PT assault
Lets keep in mind Crusty ER Tech has now had several shots of liquor and decided to post. With that said ....
Recently again I have been attacked by a patient. this time they actually connected giving me a black eye among other scratches and bruises associated with fighting with a pt in a dynamic urban hospital environment.
I encourage you all to ALWAYS press charges against pts of people that attack you. The other is to get trained on how to defend yourself. Often you will get put in a position where you will be attacked, do all you can to defend yourself. Know your protocols, know which drugs work best for chemical restraints and above all know how to handle yourself if and when the system breaks down.
Reassurance does nothing stay on your toes.
Tuesday, August 2, 2016
Monday, July 11, 2016
Seventy
The Willfully ignorant Nurse Bass
As promised this next entry is about for the 3rd or 4th time the willfully ignorant Nurse Bass and I have had a run in. In the recent past Crusty ER Tech had yet ANOTHER run in with her. Crusty has tired of this and decided once and for all to slap his cards onto the table and in the most figurative sense slap some sense into her.
Other techs have approached me about her she has said some real hum dingers one of which I will include here:
"Honey we want you here but we don't NEED you here."
this comes from an experienced charge nurse in a large urban ER. Nurse Bass is of the opinion that staff that is certified like EMT, Paramedics and others are not necessary to running an ER. That the nurses, docs and midlevels can do effective patient care with out us.
Let's put it straight the ER tech does a lot of the scut work that is needed to make the ER run effectively. I ain't talking about code browns either. ER techs stock the rooms run paients to the floor and to various places in the hospitals. Meet the ambulances in the ambulance bay. Dispatch ambulances, answer the EMS calls into the ER and direct them (at least in two of the ERs I have worked) Go get oxygen tanks, find anything you need in the ER. In many places the ER tech is taking over the ward clerk job because the paper push is no more. You just need a dedicated person to field and make phone calls and help direct patients ER techs can be cross trained to do that. Need a suture set up ER tech can run down everything the doc needs. Warmers and linens need to be stocked, ER tech has got you. Need scrubs because you are covered in some sort of human goo, ER tech can find you another set of clean scrubs. Need a pelvic set up ER tech has it all on hand. That way the nurses, docs and midlevels can do their jobs and frankly not sweat and worry over menial stuff. All of this is just stuff off the top of my head. So if the ER tech is needed to do the smaller things that help make the ER run smoother.
I think I have proven my point.
Nurse Bass decided to yell (yes yell) at me in front of patients in the waiting room when I was doing something that our bosses boss told me to do. The details are not important but needless to say her tone was condescending as usual and I was in a foul enough mood not to let it pass. Knowing that trying to reasonably resolve things with her proved futile in the past (Which included her calling me a liar and denying the incident took place) I had no other option except sit down and bring in manglement.
I don't really like bringing in manglement because it can turn into a mess and things get put on a back burner. Lately though I have done somethings for manglement that shows the true effectiveness of the ER tech and shows how we are valuable assets to the dept. Plus I have tried to back channel this problem to manglement and still this problem persists.
We got called into the office and there I took off the gloves and dismantled her verbally. At one point I called her an ignoramus. Now it helps that I've been working with manglement a bit more lately and it helps that this particular manager REALLY likes me and is keenly aware of how Nurse Bass is and has been privy to some of Bass's back stabbing attempts to me. As one unit clerk told me recently "Crusty ER Tech you're a sneaky fucker."
Indeed I am.
I won't go into the details of the entire nearly hour session but at one point Nurse Bass tells me:
No shit full stop. I laughed at this. At this point the manager face palmed and shook her head. This among other just as condescending things she laid out. I was not kind to Nurse Bass and my assessments of her interpersonal relations with staff. At the end of the session the manager asked me did I need to say anything else. To which I said "I do believe Nurse Bass has said enough for both of us" Nurse Bass chose to stay behind and talk to the manager for another 20 minutes after I left the office. Bass realized that she had royally inserted her foot into her own ass and mouth.
Since then I have worked with Nurse Bass once and she was rather pleasant. Will this hold? I have no clue I honestly don't know. For now it's good enough for me. I had to expend some political capital in the department which is fine if it makes my day to day in the ER more tolerable.
Lessons learned:
Over the years I have had numerous run ins with nurses of this ilk. Rarely has it turned out for the positive for me. In actuality in rare cases are ER Techs respected. There is a lot of ignorance surrounding what we do and what we are capable of. Many nurses are really do not know and a few like Bass are willfully ignorant and only see us as gophers who need to shut up and do what we're told. With that said me spending now a few years in this urban ER and knowing manglement as well as I do got me a bit of favor with them. I am by no means an ass kisser but I have shown my worth to the department time and again. This got me a nod and because I followed guidelines, because Bass did not know when to shut up got me a favorable nod. Write shit down and if you're being treated like shit don't blow up esp after trying to calmly resolve an issue just keep plugging way eventually you'll be heard.
Now hopefully Bass will go work in some clinic in the suburbs some place.
As promised this next entry is about for the 3rd or 4th time the willfully ignorant Nurse Bass and I have had a run in. In the recent past Crusty ER Tech had yet ANOTHER run in with her. Crusty has tired of this and decided once and for all to slap his cards onto the table and in the most figurative sense slap some sense into her.
Other techs have approached me about her she has said some real hum dingers one of which I will include here:
"Honey we want you here but we don't NEED you here."
this comes from an experienced charge nurse in a large urban ER. Nurse Bass is of the opinion that staff that is certified like EMT, Paramedics and others are not necessary to running an ER. That the nurses, docs and midlevels can do effective patient care with out us.
Let's put it straight the ER tech does a lot of the scut work that is needed to make the ER run effectively. I ain't talking about code browns either. ER techs stock the rooms run paients to the floor and to various places in the hospitals. Meet the ambulances in the ambulance bay. Dispatch ambulances, answer the EMS calls into the ER and direct them (at least in two of the ERs I have worked) Go get oxygen tanks, find anything you need in the ER. In many places the ER tech is taking over the ward clerk job because the paper push is no more. You just need a dedicated person to field and make phone calls and help direct patients ER techs can be cross trained to do that. Need a suture set up ER tech can run down everything the doc needs. Warmers and linens need to be stocked, ER tech has got you. Need scrubs because you are covered in some sort of human goo, ER tech can find you another set of clean scrubs. Need a pelvic set up ER tech has it all on hand. That way the nurses, docs and midlevels can do their jobs and frankly not sweat and worry over menial stuff. All of this is just stuff off the top of my head. So if the ER tech is needed to do the smaller things that help make the ER run smoother.
I think I have proven my point.
Nurse Bass decided to yell (yes yell) at me in front of patients in the waiting room when I was doing something that our bosses boss told me to do. The details are not important but needless to say her tone was condescending as usual and I was in a foul enough mood not to let it pass. Knowing that trying to reasonably resolve things with her proved futile in the past (Which included her calling me a liar and denying the incident took place) I had no other option except sit down and bring in manglement.
I don't really like bringing in manglement because it can turn into a mess and things get put on a back burner. Lately though I have done somethings for manglement that shows the true effectiveness of the ER tech and shows how we are valuable assets to the dept. Plus I have tried to back channel this problem to manglement and still this problem persists.
We got called into the office and there I took off the gloves and dismantled her verbally. At one point I called her an ignoramus. Now it helps that I've been working with manglement a bit more lately and it helps that this particular manager REALLY likes me and is keenly aware of how Nurse Bass is and has been privy to some of Bass's back stabbing attempts to me. As one unit clerk told me recently "Crusty ER Tech you're a sneaky fucker."
Indeed I am.
I won't go into the details of the entire nearly hour session but at one point Nurse Bass tells me:
Since then I have worked with Nurse Bass once and she was rather pleasant. Will this hold? I have no clue I honestly don't know. For now it's good enough for me. I had to expend some political capital in the department which is fine if it makes my day to day in the ER more tolerable.
Lessons learned:
Over the years I have had numerous run ins with nurses of this ilk. Rarely has it turned out for the positive for me. In actuality in rare cases are ER Techs respected. There is a lot of ignorance surrounding what we do and what we are capable of. Many nurses are really do not know and a few like Bass are willfully ignorant and only see us as gophers who need to shut up and do what we're told. With that said me spending now a few years in this urban ER and knowing manglement as well as I do got me a bit of favor with them. I am by no means an ass kisser but I have shown my worth to the department time and again. This got me a nod and because I followed guidelines, because Bass did not know when to shut up got me a favorable nod. Write shit down and if you're being treated like shit don't blow up esp after trying to calmly resolve an issue just keep plugging way eventually you'll be heard.
Now hopefully Bass will go work in some clinic in the suburbs some place.
Monday, June 27, 2016
Sixty Nine
I was going to sit down and write about how quite recently a nurse told me that it was not in my scope of practice to assess bleeding. Then I realized it was entry number sixty nine and well the number conjures up thoughts of genital injuries.
Genital injuries and the insertion of various objects into the rectum are great fodder for ER and EMS types. In fact the subject of objects inserted rectally has it's own book:
This dear readers is about genital injuries. Now I won't talk about genital injuries sustained during a sexual assault. Those are a sensitive subject and Crusty takes those rather seriously. Male genital injuries are more common because hey let's face it our anatomy hangs out. Again, this is easy fodder for those of us in the business. Less common are the female genital injuries that are not related to sexual assault.
I was trying to remember a real rare genital injury and then I remembered the home bar stool accident.
Way back when I was a new ER Tech I assisted a doc with a woman with lacerations to her vaginal wall secondary to sitting on a home bar stool.
Pt was a mid-50's female. Nice woman. Her husband a few years prior made their basement a home bar with taps televisions pool table and such things that normal bars have including bar stools. The bars tools they had were of the four legged padded top types the ones that you can find in discount furniture stores all across our great nation. The stools got wobbly over the years and the husband said soon they would buy newer better ones. The wife being "thrifty"(cheap) decided to fix the stools herself when the husband was off at work, she got home early and wanted to surprise him with the repairs.
She grabs his portable drill and what screws she can find which if I remember right would have been 2 or 3 inch drywall screws. She screws the legs into the top of the seated portion of the stools which takes the wobble out. She's proud of herself pours up a beer turns on the TV behind the bar and sits onto one of the newly "repaired" stools and it collapses once she puts her full weight on it. She was not a hefty woman, she was weight to size appropriate.
Naturally this hurt then the woman discovered she was bleeding from what she thought was her behind. She thought the screws came up and poked her in the ass. Which honestly I would have thought the same thing. Problem is that she's bleeding a lot. She goes into the bathroom drops her pants and looks in the mirror no holes in her ass besides the ones she already had.
Then she notices that there is blood running down her leg from her vagina. No she was not preggers and lost the baby. She feels inside her vagina and feels the laceration in her vaginal wall. She runs out of the bathroom wraps a sheet around her waist and calls the ambulance. Which of course brings the police and fire too. What can I say it was a slow day in this particular suburb.
Husband pulls up as they are wheeling her out and asks what's going on all he hears is that his wife's genitals are injured and sees the police. The cops assure him that there was a strange accidnet and his wife will explain. Which she does once they get to the hospital.
Ended up that she had a couple of decent lacs to her vaginal wall secondary to a lot of embarrassment. I had to assist the doc in the lac repair. The couple had some humor about it but the wife was clearly mortified.
The husband and wife decided that night to use the stools for fire wood and buy nice top of the line stools instead for future use. Thus endeth the story.
Next the willfully ignorant Nurse Bass.
Sunday, May 29, 2016
Sixty eight
Ol' crusty got a question here recently:
Crusty (ER TECH), any thoughts on combative patients and ER staff being hesitant to help out to restrain them?
I apologize for the late reply. Every situation is different. Sometimes with enough patience you can talk them down which if possible should be the first thing you do. I highly recommend "Verbal Judo" by George Thompson. Pick up the book and give it a good read and try to re-read it once a year. When I worked the ambu for a major west of the Mississippi river urban agency they sent us all through the training, it changed how I dealt with difficult and violent patients.
You can't always talk them down though and sometimes no matter what you say the pt is altered via a substance of their choice or mental illness (or both) and it'll be go time.
I gotta buddy who works in a left coast state who told me they have an overhead page for a violent page where all males in the area show up to help restrain the violent pt. and there is a standing order for chemical restraints in that situation.
Where I work at we have a crack security staff who get in there and really do the job.
One really shitty I worked at we had terrible security that just patrolled the parking lots and if a pt really got out of hand the charge nurse would call the cops which may take forever.
Along the way I have learned a series of wrist locks and holds that help control a violent patient. If you wanna go that way I recommend getting trained. People are reluctant to get involved because let's face it's a hospital and we're there to heal not wrastle with pts. Besides that staff often is not trained on how to deal with this type of situation hence the hesitation.
If it is a huge concern organize some fellow staff members and propose a solution to manglement. Then once you propose something dig in and don't let up til they resolve the problem. Never tell someone about a problem unless there is a solution.
Bruh, if ya got more questions about this drop me an email and I'll give ya some more idears.
Above all dude stay safe. Never go in to restrain a pt with less than 5 people (one for each limb one for the head) We prefer 7 one for each limb one for the head one to apply restraints and one to supervise, talk to pt calmly and to medicate. remember I currently work in a very large urban hospital with a shit ton of resources. Other places are not so fortunate
I cannot stress that enough BE SAFE BE SAFE BE SAFE.
Ol' Crusty has got a shift today soas the kids say" I'm outtie". Take care out there.
hopefully that helped you out and some others
Crusty (ER TECH), any thoughts on combative patients and ER staff being hesitant to help out to restrain them?
I apologize for the late reply. Every situation is different. Sometimes with enough patience you can talk them down which if possible should be the first thing you do. I highly recommend "Verbal Judo" by George Thompson. Pick up the book and give it a good read and try to re-read it once a year. When I worked the ambu for a major west of the Mississippi river urban agency they sent us all through the training, it changed how I dealt with difficult and violent patients.
You can't always talk them down though and sometimes no matter what you say the pt is altered via a substance of their choice or mental illness (or both) and it'll be go time.
I gotta buddy who works in a left coast state who told me they have an overhead page for a violent page where all males in the area show up to help restrain the violent pt. and there is a standing order for chemical restraints in that situation.
Where I work at we have a crack security staff who get in there and really do the job.
One really shitty I worked at we had terrible security that just patrolled the parking lots and if a pt really got out of hand the charge nurse would call the cops which may take forever.
Along the way I have learned a series of wrist locks and holds that help control a violent patient. If you wanna go that way I recommend getting trained. People are reluctant to get involved because let's face it's a hospital and we're there to heal not wrastle with pts. Besides that staff often is not trained on how to deal with this type of situation hence the hesitation.
If it is a huge concern organize some fellow staff members and propose a solution to manglement. Then once you propose something dig in and don't let up til they resolve the problem. Never tell someone about a problem unless there is a solution.
Bruh, if ya got more questions about this drop me an email and I'll give ya some more idears.
Above all dude stay safe. Never go in to restrain a pt with less than 5 people (one for each limb one for the head) We prefer 7 one for each limb one for the head one to apply restraints and one to supervise, talk to pt calmly and to medicate. remember I currently work in a very large urban hospital with a shit ton of resources. Other places are not so fortunate
I cannot stress that enough BE SAFE BE SAFE BE SAFE.
Ol' Crusty has got a shift today soas the kids say" I'm outtie". Take care out there.
hopefully that helped you out and some others
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.
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.
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.
-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.
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