The hospital industry might just be the most unpredictable of any industry in the world. Of course I'm saying this as a person who works in the hospital industry and hasn't done much of anything else.
Yet, so far this year, Shoreline Medical has gone from extremely slow, to swamped, to slow again. And I can tell you something with utter honesty: when you go from being swamped to all of a sudden being slow, you appreciate every moment of slowness. That's a fact I won't back away from.
Normally my work doesn't effect my home life, but we had a three month rush that was so bad here I had no energy to do anything at home. If there were dishes sitting out I might just leave them out and let the wife gripe at me because I'm sitting around doing nothing but watching TV.
And, with children at home, that's saying a lot. When you have kids, and your wife is watching those kids for five straight days while you work long hours at night and sleep all day, she becomes weary eyed and very eager for an adult conversation and some help around the house.
Yet, after five days of hell at work, the last thing I want to do is anything more than the minimum when I'm on my days off. It's hard. It's the hardest part of this job as an RT. I would hate to work at a larger hospital that is THAT busy all the time. To come home every day with achy feet and weary head would make for a long life.
The last two days, however, were so slow I basically sat around and talked all night, or read books, or surfed the net, or blogged, or cleaned out my locker. It was nice. And, trust me, I appreciated every minute of sitting around. Not for one second was I bored.
I think one of the reason I appreciate it so much is you know -- in a heartbeat -- the good times could end. In a way, the way I felt the past two nights was not unlike a marathon runner in the moments following the race -- relief, joy.
So, for the first time in 12 years, I get to take a scheduled night off tonight. Even while I slept until 5:00 p.m. as I would if I were to work, I think I'm going to go to bed at a regular time tonight, which is right now: 10:16 p.m.
Have a great night
Showing posts with label working solo. Show all posts
Showing posts with label working solo. Show all posts
Saturday, May 23, 2009
Monday, March 30, 2009
You know it's time to go home when....
....you just finished hooking up a patient to the EKG machine and, as you go to type in the patient's information, you realize you are in the wrong room with the wrong patient.
Oops. No harm done.
That's about how crazy it's been around here lately.
'Nuf said.
Oops. No harm done.
That's about how crazy it's been around here lately.
'Nuf said.
Friday, March 20, 2009
3 types of lethal arryhthmias
Dear RT Cave readers:
I promise I will write something useful soon. It has been extremely "swamped" where I work each of the past six days. We have one vent right now, but we have had up to two on many of the past several days.
And, if I am not mistaken, I have had at least one BiPAP ongoing all 6 of those days, and have set-up at least one BiPAP each of those nights. And add to this ten regular patients on bronchodilator treatments (perhaps three of which actually need them).
And then you have to add constant calls to the ER. And, of course, you have to note that I am the humble night shift RT here at Shoreline medical, so that means I did this all by myself.
Oh, and you also have to add to that some one in in my department has been a god awful something that rhymes with twitch and starts with a b minus the tw. You can figure that one out. I swear you can have a million more important things to do, and
this person still finds something to nag about.
Whoops, I'm not supposed to complain anymore. Oh, and I forgot that we (I)had an RT student last night too for the first four hours of my shift. And since I love to teach, this kind of added another responsibility to my long list of things to do.
We RTs here at Shoreline like to share our RT humor with our students. Albeit they often aren't sure if we are joking or not. Last night the day shift RT (The sagacious Jane Sage) educated them on the three basic types of lethal arrhythmia's you should be able to recognize on a rhythm strip or EKG.
These Lethal Arrhythmia's are:
1. Too fast
2. Too slow
3. Oh shit
Have a great weekend. And, oh, as soon as my energy level returns to, say, the 50% level, I will write something useful on this blog. So bare with me.
Sincerely:
Rick.
I promise I will write something useful soon. It has been extremely "swamped" where I work each of the past six days. We have one vent right now, but we have had up to two on many of the past several days.
And, if I am not mistaken, I have had at least one BiPAP ongoing all 6 of those days, and have set-up at least one BiPAP each of those nights. And add to this ten regular patients on bronchodilator treatments (perhaps three of which actually need them).
And then you have to add constant calls to the ER. And, of course, you have to note that I am the humble night shift RT here at Shoreline medical, so that means I did this all by myself.
Oh, and you also have to add to that some one in in my department has been a god awful something that rhymes with twitch and starts with a b minus the tw. You can figure that one out. I swear you can have a million more important things to do, and
this person still finds something to nag about.
Whoops, I'm not supposed to complain anymore. Oh, and I forgot that we (I)had an RT student last night too for the first four hours of my shift. And since I love to teach, this kind of added another responsibility to my long list of things to do.
We RTs here at Shoreline like to share our RT humor with our students. Albeit they often aren't sure if we are joking or not. Last night the day shift RT (The sagacious Jane Sage) educated them on the three basic types of lethal arrhythmia's you should be able to recognize on a rhythm strip or EKG.
These Lethal Arrhythmia's are:
1. Too fast
2. Too slow
3. Oh shit
Have a great weekend. And, oh, as soon as my energy level returns to, say, the 50% level, I will write something useful on this blog. So bare with me.
Sincerely:
Rick.
Friday, March 21, 2008
The saga of the 99-year-old man: part 1
I gave treatment before I went home Thursday morning to an obtunded 99 year old patient who was wheeled into the emergency room with a non-rebreather plastered to his face. I was informed by the nurse the patient was from a local nursing home and was having trouble breathing.
"We are definitely going to need a breathing treatment on him, Rick," Julie, the patient's nurse told me, "he already had a Duoneb in route." They gave this guy a treatment enroute? Why?
Exhausted after perhaps one of the worst nights on recorded memory, one where I did 12 breathing treatments in the emergency room (two of which were indicated) and 12 EKGs in one four hour span while having a nursing student at the same time, I had long lost my ability to just keep my mouth shut and do what I was told.
So I let the nurse know what I thought about giving a treatment to this guy: "Looks more to me like he's in renal failure or is septic or something like that," I said. "More than likely he's probably wet."
I did an EKG, assessed the patient, and decided the patient did have no signs of bronchospasm. More than anything, he looked like a strong 99-year-old who had had a fulfilling life and was now ready to cross through the pearly gates to meet his maker.
So, after doing the EKG, I went upstairs. "Screw that nurse and her breathing stupid treatment," I thought to myself as I exited through the double doors and out of the emergency room. "I have patients upstairs who actually need treatments."
You guessed it, I as much as made it to the patient floors and was called back to do the treatment. What the, "I wanted to say hell here, but somehow managed to refrain myself as the doctor was standing right next to me, "the heck does he need a breathing treatment for," I grumbled. Honestly, though, I didn't mean to sound grumpy, but the exhaustion and burnout had raped me of my ability to control my cadence.
"Well," the all knowing nurse said, "He's short of breath."
You see, this is what's wrong with the medical field. Instead of actually assessing the patient, and knowing the indications for bronchodilators (for which all my blog readers know I am sure), some nurses think every patient who's short-of-breath needs a breathing treatment, including those patients, like this 99-year-old, who are in respiratory failure secondary to a metabolic problem.
I just want you guys to know that most of the time I an equanimitous guy who does what he's told and keeps his mouth shut and feigns a smile and grumbles to himself instead of verbally releasing into the atmosphere his frustration about an unnecessarily ordered procedure. For the most part, I have a mission to be happy and get along with everyone.
The nurse, who more than likely knew full well how miserable of a night I had (because her night was equally miserable) did not say anything back to me like, "This treatment is too indicated you stupid useless RT who thinks he knows everything." Nope, she did not say that.
And I'm glad she didn't, because I just wanted to go home, refuel and collapse. And, after I finished doing that breathing treatment, the nurse was preparing to insert a syringe into the patients newly inserted IV. I smiled and said, "Well, you don't have to give that," Julie.
"Why would that be?" She looked up at me and smiled. She knew what was coming.
"Because my Allbetterol mist just cured him of all his ailments."
She proceeded to smile and pushed her med.
I didn't tell her this, but also tossed into this mixture some Reserectolin to ease this patients transfer across the pearly gates, and some Waytoolateolin to ease the suffering of the nurse.
For more information on Waytoolateolin or Toolateolin check out this link. If you want to know more about Resurectolin, check out my list of 'olins at the bottom of this blog, of which I will update right now.
Oh, and I forgot to inform you guys that this patient was also a full code. Perhaps that will help you to understand my RT frustration a bit more.
(Note: I will continue the saga of the 99-year-old full code tomorrow.)
"We are definitely going to need a breathing treatment on him, Rick," Julie, the patient's nurse told me, "he already had a Duoneb in route." They gave this guy a treatment enroute? Why?
Exhausted after perhaps one of the worst nights on recorded memory, one where I did 12 breathing treatments in the emergency room (two of which were indicated) and 12 EKGs in one four hour span while having a nursing student at the same time, I had long lost my ability to just keep my mouth shut and do what I was told.
So I let the nurse know what I thought about giving a treatment to this guy: "Looks more to me like he's in renal failure or is septic or something like that," I said. "More than likely he's probably wet."
I did an EKG, assessed the patient, and decided the patient did have no signs of bronchospasm. More than anything, he looked like a strong 99-year-old who had had a fulfilling life and was now ready to cross through the pearly gates to meet his maker.
So, after doing the EKG, I went upstairs. "Screw that nurse and her breathing stupid treatment," I thought to myself as I exited through the double doors and out of the emergency room. "I have patients upstairs who actually need treatments."
You guessed it, I as much as made it to the patient floors and was called back to do the treatment. What the, "I wanted to say hell here, but somehow managed to refrain myself as the doctor was standing right next to me, "the heck does he need a breathing treatment for," I grumbled. Honestly, though, I didn't mean to sound grumpy, but the exhaustion and burnout had raped me of my ability to control my cadence.
"Well," the all knowing nurse said, "He's short of breath."
You see, this is what's wrong with the medical field. Instead of actually assessing the patient, and knowing the indications for bronchodilators (for which all my blog readers know I am sure), some nurses think every patient who's short-of-breath needs a breathing treatment, including those patients, like this 99-year-old, who are in respiratory failure secondary to a metabolic problem.
I just want you guys to know that most of the time I an equanimitous guy who does what he's told and keeps his mouth shut and feigns a smile and grumbles to himself instead of verbally releasing into the atmosphere his frustration about an unnecessarily ordered procedure. For the most part, I have a mission to be happy and get along with everyone.
The nurse, who more than likely knew full well how miserable of a night I had (because her night was equally miserable) did not say anything back to me like, "This treatment is too indicated you stupid useless RT who thinks he knows everything." Nope, she did not say that.
And I'm glad she didn't, because I just wanted to go home, refuel and collapse. And, after I finished doing that breathing treatment, the nurse was preparing to insert a syringe into the patients newly inserted IV. I smiled and said, "Well, you don't have to give that," Julie.
"Why would that be?" She looked up at me and smiled. She knew what was coming.
"Because my Allbetterol mist just cured him of all his ailments."
She proceeded to smile and pushed her med.
I didn't tell her this, but also tossed into this mixture some Reserectolin to ease this patients transfer across the pearly gates, and some Waytoolateolin to ease the suffering of the nurse.
For more information on Waytoolateolin or Toolateolin check out this link. If you want to know more about Resurectolin, check out my list of 'olins at the bottom of this blog, of which I will update right now.
Oh, and I forgot to inform you guys that this patient was also a full code. Perhaps that will help you to understand my RT frustration a bit more.
(Note: I will continue the saga of the 99-year-old full code tomorrow.)
Thursday, March 13, 2008
Preparing for a busy night, hoping for a good night; and a brief review of the new Underdog movie
Another nice thing about working 12 hour shifts is your wife can work on your days off and you get plenty of time to spend with the kids, and they never have to go to day care. Then again, there are times when I only see my wife in passing.
After working 12 last night, she trudged into the house this morning with red eyes, slurring her words, and she said, "Sarah said she feels bad for you. She said it's so busy that she had to have someone come in at two in the morning to help her."
"That bad, hey," I said.
"Yep. As she was talking to us she was paged three times."
After driving the boy to school, my wife went to bed and was out almost instantaneously. That left the girl and I home alone, and we decided to watch a movie we rented called Underdog.
Many of you probably don't remember that old cartoon, but back in the day when cartoons weren't on 24 hours a day, my brothers and I used to look forward to Saturday so we could watch cartoons all day. We would even sacrifice sleep and get up early.
At six in the morning we'd sneak off into the livingroom, click on the boob tube, and watch either Bull Winkle, Johhny Quest or Underdog. We loved those shows, however simple they were. They were good entertainment.
Usually I find myself disappointed when Hollywood gets a hold of a classic. When I was a kid I loved the Dukes of Hazzard, but when I took my son to see the movie I found myself wanting to leave the studio after there was sex in the first scene. I suffered through it. I hope this experience didn't scar my son for life.
I expected the Hollywood version of Underdog to be equally disapointing, but it turned out to be pretty good. It was, in my opinion, very fair to the original show.
Fortunately for this RT who has to work all night tonight, my daughter is still at that glorious age where she likes to do the same thing over and over and over and over and over again, and still get the same enjoyment out of it each time.
That in mind, I'm going to put Underdog back in, turn the volume down, and try to take a nap. Sometimes this works with four year old girls. However, sometimes she likes to make sure I'm alive every ten minutes or so by giving me a big kiss and saying something like, "I love you daddy."
Whatever kind of rest I can get, I'll take it, especially considering I'm not rightly looking forward to going to work tonight. And being my first night back after my bi-weekly mini vacation, I'm bound to be awfully tired.
I can handle it, though. I'll just put on my running shoes, plan for the best and hope for the worse... er, plan for the hope and... well, you know what I mean: prepare myself for worse and hope for a good night.
After working 12 last night, she trudged into the house this morning with red eyes, slurring her words, and she said, "Sarah said she feels bad for you. She said it's so busy that she had to have someone come in at two in the morning to help her."
"That bad, hey," I said.
"Yep. As she was talking to us she was paged three times."
After driving the boy to school, my wife went to bed and was out almost instantaneously. That left the girl and I home alone, and we decided to watch a movie we rented called Underdog.
Many of you probably don't remember that old cartoon, but back in the day when cartoons weren't on 24 hours a day, my brothers and I used to look forward to Saturday so we could watch cartoons all day. We would even sacrifice sleep and get up early.
At six in the morning we'd sneak off into the livingroom, click on the boob tube, and watch either Bull Winkle, Johhny Quest or Underdog. We loved those shows, however simple they were. They were good entertainment.
Usually I find myself disappointed when Hollywood gets a hold of a classic. When I was a kid I loved the Dukes of Hazzard, but when I took my son to see the movie I found myself wanting to leave the studio after there was sex in the first scene. I suffered through it. I hope this experience didn't scar my son for life.
I expected the Hollywood version of Underdog to be equally disapointing, but it turned out to be pretty good. It was, in my opinion, very fair to the original show.
Fortunately for this RT who has to work all night tonight, my daughter is still at that glorious age where she likes to do the same thing over and over and over and over and over again, and still get the same enjoyment out of it each time.
That in mind, I'm going to put Underdog back in, turn the volume down, and try to take a nap. Sometimes this works with four year old girls. However, sometimes she likes to make sure I'm alive every ten minutes or so by giving me a big kiss and saying something like, "I love you daddy."
Whatever kind of rest I can get, I'll take it, especially considering I'm not rightly looking forward to going to work tonight. And being my first night back after my bi-weekly mini vacation, I'm bound to be awfully tired.
I can handle it, though. I'll just put on my running shoes, plan for the best and hope for the worse... er, plan for the hope and... well, you know what I mean: prepare myself for worse and hope for a good night.
Thursday, February 7, 2008
Ever dread going to work one more night?
Do you ever have a day you simply dread going to work? That's about where I sit right now as I write this. My wife worked last night, and she said it is a complete zoo there. And she was not referring to OB, even though they too are busy.
I do feel a certain amount of joy that I will be needed. And I do feel joy knowing that I will provide a solution to some person's problems tonight, be it a patient or a nurse or both. I do feel joy in knowing that I will be really working tonight and earning my keep, as opposed to those many days recently where I had so much time as to watch several TV shows on the Internet.
However, I dread the idea that I will be beeped every time I sit down to chart, and I dread the idea that when I sit down to chart again I will again be paged, and when I sit down to chart again I will be paged. I know this sounds redundant, but that's exactly how my nights have been lately.
I have already promised myself that no matter how frivolous the reason for paging me is, I will not complain. I will be happy. I will smile. (fingers crossed)
Well, I say that, but we'll have to wait and see. Usually when I get irritated at getting paged for stupid things, like a treatment that is not indicated, or an EKG on a patient that came in because she stubbed her toe, I grumble and gripe to myself if at all, and by the time I get to my destination I never say anything to the nurse.
And, expecially when I enter the patient's room, I know that I left my attitude, if I had one, at the door. I'll have to remind myself about this more than once tonight, as I still am burned out from the weekend from hell. And we had a wee bit trouble sleeping last night after sleeping until 1:00 yesterday. Whoops. I shouldn't have done that.
Oh well. I can say oh well, and I can rest pretty assured that I will stay in a relatively good mood tonight if only for the simple truth that I know I will not have to return to work tomorrow for my regularly scheduled final night before my six day off stretch. I say this because tomorrow I'm taking off so that I can leave for Florida Friday morning. Yippee.
Yet, a part of me still dreads that I have to work one more night. The burned out sensation that runs through my veins and has worked its way to through my muscles to the core of my bones, especially in my feet, wants me to stay far, far away from that place.
Songs like "One More Night," will rail through my head, reminding myself that it will be over soon. But soon, sometimes during hellish nights, seems like a long time while it's happening.
Do you ever dread going to work like that? I'm not talking about hating your job, but just wishing you could take that final day off, like a Friday per se for people who work normal eight hour shifts with no weekends.
Ever? I bet you do.
I do feel a certain amount of joy that I will be needed. And I do feel joy knowing that I will provide a solution to some person's problems tonight, be it a patient or a nurse or both. I do feel joy in knowing that I will be really working tonight and earning my keep, as opposed to those many days recently where I had so much time as to watch several TV shows on the Internet.
However, I dread the idea that I will be beeped every time I sit down to chart, and I dread the idea that when I sit down to chart again I will again be paged, and when I sit down to chart again I will be paged. I know this sounds redundant, but that's exactly how my nights have been lately.
I have already promised myself that no matter how frivolous the reason for paging me is, I will not complain. I will be happy. I will smile. (fingers crossed)
Well, I say that, but we'll have to wait and see. Usually when I get irritated at getting paged for stupid things, like a treatment that is not indicated, or an EKG on a patient that came in because she stubbed her toe, I grumble and gripe to myself if at all, and by the time I get to my destination I never say anything to the nurse.
And, expecially when I enter the patient's room, I know that I left my attitude, if I had one, at the door. I'll have to remind myself about this more than once tonight, as I still am burned out from the weekend from hell. And we had a wee bit trouble sleeping last night after sleeping until 1:00 yesterday. Whoops. I shouldn't have done that.
Oh well. I can say oh well, and I can rest pretty assured that I will stay in a relatively good mood tonight if only for the simple truth that I know I will not have to return to work tomorrow for my regularly scheduled final night before my six day off stretch. I say this because tomorrow I'm taking off so that I can leave for Florida Friday morning. Yippee.
Yet, a part of me still dreads that I have to work one more night. The burned out sensation that runs through my veins and has worked its way to through my muscles to the core of my bones, especially in my feet, wants me to stay far, far away from that place.
Songs like "One More Night," will rail through my head, reminding myself that it will be over soon. But soon, sometimes during hellish nights, seems like a long time while it's happening.
Do you ever dread going to work like that? I'm not talking about hating your job, but just wishing you could take that final day off, like a Friday per se for people who work normal eight hour shifts with no weekends.
Ever? I bet you do.
Friday, February 1, 2008
Working nights solo can be challenging at times
I came into work last night anticipating on working on my fantasy baseball rankings, and it ended up being reminiscent of how it used to be here at Shoreline every night: busy.
My co-worker normally stays until 9 p.m., but all I had were a bunch of 10 p.m. treatments I figured I'd knock off in no time. But, lo and behold, as soon as he left all hell broke lose. Every patient who could possible go bad did.
And, as what usually happens when you have ten treatments due and two patients in failure, the emergency room paged: "We need another now treatment on room 1," the pager read, "and then Q30 minutes after that."
"This is completely ridiculous," I grumbled under my breath, and then looked up at the middle-aged lady I was currently giving a treatment to and watched as her body jiggled up and down as she laboriously struggled to move air.
I didn't know what else to do, so I dropped the pager. This reaction prevented me from whipping it across the room. I looked at my patient, and watched as she closed her eyes and rested her head on the pillow. She was pooping out. I decided right then and there I was not going to leave her.
I grabbed the phone on the endtable and dialed ER. When the unit secretary answered, being political was the last thing on my mind.
I grumbled, "Dr. Krane really wants Q30 minute treatments on this lady?"
"That's what she ordered," Diane said very politely.
"You have got to be kidding me," I said. "I already gave two treatments to that lady,and neither of them were indicated. And now she wants this."
"Well," she said, "You'll have to take it up with the doctor."
"If you guys think she needs the treatments, then you guys are just going to have to do it, because I'm swamped up here."
And that was the truth. Not only was this lady failing, so to was her neigbor. And that's not to mention all my treatments were due, and so was my vent check, and someone on East kept paging me because the Vision BiPaP keeps beeping.
A half hour later ER paged again: "Duoneb needed in ER."
They know I can't get down there right now. Why are they paging me agian?
I grabbed the phone. The unit secretary answered, and I asked to speak with an RN.
Moments later a female nurse said, "Hello."
"Listen," I said, "could you guys do me a real big favor and do that treatment for me. I'm really swamped up here."
"We would," she said, "but the doctor ordered Duoneb."
"How about if you just give Albuterol."
"Because the doctor ordered Duoneb." She was not going to give up.
"I'll be down there soon with some Duoneb for you." I was not in the mood for a debate, so I hung up.
If that's not the dumbest thing an RT ever heard. If a treatment is ordered because a patient is short-of-breath, why make them wait 20 minutes for an RT to give Duoneb when a vial of Albuterol is right there in the med cart just because the doctor ordered Duoneb.
My co-worker normally stays until 9 p.m., but all I had were a bunch of 10 p.m. treatments I figured I'd knock off in no time. But, lo and behold, as soon as he left all hell broke lose. Every patient who could possible go bad did.
And, as what usually happens when you have ten treatments due and two patients in failure, the emergency room paged: "We need another now treatment on room 1," the pager read, "and then Q30 minutes after that."
"This is completely ridiculous," I grumbled under my breath, and then looked up at the middle-aged lady I was currently giving a treatment to and watched as her body jiggled up and down as she laboriously struggled to move air.
I didn't know what else to do, so I dropped the pager. This reaction prevented me from whipping it across the room. I looked at my patient, and watched as she closed her eyes and rested her head on the pillow. She was pooping out. I decided right then and there I was not going to leave her.
I grabbed the phone on the endtable and dialed ER. When the unit secretary answered, being political was the last thing on my mind.
I grumbled, "Dr. Krane really wants Q30 minute treatments on this lady?"
"That's what she ordered," Diane said very politely.
"You have got to be kidding me," I said. "I already gave two treatments to that lady,and neither of them were indicated. And now she wants this."
"Well," she said, "You'll have to take it up with the doctor."
"If you guys think she needs the treatments, then you guys are just going to have to do it, because I'm swamped up here."
And that was the truth. Not only was this lady failing, so to was her neigbor. And that's not to mention all my treatments were due, and so was my vent check, and someone on East kept paging me because the Vision BiPaP keeps beeping.
A half hour later ER paged again: "Duoneb needed in ER."
They know I can't get down there right now. Why are they paging me agian?
I grabbed the phone. The unit secretary answered, and I asked to speak with an RN.
Moments later a female nurse said, "Hello."
"Listen," I said, "could you guys do me a real big favor and do that treatment for me. I'm really swamped up here."
"We would," she said, "but the doctor ordered Duoneb."
"How about if you just give Albuterol."
"Because the doctor ordered Duoneb." She was not going to give up.
"I'll be down there soon with some Duoneb for you." I was not in the mood for a debate, so I hung up.
If that's not the dumbest thing an RT ever heard. If a treatment is ordered because a patient is short-of-breath, why make them wait 20 minutes for an RT to give Duoneb when a vial of Albuterol is right there in the med cart just because the doctor ordered Duoneb.
However, I handled it. With excellent RN and RT care both my critical paitents averted a vent thanks to a wonderful drug called Lasix. I knocked off all the treatments, including ER. And, while doing all this, I was being paged various times for odd procedures like setting up suction, which you'd think RNs would know how to do.
And, just as I sat down in the RT Cave to eat my dinner, ER paged again: "EKG and ABG in ER."
So I trudged down there and find a 9 YO girl laboriously breathing. It's not often that we have to take care of a little kid here, and it's always a little bit of a shock to see such a little person lying there in my need, instead of an adult.
For the record, I never did an ABG on a kid before. In all my years doing this, I was never asked to. I took my time, kept my cool, succeeded, and walked the gas to lab. I expected it might be a little off, but here's what the results were: pH 6.90, CO2 17, HCO3 2.7, PO2 162 on 2lpm.
Gulp!
The RNs and I were tossing out possible diagnosis' from sepsis to cancer, but as soon as the doctor saw the gas she said, "We need to get a sugar."
That's when you think, "It was so obvious. Why didn't I think of that?"
The little girl's sugar was sky high.
There was nothing else for me to do with this patient, so I headed back to the cave thinking I'd put my aching feet up, when my beeper went off again.
That's how it was all night until about 4:00 when I finally made it to the cave to chart. And my boss just happened to be there. And, instead of asking me how I was doing, she provided me with some criticism about how we RTs have been making too many mistakes filing EKGs lately.
"Yes maam," I said. I really wanted to tell her to just leave me alone, but I didn't want to get into defense mode. I don't know about you guys, but 4:00 in the morning when I'm on my first day back to work, completely exhausted and swamped, is not the time I want to receive criticism from anybody.
"Wow," she said, smiling. "You are the only one who didn't blame someone else."
I looked at her stunned. I had expected many reactions from her, but this reaction caught me completely off guard. "Really," I said.
Instead of charting, which I didn't want to do anyway, I participated in a nice discussion with The Boss. And, as any of you night shift workers can attest to, when you are exhausted this late in a night shift, you tend not to hold anything back.
"You know," I said, "I never thought I'd say this, but I think that I've finally reached the point that I would like to go to days when a position comes open. I think I am just burned out from ER is what I'm saying."
She gave me a look I didn't know how to read. "I used to like ER when I worked nights."
"You know, boss, I really love taking care of vents and critical patients. That's why I love the CCU. And I love taking care of the critical patients in ER, it's just... I'm tired of the B.S. down there.
She gave me another look I could read. I don't want to say she rolled her eyes, but it was close to that. And then the subject conveniently changed. She was thinking this: "We make money on all those useless doctor orders."
It's neat how the mindset changes when you no longer have to actually do the stupid doctor orders.
And, just as my morning treatments were due, the the beeper went off.
Actually, this is how it used to be all the time here. While we are a small hospital, we have a large area we cover. I wonder if this is the start of a new trend, or an aberation.
Either way, working nights solo can be a challenge. But stupid doctor orders do not take precidence over critical patients.
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