Tuesday, June 24, 2014

Getting Cold Feet

On just another summer night at Callous Bastard Hospital, long after the fast track section is closed, Young Dude (with gf) come in with chief complaint of "foot pain".

So, hey, at least it's not a train wreck full-code from the local Con(next of kin out of their money while providing no actual care)valescent Hospital. Triage basically just did vitals and dropped him off, which is cool since they're busier and I only have two other patients, so I mosey in to get the details on why he's here at 3AM.

"Can't sleep, my feet are killing me."

So, after getting him to doff everything below the waist except underpants, and put on the stylish gown, I pop back in and have a quick look at the troublesome appendages before the doc gets in.

And the guy has ten toes that are cold, stiff as a board, waxy, and with large white tips on all ten toes and larger sections on the two smallest toes on each foot, in the most textbook-perfect visual appearance of frostbite it's ever been my displeasure to see live and in person.

Digging deeper, it transpires that he's an employee at one of the local food distribution warehouses, having just finished his second shift job there at midnight. Where he was ordered to clean out the frozen food freezer (the size of most suburban house lots). Despite protests that he hadn't been trained, and sans any sort of appropriate protective gear which OSHA, CalOSHA, Union rules, company policies, and mothereffing common sense dictate, his Idiot Boss, Mr. Sumdood, sent 20-something to shovel ankle deep frozen slush in 0-degree temps for 8 hours in his Van's tennis shoes, cotton socks, jeans, a t-shirt, and a windbreaker. And being a good (though perhaps not very clever nor worldly-wise) employee, Young Dude went and did his job.

Whereupon I send my truly fantastic tech to go fill a couple of splinting and casting chicken buckets (exactly what it sounds like) and fill them nearly full of water that's comfortable but well north of body temp warm. All the sinks in the department helpfully being temperature-safetied for morons to past the point of common sense, the only actual warm water in the entire department is down the hall in our break room. He returns, and we begin rewarming our patient's frostbitten feet - generally a rare find in SoCal in the summer - and I go to let the doc know what the "foot pain" is in relation to.

He avoided surgery last I heard, but only just.
Working in an E.D., I generally don't have much use for lawyers, but for the second time in my nursing career, I advised patient and gf to start with his union shop steward, save copies of all his paperwork, and to assume that from this point out Great Big Grocery Chain, courtesy of Idiot Boss' tenuous grasp of common sense, had just bought the bill for this and all subsequent care, and that any further intransigence on the subject ought to be referred to legal counsel, as part of his have-a-nice-day departure lecture.

And told him he's off freezer duty for the foreseeable future.

Clearly the biggest morons aren't always the ones who actually come in to the department for care.

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