is tough.

Have you ever encountered someone that was into "sidepocketing"?

what do you mean side pocketing? stealing from the hospital?

no, it's when you have to have a colostomy bag, and then you prostitute yourself out and let men fuck you in that hole. I heard it on the radio.

My friend runs an inner city clinic and he told me about a patient that had an ostomy put in just for this reason. Thank you for the term, that stuff is hilarious.

what doc would give someone a colostomy for no reason other then than that

So I had to bust out the old family Google, and after scrolling down through dozens of hedge fund investment definitions, I found the only thing a redditor could mean:

"Side pocket: A prostitute with a colostomy bag he can remove to give male customers some sidepocket."

Bravo.

hahaha. I never heard that term, but yes i have heard of people using colostomy sites for sexual activity. I personally have never taken care of such pt. I have had pts that stick nails, pens and screws into their penis in attempt to stay hard. Sometimes it's tough fishing those items out.

do you work in gotham city?

kind of. no batman tho....sucks

What happened during your first shift as an ER nurse? Did you feel prepared and fairly calm or were you freaking out the entire time?

my first shift was fine. and yes i was freaking out. Any new RN work hard and help others... cuz your gunna need it someday

what is your educational background? How did you become an ER nurse?

I went to a small school to play basketball. I hated it. Moved to the city sophomore year. Loved the city. I saw what the medical field provided. I didn't want to sit at a desk. As all medical ppl say i liked helping others. Took the classes. Didn't want to be in school to my 30s like docs so took up nursing. Now I'm here

Your training and experience told you that the patient would die, but lived? any story?

I have delt with pts that come in shot every and anywhere. go to the OR and live. I dont see them leave or anything. never like a hi and hand shake thanks for saving me. might seem them later tho

is there a sexy doctor you have a crush on?

there are sexy nurses and docs... never shit where you eat

Please, give us a good news story, I'm drowning.

I really don't have any feel good stories, those are up to the ICUs and floors. I don't see the outcome.

You're not. I just know it can be hard to be around so much death, especially for nurses. I didn't know if this applied to you and I was curious.

hahaha thanks

What is an ER nurse's starting salary and salary with various lengths of experience?

i started 34 an hour, since I work nights, it makes it closer to 40. I work 3 days a week..overtime is abundant. older nurses make up to 60 an hour

What's with you nurses and your anal fixated usernames Ahem ANAL_QUEEN

as a guy...can't help it

What the hell does pt stand for?

sry patient

what the hell does sry stand for?

it's an up vote because I then know who I didn't respond to

Why is your spelling and grammar so poor?

it is poor because in the my ER we have little time to actually write an assessment, its all computer. I do very little documentation, mostly hands on.

What EHR/EMR (electronic health record) system do you use at your hospital & how do you feel about it?

MEDHOST. I like it cuz as many ppl have said I can't spell or write

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It is extremely hard because I am sure you have heard they " NEED EXPERIENCE". work as a PCA for whatever floor you what to work for.. Thats your shoe in.

ok so i dont like asking the "craziest" event, so tell me about an honorable mention that needs telling

an infant being intubated and dying, while the parents are to strung out to know what is going on... real mind blowing experience

im wondering what makes u sick everyone has something that makes them gag like with me for instance i can handle blood among other things but the second someone spits or has anything to do with spit i gag as an er nurse im sure u found out what makes u sick do u care to elaborate?

elaborate..... Ive seen a pt some high and give birth into her jeans. baby gray pt strung out... again I hate OB. baby didnt make it

female anatomy.... at least here. the women that come in.. I don't do OB.. I've seen things that ruin..um things hahah

Aren't all cities deadly to some degree?

I assume so. I also assume that some are more deadly than others.

Do you let the blacks in your fancy hospital?

anybody everybody