Parkland 3: Triage

There were many nights that as the sole triage nurse and with a gaggle of people lined up in front of me, I would hop off my chair, grab my clipboard and walk the line of sick and injured so that I could pull out those who looked ‘bad’ and triage them first.

“The Public” didn’t get it.

Derogatory remarks pointed in my direction were frequently heard from fit-looking '30-somethings' and exhausted moms. I learned early on that it was best not to respond to 'triage catcalls'. Explaining just how an abdominal stab wound 'trumps' a broken wrist would most likely fall on deaf ears and was a waste of time. You didn’t want to get into it.

Triage is an art. The effective Triage nurse is perceptive, knowledgable, communicative and decisive. An added 'skill' learned at Parkland was the trained ability to "never let them see you sweat".

On my first night alone at Triage, I was approached by a disheveled, diminutive man in a long trench coat. When I asked him how I could help him, he burst out into tears and sobbed – loudly. Heads turned. I paused and again asked him how I could help. He threw his head onto my desk, burying it in his arms. Wailing. There were several people waiting to be triaged and I’m afraid that I was a little less than therapeutic when I said in my most firm ‘Nurse Ratchit’ voice…“Sir. Tell me why you are here today.” With that, he lifted his head, looked me straight in the eye and with a disgusting amount of snot coming from his nose, said… “I have a gun in my pocket and I’m going to blow my head off”. Well then. Triage decision-making time.

- Do I become more sympathetic to the little fella? Yes.
- Do I ask for the gun? No. Could be problematic.
- Do I call for Police backup? Wanted to – Couldn’t do that without causing him alarm.
- Do I make him my friend? Definitely yes.
- Do I offer a tissue? Without a doubt.

So, asking his first name, I introduced myself and reassured him we were here to help him. Then I asked him if he wouldn’t mind if I took the gun from his pocket. Abruptly, and to my surprise and relief, he stood up and assumed the ‘frisking’ position against the wall. I took his lead and began searching him all the while looking back, all big-eyed and mouthing the words, “Help Me” repeatedly. I was trying to get anybody's attention. Nobody bit. Two Dallas Police Officers were having a conversation only about 20 feet away and were oblivious to my dilemma, the clerks at triage were busy entering data into their terminals and the patients in line were waiting their turn, people coming and going glanced in my direction but would just continue on. Not one person so much as raised an eyebrow. It was then that I gathered 'frisking' to be an added Triage nursing expectation.

Welcome to Parkland.

I never did find the weapon.

Parkland 4:Psych