The truest statement I heard all day.

Talking with patient who are confused can often be challenging, but also occasionally amusing.
Case in point:

Me, to the fairly confused patient who came to our ER because he was threatening to hurt himself:
"Sir, do you know where you are?"
"Yes, I do. I am in an unfortunate place." (I got excited for a minute thinking he might actually remember where he was today.)
"What place is that?"
"The Saluda County Jail."
"No, sir, you are in the ER of Self Hospital."
He looks totally surprised. "You are lying. I'm not in the hospital."
"Yes, sir, you are. You've been here for 3 weeks."
"3 weeks?? No, I haven't. You better ask them out there. You are mistaken." He points to the nurses in the hall.
"If you ask them, they'll tell you the same thing. You've been here in the ER for 3 weeks."
Now to them: "Have I been here for 3 weeks?"
The helpful nurse responds: "Yes."
He asks again, "Solid?"
"I must be confused." At this point he begins to look for his pockets, obviously trying to find his phone. The problem is that he is wearing the type of paper jumpers we provide to patients when they are suicidal. They have no pockets.

I try again to assess his orientation. "Do you know what year it is?"
"It's 2000."
"No, sir, it's actually 2011."
He looks at me, incredulous.

"Well, one of us must be crazy."


Sarah said…
REO in CA said…
Do you usually keep patients in the ER (Emergency Room) for three weeks? I'm trying to picutre this.
Aubrey said…
I wondered if someone would ask about this. Aunt RE, you have discovered one of the great problems in our health care system today. Like many other hospitals, our hospital decided to close the psychiatric unit at the beginning of this year. The reasons for this were numerous: our psychiatrists resigned all at once and also the psych unit itself never makes the hospital any money. I think it was a very bad decision because now we have lots of other problems, like this one. Whenever anyone comes to our ER who is suicidal, manic, hallucinating, or has any other psych diagnosis, they have to stay in our ER until we find them another psych facility to take them. Because of certain nursing issues, if they should be admitted, the only place they can be admitted to is our ICU, since most require some sort of locked unit and 1:1 nursing. Sadly, since many people like this gentleman do not have insurance, they end up sitting in our ER for a LONG time. Because of the issues with this gentleman, there is a chance he will stay in our ER for even longer.

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