Day One.

The system has been very busy when I talked to the staff finishing the nights so I looked set to continue the same for us.

Regular Pt doing to dialysis.
60F, misjudged the depth of the gutter and took a tumble, Left upper arm injury.
83F, Fell out of bed, Right wrist fracture very obvious and she kept trying to wave it around.
84M, Abdo Pain.
88F, Everything hurts, High maintenance Pt this one wasn't even hiding the pleasure of the attention.

84yo, Cerebral event. This one is worth a bit more of a story, called to a CVA but the history tells of symptoms as old as two weeks ago but not constant and then today some kind of a fall in the AM and six hours later dysphasia, semi obstruction of own airway by tongue, equal strength but no coordination.
On the way left deficit occurs, right upward gaze and decreased GCS.

As normal we didn't get to follow up that day but the next we got to see the scans. It appears to them that there was a slow bleed over the last two weeks and the fall opened the flood gates and the final presentation. Prognosis, not survivable.

Finished the day with a 30 something M with a hypo, GCS 15 with something like a 2.1BGL, sugared him up, he signed the PHCR and off back to the Ranch we went.

No lunch or crib break all day and it was a twelve and a half hour shift.

It buggers me as to how some old fart in the IRC or our own ivory towers can think that the extra two hours and still no breaks makes for an easier dayshift.

Be careful out there and I'll see you at the Big One.

Taz