Thursday, October 15, 2009

Holding down the fort

Some days it’s nice to walk in, not be in charge and not be in triage. Just holding down a zone or (gasp!) the trauma room is somewhat relaxing. As I have said many times before, we have some staff that are really scary. Maybe even to the point of negligent. Honestly though I doubt this is a purposeful act... and maybe blissfully ignorant is a better word. I think they would be exceptional school nurses, clinic nurses maybe even basic (and I mean BASIC) med-surg teachers, but they have absolutely no place in the world of acute emergency medicine!

I took the trauma room over from one such nurse the other day. The room was absolutely trashed. All kinds of shit missing to include Ambu bags, stylets in the airway carts and suction equipment. I asked the charge nurse what the hell happened.... she said the nurse's name rolled her eyes and then told me there was one trauma in there ALL day..... thats it! Ugh.... so this bitch can't even handle an easy, not-so-sick trauma. What is she going to do when they open a chest? Work a big burn? Or god forbid a police/fire/rescue person where tensions are ALWAYS high? One of the docs listened to me rant and suggested that I write her up. Unfortunately, until I actually see her fuck up or hurt someone I have no grounds to say that she is a moron.....even though it is a well known fact!

After cleaning the room from top to bottom, pulling all of the extra crap out of the carts and reorganizing, I was finally ready to rock and roll. We took a transfer from a Level 2 trauma center. 65yo F that had central cord syndrome from an MVC. She arrived fully dressed from the waist up.... although they had taken the time to cut her pants, unsnapped her little girdle-leotard thing and placed a foley. She had not been taken off the backboard or hard collar at the other hospital. Her accident was at 1300.... she arrived to us at 2045! Almost 8 hours on the fucking backboard! That is criminal! We got her off the board, into an aspen collar and into a warm gown. Ironically, once she was off the board all of her peripheral weakness went away and she was just fine. CT's were normal but she stayed for observation (and possible workup for decubs and rhabdo!).

As it gets cooler we are getting more of the "street variety" type patient. Is not so cold that they are complaining of chest pain or suicidal ideations (that warrants an actual workup) they are just coming in drunk. The new PC term for the homeless???

Urban Camper

I love it!

PS: had an exposure to a known swine flu patient for the second time in 2 months. That nasal spray better fucking work!


Anonymous Anonymous said...

At least you got the vaccine. Even though our obs unit is boarding rule-outs by the ton, NONE of us have come anywhere near a vaccine.

I always hate following incompetent nurses. Rooms are a mess, patients are a mess, orders written at 1400 have not been done and it's 1900, that load of crap. Definitely makes work a crappier place. We're working on easing these people out though...

12:21 PM  
Blogger battynurse said...

We haven't been offered the Swine flu vaccine yet. I hope your spray works. I can't imagine following a nurse not knowing what they are doing in a trauma area. I know it was enough to make me crazy working med/surg and most all of my patients were good and stable.
That said I know I would probably be one of those blissfully (or not) ignorant nurses if I ever tried to work ED or trauma. At least I have the sense though to stay away from those areas.

12:12 AM  

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