Why was it so hard just to take care of that guy's leg? I mean say he actually was suicidal, wouldn't they still need to take care of his leg?
That's the point. It was a dump job. The ER doctor found just 1 psychiatric symptom (and it really wasn't even a symptom) and turfed the patient off to psychiatry, when in fact the patient had a nonpsychiatric problem, while the ER doc erroneously writing up a physical exam that presented the patient as if the patient had no physical problem. It just demonstrates the willingness to dump the patient without examining what was really going on.
I did residency in Atlantic City. Once a year, the Wednesday before the summer tourism season starts, the police go through the boardwalk, haul off all the homeless people to the hospital or the rescue mission--which is literally dozens to hundreds of people--no kidding. Its not that the people needed to go the hospital--just that the police needed to dump them somewhere other than back to the boardwalk.
So if you're the unfortunate resident on call that night, you'll have about 30 or more people in the psyche emergency center that usually (at that point) only carried about 3-6---and none of them really in need of a psychiatrist. The ER doctor pretty much labelled all of them as suicidal because he didn't want to deal with their disposition, and the psyche emergency center had better communication with the rescue mission. So the ER docs figure they can just dump this all to psychiatry. So if you're on call that night--you'll get almost all of them with a "suicidal" on their chart and the person denied they were suicidal.
Or the Edinburgh Depression Scale which in NJ became law that it be given to women who had just delivered a baby. If the woman didn't speak English, the nurse didn't want to deal with the inconvenience of getting a translator, so they direct the woman to check off the choices indicating depression--forcing the psychiatry CL resident to have to deal with the mess. Trust me--sitting there with a translator on that scale can take 20 minutes to half an hour. Having the woman just check off the wrong boxes takes about 30 seconds.
(My solution was to write down on the consult--"will return when the the NJ Patient Bill of Rights is followed--giving the patient a translator for the scale. Please consult only after staff have provided a translator" which always ticked off the nursing staff at the Ob-Gyn ward because it made them have to do their work for real. The attendings didn't seem to care because it was not their time wasted, but I was the Chief, I'm supposed to be a resident advocate & I figured I'd actually take a stand on that position, and if they complained it'd only reveal that they weren't doing their jobs.)
I got a million more turf stories, but I'll spare you the rants.
