A Night at the Grady Red Zone

So, prior to this night I have spent about a year or so at Grady and thought I have seen how dysfunctional this place could. However, I was mistaken. I truly witnessed a combination of extremely crazy patients with severe neglect and inefficiency on the side of the staff and the system.

My patient was a guy with schizophrenia who got hit in the head with a metal pipe and had a 2 inch laceration on his forehead. In addition to that his left hand was shackled to his bed and he also had to urinate every 20-30 minutes. He was in a room with 2 other patients. I cleaned his face and his wound with some saline and
decided to saw up his forehead. I spent about 20 minutes finding the right kind of suture and then another 30 or so finding a mayo tray (if you don't know what a mayo tray is google it) to set up all my equipment.

About 10 minutes after I started to saw him up he started yelling that he has to go to the bathroom, normally I would hold a plastic duckie (angled container into which men can pee if they direct their stream right) while he directs his stream, however at this time I was wearing sterile gloves and was not able to help him. So I thought he was gonna urinate all over my equipment and I would have to start over. Luckily I was able to find a nurse to help him. Right after that was over this patient's neighbour who was drunk decided that he needed to masturbate right then and there (he was about 2 feet away from my patient and myself...hidden from my view by a strategically placed curtain) - I heard the nurses screaming at him to stop and then calling security and that patient screaming back (obviously not stopping what he was doing) that he had "to get it out".

A few minutes later I heard loud screams from the third neighbour in the room (he was admitted for snorting 4 grams of cocaine) yelling at the nurses to take off the shackles from his hand and that he will kill them once the shackles are off. He also then mentioned that he spent the last 15 years in and out of the penitentiary system and that he is "a hard mothafucka whodoesn't let shit slide easy" - especially if he is dealing with snitches or some who is trying to steal his money or his "dope" - "you just got to deal with it right then and there" he said. Then he started discussing how he was able to have sex with women while in prison he then went into more detail into that subject (of note there is noone there actually talking back to him).

His screams woke up my patient who was sleeping while I was suturing his forehead and he started moving his head right and left not letting me do my work. As a result, I had to tell him every 5 second - "don't move your head MR. _____...Don't move your head". He then started talking to his voices and went off on a preaching monologue directed at his screaming neighbour (earlier in our conversation he informed me that he is a reverend..). Finally, after about 30 minutes or so I was able to saw him up somehow managing not to stick myself while putting in his 8 stitches.

Then, I was lucky enough to get a malingering patient who just got released from jail the day before and decided to us the Emergency room as a hotel room - she called paramedics and told them she had pain every where and then later admitted she smoked some crack cocaine and drank a pint of wine a few hours prior - nvertheless she was brought in to the ED. On review of systems (whenever I ask: "have you had diarrhea?...chest pain?..headaches" in a list fashion) she answered positively to every single question - it was quite impressive that her story was changing every 5 minutes or so.

to make long story short (i am tired of writng) - it was night of crazy patients and nothing getting done to make it the most dysfunctional time I had at that hospital to date. I would argue it is most dysfunctional and inefficient hospital in the US.