Barking up the Wrong Triage

We thought our friend Sassy Winger (names have been changed) had appendicitis, so we took her to the hospital. Turns out it was just an ovarian cyst that had burst. YOU WANT TO KEEP READING NOW, DON’T YOU????!!!!

I’m uncomfortable discussing Sassy’s ovaries, so from here on, we’re going to call them phone books. Sassy began experiencing pains in the general area of her phone books — sharp, stabbing pains, as though someone had stabbed her with something sharp — and she feared it could be her appendix. Trying to be helpful, I related the story of my brother Jeff, and how he had his appendix taken out when he was 4, and how the scar has subsequently grown to be over a foot in length, due to Jeff as a whole having also grown exponentially since that time.

Sassy found this unhelpful, and Luscious Malone and I took her to Utah Valley Regional Medical Center. There we waited as she met with the triage nurse. I love the idea of triage nurses, because I love the idea of someone’s job being to tell you whether you’re sick enough to be there. She’s like the bouncer at an exclusive nightclub, holding open the velvet rope for some, but not others. (“You, you, you, not you, you, you, not you….”)

Anyway, as Sassy pled her case before the triage nurse — and each time I’ve typed the word “triage,” it has come out “triangle,” by the way — Luscious and I looked around the emergency room to figure out who was sickest.

It gave me time to reflect on all the time I’ve spent at that particular hospital, almost always to visit someone else. My first major experience there was in 1998, when my friend Chris was in a terrible car accident where he almost died and missed his own wedding. (The woman married him after he got better, and now you’d never know he even had an accident, except that he talks about it ALL THE TIME.) For a couple weeks, my friends and I would go hang out at the hospital in the afternoons, watching TV and pretending to be family so we could sneak into the ICU and see him.

The difficult thing with this accident was that Chris’ spleen was crushed, and theretofore, “spleen” had been one of our favorite funny-sounding words. Now, it was no longer funny. (It is funny again now, by the way; the statute of limitations has passed. Soon we’ll be able to make fun of George W. Bush for being stupid again, too.)

In 2000, Luscious Malone herself was the recipient of a car accident, and we all scurried down to see her in the E.R. She reports that the wooden slabs they put possible back-injury people on were not made for persons above 17 pounds in weight, and that she, being larger than that, began to feel like a Luscious-kabob. She also reports that, at least in her case, if you swear in front of your nurses, they will think it’s funny.

(My first memory of meeting Luscious Malone, by the way, was when she was playing Nintendo at a mutual friend’s house, swearing in such a manner as would knock a buzzard off a crap-wagon, if you’ll pardon my use of the vernacular.)

She also reminds me that you know you’re in bad shape if they put you in a private room in the E.R. Usually, you just have the curtain separating you from the other victims. But if they foresee a lot of screaming or sawing, you get the private room. Fear the private room.

Sassy Winger didn’t get a private room, fortunately. She was relieved, if grossed out, to learn it was merely a phone-bookian cyst and not something worse. They told her to let the phone books rest for a couple weeks, and everything will be fine. Even so, maybe we’ll head back to the hospital, just to visit. I hope we can get in. (“You, you, not you….”)

We were walking to my car, talking about Sassy's abdomen pains, and making jokes about how maybe her immune system was eating her liver, like had happened to someone we knew. This seemed funny to us (though it probably wasn't to whoever it happened to), and Sassy said I should write a column. She whistled a different tune when she found out I wanted to write about her ovaries, though!

No, actually, she OK'd the use of her ovaries for comedic purposes, which was sporting of her. My giving her a fake name helped, I'm sure.

"Triage" comes from the French "trier," which means "to sort." Also, Luscious Malone calls the hospital the "horse pistol." One of those colloquialisms from the American Northwest, I guess.

I was genuinely surprised at some of the reaction to this column. Someone posting an anonymous comment on the Daily Herald Web site said she "agreed" about UVRMC being a lousy hospital, which I don't recall saying or even implying in the column.

It also angered a couple of nurses, one of whom posted at the Herald site, and one of whom sent me this e-mail, which jumps to more conclusions than I care to count:

I took some offense at your comments regarding the ER at UVRMC. I have worked there as a nurse, and yes, even a "triage nurse" for almost 10 years.

To correct your understanding of what the triage nurse does, it does not include telling someone if they are sick enough to be seen in the ER! We also do NOT RANDOMLY select who gets to be seen first. [Sorry I used the word "randomly" -- in your imagination, I mean, not in the column. I didn't use it in the column] Maybe you were too busy laughing at medical terms [possibly] or trying to find a TV with Nintendo to entertain yourself [also possibly]. But if you had read the signs on the walls posted in several places you would have noticed that patients are seen based on the seriousness of their problem. AND believe it or not, nurses are educated in assessment skills and can make judgments based on vital signs and intial information obtained through the triage assessment. We use criteria established by the doctors who work in the ER. [Again, I apologize for saying the exact opposite of all that. What? I didn't say anything about any of this? Then what's her DEAL?]

Utah Valley has grown so tremendously throughout the past several years that our ER is overwhelming busy. We are the busiest ER in the state and for the amount of rooms we have it is am amazing feat that we can move 50,000 plus patients through each year. There are days that the only patients that get directly into a room are the critical patients and NO they don't always get a private room. Our rooms are not assigned by seriousness of condition, nor by "screaming or sawing". When we are busy you get the first available room wherever that may be!

I know that you were trying to be "funny with your snide comments", [which is in quotes, which means I must have said it at some point] but maybe you should step back a moment and think how offensive it is to those of us who work long shifts (often without breaks), nights and holidays to take care of others. We don't get much thanks for the work we do, but believe me we get plenty of complaints. With your article you have mocked a community service that provides good quality care to the people of Utah County. For many who have not been to our ER you have helped them to form a negative opinion of the care they will receive if they go there, and you have done all of this without any acurate information, only YOUR opinion. [Anyone who develops a negative opinion of the ER at UVRMC based solely on my column is a very, very stupid person -- considering I didn't say anything, good or bad, about it, except that I went there and I'd been there before.]

I would love to tell you that you'd better not come into our ER (after your rude comments) and expect good care, but the fact is, we treat everyone with the same quality of care. We even SAVE lives. (Bet that blows you away). [What blows me away is that anyone would choose to continue living when you were the one trying to save them, Nurse Ratchet.] So rest assured, you may have made some enemies but ER nurses can put that aside and be professional in our behavior without demeaning you and your place of employment. [Thank you for not demeaning my place of employment.] It unfortunate that your profession doesn't have the same code of ethics! [There you go, demeaning my place of employment.]

I'd guess that if anyone has a negative opinion of the ER at UVRMC, it would be because apparently, the nurses there are really, really surly.