NOK/Emg

Twelve updates to complete and I’ve only just arrived for my shift at the ER. So I grab a clipboard and a demo sheet, then head to room 14 to update with my first patient for the evening.

I’m only a “patient access associate.”  You could say I’m the lowest rung on the ladder of importance at the ER, but that might be giving me too much credit. I’m the first person some people see when they come through the doors of the ER: when I’m not running updates I just sit at the front desk, register and wristband the patients, then take down their signatures (which give doctors permission to treat them, so yeah, I guess I’m not completely useless).  However, I’ll never save anyone’s life, diagnose afflictions, or even administer something to ease the pain, so it’s easy to feel a little useless.

Today I was on update duty, the dreaded job that entailed lots of walking and talking and asking uncomfortable questions.

I stopped outside room 14 and listened for a moment. Doctors and nurses don’t appreciate being interrupted and I hate being in the way, so it’s better all around if I can avoid barging in. I didn’t hear any voices though, so I double checked my information. She was a young, female patient with abdominal pain and nausea. Not uncommon chief complaints, but the patient can present in a wide range of discomfort (or lack thereof).  I took a deep breath, knocked softly, and stepped in.

I was greeted with a small girl in her early twenties with dark brown hair.  She seemed more uncomfortable from her circumstances than from her pain, and I greeted her with a soft smile. I learned early on that false cheeriness is not appreciated, but my sympathetic (almost apologetic, I’m afraid) smile usually doesn’t offend.

“Hi, I’m with registration,” I said to the girl. “Do you mind if I do a quick update with you for our system?”

“Sure,” she said. She was sitting with her feet dangling off the edge off the bed, too short to reach the floor. Her color seemed good, perhaps the nausea wasn’t so bad or it had let up a bit. Her arms were crossed over her stomach, in a way that made my eyes linger there for a second longer than I meant to.

It’s part of the job, when working the front desk, for me to sum people up as quickly as possible. Even though I’m “just in registration,” since I’m often the first person a patient sees, even before the triage nurse, it’s my job to take their story and boil it down to a “chief complaint” so that the triage nurse has an idea of what they’re walking in on when the time comes for their initial evaluation. Plus, if someone comes in and explains anything that sounds like a stroke or a heart attack, Ineed to go tell a nurse. Stat.

If I were to sum her up after the twenty seconds and three sentences we’d exchanged, plus the nausea sh was complaining of,  I would’ve called her chief complaint “pregnancy.” But who knows? I’m not medically trained. A urine test is smarter than me at this point.

“Can you confirm your date of birth for me?” I asked, and she did. I then ran through my list of basic information questions, like mailing address and phone number, primary physician and marital status (single by the way).

Then I came to the tricker part.  Her Next Of Kin and Emergency contact fields had been left blank from whenever we’d seen her last.  These questions were my least favorite to ask, being somehow so much more personal than everything else.

“Who would you like listed as next of kin?” I asked, hoping she’d have a ready answer and that we simply didn’t have time to get that information before.

Her eyes flicked from then floor back to mine. “Um, there’s nobody I guess.”

“No one?” I pressed. “This could be anyone, someone we could contact...?”

I left the end of the sentence unfinished, I always do. I’d hate coming right out and saying “You know, if today or if ever you’re here dead or dying and this information is all we have to go off.”

She bit the inside of her lip. “The address I gave you is my school address, I just got here two months ago and haven’t really made any... there really isn’t anybody here. But I guess I can give you my foster brother.”

I took down his phone number and address, grateful that there was somebody out there for her, trying to ignore the fact that he lived half the country away.

“Is there anyone else?” I asked.

“My grandmother is who I used to live with, but she doesn’t answer the phone anymore. Can’t hear it.”

I nodded and swallowed hard.  “Okay, well that’s everything I need for right now.  Thank you for your time.”

I turned to go and put a hand on the door knob. I still had eleven other patients to go update with and probably more coming in every minute, but I couldn’t just leave her.

I turned back.

“Is there anything I can get for you?” I asked. “A warm blanket?  Anything?”

“Actually, some water would be good,” she said. “I’ve been here a couple of hours and I’ve been thirsty.” She was embarrassed to ask, I could tell. But beneath the embarrassment was a desperation for a basic need, and I understood. Not completely, but enough to know that this was a small way that I could really help.

“Sure,” I said, eager to fill the hole her filtered story had shot through me.  “I’ll check with your nurse and as long as it’s alright, I’ll be right back with it.”

She smiled and thanked me, and I glanced at the dry-erase board for the name of her nurse. After I tracked down the nurse, busy at her desk, I meekly caught her attention (I hate being in the way) and asked if the patient in room 14 could have a drink of water.

The nurse stopped what she was doing, checked and the looked back up at me. “Sorry but no, not yet.”

I nodded, and went back to the room. I listened, knocked softly, and then entered.

“I’m sorry,” I said, coughing a little in an attempt to clear the tightening in my throat.  “You nurse said you can’t have water just yet.  But as soon as you can, I’m sure she’ll be able to get some for you.”

The girl’s eyes misted over. She had nothing else to look forward to. No one was coming to take care of her. No one would call her tomorrow and make sure she was alright.  All she had to look forward to was the water I was bringing, and she couldn’t even have that.

“I’m sorry,” I said. I honestly, truly, helplessly meant it.

She nodded and shrugged. “It’s fine.”

I left then, hoping she wouldn’t cry once the door had closed behind me, but feeling pretty certain that she would.

I walked back to my desk to plug her information into our system.

People say that at a hospital you’re just a number, you’re looked over, and you’re just a nuisance to the terrible staff. But I don’t know, I’ve seen a lot of doctors and nurses that just honestly care. Besides, as I sat there and entered her “number,” into my computer, the hole in my chest throbbed and my face grew hot with the tears I held inside.

That girl was not a number. But there was nothing I could do.

I said a quick selfish prayer then, thanking God for my undeserved emergency contacts.