Emergency Room TROLLS
"28 year old male with possible seizure activity..."
crackled the voice over the radio. The paramedic giving report then proceeded to dutifully give history and vital signs and such, but nobody heard it. All we heard was the first line. We knew who it was.
A troll was coming in to waste our time.
In the brief time I've spent in the ER so far, this made the 2nd or 3rd time this guy came in on my shift, and the regular ER staff sees much more of him..much MUCH more.
He comes in several times a month having "seizures" that are only relieved by Xanax or sometimes Ativan - IV, always IV. Lately he's taken to being nauseated as well, because then he gets to have some Phenergan as a super fun bonus.
Seizure guy has been dealt with in various ways here, from being taken seriously and completely worked up to being pretty much brushed off. One time he was discharged without any of his goodies and he literally threw himself down on the ground, wrapped both arms around a nurse's legs and begged for drugs. "You've been discharged," the nurse had told him. "There's nothing I can give you now. Go on home."
So what did he do? He stormed out of the ER treatment area and into the waiting area, flopped down in a wheelchair, and had a "seizure." He was re-triaged, re-registered, and got his kicks.
So back to today. "He can go to triage," the triage nurse said in a bored voice as the paramedics wheeled him in. It hadn't gotten very busy yet and there were plenty of beds available, but to triage he went. Trolls often use the poor ambulance services just because they know they'll usually go straight to a treatment room instead of the waiting room.
Troll (whining): Don't you have a room open? I don't think I can walk!
Triage nurse: Oh you don't have to walk. We'll take you in a wheelchair.
Troll (whining more): But I might have a seizure, and if I do a wheelchair won't hold me.
Another nurse (curtly): You'll be all right.
Cold, aren't they? Rotten, cynical, hateful nurses! Don't they know they're supposed to be filled with compassion, dripping with sweetness, and always wear ridiculous white hats?
Trolls like that guy make everyone more tired, less loving, less patient, and a lot grouchier. We have some patients that come to the ER with a migraine, for example. And because they know that "chest pain" are the magic words that will move them to the front of the line and perhaps get them some morphine, they claim chest pain, causing us to spend money on a bogus cardiac workup based on a lie.
And what about the prison inmate who bashes his head agains the bars until it splits open, just so he can get out of jail for awhile and come waste our pefectly good oxygen with his presence?
What about the "kidney stone" patient who cuts herself and drips blood into the urine sample she's been asked to give so we'll all be convinced of the excruciating pain she's in? And let's not forget that she's "allergic" to every non-narcotic painkiller ever made.
The list goes on, each example more pathetic and ridiculous than the one before. But while the nurses in this ER may be jaded and tired of playing ames, they still manage to somehow muster up compassion and kind words for the truly sick. They still manage to at least sometimes give people the benefit of the doubt. I'd like to think I'm like that as well: somewhat suspcious, taking no crap, but being careful not to jump to wrong conclusions or be negligent. Concerning a different troll a couple of weeks ago, one of the ER docs said this: "You know you're wasting your time with this person. But you have to take this seriously as much as is reasonable. They very day you brush off someone as crying wolf or drug seeking will be the very day something really is wrong with them. Don't let that happen to you."