A team of paramedics brought Garry Hardy directly to the Emergency Department of the hospital. As he had several visible contusions Garry was seen immediately by the triage nurse. One of the other nurses on duty took information provided by the paramedics. The paramedics emphasized that not only did Garry have both known and undetermined physical injuries he was also in a delusional state. The duty nurse whispered this information to the triage nurse.
Garry was semi- conscious when the triage nurse measured his blood pressure. She handed Garry a towel to put pressure on his bloody lips. Garry could still see the nurse although his vision was blurry. The triage nurse began to ask Garry questions while typing his answers into the computer.
“Do you know where you are, Garry?”
“Yes,” Garry replied. This place looks like a hospital.” His tee shirt was bloody and he was having great difficulty seeing out of his left eye. Garry spat out a tooth in between the first and second question.
“Why did the paramedics bring you here?” the nurse asked.
“Because I got beat up by a big, fat oaf on the bus,” Garry replied.
“Why do you think the police constables helped bring you into the hospital?”
“I don’t know. They should be arresting the idiot that beat me up for no good reason.”
“Are you in a lot of pain?” the nurse asked. How would you rate your pain on a scale of one to ten?”
“Twenty,” Garry answered. That fat creep punched and kicked me in the face. Then he used his steel toe boots on my ribs.”
“Do you feel sick?”
“Yeah, I feel woozy and nauseous.” After he finished answering the question, Garry threw up on the floor. The nurse immediately called for a janitor to come clean up the mess.
“Our duty nurse will take you to a patient’s room where you can wait for the doctor to see you. Should we put a pail in your room?”
“Yeah, I would. I might barf again,” Garry replied.
The duty nurse met briefly with an intern to inform him of Garry’s presenting symptoms. The intern called to ask if there was anyone available from the Psych Department. He was told that the psychiatric on duty could give Garry an assessment in approximately one hour. This gave the intern adequate time to do a physical evaluation of Garry’s condition and to wait for the results of his patient’s x-rays and blood tests. As Garry’s lips were swollen and bleeding, the intern asked the duty nurse to suture Garry’s cut lip.