Okay, yesterday I wrote about the OD patient that we didn't intubate because we gave her Narcan and let her puke all over the ER. Tonight I come to work and an OD patient is on a ventilator.
She is awake and alert and thrashing, but she can't quite get to that ETT with her fingers all stretched out. And the Ativan doesn't work so well because she's used to getting oxycontin. This is turning out to be a miserable night.
I get on the phone with the doc. "Listen, this lady is a mess. She's awake, alert and thrashing at the bit. Can we just extubate her?"
"Not until morning." Click.
That was at 9 p.m. At 7 a.m. I was called to the CCU because, "Your patient just extubated herself."
"Yes," I said.
I took my time getting to the CCU and find two nurses all stressed and holding the ETT in place. The patient is being vocal. "This is awesome. Just yank it."
"Are you sure?"
"Yeah. It should have come out 12 hours ago anyway if the doc wasn't so lazy."
I'm telling you, those nurses were all stressed out. And here I come along all happy because my patient extubated herself.
"Oh, Dr. so and so will be so mad," the RN said.
"Who cares," were my exact words.
1 comment:
Been there--that sucks! I hate fighting with OD pts to keep tubes in so, hey, in that situation that's what needed to happen. I have a joke with one nurse where she says "I added restraints with just enough give he/she can get his/her finger behind the tube when he/she wakes up." That's my girl! She started joking that after she and I had a pt whom we had perfectly restrained--hands--so the guy self-extubated with his toes. Hey, if you can curl up into a ball and pull a tube with your toes, I thinking you're awake enough to breathe again.
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