Sometimes I'm convinced that the management and physicians have conspired to place a glowing sign at the ER entrance that states (in large flashing pastel pink and blue letters), "All pregnant freaks and their families, WELCOME! C'mon in to OB Triage" To top it off, the sign is only lit during the most inopportune (i.e., already busier than crap) times.
Case(s) and point:
You are 26 weeks pregnant and have been vomiting for four days. You are starting (Starting?) to wonder if something is wrong. When do you come in to triage? 2:00am on a Saturday night.
You are 39 weeks pregnant and twisted your ankle while tripping over your toddler. Yesterday. Oh, and you don't have a car or money for a cab, so you've missed your last four prenatal visits, despite being high risk due to a history of high blood pressure, diabetes and a pulmonary embolus. When do you roll into triage by ambulance (thanks, glad I just paid my taxes so that you could spend about $1000 of my tax money for a ride... oh look, here comes the rest of your family, who got here in their CAR.)? 2:00am on a Saturday night.
You were sitting on the couch naked ('cause
that's something I'd admit to my health care provider), 36 weeks pregnant, eating ham (I repeat, while sitting on the couch. Naked.), and your boyfriend took it upon himself to "check" your cervix, only he noticed some green funk down there instead. In addition (as if that were not bad enough), there was something pinkish on your boyfriends fingers when he pulled them back out. But it might be ham. (Gag. True story.) When do you come in to triage? 2:00am on a Saturday night.
You are 21 weeks pregnant and have not had a bowel movement in three (seriously, I'm not kidding) weeks. When do you come in to triage? 2:00am on a Saturday night. (because NOW it's bothering you?)
You are 24 weeks pregnant and have not felt the baby move for "a couple" of days, which concerns you, despite the fact that you weigh almost 400 lbs and probably have a foot and a half of adipose tissue between the baby and the nerves of your abdominal skin. Oh, by the way, you also have asthma and are having a coughing fit but forgot to bring your albuterol inhaler. What else do you take for your asthma? Nothing, just the albuterol, and since you usually feel worse at night, you use it an average of
6 times every night. (Pause, while nurse picks up lower jaw from floor.) And the icing on the cake, you are latex allergic
and have a history of MRSA, so you must be kept in contact isolation. When do you come to triage? 2:00am on a Saturday night.
You have not received prenatal care during this pregnancy due to the slight inconvenience of being incarcerated for the last few months, in another state ("It was my boyfriend's dope in the car, I swear!"), and your mother only recently bailing you out. Now you're just curious how far along you are, and "Can we do an ultrasound to find out the sex of the baby?". When do you stroll up to triage? (Are you sensing a pattern yet?) With perfect timing, you, too, arrive in the middle of our "lunch time". (Looks like it'll be a couple of peices of the Halloween candy someone brought in, swallowed whole, on the run,
again.)
Yes, there are quite a few legitimate patients who visit the triage unit amidst the chaos. I wouldn't be surprised if most of them get lost in the shuffle.
Hey, at least I still got
my health.