Throwing Your Weight Around

One thing that always bothers me is people who throw their weight around.

A patient came in with his daughter. First thing she said after explaining their visit was "I work in the ICU and I need to be with him in the room".

Due to the current pandemic, no visitors allowed except for minors and patients with altered mental status.

Her: "He doesn't know what's going on so I need to be there to explain things to him".

Me to the patient: "Are you confused, are you able to sign for yourself if needed?

Him: "I'm not confused, I can sign."

Her: "I want you to talk to your charge nurse and get me permission. If she doesn't I will call the house supervisor and talk to her."

Unless you are directly responsible for my evaluation or my check (or can influence it in any way), I honestly don't give a crap who you are or where you work. But since I can be diplomatic so I say I'll explain the situation to the charge nurse and ask her to wait in the lobby, knowing that the answer will be no.  Before going back I make sure both have phones so they can communicate with each other if she was not allowed back.

I officially confirm that she is not allowed back and return to the lobby.  I again explain to her that she is not allowed at this time and if she felt it necessary to call the house supervisor she was welcome to do so. 

Guess it didn't go her way cause she wasn't allowed back. She was even asked to exit the lobby (nobody in the lobby who isn't a patient). It was very pleasing to see that she, with all her weight she thought she had to sway our decision, was asked to leave the ER.

On a lighter note:

We rolled the patient off the backboard, doc informed him that he was going to get on something hard, but only for a minute.

It was really hard not to say it....

My Dilemma

Several years ago I worked with a tech in the ED.  I'll call her Molly.  Molly was lazy, only liked working with certain people, and if she was asked to do anything she needed company.

At one point she was the tech working in my section.  I asked her to start a Foley Catheter in a room while I took care of an ambulance in another room.  Molly immediately turned around and asked her friend, the RN, to help her. This RN was already mad at me for starting an IV for me (she just wanted to sit in her section and literally do nothing).

The combination of Molly and this RN was enough to tarnish my name.  The RN stepped out of the room and started yelling that I was lazy and I needed to get off my ass and stop eating tacos so I could do my own job (at this point this RN had only started an IV and helped Molly do her job, literally nothing else).  The Charge nurse that night for the next several months harassed me about me doing my own work. Never allowed me to speak, etc, etc.

I lost all respect for Molly (and that RN, but that's another story).

Fast forward, Molly was terminated from my department for attendance problems (considering her work ethic, this was no loss in my mind).

Fast forward again to yesterday. It was a horribly busy day, we got slammed by multiple sick patients within a few minutes of each other (including a cardiac arrest).  This backed up the rest of the ED for several hours.  Molly checked in as a patient where people were waiting up to 3 hours just to get into a room.  

15 people ahead of Molly, she was the only one who came up to me and asked how much longer until she was seen.  Once again, not exactly the best thing to do when there are no rooms and the triage nurse has little respect for you as a person.

Molly was eventually seen and discharged.

Over the last several weeks the schools in the area have been sending us nursing students.  Guess who was sent our way today?  That's right, Molly.

She spent the first 4 hours of her shift with someone else.  I'm stewing in my section, avoiding her as much as possible but still keeping it professional (that's what I do). I vent to some people about the person, the situation and my complete lack of respect for her as a professional.

After those first 4 hours she is then transferred to me to I so I can precept her.  I'm not thrilled about the situation. 

I'm glad I could keep it cordial but she was no different at with my interactions tonight than she was when she tarnished my reputation several years ago. She was still the entitled, lazy tech who is now in nursing school. 

I still have no respect for her as a person. I hope she never works at my facility because I guarantee I will have no respect for her as a nurse.  

Is this a bad thing?

What if?

After a long day at work I went to the grocery store.  Nothing out of the ordinary.  As I pulled in I overheard a domestic dispute.  The lady in the car was yelling at the man in the car to "get out of my car", "stop it", etc.  I couldn't tell what was going on but I could see the woman hitting the man.

Thinking this was only an argument initially I thought nothing of it.  As I walked to the store entrance I got to thinking "What if?".  What if he was doing something to her? What if this was the start of a date rape, etc? What if?  I didn't know.  Because of the situation I didn't want to be the guy that could've stopped it but didn't do anything.  A simple phone call could stop a potentially dangerous situation.

I decided to call the police when I was out of their sight (I parked next to them and my car is pretty easy to point out. I also wanted to remain anonymous).  I gave them all the information I could and the police informed me they would check into it.

I finished shopping and less than 10 minutes later went back to my car.  Four police cruisers had responded.  The lady was arguing with one of the officers stating she was just having an argument with her boyfriend and they argue all the time.  The officer was handling it like a champ.

Though this may have been an over-reaction to the situation after the facts were known, what if?

I'll take a moment here to thank all the officers who respond to calls like this, potentially putting their lives on the line. They never know what they are walking into but they do it every time they respond to a call.  They are underappreciated in our time and we don't have nearly enough of them to help. 

Thank you, officers, for everything you do.

The Wall

So we all know Trump is planning on building a wall between the US and Mexico border.  I even joked about it in a previous post (see joking with the parents).

I was watching Arrested Development the other night.  Definitely one of the best shows they took off the air, scoring a solid 89% on Metacritic and an 83% on Rotten Tomatoes.  And of course this is in my opinion, if you like comedy you need to watch this show.  As I tell all people about this show, they build up the jokes in the beginning so the end is hilarious.  They also build up jokes throughout the series that lend a hand to some of the hilarity in later seasons.  You can't jump in the middle of a show and miss half of what they built up because then you won't know what they're joking about.

Anyway, back to a theory I have.  Slight spoilers, nothing serious if you want to continue reading.  In Season 4, Episode 2 George Bluth Sr. steals plans from a competitor (they are property developers) for what he thinks is a monument dedicated to George W. Bush.  It's revealed later that his wife Lucille originally had the idea and it actually a wall, not a monument, that is to be built on the border between California and Mexico to prevent illegals from entering the US.

So, where did Trump come up with his idea?  Maybe someone on his team saw the show (they do have lives outside their campaign, I think) and shot the idea to The Donald?  Who knows, but now you'll be wondering the same thing (especially if the wall is built).

Smoke Breaks

I consider myself a team player.  I'll jump in and help you if I see you're drowning as long as I am available.  I don't expect you to reciprocate, especially if I'm already familiar with your work ethic (most of my coworkers become extremely frustrated if I ask for help, even if all they have to do is discharge a patient and send them home).

There are some things that are beyond frustrating that have happened lately while trying to help.  The one that pushed me over the edge was a smoke break.

Here's the situation.  I'm working the the "urgent care" section of the ED (Rapid Medical Evaluation in my hospital, sometimes known as Minor Care).  One of my coworkers in the acute side of the ED receives an ambulance (respiratory distress) and has 2 other patients, one of whom they are trying to determine if he has a heart attack.

The Charge Nurse asks me to leave my area and help my coworker.  I get there and she is taking care of the respiratory distress. I'm asked to watch her other two patients. The rule out heart attack needs a second IV started along with a heparin drip (blood thinner) and a nitro drip (vasodilator, makes blood flow easier).  No problem.  I get that going in less than 10 minutes (including all the documentation and explanations to the patient).

Because I am who I am, I take over the care of her other patient as well.  I make sure they are situated, comfortable, and I explain what is going on with their care.  Time passes (about 30 minutes from when I get there) and she steps out of the room she has been frantically working in.  I give her updates on her other patients.  They are settled, just waiting for admission orders (heart attack) and discharge orders (the other patient).  I'm told to stick around for a while until the respiratory distress is more stable. No problem.

More time passes, the doctors involved with the heart attack patient continue to ask me for updates and I continue to help.  I discharge the other patient.  The next time I see her she is grabbing her cigarettes and leaving on a smoke break.  I ask her who is going to watch her patients (remember, this is not my assignment, I'm supposed in the "minor care", just keeping her afloat so she doesn't come back to a nightmare of orders).  She rambles off that someone else is going to watch her people and runs off.

Seriously?  I've been watching her people for 45 minutes at this point and she suddenly have enough time for a smoke break? I still haven't given her report on her other patients so she can officially resume care of them.  I am still answering questions from the doctors for her cardiac patient yet she has enough time for a "breathing treatment"? Unbelievable.

The worst part of this situation is reporting this incident.  It's beyond ridiculous that she did this. Unfortunately the charge nurse is in no position to help because he was a substitute.  Even so, our current boss doesn't know how to confront people (instead of writing people up for playing Pokemon in the ER he sent yet another reminder we aren't supposed to have cell phones, easily narrowed to 2 people on the overnight shift).

So what about confronting the person who went to smoke? Can't bring it up to her because in her mind her people were covered so she did nothing wrong.

Honestly by the time I'm writing this I'm mostly over the situation.  Obviously it still bothers me a bit but for the most part I'm over it.  There's nothing I can do and at this point it's far from everyone else's mind.

Life goes on.

They asked me to stay late that night to help relieve lunches.  I agreed to remain long enough to transport the patients that were admitted but did not want to do any lunches, especially my smoking friend.

Politics and the ER

Politics is a very touchy subject. It can make or break friendships and relationships.  It's not uncommon for people in the workplace to have different political views.

Same goes for the Emergency Department.  While working there we develop a camaraderie that plays into helping the patients, especially traumas, overdoses, heart attacks, etc.  Bringing politics into the workplace can be especially tricky.  I can't take credit for these words but I want to share them.  I can't state this any better.

A plea to all my FB friends in healthcare: As the political season continues to heat up, can we please, please, please at least try and keep politics out of our professional lives? I know what my views are on things, and understand that not everyone feels the same way that I do. That being said, I also appreciate that people's individual political views are as much a part of what makes them unique individuals as their love of their career, their love of family, their hair and eye color, and all their other facets do. I may not agree with you, but that does not make you less of a person in my eyes. For me, what is more important than who you think should be running for a political office is that when the chips are down and someone else's life hangs in the balance, you will have my back and I will have yours. Very few people go into any of the healthcare professions for fame, money, or because they believe that some people are more special than others. The reality is that for most of us, caring for others is a core value that shapes who we are, and why we do what we do every day. No matter what happens in November, this will not change. The other thing that will not change is that we will still have to work together, supporting each other as we work to save lives and help our fellow humans through some of the worst moments of their lives. We are all on this roller coaster ride of life together, and in the end ALL lives matter, which is why we do what we do. Please let's not allow ourselves to forget that in the coming months.

At the end of the day, do you have my back to help save a life, even if we don't agree politically?