Management vs Saving Lives

The crew thought he was going to die, and they didn't know what to do. They were literally thousands of miles from home, a world away from their families. The closest city was a week away. The Russian vessel was fishing in some of the worlds most dangerous waters, within spitting distance of the Antartic ice shelf. The nearest help was me...well, not just me, but me and the emergency room crew whom I worked with, at the southernmost hospital in the world.

"Got it" I called out as I hurriedly grabbed the red phone. The red phone meant that a helicopter was on its way in. Several other nurses gathered around, their heads close to mine as they tried to overhear the call. "Emergency recieving over" I said into the handpiece. "We have a forty year old male with severe abdominal pain, localized to right iliac fossa. ETA twenty minutes." "Message recieved, out" I hung up the phone. I related the message to the others. "Is that all?" said Cherie in dissapointment. Cherie was an adrenalin junkie and if she wasn't jumping up and down on someone's chest or up to her elbows in blood and gore, then it didn't interest her. "That's a bit harsh" I replied, but I found myself speaking to her back as she headed back into the resusciation room.


Twenty minutes later the chopper landed and another three minutes after that our patient was wheeled into our department. Cherie was the first to greet the crew and led them over to my area, the moderate illness area."Suka,pizdec bolit,pomogi blyad" the patient yelled out to us as we transferred him from the trolley onto a bed. He was a giant of a man, a stereotypical iron pumping, Bolshevik, American eating giant. "What did he just say?" I asked. The two men in flight suits shrugged their shoulders "Not a clue" offered Mark, the head paramedic, "But he's in agony, that's for sure. It's his appendix, and it must be due to burst." By this time Jason, the ER doctor was at my side, listening to the handover from the paramedics.

"Kto nibud', nu sdelaite je shto nibud' ebannyi v rot" Yelled the Russian as Jason gently pushed on his abdomen. "I'll get the morphine" I offered, but Jason had other plans for me. "Someone else can do that, get me a translator, now. If we don't get one soon, I'm gonna have to take him to theater, and I don't want to do it without consent." I was hoping someone else would get that job as the bottom of New Zealand is not the easiest place to find a Russian translator.We did have a list of translators, three Japanese, two German, two French, one Romanian, two Polish, one Dutch... there were at least twenty nationalities covered, but no Russian. There was a Russian name there, but it had a line through it. I called hospital management to get them on the case.

"You have a Russian?" said Jenny. Jenny was the day duty supervisor for the whole hospital. She was in charge of both nursing and medical staff. "Yeah, helicoptered in twenty minutes ago. He's not well and we need a translator urgently" I said. "Does he have insurance?" Jenny asked. "Haven't got that far yet, busy trying to save his life." I replied. There was a brief silence on the phone, just long enough to make make me nervous. "You've got the list there in the ER office. There's a Russian on that" Jenny eventually said. "It's crossed out, and there's no other Russian speakers" I said. "Well there's nothing more I can do, you'll have to sort it out yourself for now Don't forget that man's insurance details. I'll come down there in a while to sort things out." The phone went dead.

I would much rather have been at the bedside as it was much easier than trying to find a translator. I asked every nurse in the department but they too couldn't help. I became creative. I called the Polish translator in the hope that they might speak Russian, after-all, they were once under the Russian thumb, but they were no help. The Romanian didn't speak Russian either and sounded almost offended at my ignorance. I called the police, and they said they would get back to me. They never did. My last call was to the High School. "Yeah, we have a Russian teacher, "Vlad Prudchenko" said the headmaster "I'll get him right away." Five minutes later a translator was on his way.

"Skolko stoit?" called out our Russian patient. I looked towards Vlad, the translator. "He want's to know how much." I looked at the doctor for guidance, but our Russian patient had more to say. "U menya est dengi i ya mogu zaplatit'" We all looked at Vlad "He says he has money, five hundred roubles" said Vlad. "Prosto pomogite mne" said the patient. "He's begging us to take away the pain" said Vlad. Jason had heard all he needed to "Tell him not to worry about the money. We'll fix him up and get him back on his ship. No one will come after him for the money." Vlad translated and I kept my mouth shut. The less people that heard this converstation, the less complicated things could get.

Our patient was operated on within the hour. The surgeon said his appendix was only moments from rupturing. We had saved his life. Two days later his ship sailed into harbour and he was there to greet his shipmates, and leave with them as well.

"What's the name of the shipping company?" asked a furious Jenny "We'll get them to pay the bill." I glanced at Jason sitting next to me in Jenny's office. "Sorry, I never got it. I work in the ER, so I didn't see the Russian after he had his surgery" I explained. "I specifically asked you to find out about his insurance, and you did nothing." Before I could answer Jason interupted. "He did ask about insurance, and the man said he could pay. The man's life was in danger and we took him at his word. We didn't have time to chase up the man's paperwork." Jenny alternated between glaring at Jason then me. I tried to shrink into my seat, relieved that Jason had spoken up. "If that's all you're going to say, then the matter is up to the board, and maybe the lawyers. You'll here from me soon. You can go" Jenny waved her hand for us to leave.

I got up, but Jason sat still."Ah Jenny, before you take things further, you might want to think about your actions that night" said Jason. The air could have been cut with a knife. I thumped back down in my chair. "You were called in to help a situation, but you didn't help. You said you would come to the department, and you never did. We are not management, we are the people saving people's lives. You left us to make a decision without support, and we did what we thought was right. I'm more than happy to speak to the board, anytime you want."

We never met with the board. We never recieved a reprimand, and we never heard about the matter again. The only time the matter came up was over a pint of ale that I had bought Jason. I pint he well deserved.

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Emergency Room Antics

This is a typical Saturday night in the Emergency Room:

2000hrs: Two drunks, one of whom is 14yrs old and was found unconscious in the gutter, while the other was very well dressed, 41yrs old and celebrating his birthday with some work colleagues. He is a lawyer, and had just finished work.

2010hrs: Fortunately the 14yr old was able to be woken up. We managed to get hold of the girl's mother who was naturally hysterical and is on her way down. Unfortunately, we couldn't wake the lawyer, even after we tried everything in the book. We tried the sternal chest rub, squashing his fingernails with a hard object, and pushing the pressure points in the eye sockets. It looks like he may end up being intubated.

2020hrs: A drunk 16yr old boy presented with a broken collar bone. He's very subdued. It's probably because he has ruined his parents car. While he is sent to get x-rayed the doc has decided that the drunk lawyer needs to be intubated and has called the anaesthetist.

2025hrs: The 14yr old girl's mother has arrived. I feel so sorry for the poor woman. The moment she saw her precious child lying there in a hospital gown with a drip in her arm she broke down in tears. The girl broke into tears as well and now they are hugging. It's so good to see a family that seems to care. It could have turned out so different.

2040hrs: The lawyer has been intubated and taken to intensive care. Meanwhile an elderly lady has been wheeled in a chair complaining of a sore upper thigh. She had a fall getting off the toilet. I was a bit worried that she may have broken something so put her on a bed and saw straight away the signs of a fractured hip, or NOF (neck of femur). Her affected leg was shorter than the other one and rotated inwards.

2045hrs: A 61yr old man was brought in after falling off a bar stool. He was very intoxicated and had some superficial lacerations to his face and hands. He needed some sutures. He did fall nearly three feet onto his hip, but he showed no sings of a fractured hip. It is almost unfair that he doesn't break a hip when the woman on the toilet did, but it's not uncommon. Drunk people often avoid serious injury because they are so relaxed. When people are sober and fall, they tense up, helping to cause a break.

2100hrs: That's my first hour of work over and it feels like forever.

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Punch up in the ER

As I jumped onto the back of one of the biggest guys I've ever seen, I wondered if I was going to make it out alive. But the guy had my friend and colleague, Damien in a headlock and was going to ram him into the wall.

Forgotten was the fact that this was a hospital, that this was the emergency room where we are supposed to help people, save lives and all that other wonderful stuff. This was a damn brawl like you'd see in your average pub on a friday or saturday night.

The good news is that the giant released my friend, the bad news is that he went for me.

I'm not afraid to run, and so I did, straight behind the ranks of security guards. "Why the hell didn't you help me?" I shouted at them. "We're not supposed to use force" was the reply. Meanwhile, the giant could see that he was outnumbered and bolted for the door.

His timing couldn't have been better because he ran straight into half a dozen friendly police officers. Thank goodness the receptionist had phoned the police at the first sign of trouble.

And how did it begin, well it was the usual story. Alcohol. The giant that the police were escorting away had got in a fight, received some nasty laceration which would need some sutures, and called an ambulance. He was angry at the paramedics for taking so long, (they were there in seven minutes) and when he came into the emergency room he didn't like being told that he should stop using the F... word, even when I explained that we had young children here who could hear him.

Hopefully he'll spend some time in jail, and maybe even have to pay us some money.

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