Another lovely set of night shifts over

First of all I want to thank everyone for the comments on my last post, 'DSH'. I was expecting some criticism but it was all very supportive so thankyou all very much. The second edition of 'The Handover' is out and definitely worth a read.

This weekend just gone we have seen far too many drunks, mostly students, and more vomit than I have ever seen in my life. One patient, I'll call him Tom, (a much nicer name than I would call him outside of work...) came in via ambulance. I'm not sure he was in need of medical care, like a lot of drunken patients of ours, but rather a good night's sleep and some headache tablets for the morning. Nevertheless he was put into majors waiting to be seen. I was in the assessment area with another nurse - 'Jill' and a matron - 'Jack', his OBs were unexciting. His girlfriend turned up. She staggered over to him and started saying 'Hey there baby, are you ok sexy man? Are we gonna move back in together now? Aww my poor baby' in a very quiet and sultry voice which conjured the same look of disgust from both me and Jill. She continued to talk, much to the irritation of my gag reflex, when she revealed something Tom didn't want us to know.

'What else have you taken tonight baby?'

'I ain't had nothin' - you shut your mouth now'

'You've been on the coke! I know you have!'

She was right. He had the characteristic white dribble in the corners of his mouth. He continued to deny it, with a smirk on his face. I diverted my attention to the next patient.

Our second '?# NOF' of the night, a lady in her 80s who'd had a fall. She was in serious pain, but was getting by with her entonox supply. I was left alone in the assessment bay whilst the other two were handing over their drunkards to majors, when I heard shouting next door. 'Get your hands off me!', Tom had grabbed his girlfriend and punched her. I tannoyed 'Security to assessment bay - STAT', he had his hands around her throat when the son of our ?NOF lady stepped in and pushed them apart. They escorted her out. Tom said that she had his phone and wouldn't give it back to him, and that's why he'd grabbed her. She said it was her phone and not his.

Drunken girlfriend: 'It's my phone you tw*t, and I'm leaving you, you've just f*cking hit me and I never want to see you again'

Of course when they've both sobered up I have no doubt in my mind that he'll win her back by showing her how different he is when he's off the cocaine. I'm sure he's a different person altogether, I'm sure he would never soberly hit his girlfriend or threaten nursing staff, but I guess that's just what drugs do to some people.

I went back to my elderly patient and thanked her son for his very brave attempt to seperate the fighting couple. Her BP was quite low, Jack got some fluids into her and we put her outside to wait for a bay in majors. By this time Tom was being wheeled round, and because he was shouting and swearing to the staff, he got put into the next available bay. I felt quite sad that Tom was prioritised because of his abusive behaviour, instead of my patient with severe hip pain and low BP. She'd been brought in about 20 minutes before him as well. I feel even worse that she didn't complain.

Tom was there for 10 minutes before he started kicking off again and he self-discharged.

I spent some time on the A&E ward, where I met a patient who I'll call John. He'd accidentally amputated his thumb with a power drill. He told me he'd drilled through the middle of his knuckle, but had no idea that it was severed until he'd tried to stop the bleeding and noticed that half his thumb was missing. He was waiting for a plastic surgeon to come and have a look at it. The registrar went to have a look at the thumb in the treatment room, to discover that it was nearly frozen solid. He asked me to put it into some cold water, so I did. It didn't look real, it looked like something you might find in a joke shop. It was grey, and had mangled tissue protruding through the part that was severed. When the plastic surgeon turned up, we learned that it would not be possible to have the thumb reattached, because it was torn off and not a clean cut. I took John up to the trauma ward, where he told me that he'd had a similar accident before. He was actually working on the hospital fitting windows, when something very large and very heavy (I forgot what it actually was) fell onto his hand and crushed two of his fingers. Luckily they were able to save his fingers, but it was a shame that this time they couldn't do anything for his thumb. That left us with a little problem, we didn't know how to dispose of the thumb. I'm sure it couldn't be disposed of in clinical waste, something to do with it being tissue, so I took it up to the ward with him. The nurses up there didn't have a clue either, but I could hardly take it back with me, so our problem had become their problem unfortunately. Oh well, at least they had some entertainment with their squeamish student nurse...

So that's my night shifts over for another 4 weeks, and I'm off to bed. I'm tempted to sleep in my scrubs. (I don't usually wear scrubs, but whilst trying to get an unconscious drunken student onto her side Jill managed to flick the vomit bowl at me). Eulgch. What a nice thought to go to sleep with.