Look! There is no excuse: you must be to work on time. You are counting on the the full slate of hours to get your full paycheck. You signed a contract with your boss to arrive at a certain time. Your coworker is relying on you relieving her. More than likely, if you work in a hospital, she is comleting a 12 hour shift, and is tired and ready to go home. If you don't show up, if you have a bad track record, then that just ads to this person's stress. Likewise, being late adds to the stress of your boss. So don't be a dunderhead, and show up for work on time. Or, as General Patton said: "If you're ten minutes early you're on time, if you're on time you're late."
Consider this an RT Cave Rule: "Be to work on time."
Showing posts with label RT Cave Rules. Show all posts
Showing posts with label RT Cave Rules. Show all posts
Friday, September 20, 2013
Wednesday, September 19, 2012
Social Space Rule: How to use space properly
Every person who works with people should be aware of how to appropriately use space surrounding another person. If you get to close to the person you're talking to things get kind of awkward. If you're too far away a shouting match occurs. So a quick refresher is in order on how to use up space.
As a general rule of thumb, the following rules should be followed:
1. Social Space: 4-12 feet (this is good for the initial introduction to the patient)
2. Personal Space: 18 inches to 4 feet (This is good for the interview)
3. Intimate Space: 0-18 inches (This is good for the patient assessment)
A majority of conversations should involve the use of social space. As a general rule, as you approach someone to talk, you should be about 4-5 feet away. I think 4-5 feet is a good distance. If you get to close take a step back. It's actually better to be too far away than too close. I call this the "Social Space Rule."
In my experiences through life I've found most people follow this rule. However, once in a while you get a space hogger. A "Space hogger" a person who feels the need to get right up close to you during even the most social of conversations. So you take a step back and they feel the need to re-occupy your personal space. Those conversations rarely flow smoothly because you feel uncomfortable, and are concentrating on the space rather than what that person is saying. It's not good.
This rule was taught to me by my parents when I was a kid, and re-introduced when I was in college in sales class. My sales teacher taught that proper use of space was 50% of the sale. So he hashed this onto us on a daily basis. His policy was if during a fake sale I invaded his space, he'd hash my grade by 50%. So you learned quickly of the importance of using space properly.
Don't be a space hog: follow the social space rule.
RT Cave Rule #59: Don't be a space hog: Follow the Social Space Rule. During a social conversation you should stay 4-5 feet from the person you're talking with.
As a general rule of thumb, the following rules should be followed:
1. Social Space: 4-12 feet (this is good for the initial introduction to the patient)
2. Personal Space: 18 inches to 4 feet (This is good for the interview)
3. Intimate Space: 0-18 inches (This is good for the patient assessment)
A majority of conversations should involve the use of social space. As a general rule, as you approach someone to talk, you should be about 4-5 feet away. I think 4-5 feet is a good distance. If you get to close take a step back. It's actually better to be too far away than too close. I call this the "Social Space Rule."
In my experiences through life I've found most people follow this rule. However, once in a while you get a space hogger. A "Space hogger" a person who feels the need to get right up close to you during even the most social of conversations. So you take a step back and they feel the need to re-occupy your personal space. Those conversations rarely flow smoothly because you feel uncomfortable, and are concentrating on the space rather than what that person is saying. It's not good.
This rule was taught to me by my parents when I was a kid, and re-introduced when I was in college in sales class. My sales teacher taught that proper use of space was 50% of the sale. So he hashed this onto us on a daily basis. His policy was if during a fake sale I invaded his space, he'd hash my grade by 50%. So you learned quickly of the importance of using space properly.
Don't be a space hog: follow the social space rule.
RT Cave Rule #59: Don't be a space hog: Follow the Social Space Rule. During a social conversation you should stay 4-5 feet from the person you're talking with.
Saturday, September 8, 2012
Rule for Hospital Scrubs
The following invisible sign hangs over each drawer with hospital scrubs at Shoreline Medical Center:
Hospital scrubs are only for people that are financially secure, such as doctors and admins. RTs and RNs must buy your own scrubs. We do not have enough money to pay for scrubs for everyone!!!!
Thanks: Laundry
*ER and surgery personnel are exempt from this ruling.
We'll make this RT Cave Rule #60.
Hospital scrubs are only for people that are financially secure, such as doctors and admins. RTs and RNs must buy your own scrubs. We do not have enough money to pay for scrubs for everyone!!!!
Thanks: Laundry
*ER and surgery personnel are exempt from this ruling.
We'll make this RT Cave Rule #60.
Friday, July 27, 2012
The kindness rule
The kindness rule involves stocking. It's being considerate of your coworkers, and if you use the last of something, you replace it. Or, if you're too busy to replace something, you tell your coworker during report so he can restock it.
If the kindness rule were followed at all times everything would always be in stock, and when you need something it will be where it's supposed to be. This would work great because when you need something you won't have to search all over for it and look like a goofus RT in the process.
The kindness rule also entails cleaning and redressing ventilators and other such equipment as soon as it's done being used by a patient. You should also do the function checks as necessary. Or, if you are unable to do it, tell your replacement.
The kindness rule also entails getting all your work done. If an incentive spirometer is ordered one hour before your shift ends, you should go out of your way to do it. However, if you are extremely busy, the kindness rule allows you to notify your relief the work needs to be completed.
The kindness rule involves consideration for the other people you work with. It involves a common sense approach to getting your work done and not leaving work for other people.
So we'll make this RT Cave rule # 58: The kindness rule entails that you get all your work done so you don't create work for your coworkers.
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If the kindness rule were followed at all times everything would always be in stock, and when you need something it will be where it's supposed to be. This would work great because when you need something you won't have to search all over for it and look like a goofus RT in the process.
The kindness rule also entails cleaning and redressing ventilators and other such equipment as soon as it's done being used by a patient. You should also do the function checks as necessary. Or, if you are unable to do it, tell your replacement.
The kindness rule also entails getting all your work done. If an incentive spirometer is ordered one hour before your shift ends, you should go out of your way to do it. However, if you are extremely busy, the kindness rule allows you to notify your relief the work needs to be completed.
The kindness rule involves consideration for the other people you work with. It involves a common sense approach to getting your work done and not leaving work for other people.
So we'll make this RT Cave rule # 58: The kindness rule entails that you get all your work done so you don't create work for your coworkers.
Friday, June 1, 2012
"Hey Respiratory!" RT Rule #53
I'm sure you've heard it where you work: "Hey respiratory!" It's the default way to get the attention of the respiratory therapist. "Hey respiratory guy!"
I hear a lot of respiratory therapists who feel they are so little respected that many nurses and doctors just call them by their profession: "Respiratory!"
Working for a small, close knit facility where I work this doesn't happen too often. Usually the people who call me that are new nurses or new doctors in the Emergency Room. Otherwise I'm usually referred to by my name.
That is, unless there's a page over head. Then it's "Respiratory STAT to..."
I think most RTs that are called by their profession are generally those who come from larger facilities. And the recommendation they give is this:
"I don't answer them if they say "hey, respiratory" or "hey, breathing guy". I just look at them and keep doing what I am doing until they call me by name. Seriously. Try calling them by saying 'hey, nurse'. See how they like it."
I really don't care what people call me. If you want to call me respiratory that's fine by me. Yet I understand where the frustration comes from.
RT Cave #53: Keep your respiratory therpast happy by calling him/ her by name. Do not refer to your respiratory therapist as respiratory. Do not say, "Hey, respiratory!"
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I hear a lot of respiratory therapists who feel they are so little respected that many nurses and doctors just call them by their profession: "Respiratory!"
Working for a small, close knit facility where I work this doesn't happen too often. Usually the people who call me that are new nurses or new doctors in the Emergency Room. Otherwise I'm usually referred to by my name.
That is, unless there's a page over head. Then it's "Respiratory STAT to..."
I think most RTs that are called by their profession are generally those who come from larger facilities. And the recommendation they give is this:
"I don't answer them if they say "hey, respiratory" or "hey, breathing guy". I just look at them and keep doing what I am doing until they call me by name. Seriously. Try calling them by saying 'hey, nurse'. See how they like it."
I really don't care what people call me. If you want to call me respiratory that's fine by me. Yet I understand where the frustration comes from.
RT Cave #53: Keep your respiratory therpast happy by calling him/ her by name. Do not refer to your respiratory therapist as respiratory. Do not say, "Hey, respiratory!"
Wednesday, April 11, 2012
RT Cave Rule #53: The borrowing Rule
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| Don't borrow what you don't intend to return |
If you're going to borrow something, use it and then give it back right away. I don't carry scissors on me, so if I need a pair I borrow it. Yet I don't want to be a slave to the lender, so I promptly use it, clean it, and place it right in the palm of the lender.
Shoot! I forgot my stethoscope again. So I borrow one that's hanging in the department. Three months later my coworkers asks me if I took his stethoscope. I say no. A few days later I find it under my bed in three pieces. How did this happen? Now I'm a liar and a slave to my coworker. I'm a slave until I buck up the $150 to purchase him a new one.
I borrowed the leaf blower from my neighbor and I never even got it to work. It sat in my garage all summer because I was too busy to return it. Then I forgot. Then my neighbor and his wife are heard arguing about where the blower could be. An awkward position for me.
So thus brings me to a rule about borrowing: Do not carry something of someone else's in your lab coat, because chances are you'll be in a rush to go home at the end of your shift and you won't be thinking about what's in your pockets.
We'll make this RT Cave #61:
Do not carry something of someone else's in your lab coat, because chances are you'll be in a rush to go home at the end of your shift and you won't be thinking about what's in your pockets. You'll then be responsible for something that's not yours, and you'll end up a slave to the lender.
Wednesday, January 18, 2012
Patient orientated versus task orientated
Sometimes we medical caregivers become so involved in the task that we forget the patient is a real person. In a way, it's almost as though we are running an assembly line and each patient is simply a part that needs fixing.
Yet patients are real people. So this means that we have to focus extra hard on getting the task done without compromising the personal experience. We must always put the patient first and the task second.
Allow for a few definitions:
1. Patient orientated: You put the patient first. You consider the religious and emotional needs of the patient prior to performing any task.
2. Task orientated: You put your task first.
We're often asked to do so much that it's easy to become task orientated. This is most common in busy patient areas, like the ER. It's easy to just walk into a room and poke a patient without clearly explaining what you're doing. You're goal here is to get the task done and quickly move on to the next task.
Yet most patients hate this. It makes the RN or RT or doctor appear to lack a personality. You become ruthless, condescending and arrogant. You may not mean to be this way, but you will by default as a task orientated person.
Surely there are times when being task orientated is necessary, such as when the life of the person is at stake and some swift action is necessary. Yet more often than not the task must take a back seat to the patient.
Task orientated people tend to get angry when the patient isn't compliant, or when the patient refuses therapy. I've seen many doctors get mad at such patients.
A good example is the nurse who comes into the room of a 3 YO little girl and says, "Well, I have a shot. Will you help me hold her down so we can give it." Yep. That's not good. That's a task orientated person for you.
A people orientated person has more empathy than that. A good example of a people orientated action was when my reserved 3 YO daughter needed a chest x-ray. Instead of just expecting my daughter to comply and shooting the x-ray, the lady had my daughter sit upright and she said, "Now look into the little tube. You'll see the bubble guppies. All you have to do is hold your breath and..."
Voila. She got my daughter to sit still while she took the x-ray.
RT Rule #57: The best caregivers are people orientated first, task orientated second.
Yet patients are real people. So this means that we have to focus extra hard on getting the task done without compromising the personal experience. We must always put the patient first and the task second.
Allow for a few definitions:
1. Patient orientated: You put the patient first. You consider the religious and emotional needs of the patient prior to performing any task.
2. Task orientated: You put your task first.
We're often asked to do so much that it's easy to become task orientated. This is most common in busy patient areas, like the ER. It's easy to just walk into a room and poke a patient without clearly explaining what you're doing. You're goal here is to get the task done and quickly move on to the next task.
Yet most patients hate this. It makes the RN or RT or doctor appear to lack a personality. You become ruthless, condescending and arrogant. You may not mean to be this way, but you will by default as a task orientated person.
Surely there are times when being task orientated is necessary, such as when the life of the person is at stake and some swift action is necessary. Yet more often than not the task must take a back seat to the patient.
Task orientated people tend to get angry when the patient isn't compliant, or when the patient refuses therapy. I've seen many doctors get mad at such patients.
A good example is the nurse who comes into the room of a 3 YO little girl and says, "Well, I have a shot. Will you help me hold her down so we can give it." Yep. That's not good. That's a task orientated person for you.
A people orientated person has more empathy than that. A good example of a people orientated action was when my reserved 3 YO daughter needed a chest x-ray. Instead of just expecting my daughter to comply and shooting the x-ray, the lady had my daughter sit upright and she said, "Now look into the little tube. You'll see the bubble guppies. All you have to do is hold your breath and..."
Voila. She got my daughter to sit still while she took the x-ray.
RT Rule #57: The best caregivers are people orientated first, task orientated second.
Tuesday, January 17, 2012
Turn it off at the door
So it's Monday morning and you woke up on the wrong side of the bed. Or perhaps you're grumpy every Monday morning. Or perhaps you're always grumpy because it's your personality. Or perhaps your grumpy because you're sick and tired of people calling you for stupid reasons.
Well it's not my problem. Don't be grumpy to me because of something that has nothing to do with me. This brings us to RT Cave Rule # 54:
I think in any profession you work with people you're going to get sick and tired of people. I know that in the ER you get so many people who don't need to be there. You get stupid people taking their kids to the ER for a common cold, and then you have people with truly sick kids who don't follow directions and end up with a kid that's even sicker.
So you get people burn out. You get stupid people burn out. Yet it's not my fault. When my wife calls the doctors office on Monday morning, it' s not her fault you let yourself become grumpy. So don't take it out on her. Don't take it out on me. Don't take it out on the patient.
This brings us to RT Cave Rule #56:
Well it's not my problem. Don't be grumpy to me because of something that has nothing to do with me. This brings us to RT Cave Rule # 54:
RT Cave Rule #55: If you're grumpy, turn it off at the door of the patient's room.Everybody has days when they are grumpy. There are days when I'm grumpy. Yet 99.567% of the time I turn it off at the door to the patient's room. It's not the patients fault that I'm having a bad day.
I think in any profession you work with people you're going to get sick and tired of people. I know that in the ER you get so many people who don't need to be there. You get stupid people taking their kids to the ER for a common cold, and then you have people with truly sick kids who don't follow directions and end up with a kid that's even sicker.
So you get people burn out. You get stupid people burn out. Yet it's not my fault. When my wife calls the doctors office on Monday morning, it' s not her fault you let yourself become grumpy. So don't take it out on her. Don't take it out on me. Don't take it out on the patient.
This brings us to RT Cave Rule #56:
RT Cave Rule #56: Smile when you're talking on the phone, it will make it easier to be pleasant.
Thursday, December 29, 2011
Don't blow up at your RT
Noting the nurses in the ER were busy, and noting the patient had a CPAP and a bunch of other stuff than needed to go to his room, I inquired to the nurse what room the patient was going to be admitted to.
She said, snarly, "Look! If we knew what room he was in he'd be admitted already. We don't know any more now what room he's going to as we did a half hour ago when you asked!"
Surely my natural instincts were setting in and I wanted to blow up at the nurse, yet I humble gained control, set my hand on her arm, and said, calmly, and with the most realistic smile I could muster, "Relax, I was just trying to help you guys out."
She mumbled a few things and was on her way. I decided never to offer my services in such a fashion again., at least when she's working.
RT Cave Rule # 54: If you want your RT to help you out in the future, don't tick him off today.
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She said, snarly, "Look! If we knew what room he was in he'd be admitted already. We don't know any more now what room he's going to as we did a half hour ago when you asked!"
Surely my natural instincts were setting in and I wanted to blow up at the nurse, yet I humble gained control, set my hand on her arm, and said, calmly, and with the most realistic smile I could muster, "Relax, I was just trying to help you guys out."
She mumbled a few things and was on her way. I decided never to offer my services in such a fashion again., at least when she's working.
RT Cave Rule # 54: If you want your RT to help you out in the future, don't tick him off today.
Wednesday, November 23, 2011
You do not have to intubate if you have a good airway
Other than certain ethical issues, the things that irritates this RT more than anything are when certain medical workers become rapt on the idea they have to intubate right away during a respiratory or cardiopulmonary arrest. The patient turns blue and they think intubate. The neonate needs CPR and they think intubate.
An intubated patient is easier to ventilate that's no doubt, yet more often than not the process wastes valuable time better spent giving breaths, giving chest compressions, and giving medicines. In most instances, I think intubation can wait until you have the situation under control.
In fact, we'll just jump to the case here and come out with RT Cave Rule #52:
Now obviously there are exceptions to this rule, such as obstructed airway. Yet this would still fall under rule #52 which states, "so long as you have a good airway." If you don't have a good airway, then you can rush to intubate. In that case, you have to intubate.
Some people might contend another exception is overdose and high risk for aspiration. Yet I would never recommend intubating such a patient. Why you ask? Because sticking a hard, metal object through someone's gag reflex is the perfect way to get someone to vomit.
But you don't have to intubate a neonate you just started doing chest compressions on. I sat and watched a doctor doing this, and also watched as the pulse oximeter went from 90 to 80 to 70 to 60. I verbalized these falling heart rates and the doctor said, "Don't worry about it."
Sorry, but I was right and that doctor was wrong. He spent way too much time trying to intubate, and his attempt, even while he had noble intentions, was inappropriate.
An intubated patient is easier to ventilate that's no doubt, yet more often than not the process wastes valuable time better spent giving breaths, giving chest compressions, and giving medicines. In most instances, I think intubation can wait until you have the situation under control.
In fact, we'll just jump to the case here and come out with RT Cave Rule #52:
RT Cave Rule #52: So long as you have a good airway and ventilations are effective, intubation can wait until the patient is stabilized.Under stress of a code intubation is often the first thing to come to mind. It shouldn't be. The first thing to come to your mind should be "are we ventilating?" If yes, leave well enough alone and move on to the next question: "are we circulating blood?" If the answer to both these are yes, then you can intubate.
Now obviously there are exceptions to this rule, such as obstructed airway. Yet this would still fall under rule #52 which states, "so long as you have a good airway." If you don't have a good airway, then you can rush to intubate. In that case, you have to intubate.
Some people might contend another exception is overdose and high risk for aspiration. Yet I would never recommend intubating such a patient. Why you ask? Because sticking a hard, metal object through someone's gag reflex is the perfect way to get someone to vomit.
But you don't have to intubate a neonate you just started doing chest compressions on. I sat and watched a doctor doing this, and also watched as the pulse oximeter went from 90 to 80 to 70 to 60. I verbalized these falling heart rates and the doctor said, "Don't worry about it."
Sorry, but I was right and that doctor was wrong. He spent way too much time trying to intubate, and his attempt, even while he had noble intentions, was inappropriate.
Friday, November 18, 2011
How to deal with hotheads at work
For the first time in a while I arrived at work feeling completely refreshed. The patient load was way down and the milieu of the RT Cave was relaxed. All was going well until my boss handed me a sheet of paper with a few errors I made the last day I worked.
No big deal, I thought. With lots of time before my first treatments were due, I wandered to the lab to result an ABG I did two days earlier. The process was a little more complicated than I expected on the new system, yet after clicking a few icons the job was done.
The lab boss was sitting there so I thought I'd go out of my way to tell him the job was done. I confidently said, "Hey, Mike, I fixed the ABG that was non-resulted."
"So how did that error get made?" he said.
"It was just me being incompetent," I said in my normal fun tone. As he spoke this I started wishing I hadn't said anything. I could see horns growing on either side of his head -- red horns. His hand moved quickly from the keyboard to the pitchfork -- also red. Steam started billowing from the tops of the horns.
"You know that's a serious issue that needs to be dealt with," he whined. "You really are incompetent if you're making errors like that. That's two days a doctor didn't have those results. That's unacceptable! What are you going to do to make sure something like this doesn't happen again."
One mistake doesn't constitute a crisis! I wanted to say. Yet common sense took over my thoughts and what came out of my mouth instead was: "You have a good day too." I turned and walked away."
The truth was the doctor was handed the results by me, yet I didn't want to humor him with that information. The fact the ABG wasn't resulted only meant it wasn't in the computer.
This brings us to RT Cave rule #49:
I had to do that because that prevents Mike from going to my boss and getting the upper hand. It was my way of staying on offense and staving off a worse situation.
Then I told my co-workers. Then during lunch I was sitting at the table munching away on a carrot when Mike came into the cafeteria. "Hey, there he is! There's the hot-headed head of lab. There's the guy who called me incompetent. Should I wave!"
A good laugh ensued. Yet more important, I had gained the sympathy of my fellow co-workers. If Mike did anything to further this incident, I had the support and sympathy of my boss and co-workers.
I suppose the moral here is that hotheads never win. So We'll make that RT Cave Rule #49:
No big deal, I thought. With lots of time before my first treatments were due, I wandered to the lab to result an ABG I did two days earlier. The process was a little more complicated than I expected on the new system, yet after clicking a few icons the job was done.
The lab boss was sitting there so I thought I'd go out of my way to tell him the job was done. I confidently said, "Hey, Mike, I fixed the ABG that was non-resulted."
"So how did that error get made?" he said.
"It was just me being incompetent," I said in my normal fun tone. As he spoke this I started wishing I hadn't said anything. I could see horns growing on either side of his head -- red horns. His hand moved quickly from the keyboard to the pitchfork -- also red. Steam started billowing from the tops of the horns.
"You know that's a serious issue that needs to be dealt with," he whined. "You really are incompetent if you're making errors like that. That's two days a doctor didn't have those results. That's unacceptable! What are you going to do to make sure something like this doesn't happen again."
One mistake doesn't constitute a crisis! I wanted to say. Yet common sense took over my thoughts and what came out of my mouth instead was: "You have a good day too." I turned and walked away."
The truth was the doctor was handed the results by me, yet I didn't want to humor him with that information. The fact the ABG wasn't resulted only meant it wasn't in the computer.
This brings us to RT Cave rule #49:
RT Cave Rule #49: One mistake does not constitute a crisis. One mistake is a normal human error, and several mistakes may be considered a crisis that needs to be dealt with.I knew from personal experience that dealing with a hot head during a hot situation never works. A better solution is what I did next. I went upstairs and went straight to my bosses office, handed him the receipt of the correction and said, "I told Mike I fixed this and he was sort of a hot-headed jerk about it."
I had to do that because that prevents Mike from going to my boss and getting the upper hand. It was my way of staying on offense and staving off a worse situation.
Then I told my co-workers. Then during lunch I was sitting at the table munching away on a carrot when Mike came into the cafeteria. "Hey, there he is! There's the hot-headed head of lab. There's the guy who called me incompetent. Should I wave!"
A good laugh ensued. Yet more important, I had gained the sympathy of my fellow co-workers. If Mike did anything to further this incident, I had the support and sympathy of my boss and co-workers.
I suppose the moral here is that hotheads never win. So We'll make that RT Cave Rule #49:
RT Cave Rule #50: Hotheads never win. Getting hot says more about your incompetence in dealing with stressful situations and resolves nothing. It merely results in you looking like the bumbling moron you are.Likewise this also brings us to RT cave Rule #51:
RT Cave Rule #51: When dealing with a hothead, it's best to shut your mouth and walk away.
Friday, November 11, 2011
They only call you when you don't want them to
As soon as you sit for lunch the emergency room will want you. As soon as you "finally" sit down to take a break a patient will need a breathing treatment. As soon as you click on the Internet they will call. Yes it's true: they only call when you don't want them to.
This brings us to RT Cave rule #48:
RT cave #48: If you want someone to page you they won't. If you're in a room and the patient won't shut up, and you can't think of a way to escape, your pager won't go off. It's just the way it is
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This brings us to RT Cave rule #48:
RT cave #48: If you want someone to page you they won't. If you're in a room and the patient won't shut up, and you can't think of a way to escape, your pager won't go off. It's just the way it is
Friday, September 3, 2010
Don't go on the defense
There's an old rule in the business world that you should stay on offense and avoid the defense. In fact, while defense might win Super Bowls, it can make you look downright immature in the real world.
First of all, I don't think it's professional of anyone to put an accusative finger in another person's face. Yet it happens. And when it does, your job is to keep your mouth shut. You can defend yourself, but do that later not now. And don't mumble under your breath either.
Look, I know this is easier said than done. In fact, just yesterday one doctor said to another, "You need to chart this and that and this and that!!!!" The doctor on the defense mumbled under his breath, "What are you? The chart police!!!"
The doctor on the defense here was, in my opinion, in the right. Yet he looked like a fool on the defense. By his mumbling and grumbling he lost a little respect.
Another example was my co-worker Tim. I watched as the RT boss came up to him and said, "You didn't chart Atrovent with your last treatment. And you never charted Mr. Atwood's treatment at 10:00 yesterday."
My co-worker said, "Yeah, but I was at a code at that time. I couldn't get to the treatment. I... I... I..."
Ahhhhh!!!! Don't you know, Tim, that RT Cave Rule #45 states that you should never go on the defense because it can only make you look like a fool. When you're accused of something, even if you are right, keep your mouth shut and take the hit. Do not make excuses!!!
I can think of many instances when I broke this rule, especially back when I was a green horn RT. I never won. I never won even when I was right. In fact, nothing good can come of making excuses, even if the excuse is a good one.
My kids make excuses all the time too. And, quite frankly, we all do. It's probably a natural instinct to want to defend ourselves, especially when we are right, or don't want to be seen as doing something wrong.
We also don't like to be put on the spot. Yet we need to learn that being put on the spot is something that's going to happen a lot to us in life, and we need to learn to keep our mouth's shut when this happens. Even though it's hard, we need to keep our cool.
Likewise, if you really have a need to defend yourself, perhaps because you're a new worker and you want to clear the water, approach your boss in a professional manner at a later date and time.
If you have good character, and keep your mouth shut, the truth will eventually come out. And you'll look all the better for it. So, in the mean time, do your job the best you can, keep your mouth shut, don't make excuses, take the hit, and get back to work with your head held high.
First of all, I don't think it's professional of anyone to put an accusative finger in another person's face. Yet it happens. And when it does, your job is to keep your mouth shut. You can defend yourself, but do that later not now. And don't mumble under your breath either.
Look, I know this is easier said than done. In fact, just yesterday one doctor said to another, "You need to chart this and that and this and that!!!!" The doctor on the defense mumbled under his breath, "What are you? The chart police!!!"
The doctor on the defense here was, in my opinion, in the right. Yet he looked like a fool on the defense. By his mumbling and grumbling he lost a little respect.
Another example was my co-worker Tim. I watched as the RT boss came up to him and said, "You didn't chart Atrovent with your last treatment. And you never charted Mr. Atwood's treatment at 10:00 yesterday."
My co-worker said, "Yeah, but I was at a code at that time. I couldn't get to the treatment. I... I... I..."
Ahhhhh!!!! Don't you know, Tim, that RT Cave Rule #45 states that you should never go on the defense because it can only make you look like a fool. When you're accused of something, even if you are right, keep your mouth shut and take the hit. Do not make excuses!!!
I can think of many instances when I broke this rule, especially back when I was a green horn RT. I never won. I never won even when I was right. In fact, nothing good can come of making excuses, even if the excuse is a good one.
My kids make excuses all the time too. And, quite frankly, we all do. It's probably a natural instinct to want to defend ourselves, especially when we are right, or don't want to be seen as doing something wrong.
We also don't like to be put on the spot. Yet we need to learn that being put on the spot is something that's going to happen a lot to us in life, and we need to learn to keep our mouth's shut when this happens. Even though it's hard, we need to keep our cool.
Likewise, if you really have a need to defend yourself, perhaps because you're a new worker and you want to clear the water, approach your boss in a professional manner at a later date and time.
If you have good character, and keep your mouth shut, the truth will eventually come out. And you'll look all the better for it. So, in the mean time, do your job the best you can, keep your mouth shut, don't make excuses, take the hit, and get back to work with your head held high.
RT Cave Rule #45: Even when you are right, and someone accuses you of doing wrong, keep your mouth shut and take the hit. So long as you're a good worker, your good character will be visible to all in the end.
Monday, August 23, 2010
Three simple rules for stocking the RT Cave
My rule for stocking is simple: If you take the last one, either a) replace it, or b) make a note of this during report.
Yet, some believe that stock should be done at all times by whomever is available. If you're slow, you better stock. If stock is low, you have to stock it.
These people tend to be more anal than me, and may even get upset that I didn't stock. Yet I never let anything run out. My rule for stocking works pretty well, I think.
The only exception is if you are really busy, like if you have a code and use up a big machine like a Ventilator or BiPAP, you need to make sure you properly put back together the machine so it's ready for the next emergency, or at least make note of this in report.
Otherwise, when that machine is needed STAT, you'll be scrounging around for parts to get it working. And you'll be viewed by others around you as an unprepared RT, and a bumbling idiot because some other idiot was lazy.
Plus, make sure you restock the airway box. I find nothing worse than opening this box up at a code only to find there is no AMBU-bag or no suction equipment. Now you have to go on a hunt for equipment, and you'll again look like an unprepared bumbling idiot.
RT Cave Rule # 44: Stocking rule #1: If you take the last one, replace it.
RT Cave Rule #45: "Stocking rule #2: if you use a big machine like a Ventilator or BiPAP, make sure you properly put it together, clean it, and do a function test so it's ready for the next emergency."
RT Cave Rule #46: "Stocking rule #3: Restock the airway box right away after you use it."
The funny thing is if you follow these simple rules chances are no one will notice, yet no one will be forced to scrounge around in an emergency looking for parts that are needed right now to save a life.
Hence, even when it's not my fault equipment is not where it's supposed to be, I'm the one who looks unprepared. Because of your laziness, I look like a bumbling idiot.
Yet, some believe that stock should be done at all times by whomever is available. If you're slow, you better stock. If stock is low, you have to stock it.
These people tend to be more anal than me, and may even get upset that I didn't stock. Yet I never let anything run out. My rule for stocking works pretty well, I think.
The only exception is if you are really busy, like if you have a code and use up a big machine like a Ventilator or BiPAP, you need to make sure you properly put back together the machine so it's ready for the next emergency, or at least make note of this in report.
Otherwise, when that machine is needed STAT, you'll be scrounging around for parts to get it working. And you'll be viewed by others around you as an unprepared RT, and a bumbling idiot because some other idiot was lazy.
Plus, make sure you restock the airway box. I find nothing worse than opening this box up at a code only to find there is no AMBU-bag or no suction equipment. Now you have to go on a hunt for equipment, and you'll again look like an unprepared bumbling idiot.
RT Cave Rule # 44: Stocking rule #1: If you take the last one, replace it.
RT Cave Rule #45: "Stocking rule #2: if you use a big machine like a Ventilator or BiPAP, make sure you properly put it together, clean it, and do a function test so it's ready for the next emergency."
RT Cave Rule #46: "Stocking rule #3: Restock the airway box right away after you use it."
The funny thing is if you follow these simple rules chances are no one will notice, yet no one will be forced to scrounge around in an emergency looking for parts that are needed right now to save a life.
Hence, even when it's not my fault equipment is not where it's supposed to be, I'm the one who looks unprepared. Because of your laziness, I look like a bumbling idiot.
Saturday, June 12, 2010
If a patient needs a treatment, give it to her
If a patient needs a breathing treatment, and the order is Q6 and Q1 prn (in English, that's every six hours or up to every 1 hour as needed). She was an end stage COPD patient, and benefited greatly from the therapy. So I gave her treatments every 2 hours.
At the end of my shift I said, "Now you make sure you call for treatments every time you need one."
"Oh, they work so well," she said, "I really appreciate you gave me one whenever I needed it. I never even needed to call you."
"You can have treatments whenever you want, so don't be afraid to push your nurses button when you need a treatment."
So the next day the night shift RT gave me report. She said, "I gave (said patient) treatments every four hours. She can't go much longer."
Based on this report, I suspected the patient was doing much better. However, when I entered the patient's room her smile grew quickly, and she said, "Rick! Boy am I glad to see you!"
I set up her treatment, and said, "So, did the night shift treat you well?"
"Oh, yeah. Everyone was such a doll. The night shift girl doing your job was great and all, but she told me I needed to start stretching my treatments out. She wanted me to go six hours, but I made her give me one at the four hour mark."
"You think you need them more often?" By looking at her I already knew she did.
"Yes."
"How far apart do you want treatments?"
"I find it hard to make it 2 hours without getting short of breath, so every 2 hours would be perfect."
"Then every 2 hours it is."
She smiled.
I don't understand what the deal is about giving a lady who actually needs Albuterol treatments a treatment when she wants. What's this about spreading them out? If the lady needs them every 2 hours, give them every 2 hours. If she wants them more often, give the treatment.
I don't know what this issue is of "spreading the treatments out." When she gets better then you can spread the treatment out, but not when she really needs it. Ventolin is a refined bronchodilator with basically no side effects, so take advantage of it!
When I had my last bad asthma attack 11 years ago, I gave myself treatments every hour, and when I was in the hospital I expected them that often too. If the RT would have told me I had to wait four hours I would have called the doctor myself.
We'll make this RT Cave #44:
At the end of my shift I said, "Now you make sure you call for treatments every time you need one."
"Oh, they work so well," she said, "I really appreciate you gave me one whenever I needed it. I never even needed to call you."
"You can have treatments whenever you want, so don't be afraid to push your nurses button when you need a treatment."
So the next day the night shift RT gave me report. She said, "I gave (said patient) treatments every four hours. She can't go much longer."
Based on this report, I suspected the patient was doing much better. However, when I entered the patient's room her smile grew quickly, and she said, "Rick! Boy am I glad to see you!"
I set up her treatment, and said, "So, did the night shift treat you well?"
"Oh, yeah. Everyone was such a doll. The night shift girl doing your job was great and all, but she told me I needed to start stretching my treatments out. She wanted me to go six hours, but I made her give me one at the four hour mark."
"You think you need them more often?" By looking at her I already knew she did.
"Yes."
"How far apart do you want treatments?"
"I find it hard to make it 2 hours without getting short of breath, so every 2 hours would be perfect."
"Then every 2 hours it is."
She smiled.
I don't understand what the deal is about giving a lady who actually needs Albuterol treatments a treatment when she wants. What's this about spreading them out? If the lady needs them every 2 hours, give them every 2 hours. If she wants them more often, give the treatment.
I don't know what this issue is of "spreading the treatments out." When she gets better then you can spread the treatment out, but not when she really needs it. Ventolin is a refined bronchodilator with basically no side effects, so take advantage of it!
When I had my last bad asthma attack 11 years ago, I gave myself treatments every hour, and when I was in the hospital I expected them that often too. If the RT would have told me I had to wait four hours I would have called the doctor myself.
We'll make this RT Cave #44:
RT Cave Rule #44: If a patient needs a treatment, and the doctor approves the frequency, give the patient the treatment when she needs it or wants it. It's that simple. Don't let a patient a sit there short of breath because you think you need to "spread the treatments out." Ventolin is a safe and effective medicine, so don't make the patient suffer due to some fallacy.
Saturday, March 13, 2010
A job well done is a job well done
Recently a code blue rang out over head, and the destination was OB. I swear I ran all the way from the RT Cave to OB in less than 15 seconds. And, yes, the adrenaline was flowing through my veins and I was even a bit shaky. I'm sorry, but even after 12 years on the job, this was the first time my neonatal resuscitation skills were needed.
I took over ventilations as soon as I got there while someone else did CPR. The doctor from ER showed up and immediately intubated the baby. He already had an umbilical art line in, so we we drew a gas and sent it to lab. Epi was given again and again and again. The heart came back, and then it faded, and then it came back and then it faded.
And while we held up strongly during the event, as soon as it was called several hours later the doctor slumped over the patient and said a long prayer. The rest of us stood by in utter disbelief that we had to whiteness this; in utter disbelief of what we had to do here at our small town hospital.
We prepare for this throughout the year hoping to never use these skills. We have to do special training to remind ourselves how to use these skills because we aren't a large hospital and we don't do this stuff on a regular basis. As I wrote above, this was my first in 12 years. And, except for the doctor and one nurse, it was the first neonatal code blue for all the rest of us.
Later I sat down to talk to the ER doctor who came up to help us. He said something along these lines, "When I arrived there you were bagging, another nurse was doing CPR, and every body else was just standing around. I think that you guys ought to be trained to do things better."
My jaw dropped. How could he say such a thing. Then my jaw dropped even lower when he said, "I hate having to go up to the floor at this hospital. Here I'm an ER doctor, and I have to go up and have my name put on a chart of a patient upstairs, so if there's a lawsuit my name is going to be in it."
How can you be so selfish? Is all I could think to say. Still riding on the rush, I couldn't let this slide. I had to defend my coworkers: "I think things went excellent up there. Considering that most of the people at that code never did that before, I thought things went awesome."
"Really, you thought that?"
"I have never left a code where I said to myself, 'Gee, Rick, I think everything went perfect.' I don't because there is always room for improvement. But considering the limited staff and the limited experience we have here, I think we did awesome."
Yet he continued to explain to me how there could be a lawsuit. I said, "Still, it's in your job description to help us. If there is a code blue you have to come, unless you're tied up with another more important situation. But I can't think of anything more pressing than a neonate that's not breathing. Can you?"
"Well, no," he said. Yet he spun off again on another rant about lawsuits. He's an awesome doctor, and I respect him deeply. I really do. And I understand where he's coming from. Yet sometimes it's best to do what's right now, do good charting, and worry about a lawsuit some other day.
Besides, all he did was put in the ETT and tried to save the baby's life. In fact, that's what we all did. Are we supposed to stand idly by and let a baby die because we might get sued. I don't think so.
In fact, I think we ought to make this RT Cave Rule #42:
I took over ventilations as soon as I got there while someone else did CPR. The doctor from ER showed up and immediately intubated the baby. He already had an umbilical art line in, so we we drew a gas and sent it to lab. Epi was given again and again and again. The heart came back, and then it faded, and then it came back and then it faded.
And while we held up strongly during the event, as soon as it was called several hours later the doctor slumped over the patient and said a long prayer. The rest of us stood by in utter disbelief that we had to whiteness this; in utter disbelief of what we had to do here at our small town hospital.
We prepare for this throughout the year hoping to never use these skills. We have to do special training to remind ourselves how to use these skills because we aren't a large hospital and we don't do this stuff on a regular basis. As I wrote above, this was my first in 12 years. And, except for the doctor and one nurse, it was the first neonatal code blue for all the rest of us.
Later I sat down to talk to the ER doctor who came up to help us. He said something along these lines, "When I arrived there you were bagging, another nurse was doing CPR, and every body else was just standing around. I think that you guys ought to be trained to do things better."
My jaw dropped. How could he say such a thing. Then my jaw dropped even lower when he said, "I hate having to go up to the floor at this hospital. Here I'm an ER doctor, and I have to go up and have my name put on a chart of a patient upstairs, so if there's a lawsuit my name is going to be in it."
How can you be so selfish? Is all I could think to say. Still riding on the rush, I couldn't let this slide. I had to defend my coworkers: "I think things went excellent up there. Considering that most of the people at that code never did that before, I thought things went awesome."
"Really, you thought that?"
"I have never left a code where I said to myself, 'Gee, Rick, I think everything went perfect.' I don't because there is always room for improvement. But considering the limited staff and the limited experience we have here, I think we did awesome."
Yet he continued to explain to me how there could be a lawsuit. I said, "Still, it's in your job description to help us. If there is a code blue you have to come, unless you're tied up with another more important situation. But I can't think of anything more pressing than a neonate that's not breathing. Can you?"
"Well, no," he said. Yet he spun off again on another rant about lawsuits. He's an awesome doctor, and I respect him deeply. I really do. And I understand where he's coming from. Yet sometimes it's best to do what's right now, do good charting, and worry about a lawsuit some other day.
Besides, all he did was put in the ETT and tried to save the baby's life. In fact, that's what we all did. Are we supposed to stand idly by and let a baby die because we might get sued. I don't think so.
In fact, I think we ought to make this RT Cave Rule #42:
RT Cave Rule #42: It's best to do what's right now, do good charting, and worry about a lawsuit some other day.
Saturday, January 30, 2010
Poor planning results in busy nurses
She was an RN. Her boss sat next to her as she was finishing her charting and asked her if she would work tonight. The RN said she was unable. The boss lectured her that "we are all in this together, and part of being a team means we all need to do our part."
The RN said, "I am doing my part. I work my one day a week and that's all I want to work. If I wanted to work more I would schedule myself for more."
The boss was dumbfounded. She picked her ear with one hand, and with the back of her other hand wiped away the drool swirling around the corner of her lower lip as it dropped almost to her jaw.
I thought for a moment she might cry. I, for a brief moment, felt empathy for this boss. Finally she said, "We need you. We're in a crisis here and we really need you."
"Look, I don't mean to be disrespectful," the RN said, "But poor planning on your part doesn't constitute an emergency on mine."
That ended the discussion. I won't go on about how it ended. I won't explain how I so happened to be there to hear the discussion, for neither of those facts matter.
Tonight I was sitting in the ER. I noticed that the charge nurse was sitting at the unit secretaries desk putting in all the orders. From time to time she'd get up, run to a patients room, do some chore there, and return to finish typing away, and flitting through sheets of paper.
"Why are you doing all this work?" I asked, knowing she didn't have time to talk with me.
She leaned back in her chair and smiled, "The unit secretary went home at 2:00 in the morning. The rest of the night we have to go without her and without any nurses assistants or techs to help us out. Plus Janet is going home at 3:00 and so is Jim. So basically it will be just me and Susan."
"So basically the powers that be want you guys to work at unsafe levels."
"Wow! That words it about right."
That was the end of that discussion.
A few years ago another nurse named Peggy was sitting in the nurses report room about 40 minutes after her shift was supposed to start. I said, "Why are you sitting in here when all the nurses out there appear to be overworked."
She said, "I'm refusing to take report because they want me to take 14 patients, and I think that is unsafe. I'm not going to put my license on the line because of their poor planning on their part." She was referring to the RN boss.
Due to her persistence another nurse arrived a half hour later and Peggy finally took report on seven patients, a load that she said was safe.
With respect to hospital bosses it is not possible to know when business is going to be swarming and when it's going to be slow. But still, poor planning on their part does not constitute an emergency on the part of the nurse.
The RN said, "I am doing my part. I work my one day a week and that's all I want to work. If I wanted to work more I would schedule myself for more."
The boss was dumbfounded. She picked her ear with one hand, and with the back of her other hand wiped away the drool swirling around the corner of her lower lip as it dropped almost to her jaw.
I thought for a moment she might cry. I, for a brief moment, felt empathy for this boss. Finally she said, "We need you. We're in a crisis here and we really need you."
"Look, I don't mean to be disrespectful," the RN said, "But poor planning on your part doesn't constitute an emergency on mine."
That ended the discussion. I won't go on about how it ended. I won't explain how I so happened to be there to hear the discussion, for neither of those facts matter.
Tonight I was sitting in the ER. I noticed that the charge nurse was sitting at the unit secretaries desk putting in all the orders. From time to time she'd get up, run to a patients room, do some chore there, and return to finish typing away, and flitting through sheets of paper.
"Why are you doing all this work?" I asked, knowing she didn't have time to talk with me.
She leaned back in her chair and smiled, "The unit secretary went home at 2:00 in the morning. The rest of the night we have to go without her and without any nurses assistants or techs to help us out. Plus Janet is going home at 3:00 and so is Jim. So basically it will be just me and Susan."
"So basically the powers that be want you guys to work at unsafe levels."
"Wow! That words it about right."
That was the end of that discussion.
A few years ago another nurse named Peggy was sitting in the nurses report room about 40 minutes after her shift was supposed to start. I said, "Why are you sitting in here when all the nurses out there appear to be overworked."
She said, "I'm refusing to take report because they want me to take 14 patients, and I think that is unsafe. I'm not going to put my license on the line because of their poor planning on their part." She was referring to the RN boss.
Due to her persistence another nurse arrived a half hour later and Peggy finally took report on seven patients, a load that she said was safe.
With respect to hospital bosses it is not possible to know when business is going to be swarming and when it's going to be slow. But still, poor planning on their part does not constitute an emergency on the part of the nurse.
RT Cave Rule #41: Poor planning on the part of administrators, bosses and supervisors does not constitute an emergency on the part of the staff.
Friday, January 29, 2010
We need to keep end stage patients happy
I think it was in 1993 at hunting camp my Uncle Donald decided to visit us. He was 80. My dad and I marveled at the fact that our 80 year old uncle was out in the middle of the woods, standing by a fire, and buzzed after drinking some homemade wine that sat up above the cupboards in the cabin kitchen for years.
Every person has one sagacious uncle, and Uncle Donald was mine. He had a white beard and mustache and gave the impression of Mark Train. He read a lot, said little, and when he did talk he impressed you with his wisdom.
You don't really think a lot about 80 year old people getting drunk, but after all they are human. And he wanted to enjoy the evening with dad and me. Dad said to me, "Yep, Rick, when you turn 80 you can do whatever you want."
That makes a lot of sense to me. And now, 15 years later, I use the same philosophy when I'm working. I believe if you are over 80, or if you have an end stage disease, that you can do whatever you want.
Likewise, if you are an end stage COPD patient you can have a breathing treatment whenever you want. And when you're done with that first treatment and you want another, by golly you can have that too.
I had an end stage cancer patient the other day demand a nasal cannula at 10lp. I had another patient who was anxious and labored who demanded a treatment every hour "even if I'm asleep get me up."
Wish granted!
Why not. The only reason I can think of for not giving it to her is if the RT were lazy or annoyed or didn't have any common sense. So, I think we'll make this RT Cave rule #40:
Every person has one sagacious uncle, and Uncle Donald was mine. He had a white beard and mustache and gave the impression of Mark Train. He read a lot, said little, and when he did talk he impressed you with his wisdom.
You don't really think a lot about 80 year old people getting drunk, but after all they are human. And he wanted to enjoy the evening with dad and me. Dad said to me, "Yep, Rick, when you turn 80 you can do whatever you want."
That makes a lot of sense to me. And now, 15 years later, I use the same philosophy when I'm working. I believe if you are over 80, or if you have an end stage disease, that you can do whatever you want.
Likewise, if you are an end stage COPD patient you can have a breathing treatment whenever you want. And when you're done with that first treatment and you want another, by golly you can have that too.
I had an end stage cancer patient the other day demand a nasal cannula at 10lp. I had another patient who was anxious and labored who demanded a treatment every hour "even if I'm asleep get me up."
Wish granted!
Why not. The only reason I can think of for not giving it to her is if the RT were lazy or annoyed or didn't have any common sense. So, I think we'll make this RT Cave rule #40:
RT Cave Rule #40: Whatever it takes to keep a patient over 80 happy, do it. Whatever it takes to keep an end stage COPD, CHF, CF or cancer patient happy, do it. Use your common sense.
Thursday, December 3, 2009
Oxygen and fire do not bode well together
I was just reading some of the information at nationaljewishhealth.org regarding COPD and I came across this question: "Can I just take "hit" of oxygen when I need it?"
I don't know why but that struck me as funny. It's really not. It's also not funny when someone who wears oxygen gets too close to the fire on a gas stove and their overflowing beard starts on fire. I've had more than one patients try this.
I've also had a COPD patient once light up a cigarette in his hospital bed. I was sitting at the nurses station at the time and heard a loud Crack! Click!Thud!
My mind's eye immediately recognized the thud, but the wheels were spinning in an attempt to identify the source of that unfamiliar crack.
Upon entering the room the patient was sitting on the floor with a disorganized look upon his singed face, an unlit cigarette dangling from his face. Next to him the oxygen tubing was doing a circular dance atop the tile floor and then it stood still.
At my foot was a cigarette lighter. I surmised the following sequence of events: He flicked the lighter which caused the crack as the oxygen was exposed to the flame, the lighter was dropped and clicked on the ground, the patient stripped the nasal cannula from his face, put out the fire on himself, and thudded to the ground in the process.
When you work in a hospital you see it all
So, we'll make this RT Cave Rule #39:
RT Cave Rule #39: Make sure your patients on oxygen do not get close to a flame, and that includes gas stoves with the burners on and cigarette lighters.
I don't know why but that struck me as funny. It's really not. It's also not funny when someone who wears oxygen gets too close to the fire on a gas stove and their overflowing beard starts on fire. I've had more than one patients try this.
I've also had a COPD patient once light up a cigarette in his hospital bed. I was sitting at the nurses station at the time and heard a loud Crack! Click!Thud!
My mind's eye immediately recognized the thud, but the wheels were spinning in an attempt to identify the source of that unfamiliar crack.
Upon entering the room the patient was sitting on the floor with a disorganized look upon his singed face, an unlit cigarette dangling from his face. Next to him the oxygen tubing was doing a circular dance atop the tile floor and then it stood still.
At my foot was a cigarette lighter. I surmised the following sequence of events: He flicked the lighter which caused the crack as the oxygen was exposed to the flame, the lighter was dropped and clicked on the ground, the patient stripped the nasal cannula from his face, put out the fire on himself, and thudded to the ground in the process.
When you work in a hospital you see it all
So, we'll make this RT Cave Rule #39:
RT Cave Rule #39: Make sure your patients on oxygen do not get close to a flame, and that includes gas stoves with the burners on and cigarette lighters.
Wednesday, September 30, 2009
She said it a little too loud
Inside the room, the patient says to me as I'm drawing her ABG because her spo2 is only 78% on a 100% non-rebreather, "I'm really stressed right now."
As I'm walking out of the room to tell the RN the patient might benefit from a Xanax, I hear the RN saying into the phone receiver loud enough for the patient to hear, "Your patient in ICU room D appears to be taking a dump on me."
I look back at the patient and wondered if her heart just flipped as she heard that, and hoped she didn't hear it.
Regardless, we are all guilty of talking too loud at times. And while this RN is perhaps one of the best I've ever worked with, this is proof that even she is human after all.
RT Cave Rule #38: When we are relaying private information about the patient, we must remember to keep our voices down.
As I'm walking out of the room to tell the RN the patient might benefit from a Xanax, I hear the RN saying into the phone receiver loud enough for the patient to hear, "Your patient in ICU room D appears to be taking a dump on me."
I look back at the patient and wondered if her heart just flipped as she heard that, and hoped she didn't hear it.
Regardless, we are all guilty of talking too loud at times. And while this RN is perhaps one of the best I've ever worked with, this is proof that even she is human after all.
RT Cave Rule #38: When we are relaying private information about the patient, we must remember to keep our voices down.
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