Monday, August 5, 2019

Processing events

The last four days I've worked have been rough.  My shift ended on Friday with a guy arriving to the ED in cardiac arrest. Saturday was a double shooting that kept me late. Sunday overall wasn't too bad other than working with a slowpoke in triage (I would triage 2-3 people to her one) but she did triage all the screaming pediatric patients.

Today things finally got to me (to an extent). Though I helped care for more, I only had three official patients over eight hours. 

First patient was a stroke and due to administering TPA that patient was 1:1 for almost two hours. I was able to sneak a lunch break in after I got her to the ICU (her symptoms had resolved within the first 15 minutes of TPA).

After finishing my lunch break I get paged for an unresponsive patient. He was dropped off by his "girlfriend" and was told his name was Gary. After a little Vitamin Narcan he became responsive and we discovered his name was Larry (close enough, right?). He was discharged.

Here's where it got rough. Triage was backed up and one of their nurses went to lunch. I went out to help, the other RN out front said it was my call.  I felt I should stick around and triage a few people.

While out there a woman asked for help getting her husband out of the car, he was having a heart attack (we hear this frequently so they can be seen quicker). Rolling my eyes I grabbed gloves and a wheelchair to help the man out of the car. He reported palpitations and being sweaty earlier. 

Checked him in and took him to the back for triage. Before I could start the official triage he started posturing and became unresponsive.

Fuck. I thought he was just trying to get back sooner.  Called a code blue, got him on a stretcher and to our trauma bay.  After 45 minutes we decided to call it, he was not coming back.

Talking with the other triage nurse we both came to the realization that if I had not felt inclined to help, this person would have literally died in the lobby in front of everybody because the other triage nurse was already tied up and didn't get back to the triage bay until after he had coded.

I'm grateful I was able to follow my impression today. I'm thankful for a good team that worked well during the 45 minute code. Even though communication wasn't 100% the extra hands were great and everything was completed as it should have been done. 

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