I'm going to get myself fired if I don't learn to keep my mouth shut, which is ironic because I'm not necessarily a talker. However I've had it with all the B.S. and I'm starting to have a difficult time keeping my thoughts to myself.
"Hey Rick," the doctor called to me as I was passing through ER. "Will you check a sat on the baby in room 5. We've been having trouble getting one."
"Sure thing."
Upon entering the room the child was sleeping comfortably in his mother's arms. I had already completed a blowby treatment on him about a half hour earlier and, needless to say, the treatment was not indicated. I also did an RSV swab on the kid, and that was ordered because the kid had a little snotty nose and a congested cough. That I also think was not indicated, and I'll discuss that tomorrow.
I looked up at the monitor and saw that the SAT was picking up just fine. I looked at it, turned around, and the doctor was gone but the nurse was standing right there.
"What'ja get," she said cheerfully.
"I get 94%. He should be good to go."
"He already bought himself a ticket upstairs."
"What!"
She looked at me with a look of surprise. "That's not a good enough SAT for him to go home with."
"94% is perfectly fine to go home with."
Her smile disappeared. "No it's not."
"Yes it is."
"Um, no it's not." She smiled to let me know no hard feelings.
I feigned a smile, but I was in rare form. "Yes he is."
"Not according to our pediatricians."
"The new thing is that a child can go home with any SAT over 91% if he's in no sign of distress, and this kid is fine."
The kid was fine. My daughter was 100 times worse than this kid, and we never even took her to the hospital.
"Well, our doctors, Dr. Hee and Dr. Haw, want a SAT to be 95% or better."
"Well, at a real hospital 94% is normal." Okay, so I didn't say that. I said, "At the big children's hospitals they have done research and determined that anything better than 91% is acceptable on a child this age." The kid was 2 months.
"Here it's 95%."
Tell me what the difference is between 94% and 95%. I didn't say it. I wanted to give her a smile as if to say no hard feelings, but I didn't. Instead stearnly turned around and exited the ER. I didnt' want to hurt her feelings, but I also wanted her to know I was serious. I was right.
One of the reasons I don't get vocal like this too often is that I have a conscience, and I don't want to hurt the other person's feelings. At the same time, I think it's high time our doctors and nurses read the latest research.
This is exactly the reason I keep up on my reasearch. Is it possible I know too much? Would it be better for me if I simply stopped learning? Is that what they want? Do they want me to stay stupid?
After all, a stupid RT asks no questions. A stupid RT cannot question a stupid doctor order or, in the case of this 95% SAT, stupid policies.
Stupid and outdated policies are really getting to me lately. And nurses and doctors who continue to live by and defend these old and outdated policies are likewise getting on my nerves.
I am very much aware that every doctor has his or her own opinion, and I know that each hospital has the right to have its own protocols. However, I think some good old fashioned common sense should be used in cases like this.
I could be wrong. What do you think?
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