Choking Hazard

After taking a patient off the bedside commode (apparently it's not as cut and dry how to properly put a bedpan under the patient, the tech put it under her backwards. At least it wasn't upside down) I started walking the stool specimen to the lab.

On my way to the lab some people shouted at me that someone was choking in the bathroom.

Damn.

I put the stool specimen in my pocket (fortunately I had double bagged it and had clean gloves on) and walk in the bathroom.

First thing I see in the bathroom was a tall thin man with glasses.  He reported "I did the Heimlich Maneuver and she's still choking!"

I push the door open the rest of the way and I see a tall lady standing next to the sink who then tells me she is still choking. I make eye contact with both of them and inform them both the Heimlich maneuver  only works if the airway is completely obstructed.

I then offer to help her check in to get treatment. She refused and then returned to the sink and induced vomiting.

Seriously, what's wrong with people?

Disillusioned at Disney

Went to Disney recently and although I had a great time, I think it'll be a while before I return to the parks (still planning a cruise in a few years, we'll see how that goes).  There are a few reasons to why I feel this way. I'll write another post on the awesomeness that was had.

1) Lines. I know it's Disney, and I know to expect waits for popular rides but damn.  It's October, how many parents took their kids out of school for this trip? Obviously I did, but more than I had anticipated.  Wait times for most of the thrill rides were over an hour. One ride, one of the Avatar rides in Animal Kingdom got up to a 300+ minute wait.

And it wasn't even the good ride (Navi River Journey)

We essentially only rode each ride once on the day we were in the park, seldom did we get to two (though a lot of that was also because our kids wanted to see as much of the park as possible and did a lot of walking because of it).

2) Their fast pass system SUCKS.  You're allowed 3 fast passes per day to start. After you use/cancel your fast passes you can then try to get another one. Problem is there are so many people even the shitty fast pass rides are gone quickly. 

3) All their meal prices have gone up. Even at their "quick service" meals (burgers, nuggets, etc) I was spending $13/adult (3 adults cause 10 year olds count as adults) and $8/kid. I spent $15 for 4 bottles of water one day (probably more,

4) So many parents that let their kids do whatever they want. No discipline. Though that is a problem with society in general.

5) Motorized scooters. Holy crap they're everywhere. I'm not just talking about one or two rolling around with a family. I'm talking groups of 10. I would literally walk the opposite direction each time I found a group with more than 1.

I swear anyone can rent them, I saw several young kids riding in them (granted they were obese and probably couldn't handle the walk in the park all day).  And, in case you don't know, anyone in a wheelchair or motorized scooter gets to cut in line. I don't know the entire process but every day, every ride, someone in a wheelchair/scooter would cut to the front of the line and their entire group would go with them. There seemed to be no wait time for them.

Please don't get me wrong, I used to work for people with disabilities. I was a program coordinator for the adult socialization program and the summer camps. I understand why it is done. But it seems like everyone is taking advantage of this. After waiting for 45 minutes to get on a ride 2 different groups came in and went straight to the front. It became tiresome after seeing this happen all week long.

So long story short, it'll be a while before I enter a Disney park again.  I do love the experience but I need some time away.

Why?

So I feel like I'm using this blog as a venting ground but whatever.  If I don't I'm going to snap at someone and put myself at risk of losing my career.

My day starts off with my supervisor asking me to come in early.  Apparently one guy is targeting me and a handful of others and tattling that we have cell phones out in the department. He is also claiming my documentation isn't "up to par" and they have a lot of things to do when my shift is over and I've left.  He's targeting me so much that I'm one step away from being written up and put on probation.  He hasn't confronted me, he is spineless and would rather stab you in the back.  I'm pretty close to telling him off (I'm probably never going to do it, I don't do well with confrontation).

I clock in and start my shift, already disheartened from the situation above.  I get an ambulance in one of my rooms and this person is really ill.  He has a pneumothorax (a collapsed lung) in addition to pneumonia and a shitty medical history.  I've taken care of him before and he is really sick.  He gets intubated because he can't tolerate Bipap (a breathing machine, puts positive pressure on the lungs, not a good idea for the pneumothorax) and he isn't doing well on his normal nasal cannula.

Long story short (too late) as the doctor is inserting the chest tube (he has received rocuronium and etomidate for the intubation process) he goes into PEA (pulseless electrical activity, the machine picks up on the heart rhythm but there is no heart beat).  Start chest compressions and ACLS protocol.  He goes into V-tach (ventricular tachycardia, not a good rhythm, needs to be shocked ASAP) and finally after 30 minutes of working him we get him back.

This person is 1:1, I need to be in there and I can't leave him alone.  He gets an A-line (inserted into the artery to give us accurate blood pressures and instant changes), central line (IV access inserted by the doctor that goes deep into the larger veins), peripheral line, and intraosseous line (IV into the bone) by the time we're done.  I end up working with this patient for almost 4 hours before I can do anything else.

While working with this patient someone else takes care of my other 3 patients.  She discharges 2 of them.  The charge nurse puts a sick person in one room and at 3pm she leaves.  She never told me about my new patient. She never asked anyone to watch that patient. The person who cared for and discharged the other patients left at 3pm also.  I have no clue what's going on outside of my 1:1.  The next charge nurse puts another really sick patient in my other empty room.  In my opinion those rooms either should have been closed or they should have received a different nurse to take care of them while I was with my sick patient.  Nope.

Backtrack a little.  I have a patient being admitted because she is having difficulty breathing.  The patient is in no acute respiratory distress, she is actually able to complete sentences without struggling to breathe and she is stable.  She is in room 32.  While I'm literally doing chest compressions Someone asks me to answer the phone because the hospitalist needs to talk to me about room 32 and how she needs me to put orders to change her room assignment.  I ask the messenger to tell the hospitalist to do her own fucking job (I'm not sure it was relayed in that manner).  I continued to get requests from the hospitalist regarding room 32 like why didn't you change the bed request or can you administer meds or can you put in orders for me.  Each time I had to explain I was in the middle of taking care of someone else and she would either have to do it herself or wait (guess what she did, if you guessed she did her job YOU'RE WRONG!).  At one point I finally got some orders in for this lazy, incompetent POS hospitalist and I ask the lab to draw her blood because of everything going on.  They come over and inform me the patient has a port and they can't access blood from a port.  OK, well I didn't ask her to access the port so I assume the lab tech drew blood because she moved on.  There are other ways to draw blood, just because a patient has a port doesn't mean you can't find a way.  I guess that's my fault for assuming.  She had walked off without drawing her blood, leaving me to do it for her.

While I'm still dealing with the aftermath of my sick (almost dead) patient they continue to give me ambulances and expect me to care for them as well.

Even though I'd never walk away from a job (I don't ever want to put my license at risk), I was about to snap.  My usual mostly composed responses to frustrating questions were a little testy and snide (like room 32 asking for dinner even though her blood sugar was 700, my response to the messenger was "tell the fat fucker to stop eating like a pig so her sugar is more easily controlled and maybe I can give her a trough", hopefully room 32 didn't hear that).

This makes me wonder why it's OK for nurses to fix hospitalists problems.  Why is it OK for them to fuck up and expect us not only to catch their mistake but correct it both in the computer and before it touches the patient?  I don't get paid to do their job and they won't give me money to do so.  So why do I have to put up with their incompetence while they expect us to fix their shit?

I need a mental day. Glad I don't return until Saturday for my next shift.  Until then my job can just fuck off.