The Shoe


I was freshly out of ER orientation and really wanting to prove myself to be a competent nurse, when an unconscious petite young woman was brought in by DFD ambulance. She had a high fever and had experienced a seizure PTA. She stood about 5 feet tall and may have weighed 100 lbs. As a team, we stabilized her condition and were preparing to send her to the ICU when a resident announced that he had to perform a spinal tap first. Well hell.

The spirit of the ER was to “Treat and Street” meaning…“Stabilize them and get them out of the ER”. The rationale was that since you never know what will come through the ER doors at any time a bed must be available for the care of someone else. It made sense to me and it was a priority of the ER nurse to facilitate transfer to another area of the hospital as quickly as possible.

So, I reluctantly set up an LP Tray for the resident and left him and three other residents to their own devices while I took care of other patients – this was my first mistake. About a half hour later, I couldn’t help but notice that they hadn’t finished the LP yet – the procedure usually just takes a few minutes. So, I poked my head in the door and saw that all four of them were still inside. “What’s up?” I asked. The senior resident replied, “Dr Surly is coming down do it.” (‘Dr. Surly’ is a pseudonym) Another delay.

On a good day, Dr Surly, a tall, imposing doc was grumpy. Today, he was grumpier. Being summoned to ‘the pit’ because no one on his service was successful in performing a simple L.P. put him in ‘a mood’ to be sure. He walked into my patient’s room, and without saying a word, rolled up his sleeves and began the procedure. The tension in the room was palpable. Everyone, including myself remained in the room, silent.

I took this opportunity to quietly create a written inventory of my patient’s belongings - a hospital requirement prior to transfer – and (as I was told) one of the signs of a good ER nurse. I found her bag and began my list…1 pair of shorts, 1 pair of socks, 1 towel, 1 bottle of unmarked blue pills - “I should mention this later – after the tap is done”, I thought.1 bottle of unmarked white pills - “Wow. This is critical information, but it can wait until after he’s finished” thinking to myself. The only sound heard in the room was the ticking of the clock. Back to my list, 1 set of keys, I then made my second mistake. Reaching into my patient’s bag, I removed a HUGE tennis shoe. It must have been a size 13. Unable to resist, I held the shoe high in the air and blurted out, “Holy Cow! Would you look at the size of her feet!” With that exclamation, everyone looked at the petite woman’s feet. Without missing a beat, Dr Surly (with the spinal needle still in the patient’s back) said, “May I ask just what you are doing in my gym bag?”

One by one, the residents filed out of the room. We could hear them howling with laughter in the hallway. Then Dr Surly’s eyes met mine. I couldn't take it any more. I sat on the floor in the room, with tears streaming down my face, I was close to convulsing in laughter. Although his shoulders began quivering and he was biting his lip - Dr Surly successfully completed the LP and without a word, walked out of the room after I handed his bag back to him.

I wonder if he got a kick out of finding the completed "Patient Valuables Record" I had left inside.

DFD - Dallas Fire Dept
PTA - Prior to arrival
LP - Lumbar Puncture

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