In All My Career…Stories from the ED





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An Orderly Shoot-out

Back in the 70’s I was moonlighting at a hospital in Florida and was partly through my shift when an “orderly” appeared asking if he would mind if he followed me around because he had an interest in emergency medicine. He seemed to be a reasonable fellow, dressed appropriately and so I said “sure.” After a few patients a charge nurse appeared and began to accost him for apparently leaving his post and coming down to the emergency department. A shouting match ensued and security was called as the orderly became more and more belligerent and she (the nurse) continued to push all the wrong buttons. The next thing I knew a quintessential southern sheriff with his wide brim hat and his silver .44 magnum was in the department with the gun aimed at the orderly and the orderly opening fire with one liter glass IV bottles which landed at the feet of the sheriff. Utilizing all my superior interventional skills, I bolted for the parking lot and awaited the sound of gunfire. Hearing none in about 15 minutes, I came back to the emergency department and found thankfully that the situation had been resolved with the orderly being carted off somewhere, the sheriff leaving the department and the charge nurse leaving me to my own devices. It was an interesting introduction into why one should not continue to escalate a tense situation with a patient who in retrospect was probably schizophrenic.

Bruce Janiak, MD

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