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One time, one night
Nurses calm chaos
By Eric O'Link
Published:
Monday, April 26, 2004
Bleep. Bleep. Bleep.
At 11 p.m. April 8, to the steady rhythm of the heart monitor units adjacent to the nurses' station in St. Cloud Hospital's Emergency Trauma Center, commotion steadily dissolved into an efficient working calm. Nurses checked on patients, spoke with doctors, answered their inter-hospital cell phones and checked charts as they moved briskly across the emergency room's tiled floor. The ER smelled, comfortingly, like clean laundry.
The trauma center was processing an influx of patients that arrived between 10:30 p.m. and 11 p.m. Patients had been admitted and triaged. Now, under the soft white glow of fluorescent lighting, nurses flitted between patient rooms and the main nurses' station. They were chipping away at momentary pandemonium, returning the ER from chaos to composure.
"That's the thing about the ER," Nurse Dayon Dropp said. "You try to put chaos back into order and we're pretty good at doing that."
About 30 of the trauma center's 39 rooms were occupied by patients at 11 p.m. Many patients were admitted for less urgent maladies including headaches and flu symptoms. But some patients were in the ER because they had been in one of several motor vehicle accidents that night, had an infection or were intoxicated.
"We had multiple ambulances come in all at one time and our ambulance radio was going off like crazy. Earlier, we had helicopters flying in from all over for various things," Dropp said. "You name it, we had it."
Briony Bohn, a nurse who worked the front desk of the trauma center that night, helped admit some of those patients to the ER.
"It's just been crazy," Bohn said. "We've had a ton of patients. We've had people waiting out in the lobby for an hour."
When patients come to the ER, Dropp said, nurses first take their vital signs and a blood sample.
"Then it's a hurry up and wait game," Dropp said. "You have to assess people and find out who needs medical attention first by the doctors. You triage them; you've got to sort through people to see who needs to be seen first. To everybody, being in the emergency room is an emergency, of course. But we always have to see who's the sickest patient and who has the most life threatening injuries and go to them first."
Bleep. Bleep. Bleep.
The heart monitors droned on as 11:30 p.m. passed. The not-quite-frenetic energy that buzzed through the trauma center at 11 gave way to a lull. A few nurses caught a breather between patient checks and chart reads. They chatted, smiled and joked, but remained hawkishly attentive to every detail of the room around them.
Across from the nurses' station, behind the frosted glass that separated one of the cube-like patient rooms from the main bustle of the ER, a mother held her son's hand.
The boy, Patrick, had suffered a head injury from an all terrain vehicle accident earlier in the evening.
"He was riding his four-wheeler and tipped and cut his head," said his mom, Jacki.
Patrick lay on a gurney, his head wrapped in a thick white bandage. He was awake, but groggy. The heart monitor in the room beeped conspicuously while the family waited.
"The tests came back good so he's getting better now," Jacki said. "He has to go have surgery and they're going to finish it up. Everything should be fine, they just want to take some precautions," she said.
"He's a brave guy."
Patrick's father brought him to the hospital shortly after 8 p.m., his mom said. It was 11:40 p.m.; Jacki said ER staff told her Patrick would go in for surgery soon. They expected to release him the following day.
The staff has been good thus far, she said: "Just not moving quite as quick as we'd like - but they've been very nice."
Just then, the ambulance radio at the nurses' station gave a shrill whine and crackled to life. A Gold Cross ambulance was headed out on a call and, presumably, would bring another patient to the trauma center soon.
But the lull in the emergency room continued until midnight.
"It's been 53 minutes since we've had a patient," Bohn said shortly after midnight. "That's a nice break."
She estimated that patients usually arrive at the ER about once every 15 minutes.
"This is how the ER usually is," she said. "We've had a slow point for a while now and all of a sudden it just kind of picked up."
Dropp spent the 11 o'clock hour getting a patient ready for the operating room and monitoring psych patients and an intoxicated patient. By midnight, her patients and the others in the emergency room were processed and waiting to go on to whatever care they needed next.
"That's what the ER is about, is sorting people through and deciding who gets to go home, who has to be admitted, where they need to be admitted, who needs to go to OR," Dropp said.
Both Bohn's and Dropp's shifts ended at midnight. Dropp admitted it was tough to end her day, which started at noon, on a hectic couple of hours.
"But it's nice because now we're putting all the chaos into order, kind of simmering down," she said.
Next to the nurses' station, the heart monitors continued their monotone vigil.
Bleep. Bleep. Bleep.
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