Monday, March 28, 2016

Sixty seven

Plumbers, HVAC and other home contractors love retired ambulances.

Ambulances that survive or don't have the box removed and put on another chassis get auctioned and are usually snapped up by these guys for a couple of reasons. The primary one being that the compartments are convenient for them to put tools, fittings and other bits of their trade into and sometimes the electrical systems hold out so that you still have electricity in the box.

One fine spring morning I am standing in the ambulance bay grabbing ass with an ambulance crew and out of nowhere we hear a siren and of course it gets closer and closer. I stay outside to help with whatever comes rolling up.

The ambulance comes screaming into the ambulance bay which in itself is highly unusual emergent ambulances unlike what you may see in the media are usually pretty careful when they pull in because there is usually an unrestrained medic in the back working a pt.

The ambulance looks familiar yet unfamiliar it's a dead ringer for one of the local fire depts but no markings. I'm intrigued and then stunned to see a guy in blue come stumbling out of the drivers side all bloody. He has his left hand elevated with blood pouring down his arm. For some reason my primal brain thought that this ambulance crew had been ambushed and they drove straight to the hospital.

This is not the case.

Turns out that this particular ambulance had been auctioned off a few months before by one of the local FD after having their markings removed. Home contractor snaps it up and uses it. Turns out he cut off some of his fingers in a saw. Instead of calling an ambulance to take him to the hospital he just figured that fuck it, I have a retired ambulance and the fire dept never disconnected the lights and sirens so I'll just drive emergent to the closest hospital and park in the ambulance bay.

I laughed at the reasoning and loved the clear mindedness of his thinking although did not appreciate him driving like a lunatic with one hand the few miles to the hospital. After we got the bleeding stopped and the pt calmed down I moved his vehicle (the retired ambulance) out of the ambulance bay and parked it in the ER managers spot. Security did not dare to tow it because they thought it was an in service ambulance and we all know certain types of clip board nurses don't show up on weekends.



Monday, March 21, 2016

Sixty Six

No. 66

A good ER tech is always watching and listening, that helps them anticipate the needs of patients and their coworkers. It also gives you a leg up on how your co-workers especially charge nurses will treat you. If they treat other people well then you have a good chance on getting treated fairly by that person. Same holds true of the opposite, if they treat their coworkers poorly you can bet your ass they'll treat you the same.

Nurse B-ass is a  prime example. She and I have a couple of run ins and after the first run in I started paying a bit more close attention to how she treats other folks. Yup, she treats others just as poorly over often trivial things including her nurse peers. It's one thing to shit on the ER tech at this point I kind of expect it but your peers...c'mon. She's jumped all over her peers from wanting a stapler to getting a patient she did not want.

When she walks up to me after the shift meeting and assignments and tells me that I'm going to be in "her" area for the day and she's going to see that I'm going to do my job and will be checking on me to insure it. I decide to make a stand. I tell her that I remember a couple of our run ins and that she is a bully and that frankly I'll do my job no worries there but I will not take her trying to intimidate and bully me. She asked for an example and I gave her this particular encounter.

At this point she tells me that "I've never done such a thing" and "I don't remember that." I tell her that I have no reason to lie that I'm not the one that came up to her trying to intimidate her she came up to me and "informed" me unsolicited. She walks off. A few minutes later I am informed by the charge nurse that my assignment has changed to another area. Hmmmm, no coincidences there.

The saga will continue with Nurse B-ass I'm afraid.

A couple of shifts later I had a chance to work a good trauma. Pt is flown in and due to an explosion he has had one of his appendages blown off completely and totally. The pt has no burns and the limb that was severed was not viable according to the flight nurse. Another words it was blown into tiny bits or not enough was found that was worth saving. The pt is brought into the trauma bay and the flight crew has some how gotten their lines all sorts of ways fucked up. Their IV lines are wrapped around everything, the respirator tube, the portable respirator their cords for their monitor in the pt clothes and of course the pt himself. It was one of the worst rats nests I had ever seen. It's my job to help get this mess untangled and help get the patient stripped and get additional IV lines if needed.

I'm untangling the mess and it just is not working we cannot even get him off the flight transport bed it's such a mess. If we snatch out comes the tube and lines a certain no go. the pt is transferred onto the trauma bed and I turn to work on this shit. We cannot move the flight stretcher too far because all the flight crew stuff is wrapped up in that stretcher as well. There is no real estate on that side of the patient which by happenstance is the same side the amputated limb is on.

Let me stress here that the patient despite this horrible injury is hemodynamically stable for the moment. The field applied tourniquet has stopped all bleeding his VS are 130's systolic and a little bit tachy at just over 100 with about 250 cc of NS in. We had a little bit of extra time still gotta get to the limb though. I'm exasperated with this mess and tell the flight medic if this shit does not get cleared up soon then I'm gonna cut his monitor cables. I'm not mad just like "Dude WTF?" we get their monitor clear and we get the pt on our vent the IV lines are all tangled but fuck it lets move on and see where we can put some uncrossed "O" blood in. The lines work until a surgical resident snatches something and pulls out the line we are using for blood. We had a second line fortunately.

These things happen.

I talk to the flight medic and apologize for getting terse with him and we're  all good. Never have seen a flight crew's monitor and lines SOOOO tangled.

Pt makes it to OR and goes under the bright lights of trauma surgery.

This trauma gave me a chance to work with Nurse Star. Nurse Star is fantastic! She is the type of nurse that anyone worth a shit should aspire to be like. Over the time I've been at BCH she's been promoted a couple of times because she's that good. But today she comes in to do something else like clip board nursing paperwork and pokes her head into the dept to see what's up. Naturally because we are short nurses she drops the paperwork and takes an assignment. This means she'll be here extraordinarily late because she has some sort of office thing due the next day.

 Most of the staff now only knows Nurse Star as a clipboard nurse and don't believe me when I tell them that she is more than capable at bedside. Watch and learn I tell them. She works this trauma then afterwards helps us straighten the room then helps the newish nurse finish up the chart. All while fielding calls related to her clipboard nurse job. Awesome! Crusty ER Tech misses working with Nurse Star and says so often.

So ends the shift and this post. I'll cover the rest of what I intended to write next post. The life of the Ol' Crusty ER Tech continues.

Sunday, March 20, 2016

Sixty five

Preview for yous guys...

-Nurse Bass, bully extraordinaire.

-Massive hemorrhage and your fucking lines.

-Falling in love with the job again and the abusive co-dependent relationship I have with it.

-Training...always training.

-Nurse Star drops the clip board for a day, rolls up her sleeves and shows us why she is a true leader and no matter the day or hour, a superior nurse.

-Good techs are watching always watching and listening.