It’s been 7 years since I graduated nursing school and started on this journey of being an Emergency/Trauma RN and, let me tell you, it hasn’t come with a shortage of insane stories. Over 5 of those years working as an RN have been in the ER which has been almost exclusively in level 1 trauma centers all over the United States.

For those not in health care, hospitals have trauma designations of Level 1 (this is the highest possible designation meaning they take the worst traumas because they have the most resources…AKA specialty physicians [especially trauma surgeons], MRI/CT/etc. capabilities, trauma trained nurses, capable and qualified units for the patient to go after they’re done in the ER or OR [burn unit, cardiac intensive care unit, neuro intensive care unit, etc.]. Depending on the state, these levels continue to 2,3,4 and 5 decreasing in available resources as the designation goes up in number. Other states only recognize 3 trauma designation levels [like Illinois where I was trained].

This basically just means that I’VE SEEN A LOT OF CRAP.

For the entertainment of all and in honor of the new nurses about to start compiling their own lists of WTH moments, I have rounded up some of the craziest stuff I’ve heard and seen over the years. In the spirit of trying not to depress everyone, I have tried to keep this fairly light-hearted and aiming on the side of humor. So, although I could also give you a list of the saddest patients I’ve ever had or the most life-altering, still-think-about-to-this-day horrific patient stories, that is not that list. Follow along for a glimpse into another day in the insane controlled chaos we call the ED.

Get Your Freak On

It’s midnight on some random weeknight and a completely horrified young couple come running into the ER. The story is that they were having sex when suddenly an unfortunate and forceful meeting of his penis with her pubic bone caused a loud snapping sound and a sudden intense pain for him. While we’re getting him x-rays [yep, you can x-ray a penis], his scrotum is growing to the size of a spaghetti squash and turning black due to it being filled with blood. Long story short, he legit broke his penis and SHATTERED his urethra. Knowing he would be heading off to surgery soon, his parents along with his two elementary school aged niece and nephew show up to wish him luck before he goes to the OR. I was pretty sure we were going to have to do CPR on his girlfriend when she died of mortification.

A man walks into the ED triage window and hands a coworker a note that reads “Do not laugh. This is serious. Last night I got really drunk and put a small apple in my anus and I can’t get it out.” Guess an apple a day doesn’t keep the doctor away in this instance…

A gorgeous probably 19-year-old girl walks into the ED triage with her mouth wide open looking like she just watched the video from “The Ring” [someone please tell me you get this reference…]. I help her put a face mask on to hide her situation, take her back to a room and triage her where I find out that what I thought had happened was exactly what had happened. During a particularly vigorous performing of oral sex [I’m cringing right now thinking of my grandparents reading this but IT’S WHAT HAPPENED!] on her boyfriend, her jaw locked, and she was unable to close her mouth due to its dislocation. Best/worst part about this story? Her boyfriend brought her to the ER but stayed in the car because HE WAS TOO EMBARRASSED.

Light bulb up the butt…screw-in side first. Yeah, that went to surgery right away being careful not to move him too much and cause the light bulb to break thus potentially perforating his bowel. DUH DUDE.

The classic tale of a vibrator stuck in someone’s butt…still on. Ya’ll listen to me now when I tell you that your booty hole does NOT have a set end point! Things can and will get lost up there. Stop putting things that can get “swallowed” by your anal sphincter up your butt!!

A young 20-something year old guy comes in with a dog bite to his penis and scrotum. The story? He went over to a friend’s house and when he opened the door, the dog seemed friendly at first but then lunged at him and bit him through his pants. I don’t like calling anyone a liar but NO HE DIDN’T. First of all, this is a docile dog breed that is known for being gentle and good around kids. His “friend” also was really wanting to come to the hospital with him and make sure he was okay. Oh, and he went home and showered first before coming to the ED to get examined despite blood coming from the head of his penis. Reading between the lines and using my nursing Spidey-sense, this dude 100% slept with a girl and then while naked was bit when the dog, who was already all riled up from not knowing what kind of wrestling match had just been going on between this stranger and his beloved owner, thought he found a new toy and bit the guys junk. Regardless, homeboy had a dog tooth go through his urethra that day which was what was causing the bleeding. He got sent home and followed up with a urologist later in the week. Not the best first date impression but points for drama.

You did WHAT??

One day I was taking care of an elderly man who had a chronic Foley catheter and was having issues getting it to drain. He was telling me how he didn’t understand why he was having issues because he keeps it really, really clean. When asked what his normal routine is, he casually reports that several times a day he FLUSHES IT WITH BLEACH. When my appalled facial expression and “You WHAT??” reaction was verbalized, he attempted to downplay it by telling me he puts a little bit of water with the bleach to dilute it a bit. When I attempted to educate him on the fact that soon he won’t need a Foley catheter because he WON’T HAVE A BLADDER LEFT, he told me he didn’t care what I had to say, and he was going to keep on doing it. Jesus take the wheel…

At the personal request of my manager and with the help of a bribe in the form of a very high bonus, I finally picked up a night shift at a hospital I worked for. What appeared to be the makings of a very boring night turned around when we got an inbound report from EMS that a stabbing victim was being brought in with a very low blood pressure and approximately 5 stab wounds to the torso. Homeboy comes in COMPLETELY wrapped in duct tape courtesy of his girlfriend. When his girlfriend arrived in the ER, she was screaming at the staff and being a huge distraction from us helping her boyfriend. I would be lying to you if I said I didn’t giggle a little when I found out the same woman who had stabbed her boyfriend had also whacked her a couple times with a random pipe. Sorry, not sorry. He ended up having a ruptured bladder which I found out when I inserted a Foley catheter at the insistence of the trauma doctor and got nothing but frank blood [oopsy boopsy]. Taking the duct tape off was crazy because it pulled the wounds wide open as we did it but truthfully, his “innovation” [if you will] probably helped his case quite a bit because his blood loss could have been much worse. He got transferred to another hospital after getting a couple units of blood infused. His girlfriend ended our interaction screaming at me to give her a ride to the hospital an hour away. That was the hardest of hard no’s and the police took her elsewhere for the evening.

I’ve got a great demographic for you for insane stories…prisoners. They really do provide a plethora of WTF moments for the emergency department. Although staples being put into eyeballs, crap being swallowed, and arms being cut are very run-of-the-mill visits for prisoners, they don’t get any less nasty. One popular self-harm behavior is the super fun activity of shoving pens up their penis; one guy that I helped care for had 3 just swimming around in his bladder. Another guy swallowed a ton of paper clips, pens, staples, etc. which all had to be removed because it caused a bowel blockage; as my hilarious cousin Kristen said, “He turned himself into an Office Depot pinata!” The worst of the worst prisoner stories though happened early on in my career. This guy had previously cut into his stomach super deep requiring a colostomy bag to “fix” what he had damaged. Down the road, he was found pulling his intestines out through the hole (ostomy site) and was EATING HIS OWN INTESTINES. This nut job has done this several times and each time earned himself a trip back to the OR. When you have nothing but time, I guess humans will do some pretty crazy crap.

 I took care of a young girl early on in my career who had hundreds of sewing needles pushed into her abdomen. She was a thin girl so the ones that she pushed in sideways were superficial and if you ran your finger over her stomach, you could feel the ridging of all the needles. When she pushed them straight in, however, she usually required surgical intervention of some kind. The worst part was that she had HIV, so her stomach became a very dangerous area for healthcare workers to deal with due to their risk of exposure. She ended up getting refused by most of the surgical doctors in town because of her repeated behavior. Eventually she stopped showing up to the ER, so I hope she got the help she needed.

One late night a man was brought in from the gas station nearby. He had doused himself in gasoline and lit himself on fire right there in the parking lot. He was brought in with his entire body so badly burned that he required an IO (an IV that is drilled into the bone) because he had no usable areas in his arms or legs for an IV. Thankfully the trauma surgeon who was working that night is also a burn doctor and knew exactly what to do. He was given a heavy dose of pain medication and helped to die much more comfortably. I have no idea what was going on in this man’s life to bring him to do such a horrific thing, but there’s a lot of people who saw him that night who will never be able to forget him which is exactly why suicide is so infuriatingly selfish.

Ya’ll knew this post wouldn’t be complete without a good maggot story or two, right? Oh, you’re not here for disgusting maggot infested wound stories? Sorry ahead of time. This is unfortunately not an uncommon situation and I personally HATE taking care of these patients [but smile and do it anyway…just kidding, I’m making barfing faces under my surgical mask that I’ve sprinkled with peppermint oil]. Sure, I’m an ER nurse and usually have an iron stomach when it comes to this stuff, but this is downright gross. One patient I remember well was a known diabetic who had been in the ED previously for vascular disease issues in his feet. At the time of his last visit, his foot wounds were dressed and wrapped properly, and he was sent home with instructions on how to change his dressings. Fast forward 3 months and he shows back up in the ER unable to walk well due to pain issues in both of his feet again. Let me point out that this man is NOT homeless; he has a home and access to medical supplies. Well come to find out that THREE MONTHS LATER he had not changed his dressings placed in the ER one time and also had not changed socks. His reason? If he couldn’t see it, he didn’t have to deal with it. Lucky me got to take the socks and wrappings off and as I did, pieces of the ACE bandage wrapped around him had literally disintegrated. What I found under those wrappings were two necrotic legs with TONS of maggots just falling out of them. When you initially remove dressings where maggots are underneath, the second the skin hits the air, the maggots begin wiggling around like crazy and it appears that the patient’s skin is moving. I got to flush tons of maggots out of his wounds and send him on up to OR to continue the efforts, but I would imagine he ended up losing both his lower limbs.

The second maggot story I remember so well was at yet another hospital where an over the road truck driver came in because his feet were “killing him”. This is a fully employed man who should have 100% been able to care for himself. Alas, when his feet/lower legs were examined, he too had tons of maggots crawling around inside of him. How you can go about your day to day life without realizing this is beyond me because the issue clearly hadn’t started any time recently. He ended up being in the ER so long that a couple flies made their way into the nurses’ station and I had to resist the urge to go home and bathe in bleach.

Well That Escalated Quickly…

Let me set the scene for you…it’s the middle of the night and I’m sitting at my desk in the nurses’ station charting. Everything is pretty quiet and there’s not much activity in the department. I glance up and notice one of our psych patients is sitting up in his hallway bed rummaging around in his backpack. I know this backpack has already been searched by the cops which was why he was allowed to keep it, however, something deep down inside told me he wasn’t looking for his Chapstick. This 6’4” [or something like that…whatever, he was a big dude] guy pulls [I sh*t you not…] a 6 inch buck knife, stands up, takes several steps out into the middle of the hallway and just starts fileting his arm while staring at me. I’m an ER nurse people, and that statement still makes me shiver. Staff were able to de-escalate him, and the cops were thankfully nearby and got the weapon away from him, but my night was officially ruined. The backpack was taken away from him and he got moved into a padded room. How did that huge knife get missed during the obviously “VERY THOROUGH” search of his property and person? I have no idea, but the officer apologized and brought us 2 huge boxes of donuts so all was forgiven [but, like, not really so can I get a policy change regarding psych patients being able to keep their stuff please and thanks??].

Along the same lines as that story, at another hospital with another psych patient things got a bit dicey when he was also allowed to keep his personal property while he waited for an appropriate room. This time, however, all he was able to keep was his cell phone. Unfortunately for, well, everyone, nobody thought to check behind his phone case where a handy dandy mousekatool was hidden. During one trip to the restroom, he pulled the razor blade hidden in his phone case out and slit his own throat ending up intubated in the acute care area of the ER. Shockingly, all phone cases had to be removed prior to psych patients keeping them from then on.

One of my former repeat customers at one particular hospital had a compulsion disorder that caused her to eat glass SPECIFICALLY from old Snapple bottles she saw laying on the ground around town. This little Grinch-wannabe was taken to surgery so many times to remove pieces of bottles. Her GI system had to be so scarred it was like leather because as far as I know, she never actually perforated her esophagus.

That one time a psych patient came into triage with complaints of homicidal ideation while still wielding a gun in his hand. COOL, COOL, COOL. When he was asked to put the gun down, he was genuinely shocked to see it still in his hand; he set it down right away and there were no issues but, hello butt-pucker moment.

I cared for another psych patient who came into the ED with homicidal ideation for the umpteenth time escorted by police after being “searched”. Not only did he end up having a huge knife in a holster thing on his hip that was taken away from him AFTER a verbal altercation between him and several staff members when he tried to leave, he had also told one of my coworkers at a previous visit that he had murdered several people but wouldn’t disclose where he hid the bodies. There is, of course, the chance that he was lying through his teeth, however, I kind of think not. Later on when I was in his room with 3 security guards, the guy looked me dead in the eye and said “I am having an overwhelming desire to fold your body into a 50 gallon drum, nail 10 inch spikes into it and kick it down a hill.” Mazel tov.

Around 4am on a Sunday morning a very upset Hispanic woman and her brother-in-law who did not speak much English came into the ED after he had come home covered in blood and intoxicated. The story ended up being that he had gotten into an argument which turned physical and the other guy had lunged at his face and BIT HIS NOSE OFF. Ya’ll, when I say bit his nose off, I don’t mean he bit the tip of his nose and a big chunk of skin was hanging there or whatever you may be picturing. THIS VOLDEMORT LOOKING DUDE WAS COMPLETELY MISSING HIS NOSE. Actually, that’s not entirely accurate. His nose wasn’t missing, it was in a zip lock baggie he had brought into the ED with him. He was too drunk to remember anything else but had the where-with-all to pick his nose up off the ground. This was clearly a call for plastic surgery who took him to the OR a couple hours later. Mike Tyson who?

I took care of a really cute kid (probably 10ish years old) whose older sisters got into a big fight with each other. In an attempt to break up the fight, he jumped in between them and yelled at them to stop. One sister apparently picked up one of those two-prong grilling forks and straight up launched it at the other sister. Unfortunately, the brother caught it with his head and came into the ED via ambulance with the fork still sticking out of him. It was fairly easily removed as it had wiggled loose in the 20-minute transport to the hospital. He ended up having a tiny spot where the tip of one of the fork prongs went all the way through his skull and introduced air into his brain. He ended up being fine but was airlifted for extra safety to a hospital that had a pediatric neurosurgeon. It was his first helicopter ride and he was STOKED about it.

The luckiest man alive came into the ER on a warm summer day and I was fortunate enough to get to witness it all. A guy in his 40s was at work doing repairs on the roof of a shed when he lost his balance and fell off. Normally this would result in broken bones and maybe some internal bleeding. Today this was not the case. Instead of falling onto the ground, this man fell directly onto a rebar fence post turning himself into a human shish kabob. This metal bar went in through his left butt cheek and exited out his right shoulder; as you can imagine, there’s a lot of important crap to hit on the path through his body. EMS basically removed the rebar from the ground and the patient came into the ER laying on his side with the rebar still inside him, dripping blood onto the floor the entire way in. His 39-week pregnant wife came flying into the ER in a full-on panic soon after, however, all ended well. He went to surgery and less than 24 hours later was sitting up in the ICU asking for food and to go home so he could be ready for his new son to arrive. The only thing he damaged was a single spinous process of 1 vertebra [which for you non-medical folks means he broke off a piece of your vertebrae that doesn’t really matter and causes no issues besides maybe some minor pain]. This was truly a medical miracle I still don’t understand how he got so lucky.

Probably won’t ever see that again…

While working at a Catholic hospital I had a woman come in with probably the most unique concern I’ve ever heard. She worked as a nurse at that time and calmly told me, “I know this sounds completely insane and it’s going to be really hard to believe me, but I think I have a demon inside me. I can feel its presence and I don’t know what to do.” I’d like to think I kept my poker face on, but being a new nurse, it’s likely I did not. What was so shocking to me was she was SO NORMAL [whatever that means, right?]. Long story short, she was admitted into our inpatient area and an exorcism was organized while she was in the hospital. Yeah, you read that right.

Okay, so this was kind of crazy and I am beyond impressed that my attending physician I was working with this night caught it. A woman in her 60s came in with her family confused and asking the same questions over and over again. Her neurological exam was otherwise negative making the diagnosis of a stroke unlikely. She was apparently outside gardening earlier in the day when she suddenly had no idea what she was doing or how she got there. She could remember who she was and her long-term memories seemed to be intact, but when she talked on the phone with her daughter later in the day, her daughter instantly knew something was wrong. This woman ended up being diagnosed with transient global amnesia. This is a bizarre condition of an unknown cause that results in a person being unable to make new memories and become confused. This usually lasts for 24 hours or less and once someone experiences it, they most likely will never have it happen again. The condition gets even more peculiar because when the short-term memory function returns, it isn’t a gradual thing; it’s just as sudden as the onset and instantly comes back completely. There are no residual effects besides a crazy medical story to tell later on.

Recently I had a teenager from a behavioral institute nearby come in via ambulance after inhaling an MP3 player in an attempt to kill himself. Initially his entire medical crew thought that by “MP3 player”, the staff where the patient lived meant one of those tiny iPod Shuffles or something equivalent in size. When the doctor was finally able to pull the device from his throat [after giving him a bunch of Ketamine], it was the size of a freaking flip phone! It was HUGE and seeing it pulled out of someone’s trachea was about as shocking as knowing he put it there on purpose. When all was said and done, the patient was so apologetic and kept repeating “I couldn’t breathe” while looking absolutely horrified that I truly don’t think he will try that little maneuver again.

As an ER nurse, I’ve taken care of many nose bleeds over the years. One was by far the worse I’ve ever seen and provided me with an incredible learning experience that I will, fingers crossed, never have to repeat. This gusher was an older woman in her 70’s who had been seen earlier in the day for the same issue. Her nose had been packed with “rhino rockets” [AKA giant tampons shoved up your nose] and I think she had also had an area of her nose cauterized too. It worked for a bit but then the dam broke and back to the ED she came. She was spraying blood out her mouth in an attempt to clear her airway many times over again. All the staff members in the room were speckled with her spit and blood and the main issue quickly became her compromised airway. She ended up being intubated to protect her airway and, apart from giving her fifty gazillion medications to try to help, I don’t really remember the outcome after that. Nose bleeds [aka epistaxis] is such a boring-sounding ER complaint but sometimes those patients need far more intervention than originally thought.

A young 20-something man worked at a factory nearby when his hand was caught in a piece of machinery and, out of reflex, he pulled it back forcefully. Fortunately, his hand came out of the machine, unfortunately his skin covering that hand did not. His hand looked EXACTLY like a Halloween decoration; all bone with no skin or tissue left on the majority of it. It was so fake looking that it didn’t gross me out at all but instead fascinated me entirely!

I love a good traumatic injury and boating season in Iowa did not disappoint. I got to help take care of a man who was involved in a boat accident along with several other gentlemen who came into the ED with their own injuries. This boat full of 50-something men was speeding as fast as they possibly could across a lake when they hit a rogue wave and flipped thus resulting in all of them going flying into the air and landing in the water. Unfortunately for my patient, he landed on the propeller. *Pause for cringing* Amazingly, he filleted his arm and leg open but didn’t injure any tendons or ligaments. He had some of the coolest videos in his chart [because this hospital was amazing and regularly put photos and videos into patients’ charts] of the resident doctor having him wiggle his fingers and toes. You could clearly see his muscles moving with each action; it was like watching a live cadaver. SO AWESOME.

There was a similar situation at another hospital I worked at except this time it involved someone’s face. This guy was a biker dude involved in a bar fight and had his cheek slashed open with a broken beer bottle. Now normally I have a pretty solid poker face but coming around the corner to see him walking back to the triage room, I definitely did a double take and he most definitely saw me do it. Oops. It was pretty amazing to watch him talk because I could see all the muscles in that side of his face moving as he did so. The bottle was also apparently super sharp because bleeding was minimal. Because of his affiliated gang, he refused to be admitted into the hospital. He ended up being washed out really well in the ER, stitched up, and given oral antibiotics and a strong suggestion to follow up with another doctor soon. He was very respectful, but we didn’t ask many questions and he didn’t offer up much info which is usually how it goes when caring for gang members.

While working in the ER, I get to sometimes care for patients who have very rare and often bizarre genetic disorders; these are incredibly interesting to me and I always try to do some extra research to expand my knowledge when they do. They are the best teaching opportunities and I often ask the patient or their parent if the patient is a child all about the disorder; they are such a wealth of knowledge and I always walk away knowing more than I had before I met them. One day a sweet kiddo [I think around age 3] who suffers from osteogenesis imperfecta came into the ER. This disorder is also caused “brittle bone disease” and effects less than 20,000 people in the US every year. This disorder makes patients very susceptible to bone fractures and can vary in severity. This little guy had it rough; he was born via cesarean section [as most babies with this condition are as a pass through the vaginal canal would likely kill them] and STILL was born with 20+ fractures. His arms and legs were twisted and mis-aligned due to multiple fractures throughout his life and he would never walk, much less sit upright during his likely short life. One thing I remembered about him the most was he had the SOFTEST skin on his little feet; I couldn’t stop gently touching them! This little guy needed an IV and because his bones were so brittle, I couldn’t even use a tourniquet as it could fracture his limb. He ended up getting transferred to a large children’s hospital, but it was such a unique experience, I don’t think I will ever forget him!

Bizarre travels <3