Burn
My last of 4 straight, the day before my long weekend with fun plans. I'm in triage. Praise the lord, I can relax, read and not be completely exhausted. I can watch whats happening in the back, but am not stuck having to deal with the drama. I had a couple of sick ones come in, including a young hispanic guy with varices that bled about 2 weeks ago. (he was in green when I was in charge and had a hgb of 4) He was back, with a trash bag full of blood. Bleh.....
At 315 I get a phone call.... "we need you to go to the trauma room, the nurse has to go home." Normally, not a big deal. Tonight though the chief is a chick I went to middle and high school with. I didn't like her then, and I don't like her now. She is one of the people that I mentioned previously. Her whole childhood through adulthood she has been groomed to be a doctor. She really has no other worldly knowledge and has always been a little "holier than thou." Not a good way to deal with a nurse who has been here longer than you have, and has bailed your ass multiple times. But there we go......
I picked up a burn patient. He was asleep in a trailer when it caught fire. He was burned from the nipple line up and circumferential bilateral arms to the elbows. It was a white guy... but you wouldn't know it to see his head/face... he was THAT burned. The flight crew had him tubed and I picked him up in the CT scanner. Why the hell she decided to scan a burn, I have no fucking clue. Car accident with fire, yes, explosion, yes. Simple house/trailer fire? WTF?!?!? So the patient's transfer to the burn unit and procedure room has been delayed because you want to shotgun scan this patient.
On arrival back to the trauma room I started hanging more fluid. I asked the docs what the rate needed to be... (hello parkland formula friends?) The didn't know.... So I hung LR on the pump to each line and told them to pick a damn number. They had 1) done a cyanide kit since there was furniture burning in the trailer so the urine was grape-ape purple 2) been unable to place a foley. As I'm trying to get the lines straight, urology was setting up to dilate and then place a foley. There were 8 doctors watching this process. Myself, respiratory therapy and urology were at the bedside. These fuckers kept yelling out orders..... I had to assist urology, get the fluids squared away, get the patients sedated since he had NO sedation, have him loosely restrained so he wouldn't pull his tubes and continuously listen to...
"has he had a tetanus shot?"
"he needs a gram of Ancef now"
"why isn't he on the monitor?" (he was still on the portable one..."
"why aren't we monitoring his pulse ox?" (because all of the places to put it are BURNED dumbass....plus he is on the capnography)
"why doesn't he have an a-line?' (did you put one in you stupid bitch?)
"why doesn't he have versed and fentanyl hanging?" (did you order it?)
"has he had a tetanus shot?"
The burn fellow proceeded to yell at me because he had received a liter of normal saline before going to LR. This had been done by the flight crew, and had completed in CT.... before I ever saw the patient. But it was now my fault.... a problem that I reminded him was not going to stay with me. I have known the burn fellow for a long time as well and don't take kindly to being yelled at for something I have nothing to do with. All 8 of these fuckers continued to bark orders like a firing squad as I took care of the patient. I was too pissed off to even think straight. RT saw my face and was helping as best she can. The intern jumped in.... she was a medic in the ER and is a smart girl. We got as much as we could done..... and I called burn to give them an update. Their complaint? The patient hadn't had a bronchoscopy done yet. Again..... not my fucking problem.
In the elevator on the way back down I went OFF. Respiratory was laughing so hard we missed our floor. She said that I kept my cool very well.... but I continue to call the chief an ignorant-cow-worshiping-c u n t behind my mask. Not very politically correct, and I'm sorry if I offend, but that's how I feel about her.
Go eat a burger and stay the hell away from me, thanks.
At 315 I get a phone call.... "we need you to go to the trauma room, the nurse has to go home." Normally, not a big deal. Tonight though the chief is a chick I went to middle and high school with. I didn't like her then, and I don't like her now. She is one of the people that I mentioned previously. Her whole childhood through adulthood she has been groomed to be a doctor. She really has no other worldly knowledge and has always been a little "holier than thou." Not a good way to deal with a nurse who has been here longer than you have, and has bailed your ass multiple times. But there we go......
I picked up a burn patient. He was asleep in a trailer when it caught fire. He was burned from the nipple line up and circumferential bilateral arms to the elbows. It was a white guy... but you wouldn't know it to see his head/face... he was THAT burned. The flight crew had him tubed and I picked him up in the CT scanner. Why the hell she decided to scan a burn, I have no fucking clue. Car accident with fire, yes, explosion, yes. Simple house/trailer fire? WTF?!?!? So the patient's transfer to the burn unit and procedure room has been delayed because you want to shotgun scan this patient.
On arrival back to the trauma room I started hanging more fluid. I asked the docs what the rate needed to be... (hello parkland formula friends?) The didn't know.... So I hung LR on the pump to each line and told them to pick a damn number. They had 1) done a cyanide kit since there was furniture burning in the trailer so the urine was grape-ape purple 2) been unable to place a foley. As I'm trying to get the lines straight, urology was setting up to dilate and then place a foley. There were 8 doctors watching this process. Myself, respiratory therapy and urology were at the bedside. These fuckers kept yelling out orders..... I had to assist urology, get the fluids squared away, get the patients sedated since he had NO sedation, have him loosely restrained so he wouldn't pull his tubes and continuously listen to...
"has he had a tetanus shot?"
"he needs a gram of Ancef now"
"why isn't he on the monitor?" (he was still on the portable one..."
"why aren't we monitoring his pulse ox?" (because all of the places to put it are BURNED dumbass....plus he is on the capnography)
"why doesn't he have an a-line?' (did you put one in you stupid bitch?)
"why doesn't he have versed and fentanyl hanging?" (did you order it?)
"has he had a tetanus shot?"
The burn fellow proceeded to yell at me because he had received a liter of normal saline before going to LR. This had been done by the flight crew, and had completed in CT.... before I ever saw the patient. But it was now my fault.... a problem that I reminded him was not going to stay with me. I have known the burn fellow for a long time as well and don't take kindly to being yelled at for something I have nothing to do with. All 8 of these fuckers continued to bark orders like a firing squad as I took care of the patient. I was too pissed off to even think straight. RT saw my face and was helping as best she can. The intern jumped in.... she was a medic in the ER and is a smart girl. We got as much as we could done..... and I called burn to give them an update. Their complaint? The patient hadn't had a bronchoscopy done yet. Again..... not my fucking problem.
In the elevator on the way back down I went OFF. Respiratory was laughing so hard we missed our floor. She said that I kept my cool very well.... but I continue to call the chief an ignorant-cow-worshiping-c u n t behind my mask. Not very politically correct, and I'm sorry if I offend, but that's how I feel about her.
Go eat a burger and stay the hell away from me, thanks.
posted by jeepgirl at 23:26
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