'Walk-in' head injury patients are the bane of my existence...
...not the big freaking machete-in-the-head type of head injury...or even the rugby player who was unconscious on the field, and who is now obviously confused and who has blood running from his nose or ears...they're straightforward.
Even the "I may have been unconscious but I'm not sure because I was drunk and have the IQ of a newt" head injury is easy to deal with...as a Nurse I am not legally allowed to discharge a 'drunk' head injury...I simply pack them in an ambulance and send them to St Vulvas to be assessed and (frequently rapidly) discharged by the A&E doccies...
...Buff-and-Turf...Result!!
Its the weird stuff that does my head in...are you confused because you are 95 years old and don't really understand electricity...or because you've got a bleed on your brain...?
Are you confused because you're 25 years old because you're a f**kwit,or is it because you've got a bleed on what passes for your brain...?
So we do the Glasgow Coma Scale and the Revised Trauma score as a matter of course...well..sometimes we do...
...mainly we just do the stupid 'head injury' chart that someone in the Unit cobbled together after an earlier 'unfortunate incident'...
...still...
...it could have been worse...
...I could have been the nurse involved...
Part of the problem is that the scores only tell you part of the story...at some point you have to sit and talk to the patient...you need to get a thorough medical history and then just chat to them...
...the only way you are going to find out if they take any blood thinners,- like warfarin-, is to ask them...so that you can admit them and rotisserie their brains in a CT scanner...
The other part of our problem is the hysteria and paranoia from managers ,and the explicit instructions from our insurers, to treat even the most minor and inconsequential event that involves any anatomy above the collarbone as a major head injury...
...if you cut yourself shaving then ShufflingBob will start the head-injury-protocol on you...
So often its easiest to just sit and talk to the patients...can they talk about things that interest them...do they make sense...?
The patient was a 23-year old male who had fallen off of his bicycle after riding into the side of a car whilst trying to enter a traffic circle...
...he had a cut to his chin...
...the car was fine...
He was dressed in black patent-leather winkle-picker shoes;black socks;stove-pipe black jeans;a black shirt over a black polo-neck jersey...and of course had earrings in both ears.
(Lordy...I hate young people)
He was reading a kindle and sighed theatrically when I called his name in the waiting room.
We had reached the stage in the consultation when I just wanted to check his brain was generally processing thoughts and memories.
"So...do you know the name of the Prime Minister?"
I'm a student...why would I know who the Prime Minister is?
"Okaaay...do you know the name of the Monarch?"
The 'who'?
"The Queen....of England...?"
No...I'm a Republican...
He smirked.
(Did I mention that I hate young people...)
"Okay...what are you studying?"
English Literature...
"Okaaay then...can you name 3 books written by Charles Dickens?"
Who...?
"Charles Dickens...a relatively famous English writer..."
I've never heard of him...
"Right...so you were born and raised in England...Jah...?"
Yes...still smirking
"And you went to school here...Jah...?"
Yes...still smirking
"And now you're at University reading English Literature and you're seriously telling me that you've never heard of Charles Dickens...?"
Yes...still smirking
I just wanted to punch him in the mouth on behalf of people everywhere who believe that a university education is a privilege and not a 'right'...and who have had to pay for their own education...
"Okay then...I'll give you a copy of my notes when we're finished and you can ask your university for a refund..."
What...?
"Well...*Sir*...since you appear to know nothing about one of the foremost writers in the English language...
...and whose bicentenary year it is...
...I think your university has ripped you off...
...there are goat herders in Africa who know who he is...
...there are rice paddy farmers in Cambodia who know who he is..."
Oh...Charles Dickens...well of course I know who he is...I just didn't understand your Australian accent...
He smirked again.
"Right ...*Sir*...now we've got that sorted out, lie down and let me stitch your face for you..."
It was my turn to smirk.
*******
For those of you who do know who Dickens is...and that will be all of you...there are a number of exhibitions in the UK this year to mark the bicentenary of his birth...if you get over here...and BTW...buy me a beer when you do get here!
*******
Charles Dickens walks into a bar...
"Can I get a dry martini please?" he asks the barman...
The barman asks..."Olive or Twist?"
So funny. Love Charles Dickens. Came into the Uk for a visit, but leaving tomorrow.
ReplyDeleteAh well..they serve the beer warm here...
ReplyDelete