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Sunday, November 25, 2007

Good night at Shoreline

I have to admit that despite getting called STAT to ER a few hours ago to do a sputum induction, I'm having a pretty decent night tonight.

The patient load yesterday morning was down to only five patients, so Dee worked solo days. And, which usually happens when one of the day shifters is called off, all hell broke lose.

"Why didn't you call Tom in?" I asked her in report.

"I wish I would have," she said, and sighed.

"Other than this one, none of these patients need these treatments," I said, "And besides, you knew I was coming in, so you could have just left stuff for me to do, no point in being overwhelmed."

"I know, I should have, but you know how it is."

When you have a shitty day like I know Dee had, it pays to know you have a good RT relieving you. We good RTs aren't nit-picky when the day shift leaves us things to do, especially if there is a good reason.

I grabbed the stack of 20 EKGs Dee did during the day and filed them despite her objections that I was doing her job, and told her to go home.

I had a little rush in ER right off the bat, and (get this) I was called STAT to ER to do a sputum induction. Not only that, but the doctor wanted me to NT suction the patient to get it.

"You really want me to traumatically suction this patient," I asked the doctor. How about if we do this to you to see how you like it, I wanted to tell him, but held my thought to myself.

The doctor looked at me like I was an idiot, and said, "Yes I do. We need to bla bla bla bla."

Okay, so I did it.

Afterwords, the RN, who happened to be a rental RN, cornered me and explained why he ordered the STAT sputum induction: "We have a pneumonia protocol and we have to have the antibiotic given within four hours or I get written up."

"Okay," I said. "That's fine." Well, I wasn't really fine by it, but I wasn't going to debate with a rental nurse who's done working here in a few weeks.

However, after asking many questions, I leanred the pneumonia protocol does require a sputum induction prior to antibiotic, but it says nothing about having to be done in a certain amount of time. He must have been thinking of someother hospital protocol.

This RN, I am certain, pressured the doctor into getting this induction. What a moron. I'd like to suction him.

Despite that episode, I'm having a decent night tonight. While not all my treatments are indicated, I have no gomers, and no sundowners and no outrageously crazy patients. They are all nice individuals who appreciate my time.

I have two real COPD patients who really need the treatments, and both want to be awakened, so I don't have to worry about being snapped at (one of the things us night shifters worry about).

I have one patient who has septic shock secondary to pneumonia secondary to COPD who is probably on the verge of STD (Swirling the drain). But her Q4 breathing treatments are supposed to cure all these ailments (see Holy Water or Scrubbin-bubbles on right side of blog.)

I believe she is a full code, as there is no "plunger" at the bedside (a little inside humor there).

The best part is that I've been called on three occasions tonight by nurses for me to assess their patients and give my opinion. One patient appeared to be fine, but the RN wanted me to listen and give my opinion "just to be on the safe side."


I love it when I work with nurses who respect my opinion this way. I love it, and I make sure they know I appreciate it.

Good patients + great nurses + a decent doctor in ER + an ideal equilibrium of the planet = good night for the night shift RT.

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