of course work was busy last night - 11 patients, 3 of them minors (who are supposed to be seen ASAP), no triages possible. we did get three people out but of course more came in. one whole female adolescent bed in the state and they don’t take patients on overnights. another patient’s mother, almost crying because her daughter didn’t have health insurance and thus had no recourse, really, but the county hospital, which does not have a good reputation. “what if she refuses to go to buttonwood?” she asked. i told her we would commit her daughter. the system is terrible and i wish she could go somewhere - anywhere - else. but it’s out of my hands, really.
another patient, upset that she was fourth to be seen. i politely informed her that she wouldn’t be seen until the next shift (she’ll be lucky if she’s even seen then). can you let me have a cigarette? no, there’s no smoking on the unit. last time i was here they let me go outside with a security guard to smoke. that hasn’t been policy for a while. do you want a nicotine patch? no. can i check myself out? no. you guys can’t hold me here! new jersey law states that we can until you are evaluated. why? because we don’t know if you’re a danger to yourself or others. i’m not a danger to myself. that’s not what your chart says.
this is a conversation i have almost every shift.
it is amazing how important smoking is to people. they’re voluntary for inpatient treatment until they find out they can’t smoke there. oh, i can’t go to a hospital that won’t let me smoke. well, hospitals that let you smoke don’t really exist any more. they’re gonna give you a nicotine patch. i’ve had multiple patients telling me that if they could just get their hands on a cigarette their mind would clear and they’d be able to focus on what was going on. nope.
an old lady calling at 7am to ask if she can speak to her nephew; the patients who call telling us they didn’t consent to treatment and aren’t going to pay the bill; the far too many people who check themselves in for medication adjustments (we don’t prescribe medications here. oh, but so-and-so told me you did. nope.); the patients that are open, and honest, and insightful, who are so motivated to get help; the patients who refuse to talk, too scared of what’s going on and too far down the hole to notice. it’s such a variety, and i love it. i am exhausted right now, having worked from 11pm to 7:45am (first shift came on late), home at 8:40am, sleeping only two very fragmented hours, during which i kept waking up thinking i was at work. leaving for work again in an hour and a half, 3pm-11:30pm, and i am sure i will see many of the same patients still there. by the time i left there were still 5 to be seen, and two passed cases. and i will be absolutely exhausted.
but at least i love my job.
