Tuesday, February 21, 2012
2:30 pm: complete chaos
In comes a respiratory arrest, followed about 20 seconds later by another patient in cardiac arrest. Meanwhile the ER is already very busy. Those two threw us over the edge into the chaotic abyss. Two intubations going on at once with CPR in progress and everything else that goes along with an arrest.
It was that kind of day. At one point I had a man who has about a 90% chance of having TB and did I have a mask on at the beginning of his visit? Of course not. At the same time one of my other patients who happens to be 99 years old has a BP in the 70's, is in renal failure and is septic. The other patient is a frequent flier dialysis patient who is in with his usual chest pain. All this is going on while the two arrests are being dealt with. The guy from dialysis is an anxious man with emphysema who has the patience of a two year old. They decide to admit him and the charge nurse decides to have someone take him to his room upstairs while I call report. When I call report they tell me they can't take him after all, so soon as he gets there he will be heading back to us.
Wonderful. Then the nephrologist comes in and decides that he can be discharged, writes orders but can't talk to our ED doc who is in desperately trying to intubate one of the arrests. So we start making arrangements to send the guy back to the nursing home. I mention to the ED doc, when he is done intubating, something about this guy going home and he blows up. He says that the guy isn't going anywhere, he's going to be admitted. And get that nerphrologist on the phone right now.....OK so now he is back being admitted again. Then the patient says he wants to be transferred to the VA where he normally gets his care....OK somebody shoot me before I completely lose it.
Oh by the way did I mention that at 3 pm I assume the coveted position of charge nurse? So in the midst of all this shit, I dive in. Did I also mention that we have been down two nurses on days? Eventually, after a couple of hours, during which we wentr on divert for ambulances, the ER settles down and as the evening winds down it actually calms down enough to have some empty beds.
This is the time when you sit back and wonder why you do this shit? Why do you kill yourself working these twelve hour shifts? One of my co-workers told the story of being in such a zombie like state of exhaustion one night this week on the way home that she drove away from the gas pump with the nozzle in her gas tank and took the hose down....Why do we do it? I don't know. I'm just trying to make it to retirement. I think I'll start a calendar like they do in jail or during a war....
Posted by girlvet at 12:59 AM