The Leap to Crusty Status

Julie Reyes, DNP, RN

I have been after this guy for a long time. I spotted him last Christmas at my cousin's party. He was with some buffoon of a girl - but I did catch him glancing at me a few times. Over the last 12 months, I have run into him several times when he was with my cousin. I couldn't believe it when he called me last week and asked me to this New Year's Eve party.

Fortunately, I am going to be finishing my third of three shifts for the week, and he will pick me up at 9pm, since I get out of work at 8. I am so excited!

I know I will barely have time to go home and get ready after my shift. I work in the ED at a hospital in rural county America. My shift shouldn't be too bad - it has been slow lately. I will just fix my hair this morning so that all I have to do is rinse off, put on my party dress, and head out for a night of dancing!

Makeup...now I wonder if I should do the 'cat eyes' eye liner and go with the sparkly eye shadow or the smoky eye look? After all, the more I do this morning will be less I have to do when I get home. So - sparkles and glitter it is. Curlers in my hair, a dab of perfume. Oh, I look a lot cuter than normal...hmm, maybe I can go ahead and wear these super cute scrubs (a little tight but cute). What the heck? I am going to go ahead and wear my cute undies too. I may not have time to shower tonight, so just in case I will wear them and then I can just throw on my dress and rush out the door tonight.

I head to work looking and feeling fabuloso. As long as I don't exhale, these scrubs fit just right. Oh, thank goodness, the waiting room is empty. Just what I wanted to see. I will have time to look on the internet for after Christmas sales! I get report on my one patient from the night shift who reports the shift was quiet and my patient should be going home soon. I start preparing the discharge instructions soon after I assess him.

"Medic 3 to ED". Oh, well, here comes the EMS call just an hour into my shift. "In route to your facility with a 54 yom with nausea/vomiting/diarrhea for 2 days." He then goes on to list the vital signs and current status...which is lethargic and confused. When the truck pulls up into the bay, the paramedic walks into the ED without the patient. "Um, our patient weighs over 600 pounds. Do you have a bed that will hold him?" As we scramble to get the appropriate bed to accommodate the needs of our patient, we have several more patients appear in the waiting room.

After an hour, we have transferred the ambulance patient to a heavy duty bed. The patient is covered in...poop. I swear I can see the paramedics stifle a smirk and I KNOW they did not tell us that prior to handing him over. The smell is overwhelming. The patient is lying on his left side - sort of. He states he feels a little better this way. I struggle to place in his IV. Only 4 attempts between me and my coworkers. We finally get his IV fluids going. The doctor asks me to get him cleaned up. Great. I gown and glove up. This is not going to be pleasant.

I am talking to my patient and he tries to answer me, but is having a hard time due to his current position, mental status, and ... weight. He has a tickle in his throat and mumbles he thinks he has allergies. I walk behind the patient to continue cleaning him up when he sneezes. I had just turned to put some soiled wipes in the trashcan when I feel a thump on my side and back. "Oh...S...Crap!!!" The doctor burst out laughing - OH NO! I just got targeted by a missile of crap! Of course the gown did not cover all of my clothes. Why would it?!

Disgusted, I call EVS and ask them to rush deliver me clean OR scrubs. I run to the bathroom and strip down to my skivvies and desperately try to clean myself off. I swear I can feel C-diff crawling all over my body. I can hear the clerk laughing as she knocks on the door and hands me the clean scrubs. These scrubs are stupid...they don't even match my eye shadow.

It is only 9:30. How can this day just be starting out??? It feels more like wine-thirty....

My next patient is a 2 year old with nothing wrong but the mother. Who is paranoid. She caught the child eating a cookie off of the floor and is sure the baby has worms. First time moms - really???? She is demanding antibiotics and a prescription for Tylenol. Seriously.

I hear the Medic calling in a report again as I am coming out of the room. As I pause to bang my head against the door jam, I hear the medic say "mass causality".

When I look up again, the time is 19:55 and my relief is just coming in. I have yet to document the code, the patient I took to ICU, the assessment I did on the beaten infant, or the drug seeking maniac who had tore through the ED and kicked the tech in the hip before cursing at all the patients in the waiting room and throwing a chair against the triage window before being restrained by security. My hair has been pulled back since 9:31 am and I have sweated through my scrubs at least 3 times...which is the only release of fluids I have had today since I haven't even had a bathroom break.

When I finally get to my locker at 21:15, I look at my phone and see that I have 67 missed calls and text messages. The once cute engineer begins to look like a bit like a stalker, and I now see a tarnished, needy jerk -- and I have an instant hate for him because of his whining text messages asking me where I am and then accusing me of not wanting to go out with him. I am tired, hungry, thirsty, and sore. I may have been disillusioned this morning by getting all primped up, but...

That SOB can drop dead.

After all, I had a hard, busy, long day. I saved some lives, dammit. I made a difference!

The Leap to Crusty Status

About Julie Reyes, DNP, RN

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