Hi! Nice talking to you again! It's always so pleasant when I get to catch up with you on the night shift. Me? I'm 6 hours in with no bathroom break or chance to get a drink of water, so you can bet I'm feeling pretty guilty right now about waking you while you get paid way the hell more than I do to be on call in the comfort of your own home. Sorry my friend. But enough about me, I'm calling about the uroseptic nursing home patient we've been holding down here in the ER for a bit now. I know you told my ER doctor to stop the vasopressors we've been giving her to keep her alive immediately and switch to NS at 50 mls an hour, but since that's dumb as hell, we decided to taper of the pressors gradually, and unsurprisingly to either of us, it isn't working, so we'd like your guidance on the next step. Yes, I do realize that not following your orders exactly is an insult to your infallible judgement as a physician and probably practicing medicine without a license on my part. I'm very sorry about that. Next time we'll just stop the lifesaving medications abruptly and gently hydrate your patient's corpse. We'll call you in the morning after your coffee and omelette about the disposition of the body, just let us know when you usually wake up. Please continue to scream at me about it for the next couple of minutes, though, because it's actually making your patient less sick the more you do it, and it's a great use of my time.
Oh! I see! The real problem is that we started the pressors in the first place without consulting you. Sorry. They started this during the day shift, but I'll pass along to them and my doctor that you would like to have nothing at all done on your patients in the ER until you are asked. We'll make sure not to do any interventions until the average 45 minutes it takes you to return a page. At that time, the patient will be pulseless and asystolic, and we will make sure that you want to use the new ACLS guidelines or whether you, lord and savior or all ER personnel, have your own guidelines for us to follow. After all, you know best about everything because you have "been at this a lot longer than I have", and you're so good you can make these kind of judgement calls without having ever laid eyes on the patient. Also, please continue to refer to call me "young lady" because it make me feel very special and not at all like a child who has done something wrong. What's that? Go ahead and admit the patient to the ICU on pressors because I'm going to do whatever the hell I want anyway? Oh, thank you darling. You're a peach, as always. We'll have to do this again soon, because I really love getting in screaming matches with the doctor on call at the nurses station with the other staff and all the patients in the hall beds looking on. Okay! Bye now! Have a great evening!
Hugs and Kisses, Hood Nurse