Only in New York

I work in a busy emergency dept. in NYC. The atmosphere can get pretty intense, my colleagues and I try to use humor to lighten things up. One way we do this is by giving patients pet names. "Scratchy" a regular homeless patient, was one of the people for which this was true, until recently that is... Nurses Announcements Archive Article

It was 3 AM on the first day of Summer in New York City, I was taking the subway home after working a grueling 12 hours in the emergency department. You must be wondering about the kind of people I run into on the train at that hour. Up until recently, it wasn't anyone I would consider particularly special. But that changed after I was nearly robbed for my phone and who else but "Scratchy" a familiar (homeless) patient, came to my rescue.

I was playing Sudoku on my phone as I typically do during the commute. Scratchy was sitting on the opposite end of the empty train car carrying a tattered plastic bag and as usual, scratching his head. His name isnt really Scratchy of course, but thats the name we gave him in the ED after he became a regular admittee. Every time I saw him on the train I wondered if he recognized me from work, but figured he didn't.

I was mid-game when suddenly a young man wriggled in as the train doors were shutting close. It was a Saturday so I figured he was coming from a club or something but in retrospect it was odd he chose to stand up with so many available seats. He turned his back looking at his reflection in the dark window. I only had a few more stops to go so I refocused on my game.

At the next stop and at the brink of Sudoku victory, I felt my phone violently snatched from my hands, the young man had lunged at me and was trying to run off. I yelled "stop!" but couldn't move. He was darting for the exit when suddenly he dropped like a ton of bricks. His head was nearly pinched between the closing doors but all I could do was watch, I was physically frozen.

"He's having a seizure put him on his side!"

yelled Scratchy but I couldn't get up, my legs felt like wet noodles, my head was spinning. Finally Scratchy came rushing to the young man and carefully positioned him on his side,

"Ain't you a nurse, why don't you help him?!" scolded Scratchy.

I'm not sure if it was realizing that Scratchy could talk (he never said a coherent word before) or if him knowing medical procedure for seizures snapped me out of shock, but at some point I woke up and went into RN mode.

I quickly placed my nursing bag at the base of the subway pole to protect the young man from bashing his head,

"YES I am a Nurse...I was scared, he tried to rob me didnt you see!" I retorted glaring at Scratchy.

"Anyway, how'd you know he was having a seizure?"

He ignored me, eyes planted on the young man who was coming to a calm. During all this time the train was slowly elevating from underground. The whole ordeal probably lasted a couple of minutes but felt like a lifetime. As the train screeched upward I could see the silver moon glowing over the brick buildings, "only in New York" I muttered. Suddenly my phone rang with my husbands ringtone. I got on the floor searching but couldn't find it. I stood up frustrated to find Scratchy with his hand out, my phone in his palm.

"By the way, my name is Jerome not Scratchy" he said "Your phone was under the boy".

I felt my face flush as a wave of shame came over me. He did recognize me from the ED and he knew we called him Scratchy. I took my phone and explained everything to my husband who somehow was able to meet us on the platform with the authorities in just minutes. I assessed and then warned the young man before the police took him away. I also apologized to Jerome and thanked him for everything. We offered to get him food but he refused. We waited with him for the next train, when one finally arrived he got on, turned back to us and said

"That boy, his name's Mark. He got epilepsy, like me. Met him once in the hospital you work at".

The doors closed and the train pulled out of sight leaving my husband and I standing in humbled silence. On our way home I reflected on how callous my colleagues and I have become. The ED can be a really intense place. We try to have a sense of humor and although we don't mean any harm when we come up with these pet names, we must keep in mind that our patients are not pets. They are human beings in our care and they deserve respect.

I don't take the train home anymore, I also haven't seen Jerome since then. As long as he's safe I'll consider that a good thing and pretend that he's off doing superhero things in the subway like saving lives and cell phones. As a matter of fact, I wouldn't be surprised if that tattered plastic bag he carries is actually where he keeps his cape.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you for sharing this fantastic article, which is a great reminder to us that our patients are individuals with their own life-stories and challenges. We should always treat all with respect.

There but for the grace of God, go I.

Amen....

Funny. I think similar situations are likely to happen anywhere in the public service sector. When working in mental health there was a patient that I saw often that my co-workers named "bubble boy". He had what some call "The Truman Show" delusion where one thinks that he literally lives in a bubble and that he is the main character in a T.V. show (like the Jim Carey movie with the same name). In his mind my co-workers and I were merely paid characters in the many plot lines that "The Company" created in so called life. Apparently this is not an uncommon delusion. In fact I'm pretty sure that there was an NPR report on the condition... but I regress. We called him bubble boy. As far as I know he never knew that we gave him that nick name and I don't honestly know that he would have taken offense to the name had he know. Because the bubble was his reality. At the moment I don't think I can make any deep connection to the story about Scratchy, only that Scratchy and bubble boy received their nick names for unfortunate reasons that aren't funny. Despite the humor that we bring to what can be stressful situations by giving nicknames these individuals have names and are people that deserve respect. So we should just call patients by their names... yeah.

Thank u for this amazing story, It is a pleasure to know that you turned out well and that you've learned a valuable life lesson from it all. I do believe that everything does happen for a reason and hope Jerome is doing well too :)

Thank you for sharing your story! It's amazing when you think of how intricate one human life can be. It's also humbling to remember that. Made me tear up a bit!

digress* not regress. I hope I'm not regressing.

Specializes in Geriatric/Sub Acute, Home Care.

wonderful story....I could see doing that...I worked in an ER but not as a nurse...wasn't then , I am now......and we always tried to lighten things up.......its very stressful, upsetting and dismal at times seeing suffering , sick people all the time......its human nature in a way to try to get that burden of despair, depression , anxiety and general heaviness of the day off of you......we aren't made of steel.....many people do think we are.....but.....giving pet names doesn't do any real physical harm to anyone....but psychologically it may do deeper harm to those who need us.

i'm studing to become a helping nurse (i don't know how to spell it, cause i live in uruguay and i speak spanish, but the carreer it's nearly two years) anyway, in the hospital studing we try to use humor but your article was amazing cause you see how tiny the line is from take things slow to not feel bad about to the point of make someone feel bad.

this is a great reminder, thanks.

nurses comments and even facial expressions can hurt deeply and keep patients from getting the health care in need.

here is a story of someone i knew a while back:

ex druggy- with years of sobriety- goes to a dr's office says they have hep c+ first thing noticed is the negative facial expression...

this after the fact he already feels the medical profession isn't to crazy about people on medicare: he feels like he is a burden to the system, feels bad the Dr isn't getting paid fairly, yet knows the Dr. will react negatively to the fact he screwed up in the past... going to the Dr is never a pleasant experience--- because 20 years earlier he was a teenage druggy that was beaten daily.

of course during intake the Nurses ask questions - what they do for a living.. he responds, I am on disability for depression... Nurse asks, "what do you mean you feel sad ?".well how do you think the patient feels after the nurse says, i feel sad and tired as well , maybe i should stay home as well and collect a check as she and her fellow nurses laugh.... this patient never returned for the follow up.

even worse was when the patient went in for meds to help with the major depression and asked the physicians assistant about the drugs she was prescribing--for he was having severe side affects, only to wind up scolded, as she comments... why does it matter? it never mattered when you were putting all that other crap in your body... the patient never returned

only to wind up with attempted suicide later on, 150+ lbs overweight, for this patient was off their meds, wound up isolated and became an honorary member of the NFL club, (no friends Left)... there is more- but you get the idea

so yes, what you say and express as a health professional does matter

at least scratchy helped - when he could have reacted like many in the profession- just sit back, judge and laugh--- not knowing the why a person is the way they are. Kudo's to Jerome

Fantastic story. It's a great reminder that we really do have to believe within ourselves that we are all connected. We can go through the motions at work, but until we allow ourselves to have real empathy, we're not fooling anyone. But it's a difficult balance; if we access our empathy for people who are going through unacceptable hardships, we also have to face some hard truths. I'm a student nurse doing my med surg rotations at a country hospital. I love the patients so much, so I have to keep reminding myself that 1. there are a variety of ways to cope - some are better than others, and I have to choose wisely 2. that every nursing intervention is a step in the right direction. I love this post!

Specializes in Emergency/Clinic.

Sometimes even in the reporting of pertinent information to the provider you can upset a patient who decides they do not like your "tone of voice", etc. This happens even though you may not intend anything or realize how you may sound to someone that is ill and defensive about the reason they are there. We try to be the best we can but this serves as another reminder of how much harm we can do if we are not careful.

Specializes in Cath Lab, ICU's, Pediatric Critical Care.

Wonderful story!!

^'They are human beings in our care and they deserve respect.' (Sea of Roses)

I would like to relay this story to others...

I had an uncle, (my mom's brother) who was a homeless person in Manhattan. He had a long history of mental illness, untreated as he refused medications, which started in his teens. He visited my Grandmother once a month in a Brooklyn nursing home. After she died, we didn't see him for several years. We had no way to get in touch with him.

Several years after my grandmother died, one of my mom's sisters (on Long Island) received a phone call from a rehab facility in Manhattan, asking if she was Rose R. They told her that they had a male patient there who was asking for her, and he said he was her brother. Her last name was common, so for quite some time they had been calling similar names from a phone book. And they started by looking in Brooklyn, as that's what my uncle remembered. She went to the hospital to identify him.

My uncle had been hit by a truck, he was crossing the street on a green light, and the truck drove through a red light. He was taken to a hospital, given a 'John Doe' and he was treated in the ER, taken to the ICU where he remained for 3 months undergoing several surgeries for his injuries. His severe head injury was the most significant of his injuries. He had severe short term memory loss, among his neuro deficits. From ICU he went to a med-surg floor for some time until he was all healed, then on to the hospital's rehab facility.

When he started to remember things that were from way back in his past, my aunt's married name was one of the first things that made sense to him. He couldn't remember his last name, or my aunt's maiden name, but remembered her getting married in 1950!

Someone took the time, interest, and compassion to keep him alive, and take good care of him for almost 2 years before they found my aunt! And when they couldn't find someone immediately, staff people unknown to us, keep trying to find his family.

He was eventually moved to a nursing facility near my aunt on Long Island, and lived there until he passed away from bone cancer.

yes we nurses will be always in service mood only . one day i too was travelling in bus . one old man was travelling in standing near the door . when driver put break he was about to fall from the bus and i was near to him and with out my knowledge i hold ed his hand and saved him from fall . According to our culture female won't catch males in public but i did it . Because i am a nurse my service mind only did it not me .