4 Things Emergency Room Nurses See That Would Gag A Maggot
You've been to the emergency room. You know what it's like: A crowded lobby that smells like blood and feces, lit by depressing fluorescents, full of unhappy people nursing a variety of untreated wounds. It's like the DMV, only the line moves a bit faster. We wanted to know what it was like to spend all day, every day in that terrible place, so our interview options were limited to "emergency room employees" and "drunken amateur daredevils." We wound up with Ben and Paul, two nurses who work in two different Chicago ERs. They told us that ...
Being An ER Worker Is Like Running The Special Effects Department For A Horror Flick
ER nurses are taught to emotionally detach themselves from patients so that they don't freak out if part of one of said patients physically detaches and falls on their shoes. That's not a hypothetical scenario, as Ben told us: "One of the first trauma cases I ever had was a high-speed motorcycle crash. When I lifted away the rider's hat, pieces of bone and brain fell across the back of the stretcher. The patient passed away shortly after reaching us." Later, when Ben was leaving the hospital, he "caught sight of a little blob on top of my white sneakers. I'd forgotten to wear shoe covers, and a bit of that patient's brain tissue had fallen onto the shoe and stuck. never forget that dark red blob stuck to the clean, white leather."
And now, neither will we.
Whereas we would've stripped naked and walked straight to the psych ward and/or liquor store, Ben calmly walked back into the hospital and disposed of the brain shrapnel in a biohazard container. And if you think we're trying to shock you by starting with the worst anecdote, oh boy are you in for a treat. Here's something Paul saw: "A guy walked into the ER after a car wreck, saying, 'My neck kind of hurts.' When the scan came back, the attending runs into the room and starts barking orders. 'Don't let this guy move another fucking inch!' The base of the skull rests on top of the first cervical vertebra, called 'the atlas,' and this patient had essentially dislocated his skull off the atlas. If he had turned his head quickly to look at something, his skull would've slipped off the shattered atlas and sheared through the spinal cord, killing him instantly. This is known as internal decapitation."
Which, as terrifying injuries go, is right up there with internal castration.
Oh, but those are the more existentially troubling stories. We have not yet ventured into the straight-up disgusting. "One of the most challenging conditions to care for," Ben said, "is an infection called Clostridium difficile. Its main effect is to cause severe diarrhea. The stool is so watery that it becomes a nearly-constant leakage, yet it's so mucousy that it's quite sticky and difficult to clean. Plus, it has a distinctive, extremely foul odor that tends to linger in the nostrils for hours or days afterward."
At least you can take brain-shoes off.
"On top of that, it's incredibly infectious. Sometimes we have to place a tube into the patient's rectum to drain the stool away into a collection bag. It's uncomfortable, embarrassing, and doesn't make a perfect seal, but it at least gives us some chance to keep the patients from getting covered in their own stool. If you are ever a visitor in a hospital and your family member has one of those tubes in place, please make sure not to trip over it. The resulting mess will ruin a nurse's whole day." And the janitor might actually end up killing himself.
Then again, it might end up washing away some of that sticky, troublesome brain.
The Terrible Things Nurses See Every Day Can Cause PTSD
Watching more brains explode out of skulls than a Mortal Kombat game can apparently get to you emotionally. Shocking, we know. "In some of the trauma centers in this city, we're watching young black men die from gunshot wounds every single night," Paul said. "It doesn't even make the news anymore, but more and more healthcare providers are dealing with post-traumatic stress disorder because we live and work in a war zone. I myself was diagnosed with PTSD a couple months ago. I was having terrible nightmares every night. I was incredibly jumpy when out in public, and even in my own tiny apartment. I was in 'fight or flight' mode at every moment of every day. It kept me from wanting to be intimate with my girlfriend. It was making me depressed, irritable, and mean."
Code Blue wasn't meant to describe the staff's emotional state.
According to a 2007 study, 24 percent of intensive care nurses show signs of PTSD, as compared to 14 percent of general nurses. General nurses deal with far more death and disease than anybody should have to, but at least those are usually from natural causes. It was seeing what people do to each other that got to Paul: "When a 17-year-old kid rolls into the trauma bay with multiple gunshot wounds or stab wounds and dies, it's easy to forget that you watched someone get murdered because it happened in a hospital. The disconnect between the shooting and the death didn't really register for me until I got home and realized that I couldn't save a kid from getting murdered. Eventually it all piled up, and the emotional toll began to exact a physical response."
And you can't even become a vigilante, because they keep giving you the night shift.
Witnessing the death of a child is the leading cause of PTSD in ER nurses, but in most cases, they're told to suck it up, wash off all that pesky child blood, and get back to work. It's a job where you're expected to be immune to human tragedy, where adverse reactions are seen as a weakness and not an inevitability.
"There are virtually no safety nets in place for us," Paul said.
It's Not Just Death; Even The Sex Is Horrifying
Let's move away from troubling deaths to talk about other, equally troubling things. In this case, sex. "This patient came to the ER several times per year for huge urinary tract infections," Ben said. "Nobody knew why they kept happening. The time I was her nurse, I a catheter in her bladder to monitor her kidney function. After you insert the catheter, you inflate a balloon at the end which keeps the tube from falling out. But after I inflated the balloon, the whole thing slid straight out, intact balloon and all."
That's highly unusual, and not generally seen unless the patient passed a kidney stone the size of an actual kidney. This was not the case. "After gentle questioning, she finally admitted that she and her husband shared this esoteric fantasy of urethral intercourse." Without getting too technical, a woman's urethra is very clearly intended to be an exit-only orifice, and horrible things can happen if you void the warranty on that equipment.
The urethra is supposed to be 2 inches long and 0.25 inches in diameter.
"They started out with very small toys, and gradually moved to bigger and bigger ones, and after some years, they finally stretched her urethra enough for the guy's penis to fit. They were both overjoyed that they could have sex in a new and different way. But they couldn't have sex that way very often, because every time they did, she wound up with a bladder infection and had to go to the ED."
You'd think that multiple trips to the ER would encourage this couple to simply try some butt stuff, like normal people do when they tire of the more utilitarian orifices, but they wouldn't stop. So they were referred to "a very understanding urologist, who would treat the infections when necessary without requiring more trips to the emergency room. The couple went away happy, and as far as I know, they haven't had to return to the ER since." Finally, they could live out their lives in piss.
There was some crying later, but that was because they tried tear duct sex.
But not all of Ben's patients get uh ... happy endings. "In my area, there's a fad for injecting erectile dysfunction drugs directly into the flesh of the penis. This is quite a bad idea. If the erection doesn't go down after a few hours, a physician will take two 18-gauge needles and stick them lengthwise into the penis, through the glans, to let the blood out. Sometimes it sprays pretty far."
This is an 18-gague needle, although the doctor might swear that it's a 20 on a good day.
The One Thing Even ER Nurses Fear Is ...
Hospitals should be so sterile that you could theoretically eat lasagna out of someone's chest cavity without consequences ... to the patient. The lasagna would surely suffer. In an environment like that, nature is your worst enemy:
"Blood, poop, and gore is no trouble at all," Ben said, "but I have to steel myself very carefully before I can do anything bug-related. The chance of getting bedbugs or scabies at work causes me a lot more anxiety than the chance of blood-borne infections. HIV might be a life-changing incurable infection, but scabies are invisible mites that burrow into you and live inside your skin. They're like a horror movie come to life. We had one confused and aggressive patient brought in by police. Once we started looking for injuries, we saw he was absolutely infested with lice, bedbugs, and scabies. I mean, you could see hundreds of little critters crawling for cover as soon as the light hit them."
Picture that, but on your junk.
When that happens, the entire ER enacts protocols straight out The Thing. "With two other nurses, I had to gown up in isolation gear, give the patient a sedative, strip him completely, shave off some of his matted body hair, perform a full bed bath from scalp to toes, and cover absolutely every centimeter of his skin in medicated cream."
The exam room then had to be quarantined and decontaminated, as did two police officers and squad cars.
"Everybody in the department was involuntarily scratching all night, even though none of us contracted an infestation. Even remembering it now, long after the fact, gives me the phantom itches."
And now you have them too. You're welcome.
Ben is a registered nurse at one of the largest trauma centers in the US. You can meet him by getting shot, falling off a high place, or by saying "Hey, hold my beer and watch this." Cezary Jan Strusiewicz is a Cracked columnist, interviewer, and editor. Contact him at firstname.lastname@example.org or follow him on Twitter.
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