Working a department like the E.D. is fascinating, fast and never dull. Any kind of case could come through at any moment. During my time there I saw the best and the not so good of humanity. I witnessed terrible sadness and loss, relief and joy, anger and frustration, disappointment and confusion and a surprising amount of gratitude. From our perspective were just doing our job but from the patients and their families perspective we were sometimes the team that saved their loved one's life. Of course other times we were abject failures who let their loved one die or gave them distressing news about life-threatening illnesses.
Even then I have witnessed patients and their family thanking the team. However a large majority of our patients came in with broken limbs from falls, cuts and gashes, chest pains and back aches, severe migraines and dislocations. There were foreign objects stuck in eyes and various parts of the body and children that swallowed something they shouldn't including candles, bubble bath, hair dye and the little packets that keep things dry from a flat pack from that well known Swedish store.
You may have thought that I would have witnessed many deaths but this is not the case. Very few people die in the E.D. despite the stories that appear in televisions dramatic versions of the department. And whilst we are on the subject of dramatic interpretations, I am sorry to disappoint you but there is very little romance between the staff either. I haven't seen a television drama that captured the frenetic pace of the work involved nor the humour that we employed to cope emotionally. A bit like school children, it could be the little things that we found hilarious within the department. Like the time that we had a motorbike rider come in who had survived a rather nasty crash. It was his matching army camouflage telephone cover and underwear that made us smile, although obviously not to his face. Or the time the 50 year old male came in having collapsed at a party and we were concerned that he had had some kind of heart attack but his wife made him tell us about the 'special brownie' that he had eaten minutes before his collapse. He was concerned that we would contact the police and also that we would judge him. Let me reassure everyone reading this that our job is to care for everyone who comes into our department. We don't contact the police, we don't give less care to someone who received their injuries through hurting another person and we don't turn people away.
I have provided nursing care for men in white paper boiler suits who were in custody for swallowing large amounts of illegal drugs to a man who came in with a paper cut and just about everything in between. Sometimes we were able to make a big difference, and sometimes just a little difference but that was only in our view. Patients came in to have their physical problems solved and sometimes their emotional problems as well. Occasionally we would have a patient who had to remain anonymous on the whiteboard for their own safety because they were victims of assault and there was a risk that their partner would turn up and have another go. Once the department was in lock-down because a very angry partner turned up with a car boot loaded with riffles and a bomb. Fortunately he was so angry that he warned everyone that this is what he was going to do and we had time to lock-down the department and keep safe until the situation was defused.
I mentioned Gatwick Airport and the red phone. It was an old fashioned telephone with a dial and heavy hand receiver. It sat on a little shelf in the middle of the department where our radios connecting us the the ambulances and land line phones sat along with mountains of paperwork and the computer, otherwise known as the 'nurses station'. It was used by every health professional that entered the department and the emergency doctors also had their own office. That red telephone could signal a single patient or a plane load of possible casualties. They were always thoughtful enough to call us to let us know to 'stand down' which was the most common outcome. Next time you are considering a sneaky smoke in the toilets you should probably know that you will be found out, that the smoke detector will register and that an emergency department like ours will be on 'stand by'. We had a few medical emergencies every year, mostly passengers who were determined not to miss their flight despite chest pains, blinding headaches, chest infections and gastro. What might be manageable on the ground is not the same flying at 37,000 feet in a pressured cabin. Then there were the times that the wheels didn't lock properly, the plane was very low on fuel and once when the captain collapsed. His co-pilot successfully landed the plane and the passengers were none the wiser. The department however had heard whispers about a forth-coming emergency practise when actors are prepared off-site or out of our site and suddenly turn up. The senior staff of the hospital know before hand and have additional wards and beds open and additional staff to help out, but we don't know that until the first set of casualties arrive. So when the call came through that a plane load of passengers were potentially at risk because the captain had collapsed the team thought that it was another practise. It makes no difference in that we always prepare and act as if it were real but imagine their surprise when the ambulance arrived with the captain. And please, if you are sick, don't get on a plane.
For me three years was enough drama but there are some amazing and dedicated nurses that devote their entire career to working in this department.
Keep safe
love
Sarah
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