Three Ring Hospital

I feel as though I should have circus music playing the background for this blog. Truly, the hospital is often a circus. At least, it seems to be whenever I am there.

A few stories to wet your whistle.

A doctor once told us of a morbidly obese woman that came into the hospital in critical condition. She was intubated and therefore, was unable to verbalize anything to her doctors or husband. Her also morbidly obese husband sat by her side, talking quietly to her, day in and day out. The doctors were convinced that he was a doting husband that was badly grieving over his wife's illness. But, no. Turns out, the couple had two refrigerators. Hers was padlocked because she was tired of him stealing her food. He sat by her bed in the unit each day awaiting for her to awaken so he could find out her combination. Now, that's true love.

Another morbidly obese woman presented to the hospital with a myocardial infarction. While waiting for her heart cath, she was NPO - which means, nothing by mouth. During an examination, a doctor lifted up her breast to listen to her heart, only to find a turkey sandwich that her daughter had snuck in for her. Apparently, not eating for a few hours was too much her.

Recently, there was a middle aged gentleman that presented to the ED with chest pain. As per the usual, the CCU resident evaluated the patient and admitted him to the CCU, with plans for a heart catherization in the very near future. For the most part, he seemed like a normal house patient. Of course, he made odd comments to the attractive female residents and nurses, such as, "How much would it cost me to sit here and just stare at you all night long?" and "I'm going to go to sleep now and dream about you." Kinda creepy, but we figured he was just a dirty old man.

Anyway, he went for his cath, had triple vessel disease, and cardiothoracic surgery was consulted. CT surg saw the patient and determined he was not a candidate for surgery. The next day, the cardiologist returned with the patient to the cath lab and stented the more critically stenosed vessels. All was fine and well. That is until he went CRAZY.

At around 4pm, the nurse came to inform me that the patient was dressed and threatening to leave. I inquired why and she proceeded to tell me how he believed a certain nurse in the CCU was stealing money from him. I rolled my eyes and calmly approached the patient, asking why he was so determined to leave. He cried, he yelled, he told me how the nurse/his girlfriend (who, by the way, are NOT the same person, but appeared to be in his mind) was stealing money from him, lying to him, manipulating him. I attempted to reason with him, explaining that the nurse was NOT his girlfriend.

Then, I dropped the bombshell - he would not be permitted to leave the hospital. OMG, you would have thought I told him that I was going to cut off his arm. He threatened to sue me, he told me he was going to bury me in legal papers. Of course, I laughed at this, which apparently he didn't appreciate. He told me I was the devil's child and he was going to put me in a dark room with spiders crawling on the walls and cracks and blah blah blah.

Then, HE dropped the bombshell....and the threat that I needed to offically pink slip him. He said he was going to bury his girlfriend alive for keeping him in the hospital. So, I pink slipped him, told the nurse to call security if he threatened or tried to leave, and retired to my call room.

Twenty five minutes later, the fire alarm went off. For a moment, I sat there staring blankly at the blinking light in my call room, thinking, "Huh, is that for real?" Then, the code Violet was called. I ran out to the CCU to find the nurses wrestling the above mentioned patient to the ground and security rushing to the scene. Apparently, the patient had pulled the fire alarm - not once, but twice. The patient was ushered back into bed, kicking and screaming, put into leathers, and given a hefty dose of haldol. I called psych and arrangements were made for the patient to be discharged to the psychiatric hospital once he was medically stable.

Now, for any of you non-medical folks reading this, you probably think that we were cruel to this guy. But, here are the reasons we did what we did:

A. He was delusional (and likely an undiagnosed schizophrenic)
B. He was not able to make his own decisions based on A. - therefore, he could not be allowed to leave the hospital against medical advice. For people that are competent, if a patient wants to leave and verbalizes understanding of the risk of leaveing, we give them a paper to sign and they're welcome to leave AMA.
C. He was threatening to harm other people if he did leave.
D. He was physically abusive to the nurses AND pulled a fire alarm. We had to wait until the fire department came and released the alarm before we could even leave the CCU or get into the med room. That's very dangerous to other patients in the unit.

These are all reasons why he was not allowed to leave and why he was restrained. So, stop judging me and thinking how I'm such a mean girl. ;)