Monday, March 17, 2014

taking anal retention to a new level

So I gave TPA the other day.  So I had to take the patient to ICU myself.  Normally we have the float nurse take the patient up, but in this situation the dreaded "mutual neuro exam" must be done.  This is a requirement whenever there is a patient with a critical neuro problem who goes from ER to ICU.

So I get to ICU and there is the nurse sitting waiting for the patient. I take the cart in the room.  The performance begins.

The patient is slid from ER cart to the bed. The patient is rolled to get all of that messy ER stuff from underneath them: extra sheets, blankets, half eaten sandwiches, etc. As we roll, of course the nurse must stop to listen to the lungs, assess the skin.  The patient is repositioned. The gown is changed.   Ah...hello I gotta get back...The patient is placed on the monitor, BP oximeter, etc.  This takes about 10 minutes.

Now, this being ICU, staffed by ICU nurses, everything has to be straightened out before anything else can happen.  I like to tangle the IV lines as much as I can before I came because I know this will drive them insane.  So about 10 minutes is spent untangling the two IV lines.

The patient has to go to the bathroom.  The bedpan procedure is done.  Another ten minutes.

Finally 30 minutes in, its time for the mutual neuro.  Now the real performance begins: The patient is examed head to toe, doing 30 different actions, some of whom I have no idea what they test.  Is this a neurologist or a nurse? Is she showing off?  Hell, I'm happy if they can talk and move their arms and legs.

Finally about 45 minutes later, the deed is done and I head back. The charge nurse asks me: "Where the hell have you been?" I sigh and walk away.  I hear my name over the intercom saying I have a call on line one.  Its the ICU nurse has a few more questions.  Of course she does.

1 comment:

Anonymous said...

I don't know about a 30 point check...but as neuro ICU nurse, I am impressed with your follow through. I have never met an ER nurse who followed her patient as well as you did. And please don't complain RE the f/u and more phone calls. We get shit if the neuro exam has changed. The neurosurgeons are very particular!