Crazy Nurses and Toilet Babies
Last night I was in the penalty box for 12. That's our "screener desk." I do the "hi, WTF brought you here", make sure nobody is actively dying and then send them to the triage nurses. The triage nurses, one their own, are pretty cool. But together (they are both crazy as fuck AND good friends) they don't do shit. Seriously, they kept disappearing. People would go wait to be triaged and after 15 or so minutes I ended up having to triage many myself. What BULLSHIT! The hard part is that they are in the "battle axe " group that saying anything to the coordinator would be worthless.
The upside of screening is you seriously get first crack at the acute walk-in patients. When someone walks in complaining of chest pain you get a feeling if they are real or not. As soon as I saw this guy AMI popped in my mind. History of stents and htn, chest pressure for 3 hours. My triage EKG was a LBBB.
(I will admit freely that cardiac has always been my nemesis. I hate it. I can fake it like a motherfucker, but when interviewing for flight jobs that's not good enough. A very smart person has been helping with the learning curve. While I'm not an expert, I'm getting better)
So seeing a LBBB in a patient with a vague cardiac history, I hauled ass to the back, gave the EKG to the attending and puled up the old one which (TA-DA!!!) showed no block. The AMI page was sent out and the patient was in the cardiac ICU within an hour of my "hi how are you." Yea me! The triage nurses had no idea that I was even gone.
Finally I must lament that college classes are starting again. The drunk freshmen are here. One got carried out from the ED by 6 people last night. 1 on each extremity, 1 on the collar and one by the belt..... he looked like a pig on a spit!