Prioritization

I'm for serious, y'all. Tonight marks the closest I have ever gotten to just beating the living shit out of another nurse in front of a patient.

It was the perfect storm. Charge sends three ambulances to our pod at once- it was me, usually charge nurse buddy, and the worst agency nurse in the history of nursing. So, okay, let's do the math here, one per nurse. Except all my rooms are full, so my buddy gets two and I help her with one, except worst agency nurse ever refuses to start her ambulance because she's too busy applying a knee immobilizer and fitting crutches or some other non emergency crap. The two ambulances my buddy is dealing with are a trauma twofer, who, by the way, had absolutely no business coming to our not-trauma-center ER, but unit number fucktard doesn't seem to understand that smelling like alcohol does not mean the emergency is not real (hi, blood coming out of the ears is a BAD sign you guys). Luckily one of the patients is not sick. The one with the bloody ears... yeeeah.

And the one I started. It's a bad sign when your patient is grey and you can't get an O2 sat and also they're breathing really fast and I think this might not be related to the slightly elevated blood sugar, but thanks again fire rescue.  So cool ER doctor orders the kitchen sink in labs, we scramble to do them while agency nurse shops for microwaves on the inter webs (because why the fuck not), and what do you know, it's already 715 and dayshift is here to take report!

Oh, BTW, so sickly grey dude is probably looking so sickly and grey because his hemoglobin is 3. Why? I don't know, but we better get a type and screen before he gets to the pearly gates. Enter dramz. Day shift princess prances in as me and usually charge nurse buddy are trying to get blood to come out of this dude with no circulating volume so we can send a type and screen and get the life saving blood and shit, and she immediately starts passively aggressively chastising us because 1)the room is dirty and 2)the patient isn't in a gown. Really? WTF. Girl, I'm gonna need you to sit down there in the corner for a while and study your BLS book and not speak to me again until you have absorbed and fully processed all the information contained within. Okay, are you ready? Let me explain my thought process with this patient. When I am the sole person in the room with this patient, and I notice they are breathing real fast and stuff- B- Breathing-I will apply some oxygen and that will help. So, I then notice the patient is kind grey and his cap refill blows and the blood pressure is in the toilet-C-circulation-so I opened up the EMS fluids and I started another IV and I got those labs which have already been run. Now the blood pressure is better, but it turns out that this patient needs blood, which we're working on, so we're still on C for circulation.

Am I getting through to you? Basically, G-gown and P-picking up the trash come way the fuck after C in the alphabet so please stop embarrassing yourself by concerning yourself with this frivolous crap in front of your peers. Thanks. I explained all of this to her with my verbal filter, which I am not using now (does not stand up to bourbon), and THE ONLY thing she managed to gather from this conversation was that one of us needed to change the triage code in the computer. At that point, my buddy basically had to drag me out of the room to keep me from slapping her, and then as we were trying to catch up on an hour's worth of charting, she was trying to rope us in to trying to put a draw sheet under this patient.

WTF. That's really scary and I honestly hate to see what will happen when someone sends homegirl a critical patient all by herself and she actually has to manage their care. Obviously, the patient will die, but their corpse will in a fresh new gown, very easy to move up in bed and will have an allergy band if appropriate. I bet the doctor will really be impressed while they are coding the patient as rigor mortis sets in.