Early Friday

Hey all.  How are you?  Not a lot going on here at the moment.  Had a lazy day.  I was worn out from working last night.  Very, very busy. Didn't stop all night.  I was in charge and in triage.  I worked my butt off.  I got upset with the doctor who was on last night because he jumped my case about one mistake I made all night.  I thought I ran a darn good shift and kept things moving and for him to come down on me in the way that he did was not right. I just felt he could have addressed his grievance in a more productive and less rude and judgmental way.

 

What happened was I triaged this lady who came in complaining of chest pain.  Basically she was a train wreck, but because of her significant medical history felt like I had to treat her complaint as legitimate.  So I got her back into a room and got her changed.  I alerted the PA who was the only "provider" at the desk and went back into the room to finish connecting her to the monitor.  The PA then walked into the room and I went back out.

 

An ambulance came in right as I walked out of the room with a lady who was also complaining of chest pain with a cardiac history.  I didn't have any other monitor beds available so I had to move people around.  After doing so I took report from the EMTs and went to the room.  Not one single nurse had been in there to get the lady changed or connected to the monitor, even though I had alerted that nurse that I was putting the ambulance in her room and she was at the desk when the ambulance came in.  So I proceeded to get her changed and connected to the monitor.  The nurse then walked in and I went backout to triage.

 

Normally, when I put a chest pain in a room, I walk back up to the desk and request the secretary to call for an EKG.  I didn't in either one of these circumstances because another person walked into the room while I was still there and felt the situation was taken care of.  What happened to the first patient was that the PA ordered all the appropriate tests right away.  What happened in the second instance was the patient wasn't seen for over 30 minutes and there was a huge delay in her getting an EKG (according to the doc, 55minutes, but part of that time was not being able to contact the cardio for the EKG).  I really didn't think anything about it until the doctor called me over said "What excuse do you have for the patient in 5A not getting an EKG for 55 minutes?"  I tried to explain that I felt the situation was under control as her nurse walked into the room while I was still connecting the patient and felt I had turned the patient over to her and subsequently everything was taken care of.  But he just kept interrupting me by saying "what reason do you have?"  He was obviously not going to be satisfied until I took complete blame and so I said, "You know, I doing the best I can to have control over every patient that comes into this ER tonight and felt I had that situation under control.  I overlooked the fact that I could not rely on someone else to do what was needed.  I'm sorry that detail was overlooked."  He then said "Thank you."  Doctors!  Egos!  He just wanted someone to blame in case the situation was bad, and it wasn't.  Her EKG and enzymes were completely normal.  Of course it could have turned out differently, but didn't thank goodness.

 

Tell me what is the point of assigning a nurse a room/patient if you have to ultimately have to take responsibility for everyone and everything?  I'm still mad because that is the one oversight I had all night.  I was pre-ordering tests on people, medicating fevered babies, ordering breathing treatments, xrays, EKGs, etc.  But this one time when I felt the nurse took over the patient was where I went wrong.  Geez.  Makes you feel really appreciated when you do good all night and someone zeros in on one thing that where they feel you failed completely.  Sure makes you feel unappreciated.

 

Also, my sister Kathryn went and saw the oncologist yesterday in Shreveport.  Complicated  news right now.  I had her boyfriend, scan her reports and send them to me email.  I read everything.   Basically this is being considered an endometrial tumor that has invaded her cervix, vaginal wall, and possibly her colon.  It is pressing on her urethra and there are cysts on her kidneys.  The doctor said it needs to come out "now".  Initial pathology suggests that it is benign, but because of how invasive the tumor is the oncologist feels there is a certain urgency in getting it taken care of.  Needless to say, Kathryn is feeling a bit overwhelmed.  The doctor did assure her that he had seen endometriosis do this exact thing, although not very often.  He hopes by going ahead quickly with the surgery he would be able to preserve her fertility.  I urged Kathryn to go ahead and schedule the surgery as quickly as possible so as to encounter the least possible complications.  She is going to call the surgeon back tomorrow and let me know what is going on.  Poor thing.  So needless to say, Kathryn is greatly in need of your prayers.

 

Well, I have to work today so I hope you all have a great day if I don't touch base.

 

De ;)

 

Tags: nurse, doctor, chest pain, ekg, endometriosis, tumor, sister