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I am in the middle of practicing the fine art of splinting with some of the newer Rescue members down at headquarters when, thankfully, the tones drop. Myself and two other EMTs rush out of the room before we even hear the dispatch information, glad to be free of the scrutiny our seniors were putting us through.
We are walking into the ambulance bay when the dispatch info. comes over. "Respiratory distress at a local nursing home." We groan, and get ready for the uneventful 4 minutes it will take to get the patient to the hospital.
I grab the oxygen bag and the PCR book, and walk into the nursing home. Immediately, I am greeted by a friendly security guard that denounces men and praises us for being so quick in our response. In her words, "it takes the guys that respond here at least 4 times longer then you ladies!" I play along, and then follow her as she leads me to our patient.
The patient is lying on the bed with a non-rebreather on. She has her eyes closed. Before I even walk fully into the room, the nurses shout out that she's DNR... I blink. Upon further questioning, it seems as if this patient hasn't had a pulse or, consequently, a blood pressure for approximately 40 minutes. She is agonally breathing. For all intensive purposes, this patient is dead.
I turn to the other EMTs, with a "what do I do?" look, but they are as perplexed as I am. It strikes me as ridiculous, to tie up an emergency vehicle and an emergency crew for this kind of thing. Isn't that what transport services are for?
One of the nurses says "uh... so are you gonna take her now?" I look at our patient. "I guess," I say, "but I need to see the DNR order." They go to photocopy it, and leave me and 2 other very small EMTs to move a rather large patient ourselves.
We manage. We get outside the nursing home, papers in one hand, stretcher in the other. We call our captain to make sure we're doing the right thing, and we head off. I begin filling out the PCR. Vitals.... pulse... zero? blood pressure.... zero/zero??? I pick up the radio to give the hospital report.
"Uh... be advised we are en route to your location with a 81 y/o female from stars nursing home. She is DNR. She has a doctors order to be sent to you. Was found unconscious for about 40 mins. Vitals are as follows.... pulse zero, blood pressure zero, respirations 6. she is on oxygen. we are pulling into your back door."
I hang up. I am dreading hearing the response from the ER nurses. I am half-expecting laughter at the other end. Instead, the radio crackles and spits, "You have clearance to the main room." It still seems insane to me to give this patient a bed in the ER for any extended amount of time, but hey, who am I to judge?
We roll into the ER and are greeted by 2 nurses. They direct us to a bed. We obey.
I am about to finish filling out the paperwork when the hysterical relative shows up. "Please tell me she's okay" she says as she approaches me. I sidestep her, saying that she's got to wait for the doctor to show up. In retroscpect, I probably should have been straight with her, kept her away from her now dead relative, not let her see her that way quite yet.... Anything to soften the blow. But I was confused by the entire call, and not prepared to deal with a hysterical relative in any form, so I left her alone.
She walks into the area where the bead was, and one of my co-workers does her best to calm our patients relative. I fill out the paperwork and listen as the relative screams, and cries, and hugs my partner desperately. I watch as my partner, equally as shameless, comforts this woman. I am struck by the complete abandon, the truth to this womans grief. the depth. the reality.
We all walk out of the ER a bit shell-shocked. We get into the ambulance and head back to quarters, now ready to welcome another lecture on the importance of proper splinting technique. I close my eyes for a second, to absorb what has happened in the past 20 minutes. The tones drop. "possible fracture, adult male." The sirens blast, and the lights turn on.
Here we go, again.
