Been away for a bit, Crusty ER Tech has been busy picking up extra shifts in the grind of a summer term and now present fall semester. I've had some stories that stick out. One I'd like to relate to you is how some people work hard (and sometimes at the expense of a patient) to make themselves look good.
Nurse Bass is a prime example. Nurse Bass is the typical busy body nurse who is the one arranging baby showers and birthday parties for everyone on staff whether or not they want it. Nurse Bass will make it a point to guilt trip you into putting money into the hat even for people you don't particularly like, which makes for a rub between she and Crusty because his funds are limited and he's not going to pay an ATM fee break a twenty and donate a fiver for a jackass resident who does not know what a sterile field truly is. Nurse Bass once spent a full four hours of a 12 hr shift going around the entire ER (and ambulance bay) getting people to sign a card and donate money for a baby shower she was throwing the next day. Crusty has no problem with these little baby showers and bday parties on shift. he likes the food. Crusty just has a problem with you practically abandoning your assignment and the patients curse him because you're never around. Nurse Bass never ever speaks to the ol' Crusty one unless she wants something. I've even told her so. She does not take me seriously of course because she's a nurse and Crusty he's just an ER tech. Which leads into today's story.
Awhile back Crusty is working Triage. Crusty's job in triage is simple, take vital signs and do what he is told. Naturally, when he sees a sick patient pop up either right in front of him or on the screen he tends to want to take initiative because patients have died in waiting rooms before.
A SOB (Shortness Of Breath) pt pops up on the screen and I jump up to go see if I can find her. For a couple of reasons one because of standing protocols a 12 lead EKG is going to be ordered on the patient, usually the EKG tech is not around so the ER tech is stuck doing this simple procedure. Secondly and MORE IMPORTANTLY the patient might need some oxygen. Due to the demographics of the population that goes to our hospital these patients tend to spend their money on rent and food instead of meds that can keep them alive. Knowing this I go hunting for the patient.
The ER waiting room is crowded. We have terrible lines of sight in the waiting room in fact the main waiting area is a dead end fire trap. I'm going into the main waiting area when Nurse Bass asks me what I am doing. I tell her I'm looking for Pt R. who is on the board as being short of breath. I want to make sure she gets O2 if she needs it and an EKG is going to be ordered according to protocol.
Nurse Bass says to me. "Oh Pt R? she's getting an EKG right now." I ask if she is sure. Nurse Bass gives me a dirty look and responds in the affirmative. Great, I think and return to my station to do vital signs and what I am told.
Not even a minute later Nurse Bass is running up to me telling me she needs a wheel chair. I say sure it's right behind me (The techs in this particular ER are in charge of keeping track of stretchers and wheelchairs) I ask what's up. Nurse Bass informs me that Pt R who was suppose to be getting an EKG is on the floor in the back of the main waiting room and she is "very much short of breath"
I give Nurse Bass the wheel chair and off she trots. We get her into the wheel chair and while I am walking off to get O2 and a non-rebreather mask and a nasal cannula. Nurse Bass tells me "Get her O2 and a nasal cannula stat!" No shit she said stat. I return quickly with both and Nurse Bass has now put the pt in the EKG bay with an EKG tech. I tell Nurse Bass we need to put the pt on O2 now she puts the kibosh on that idea. We can't bother them because they need an accurate EKG.
I was taught Airway trumps everything else, ya know the "A" in ABC (airway, breathing and circulation) I've seen the Pt I know they are gasping for breath right when I start to go into the EKG bay the EKG tech (who was only around because he was delivering coffee to some friends in the dept) says he's done. Nurse Bass because of her sheer size pushes me out of the way and puts the pt in the wheelchair. I figure she is going to put O2 on the pt while at least get a baseline pulse ox and VS because usually the, respiratory therapist, mid-levels, residents and attendings like to know those details.
She snatches the pulse ox probe off the patient puts the patient onto 2 liters nasal cannula and rushes to the back with the patient. About half an hour later one of the attendings is following Nurse Bass back out to the waiting area congratulating her on her great catch of a patient who was severely short of breath. Once that is over I approach Nurse Bass.
"Nurse Bass I just want to make clear that you stopped me from looking for a patient that was SOB, telling me they were in the EKG bay getting an EKG. That you then proceeded to look for and find the same patient I was looking for who you lied about. When I went to put this same patient onto O2 you denied them oxygen because they were getting an EKG and you also kept me from getting baseline pulse ox and VS on a pt before a provider saw her. I just want to make that clear."
Nurse Bass tried to interrupt me while I was saying this and I just held up my hand stopping her momentarily. When I was done, she gave me a dirty look and walked off. Nurse Bass did not talk to me for the rest of the day. I guess I'll never have her throw me an on shift birthday party or baby shower.
Damn.
So went another shift for the old Crusty ER Tech.
