Or as I think of him The ER equivalent of Foghorn Leghorn:
I call him Nurse Threepeat because he says everything three times, I say three times, three times I said. The man truly does not know when to shut up. I've pointed this out to fellow co-workers and we are all stunned at the similarities between Nurse Threepeat and Foghorn Leghorn.
Saying the exact same thing three times although quirky and borderline annoying is one thing being a hardheaded lout is another. Nurse 3P (threepeat) is never wrong there is no give and take with the man, you cannot get your point across even if you think it's right or even a teensy bit better because he never ever shuts up. You throw up your hand in frustration just to get away from him. The other thing is that the dude cannot make a decision. He is now a charge nurse and has been for awhile. This goes along with the long standing tradition at any hospital I have worked at. Which is to promote the incompetent. I gather from reading other posts that this is a standard practice at most any hospital in America.
Waiting for an assignment at the beginning of shift. Well fellow BCH co-workers we'll keep on a waiting. With the previous shift getting more and more upset cause hey they wanna go home and sleep. Nurse Leghorn is busy flirting with the Ukrainian nurse or the newly divorced European nurse. Trouble is that he's married and oh so is the Ukrainian nurse. It's a regular "As the bowel churns" soap opera before shift at times.
Another frustration aspect of Nurse 3p (and there are quite a few) is his wanderlust. When he was a nurse who carried patients the man would wander all the time, shit he still does and he's a full time charge nurse now. Why you ask, well he is how he puts it "making time" he's chasing women. Now Crusty does not fault any guy for being a swordsman in fact I give a nod to such behavior thing is that well that whole married thing and he'll hit on anything with a heartbeat and a vagina. ladies whether you have a ring on your finger or not you will be an object of his poonhoundery. Need a decision made on where to move a pt when he is in charge? Well try to do that and get chewed out if you make a decision in his absence. If you don't then get chewed out for NOT making a decision in his absence.
Nurse 3p is on rails when he's working if you do anything outside the lines (which often happens in an dynamic environment known as the BCH ED) color outside the lines and well, he gets his all flustered. Triage nurse order stroke labs on a Pt they are sending back with signs of a CVA? Not with 3P. As with all of us he gets his job done, often slowly agonizingly done. So the bowels churn.
Nurses, Mid-levels, Residents and Attendings are treated in accordance with this hospital's "Licensed staff care and use guidelines" and in compliance with this institution's protocols as stated by the human resources department in sections 601.5 B to 804.T. The "certified staff/techs" (Paramedics and EMT's) however are treated terribly and paid very little. In fact we work them pretty hard. This was done in accordance with the fact that they kept showing up to work so why not.
Fairly often as an ER tech you get hassled about everything "Where are my VS?" "Did you do my IV in rm 19?" "where is my coffee?" "Why didn't you replace the water in the water cooler?" Usually this stuff is already done or in the process of being done and the asking party just does not realize that the task has been completed. I have found and said in this here blog the ONE thing I have never been hassled about doing this job is when I have to take a dump. When my high bran breakfast hits my bowels. BOOM! It's time to go. It's nice and quiet in there because maintenance screwed up and never attached the speakers after a pipe busted in there to the overhead paging system. Unless a person gets thrown into a wall on the other side of the door you don't hear anything.
I had to take a dump. I had been holding it for close to two hours my bowels were cramping and I was starting to get the walking farts. It's a sure way of my body telling me that "Dude, really get to a toilet soon or you're gonna shit yourself." I finished up my latest task at hand and went to the shitter. Without giving out TMI let's just say holding back a bowel movement for that long makes for a long visit in the toilet.
I was not worried because I've never been hassled about taking a dump, no where....ever. Not even when I was in the Army, the shitter is sacred in a sense. When asked I'm honest "Hey, I was in the shitter." Then it's a curt "Oh ok" and we move on. Also I was on shift with the Rockin' Redhead charge nurse. A veteran nurse who is very competent, super cool and honestly not bad to look at. She's been at BCH for a long while and knows how it goes. She's great. Well unbeknownst to me she went to a meeting of some sort and one of the middle-upper managements fell out of their office long enough to cover the area Rockin Redhead was charging that day.
Who is doing the charge duties you may ask. Well this character is a recent addition to the blog "The condescending nurse" I had a recent run in with her in the last few weeks. There is one or maybe actually several like her in every department. They usually rear their ugly heads when a new person is in the department or if they have to deal with staff members who are not licensed or if they are dealing with nurses who have not been in the trenches for as long as them heavens help you if you have only been a nurse for 20 years and she has been one for 21 years. naturally as a tech I feel I get the brunt of this kind of haughty behavior. I've dealt with them in many ways usually letting them drown or telling them to FOAD maybe both depending on the mood.
I come back into the area I get rolled up by the condescending nurse who is upper mid-level management type. One thing that is known that I am (despite what I say here) a very hard worker. I'm always proactive and on task. First thing out of her mouth "Where have you been I have been paging you?" Which meh, it happens so I answer honestly "I was using the bathroom" Choosing not to speak bluntly with the condescending nurse because this is not the time for it. I'm honestly expecting the "Oh..ok". She looks at me and says again "Well I was paging you, you need to be in the department." Which really takes me aback. She is clearly implying I had wandered off someplace. I tell her "I was in the department, I was on the toilet." CN then says "I was in the department too and I was paging you."
I'm puzzled by this I have clearly stated that I was in the toilet perhaps she needs some clarification. "Hey, if you must know I was having a massive bowel movement" By giving TMI I was hoping to back her off and avoid a write up of some sort. Nope, she's squarely letting me know that I am not getting away with literally shit. I change gears, "Ok I'm here now what can I do to help?" hoping that this would change the tone of the conversation. She says "It's too late now, I did it myself already." She is not interested in changing any tone. Obviously she is showing me that she is in charge and she thinks I am slacking off and by slacking off I have made this nurse of "29 years of experience " do some work besides shuffle papers. I have not given up yet because this is the kind of thing that can haunt you later "CN all I can say is that I was here, I was in the bathroom having a massive bowel movement I had held for almost 2 hours, we can't hear pages in the men's bathroom, if there is something you need done let me know." Not letting me have the last word in the conversation she says "I am in the department too and I am in charge, when I page you, you need to respond."
I face palm as she walks off, she never heard a word I said. Which again is common for the ER tech Crusty or not. By not seeing me as a person of even minimal importance she does not even regard my very word. I never learned what this important task was. I did find out that Rockin' Redhead got me out of getting paper put on me (which would have been a very ugly experience for all concerned) RR told me that she was cautioned to "Keep an eye Crusty ER Tech" for the rest of the day.
What could be learned from this. Well I could just shit myself, which would cement my reputation as a world class nut job. I could ask permission to use the bathroom, which reminds me of what prisoners have to do. I could suggest that if it's so important that you get in touch with techs that hey, buy radios or tag us like they did in other hospitals. The thing is that I am an adult and really I should never have to ask to use the bathroom.
I hate to say this, I think Condescending Nurse 29 (for 29 years experience) and I will have other conversations later down the line that are similar to this one. Perhaps I'll just shrug my shoulders and state "I have nothing to say because you don't hear what I am saying." which will serve to piss her off, decisions...decisions...
Well I better get my skates on, it's a Tuesday after a long holiday weekend.
The more shit changes the more it fuckin' stays the same.
It's that time of year folks where our education department screws it's collective heads on long enough to take a crack at getting everyone through their annual competencies. Usually most places I have worked it's a day or two of doing skills and a test or two maybe a mock code on a life like automated mannequin, nothing big. For the last few years that I have been at big inner city hospital the process is more shall we say convoluted. The only thing that stays the same is that you have to do a certain set of skills. Then there is the computer learning modules which it seems like someone decides to change providers for each year. So you need new logins and passwords different than your regular ones.
One year they opened up the computer modules a month in advance for us to get everything done before getting skills done. As a tech we don't have much to do, the nurses though have got a shit ton. This ain't about nurses it's an ER tech blog so we talk about medicine's equivalent to sherpas. Any how, I suppose that idea of opening up the modules a month early was a bit too smart. So education decided to only open it up AFTER you talked to them on the day you wanted to get your skills done. Hell, they even gave us 4 non-productive hours to get it all done, awesome. Seriously Crusty ER Tech will roll with the punches to a point. I guess their idea was that folks would come in early get their shit done early and not dog pile in on the last day of annual skills. I'm following the thinking, fuckin' A. It was a good idea until it wasn't.
Case in point my experience of getting annuals done. Lately I have drunk the kool-aid and started to believe that hey as an employee I am being treated better and that I am valued as a team member. Sure there have been minor head aches it's part of the job. I thought that for once I'll get ahead of the herd and take advantage of the annuals being done in the ER for once (instead of in the secret hall on the other side of the hospital up on the 10th floor.) and I'd be smart and take advantage of these stations being open for two full weeks instead of one. The ol' Crusty ER Tech has really been using his noggin since he started nursing school. We were assured in our morning meetings that this area would be staffed the entire time M-F 0800-1700. Fantastic!
I show up and sure as shit no other techs are around and there is one nurse who is there to check off my lowly ER tech skills. There is a slight problem, I have to do my modules first and the head educator has to unlock my access. I'm here on my off day and I get 4 non-productive hours for it, remember ol' Crusty can roll with the punches. I go over to the head educator (gasp she is in her office) and she unlocks my access. I tell her that I'm gonna knock all this out and get everything done today, hell I even wrote her to say I was coming in on an off day. No problem she says. I get the modules done pretty quick despite another third party educational module provider and slow computers. Right when I am printing my completions up the nurse that was at the check off area walks up and says. hey Crusty my time is up over there but the head educator will get you checked off lickety split.
No problemo Crusty ER tech will go with it. I am a valued team member, which I am up until the moment I need something. I go find the head educator She is gone and one of her minions tells me that she'll be back "in the late afternoon" I ask how late and i get told "I dunno...LATE." No prob the old CERT will adapt. I walk over to the check off area thinking that the head educator would not leave me hanging because I am a valued team member, certainly she'd have someone over there waiting and not waste my time.
No one is there. Alrighty, the charge nurse will help me out it's slow and she's sitting in the office on her ass. I ask Condescending charge nurse for some help I get told "That's not my responsibility or job.' said of course in her usual condescending tone. Which is fine because I expected that. She's a useless bag of flesh anyways. So I do what they have told us to do use the chain of command, if someone won't help you go up the chain. So I go to her bosses, which no surprise at all they are in their office. I walk in and ask for help with my situation. I get asked very rudely "And who are you?" I'm close to the boiling point now.
Some one in the office says "that's Crusty ER tech, he's been around forever." These two birds I am talking to are new managerial types that were hired from outside the department, double ugh. They give each other a look shuffle some papers around and say "we can't help you" then turn their backs on me.Now I simmer out of my pot for a bit. "Hey, I've been here for awhile and you know what drives us employees crazy, this kind of thing right here, I come in on my day off get everything done to avoid the last day rush and get blown off by everyone. I learned my lesson, I'll show up on the last day that way at least there will be someone around to sign me off." With that I calmly walk out the door and straight to an open computer to email their boss.
In the old days of this urban ER that was unheard of speaking out because there was a price to be paid if you said anything that would be considered criticism of any manager type. You'd get written up or given assignments that sucked the life out of you. Trust me I know it happened to me a lot in the old days of this urban ER. After awhile I learned to keep my fucking mouth shut and bear the often idiotic leadership we had to put up with.
Now with a new corporate management team upstairs we have been told that those days are over, just use the chain of command. I use it and email their boss and vent my spleen about nearly everything. lo and behold the I get an email from my immediate supervisor (well I guess she is because they swap us around like horses between supervisors) I get told that my problems will be solved but only in a cursory kind of way. I'm still pissed, so I email their bosses boss again to say in essence, ya know how you guys said things have changed, well nothing has changed you guys just added another level of management it's the same old managerial style in the old inner city urban ER. I also said that since that has not changed that I fully expect some sort of disciplinary action or retribution for me saying something, just like 2 managers ago or shit was it 3 hell I forget.
Well old Crusty ER Tech shot his mouth off and again will pay the price, my next shift is tomorrow. Time will tell if anyone there gives a shit enough bout the old Crusty one to make amends. I doubt it because after all Crusty ER Tech is only a pawn in the game of life:
Since the current semester for nursing school is over (and fuck you very much I made it to the next semester) and I don't need to study and concentrate on the nursing process , I decided to finally sit down many years later and write about my first "code blue" or "cor-zero/0" ever.
I had made it through EMT school with out having to work a code ever during my rotations. I got hired on with a small private ambulance service who held the 911 contract with a couple of counties of the state I lived in at the time. We were working out of a voly fire fighter station #42 at the time which was where we were posted at a majority of the time. I was still being precepted at the time so in essence I was a third rider.
It was snowing big wet flakes, it was a pretty quiet night until as usual we got toned at O dark thirty. The service I worked for at the time worked a primarily industrial county on the east side of the city which I lived in at the time. It was a split truck, I was working with a EMT and Paramedic. It was the Paramedic's job to pecept me and sign me off medically (back of the Ambu) and the EMT to make sure I could drive and find my way around on a map (before GPS) We boogied on over to a ramshackle Mom & Pop diner off a major highway.
It was toned as a "party down" so we went in expecting the worst. It was in the sense that the person was just DRT (dead right there). It was the cook of the establishment, one second she was frying up a late night dinner for a trucker the next she collapsed, faster than what I just typed. I vividly remember the toast on the grill and the smell of burning eggs. She had false teeth, I pulled them out while the medic set up to intubate the patient. I put the teeth in my cargo pocket simply because I thought the woman would live and want her teeth back.
We get her loaded up and a voly FF shows up to help out with compressions. It takes forever to get to the closest hospital because the winter storm has gotten worse. It's a sweat box in the back of the Ambu because four people are back there. The Paramedic is at the head doing his thing and the voly ff and I are doing compressions. Plus I am doing everything else when I am not doing compressions like getting a second line and stripping the pt down more. What was usually a 10 minute trip took nearly 40 because of the weather.
We get to the old university hospital and roll her into the very ancient resuscitation room. Which was small, cramped and was around 120 degrees (steam radiators...yes radiators!) with all parties in the room. We drop her off the Paramedic gives a quick report and out the room we walk. We're out in the Ambu bay we start cleaning up the Ambu. In the middle of this I remember the patient's teeth are in my pocket. I drop what I am doing, run (yes, literally run) back into the resuscitation room with teeth in gloved hand. I arrive just in time to have them call the patient right when I come tumbling into the room.
Everyone files out of the room except the lone ER nurse who was responsible for the resuscitation room that night. I am really surprised that the patient died. Simply because as far as I knew we did everything right. I catch the nurses attention and say "Ummm here is her teeth" The ER nurse laughs sticks the false teeth into a lab bag and places them onto the patient's chest. The ER nurse says a clipped "thank you" and goes back to wrapping up her charting.
I walk back out to the ambu, I can't believe the patient died. I tell the rest of the crew and they just shrug their shoulders. The paramedic knowing this is my first code ever tells me while we are cleaning up the ambu and doing paper work that really more often than not the patient dies for whatever reason. It's a long quiet ride back to station 42 and I just think about the previous run. I wonder if I could have anything differently to save the patient. We get back to the station, the voly FF goes home. My fellow Ambu crew members fall asleep at once. I stay up the rest of the night staring at the TV wondering if I somehow fucked up and killed a patient.
I did'nt
I learn in the coming weeks what they told us in EMT school, although I never learned it. That you can do everything right and the patient still dies for whatever reason. I learn to deal with codes as an Ambu EMT and do quite well with them. I move onto the hospital and learn even more. To the point that I can only remember my very first code/cor-0 as an EMT. I cannot tell you anything about the 2nd one up to the last current one I just assisted with. I cannot and will not speak for anyone else, it just gets to a point whether you like it or not you become use to people dying. Yes there are things that stick with me, that I remember for no reason, often though I cannot put a face to a barely (if at all) remembered name.
That's the story of my first code as well as I can remember it after a few beers on a warm May night.
