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Wednesday, March 27, 2013

Sooo. . . Which Is It, Then?

Frequent Flyer, a dude in his 50s, comes up to the ER registration desk and signs in, giving the chief complaint of "left shoulder injury."

Now, just like any other day, it's really busy, so people with a musculoskeletal injury tend to get put on the back-burner while we see the more ill patients.  Mr. Flyer must be noticing that a bunch of people who got there after him are getting to go back before him.

Finally, Triage Nurse Gigantor calls back Mr. Flyer:
Gigantor: What brings you in today?
Mr. Flyer (clutching stomach with both hands): Oooooooh, my stomach huuuuurts soooo baaaaad!!!
Gigantor: Sir, it says you signed in with a left shoulder injury.
Mr. Flyer: Noooo, I don't know why it saaaaaays thaaaaat.  My stooooomaaaaach!!!
Gigantor: Fine, sir. . . (continues triage process) 
Mr. Flyer moves up a little bit to get ahead of some of the other folks and ends up in one of my rooms.  Being as busy as we were, I wasn't able to get in to see him right away, as I was trying to get a critical patients squared away to go to ICU.  I come out of Mrs. Critical's room and see one of my favorite docs, who is notorious for taking no shit come out of Mr. Flyer's room.

Doctor Takes No Shit makes eye contact with me and rolls her eyes.  She comes up and asks me what the hell is wrong with this guy since the triage note says one thing and he's now complaining to the doc about back pain.  I told her I didn't know, but would investigate.   She sits down at her desk and says, "oh, I see.  NurseHubba, look at this."  I look over her shoulder and see that this guy has been given "the mark."  This tells us that the guy is on the narcotics watch list, is not allowed to receive narcs, and has gotten both a letter from the medical director of our ER and a visit from the case manager.

Hmmmm.  Curious, I go in to see Mr. Flyer.
NurseHubba: So, what brings you in today?
Mr. Flyer: My left shoulder is killing me!
No drugs for you!
NurseHubba: Sir, please help explain something to me.  You came in with shoulder pain, told the triage nurse abdominal pain, told the doc back pain, now you're telling me shoulder pain.  Which is it?!?! 
Mr. Flyer: Well. . . ummmm. . . It's all of it.
NurseHubba: Which one is the worst?
Mr. Flyer (without the slightest grimace): Oh, definitely the shoulder.  It's 10/10 pain!
NurseHubba: Uh-huh.  
Since I was helping out to cover shifts, this was during the day, which meant we had a case manager there.  She was the next person to go see Mr. Flyer to explain that he wasn't getting narcotic pain meds. Next thing I know, I hear him yell, "This is bullshit!  This is the worse hospital I've ever been to!"

He takes off his gown and throws it with his "injured" left shoulder and stomps out of the ER.


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