The Witching Hour

So, it was a slow day in the ER. It's nice to have a change of pace every once in a while. As the day went on, so did the reduction in staff. I don't understand this concept from management. On the floors, yes, no patients means literally nothing for the nurse to do except catch up on e-mails and education courses. I say let them do it and then decide. However, the ER is a different animal. At one moment you can have a few patients and the next, a bus crashes and now you have a mass casualty incident.
Now we have been severely cut back to bare bones staff. Only an hour left of the shift and if you have read my previous post, this does not mean good things for me. It's the witching hour. And that is what happened.....

I get an ambulance call, back pain x 2 weeks. Okay, I wonder why call an ambulance. I get the patient, he walks over to the stetcher without difficulty. I start to ask him questions when he interrupts me, "I'm going to the bathroom."  He pops up and walks down the hall. I'm speechless because I was in the middle of admitting him to the ER. I wait for him to come back and then ask him what happened today that made him call an ambulance to bring him to the hospital.
"Nothing"
"Have you seen a doctor for your back since it's been a couple of weeks?"
"No"
"Okay, so you just decided to call an ambulance?"
"Yes, my son said I wouldn't have to wait if I called an ambulance."
"You realize that's not how it works, right?"
"What?"
"There are not a lot of people in the ER right now, so if you had come on your own, you would have gone straight back. If we were extremely busy, then you would have gone to the lobby regardless if you had come by ambulance or not."
"Oh."
"Also, I want you to realize that if the insurance company does not deem your condition a medical emergency for the ambulance ride, they don't cover it."
"OH!"

I'm taking it one patient at a time, educating one patient at a time - like the story about the child throwing the starfish back into the ocean when someone told him that he couldn't save them all and he said, well, I can save this one. He tossed it into the water. I feel that way with the patients - one a time.

Oh, and true to tradition - 1800 - the witching hour - we got a call from the fire chief about a hazmat call - one patient and two firefighter were exposed. The hospital hazmat team was called in. Part of the ER was closed, sealed off from the rest of the hospital, hazmat suits, decon area set up, closed the ambulance bay, etc. It was a freakin' beautiful thing. I knew, KNEW this would happen when they cut our staff to bare bones. HAHA! It was classic. I guess they'll never learn......