Our emergency department has divided into three units. Each unit can hold 10 patients. Unit number 3 is an urgent care type which is open only for 16 hrs. None of the nurses likes me in unit 3. I did work at least 3-4 times in unit 3 before nursing staff disqualified me. Most of the nurses told their boss that they would quit if she works in the unit. They liked me as a person but not as a healthcare provider because I am too fast and they were not able to keep with my fast pace. No hard feeling because I am one out of four provider list who are not qualified for unit three.
Unit 1 has also ten beds which include three for psychiatric emergencies. Unit 2 also has ten beds which mostly end up being my unit just due to our mutual decision. All beds are well equipped to handle any type of emergency. However, there is one bed in unit two and two beds in unit two which are reserved for life-threatening emergencies such as Gunshot wounds, serious traumas, stroke, and heart attack or any imminent labor or any other respiratory cardiovascular emergency which cannot be waited.
It does not matter how compact ED waiting area those rooms never will be filled unless we authorize it. We don’t feel like coding the patients in the middle of the ED or cracking the chest.
Jack is another well-known patient to the ED. But jack is different than Johnny. Jack has some major psychiatric issues so we don’t know when he will be in homicidal or suicidal mood. Jack also has serious cardiac health issues so sometimes he ends up in unit two which is my unit.
Jack is a middle-aged man who dresses up very well. Looking at Jack, nobody could tell about his psychiatric issues. I thought he is priest/chaplain when I have met him the first time. He was dressed like a priest and held a bible in his hand.
Not everyone is everybody’s favorite. I am not in his favorite list. Sometimes he comes to my unit for medical issues. As soon nurses go to discharge him, he express feelings of suicide or homicidal. I ends up moving him to unit one for suicidal watch and psychiatric evaluation.
Jack doesn’t talk much. He is obsessed to check certain blood work twice day. We always end up telling him that his blood test is not an emergency which could be done at outpatient. But Jack doesn’t understand the meaning of emergency care so he will end up fighting with the staff. The security department ensures Jack ends up home safely.
Jack is a Jack. He also likes walking around the city and his marathon ends up all the time in our emergency department. I talked to him personally about his activity level but Jack said he knows better what he should do or not to do. Well, on his good days, Jack could make his own decision. Jack could be very violent toward the staff when he skips his medicine. Sometimes he comes to ED with full balloon both psychiatric and medical issues. I never met his family and there is no next of kin in his medical record.
Why he doesn’t like me? I try finding it myself a couple of times. I talk to him politely. I give him food to eat. But Jack always ends up seeing another provider whenever I handle his care in the RD. Jack never refuse to get medical care from me. I asked my partner who knows jack for almost 10 years. I was surprised to know that Jack doesn’t like the female staff. He believes that the males are more superior and intelligent than females. Well, I could not do anything to change his beliefs. That is his belief and we respect it. Now, the nurses make sure he goes to unit one directly if there is no compromise to his health.