For the last little while I have tried to avoid talking shop. Unless it was the extremely stupid, like the scorpions causing swine flu. But today was a stressful day and I am going to vent.

Ramadan and EID have finished and the place is back to normal. It is getting busy through the day with 130 patients in 12 hours since 7AM. However this included only 2 Cat 2 patients and about a zillion Cat 6. (for the non nurse types a Cat 6 is healthier than me on a bad day.)

The waiting time had stretched out to 4 hours and people were getting restless. I am so glad I speak no Arabic because I could ignore the complaints. Then just as things were hotting up a man with "back pain for 4 months" presents and is given a Cat 5. He rings the head of the hospital and complains that he does not want to wait. The head of the hospital rings the head of ER who promptly agrees to see the patient. The patient jumps ahead of 15 patients Cat 3 - 5.

Suddenly the nurses are asked to explain. I point out which Doctor is the head of the department and made the decision. Sadly this is a regular occurrence.

My second stunner of the day was taking my obese newly diagnoses rapid AF patient to X-ray and had a Monty python conversation.

X-ray: "Can the patient stand up for the X-ray?"

Rod: "No they have rapid AF it would be dangerous"

X-ray: Oh...(calls in the family)

Rod (notices the X-ray is sitting the Pt up in bed).."What are you doing?"

X-ray: "We are standing the Patient up" (apparently the conversation in Arabic was the X-ray asking the family if it was OK)

Rod: "NO! this patient is newly diagnosed AF their heart rate is jumping from 70 - 175 and they have chest pain. It could cause a heart attack:

X-ray "The family said it was OK"

Rod (leaves the room) "This is on your head only"

For the nurses out there, which is worse, standing for a c-spine X-ray and removing the collar because it is in the way

OR

Exercising and AF patient with chest pain

The answer can be found in chapter 6 of "Emergency Medicine Saudi Style" by Dr Mohammed Bin Rubbish. Available with a free set of steak knives and a year's supply of dates.

Anyway thank you for reading my venting. I am off for chips and salad al fresco at Najjars with the other inmates.