An Aside: Emergency Rooms as Sacred Space


Emergency Rooms are sacred.  Every last one of them.

They belong to my list of sacred spaces: The Church of the Holy Sepulchre, Yosemite Valley, Mt. Shasta, Angkor Wat, The Ganges River, Jerusalem, the Vatican, Machu Pichu, the Black Hills, the energy vortexes of Sedona, Stonehenge, those Mounds in Missouri, the Solar Compound, all those beautiful Cathedrals in Europe, Everest, Crestone-Colorado, Red Square, the site of the Haymarket Riot, The Witch Tree along Lake Superior, Lake Titicaca, Tenochtitlan, the Grand Tetons, Kilimanjaro, the Serengeti Plain, and wherever else you are that either takes your breath away or hones you into the truly sacred.

I thought that last piece of pizza in the fridge was still good.  A snack before bed.

A few hours later my tummy informed me differently.  And at three am, the first trip (of about fifteen) to the porcelain god came to fruition.  Sick all day.  Stomach pain beyond belief; rivaled only by a kidney stone I had once.  Dehydration.  I spent the day observing life from the bathroom floor, admiring the work of plumbers and the craftsmanship of “American Standard.”

Usually when confronted by such a malady, I get sick once or twice, sleep for a bit, and it’s over.  Not this time.  So about ten at night I couldn’t handle it anymore and (as an RN) rather sheepishly called the Emergency Room.  A friendly voice on the other end said: “Come on in.”

So I did.

The hospital where I work at is in the middle of the Napa Valley.  It’s not an overly used ER (they just perform very basic services) and they average around sixteen visits a day.  Usually they are about as busy as the Maytag Repair Man.  It’s a great place to go.  They see you quickly.

Into my gown.  A brief interview.  A visit with the MD.  And then the IV placement and a liter of normal saline.  I’d had the pain in my stomach for 24 hours, and I was getting a bit concerned that it could be any number of problems: pancreatitis?  A gall stone?

Along comes the friendly nurse (it is now 11 pm) with IV Phenergan, and quickly followed by IV Dilaudid (a very powerful opiate).  A hot flash thru my body from the synthetic heroin (those poppies in Afghanistan do have some real medicinal value), followed by blessed relief.  Deep asleep, they had to give me oxygen through a nasal cannula as my O2 sats were going below ninety (90 and above ensures proper oxygenation to the brain).

I didn’t care.  I slept.

A few hours later, another bag of normal saline.  And a blessed repeat of the Dilaudid combined with another anti-emetic (anti-nausea) medication.  More sleep.

My labs came back fine.  No liver problems (a relief after having consumed from half a bottle, to a bottle of wine, a day, over the last five years).  Pancreas working fine (ditto the above).  Just a tad low on the Potassium (OJ or a banana will fix that).

The Diagnosis: Food Poisoning and Dehydration.

A call to Joni (my spouse) at 4:00 am to pick me up, I left with more Phenergan (suppositories), Vicodin and paper scripts for the same.  The next two days I spent in a Phenergan-Vicodin fog.  Pleasantly hallucinating at times (this is a weird drug combination for me, once asleep on the futon I thought the living room was filled with people).  But the pain was relieved.  I held some fluids down.

And three days later, I can go back to the fridge (but am a bit more careful about what I choose).  Fine work by the ER staff!

A word about Emergency Room Nurses.  I worked for two years in a Level Two Trauma Emergency Room.  But I’m no hot shot RN.  I was the psychiatric guy.  Since about 15% of all visits to ER’s are psychiatric in nature, this ER on the western slope of Colorado had enough business to employ me full-time to do the psychiatric evaluations.

A fun job.  That particular ER was filled with mostly thirty something RNs (male and female), outdoors enthusiasts.  Being in the Canyon Country of Utah and Colorado, that’s who are drawn to the area.  They worked in the fast-paced ER with all the traumas, strokes, heart attacks, sniffles, and psychotics.  Adrenaline charged.  Then days off were filled with rock climbing, shooting rapids, skiing, snow shoeing, mountain biking, camping.  More Adrenaline.

Good People.  Smart People.  Strong People.  Calm in an emergency.  Incredibly competent.  Emergency RNs will help a person die in one room; then walk next door to comfort a kid with a cold.  They have my utmost admiration and highest regard.

Emergency Room nurses get threatened, hit, bit, kicked, and beat up by psychotics and drunks.  Do that to a police officer and you’ll get ten years in prison.  Do it to a Psychiatric Nurse, or an Emergency Room Nurse, and you get good drugs.  Go figure.

Which is why I think we need to consider Emergency Rooms as a Sacred Space.  The good people who work there need to be as protected as Yosemite, the Spotted Owl, and the Snail Darter.  We all will visit an ER at some time in our lives.  Maybe we will wait too long.  We will grumble, complain, and feel like we are being called an illness or an organ.  The “kidney stone” in 3A.  The “heart” in 7B.

But I’ve been on the other side of the ledger.  And I see how these good folks work.  They deserve our protection and admiration.  Just like Yosemite.

Allan Stellar, RN, blogs at <> .

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