Help

Okay. I'm really, really trying to figure out if I'm crazy or not. I've been polling my coworkers and I'm getting split results. Occasionally, when staffing is really sufficient and rad (one thing I will say for my management, we're no longer trying to run a 45 bed ER with 6 staff nurses, which is always nice) we get a float nurse. Like, someone whose only job is to help everyone else and make sure their shit is in order. I never actually get assigned this task (they give the rooms to the ones they know can take some punishment) but I occasionally fill this role when they assign me to the resus rooms and I don't have any dying patients.

Anyway. It's not fucking rocket science. We page ambulances overhead when they go to rooms, the trackers clearly show who needs treatments and meds now that we do computer charting, and the lab label machine prints out big red stickers for the patient that need LABS drawn. So when I have nothing to do, I look for this stuff, and I go do it, because it's my job, and that's what I'm being paid to do, as opposed to sitting at the computer paying my phone bill. I'm the float nurse. You know, float around and do shit. Find stuff to do.

So the other day I'm getting the standard ER ass kicking- ambulances waiting outside my room as the patient I just discharged walks out and housekeeping wipes the stretcher off type of day. I've been doing this long enough that I can do it all myself. It's just a lot of work. We have two, count 'em, two nurses floating. What are they doing? Shopping online for a friend's baby shower. Obviously.

Whatever. Again, I've got my head above water. I'd just really like to chart and pee and eat a snack, but oh well. That's the way the ER goes. Finally, at one point, I have to flatten myself out a like a roach to get past one of them who is obliviously standing in front of the med area talking about cruise ship food with my charge nurse who is also sitting on her ass when she notices the pile of shit I'm balancing on top of the EKG machine. Ten minutes later when I sit down to chart, the mentalist over here uses her astute powers of observation and makes a comment that I looked busy and if I needed something I could have asked for her help. Really?

Nope. I just gotta sit down and chart all the shit I've been doing for the past 2 hours, it's whatevs. Then she wants to know why I didn't ask her for help. I tell her what I genuinely believe. Really. If an ambulance is coming into my room, I honestly don't have time to figure out where you are and ask you to come help me. Because I have an ambulance. By the time I find you and wait for you to finish your conversation about which airline is your favorite to ask for your assistance, I might as well have just done all the shit myself. So that's what I do. You have ears. If you hear "ambulance to room 2" being announced overhead and you don't have the sense to go in there to help when your entire job tonight is to help, then you probably aren't much good to me anyway. But thanks. I said it in a much less harsh manner than this, yet she and the charge were both looking at me like I'd sprouted a second head.

So what is your stance on this, internets? Am I being butthurt and expecting my coworkers to be all powerful mind readers? Or is a little initiative too much to ask? I really don't know anymore.

Pile Up

We sure did have a twelve patient MVC last night.

Yeah, twelve. Van full of kids with their parents breaks down on the service road. They call their friends, who also happen to be carrying a station wagon full of kids, to come jump them. Cars are facing head on to jump the battery of the van when some drunken asshole swerves off the road, hits the van, which in turn runs into the station wagon. Naturally, this all goes down in BFE surrounding county, who has a total of three ambulances. What do they do? They go full ambulance clown car, pack like, three patients per truck, and book it on down to Hood Hospital. We knew they were all coming- my patients were all waiting on disposition, so me and my medic buddy just went out in the bay with stretchers and unloaded the patients from the back of the ambulance. We look up to see that a little shelf on the ceiling where they store extra backboards actually has one of the kids on it, back boarded and c-collared. Holy crap, good thing he was stable.

Most of the injuries were pretty minor, if not non-existent, so we parked all of them along the hall, took vitals, and did about a two minute triage- okay, were you in the car or the van? Do you remember everything that happened? Do you hurt anywhere? Do you have any medical problems? Are you allergic to anything? Okay, next. The worst of all the injuries ended up being a little school age boy with a fib fracture, who was the biggest badass of all. He was all polite and yes ma'am to everything we said, and rated his pain at like 4, was more worried about whether his siblings were all doing okay.

It ended up being kind of a funny story and almost like a little mock disaster drill, but it could have been so much worse. Don't drink and drive, kids.

More Fun With Coordinating Transportation

It started like so many other cases at Hood Hospital. Elderly gentleman who normally makes it around the house on an assistive device and gets his everyday stuff done with the help of his wife has a rough day and takes a spill. He's then transported to us via EMS without said assitive device, wife stays at home. Thankfully, pappy is just fine, his c spine is cleared, and he's ready to be discharged. Enter drama.
Awesome baby nurse coworker calls his son, who is listed as his emergency contact, to see if he can come down the road and pick dear old dad up from the ER. His response? "Um, I just lit a fire in the fire place, so, I can't."
You can't put some water on it or something?
"Nah."
Coworker then tries the approach of playing it tough and saying he really needs to come up here and get his dad. Yeah.
"I can be there in like, two to three days. You guys need to keep him, and like, check his blood, and his sugars, and his organs. Yeah. Yeah, you guys need to check up on his organs."
All I'm hearing at this point is my friend's end of the conversation. "Check his organs? What? What are you talking about? I'm hanging up now. Bye."
So I guess at this point he's trying to figure out with the wife whether the poor guy can go home via cab or if he needs ambulance transport. He's kind enough to put this one on speakerphone, where this 70 something year old lady totally loses her shit on him for asking if it's safe for the patient to go home via cab. At the crescendo of it all, she ends up on some crazy ass rant about how awful our hospital is and that's why they always talk bad about us on "the black folk radio station" and that's how come no one goes to Hood Hospital.
Finally we just say screw it and arrange for private ambulance transport. It's ridiculous, but at times it's really the only viable option. I know he was beyond frustrated about he amount of verbal abuse he took for just trying to do the right thing. I couldn't stop thinking about how long he'd been dealing with the whole situation and how many combined man hours our nursing staff must put towards non-medical fuckery like this. It kind of makes my head spin.

How to NOT Get a Cab Voucher

-Take the ambulance here for a complaint 100% secondary to you being an idiot

-Your idea of asking nicely is "go get me a voucher"

-You think you're being very cunning when you tell me and other staff members "The doctor said she'd get us a cab voucher" (world-famous emesis bag nurse's response: "the doctors tell everyone that so they can get out of the room and not have to deal with you anymore.")

-Five of your family members magically showed up here after you came in on an ambulance and you want us to get all of you turds a ride home. One, it's good for one person only. Two, how the hell did the rest of you get here in the first place? Wait, I don't care.

-The last time you were here and we said no to a cab voucher, your spouse suddenly started having a chronic back pain flare up and decided to check in.

-You mention you live within walking distance.

-And always, number one, forever: Say something about how you always get a cab voucher. Say it. Please. I will make sure that you DO NOT get a cab voucher. I will eat the cab voucher. I will make you fish the cab voucher out of the sharps container or the bio waste bin. I swear. Ever wonder why your hospital visits cost so much? It's because of shit like this. It's because there are actually assholes out there that come to the ER routinely for stupid bullshit, are sent home for stupid bullshit, and act foolish enough that we ALWAYS pay their way home. Then when some poor little old granny who would never think to ask for a cab voucher and actually needs one to get home because she can't drive and has no family in the area, we don't have any more cab vouchers because we gave them all to the same douchebag who keeps calling an ambulance for non emergent foolishness. Whatever. I'm over it. Point is, I will say no. Nope. No cab voucher for you. You can think about your life choices and what is owed to you while you walk your ass home. Bye.

Yet Another Enlightening Triage Experience

Woman presents with her toddler. You know the rest.

Pt's mother: Yeah, so I'm bring him in 'cause he has a fever, he woke up and was just shivering and stuff.

Me: Okay, yeah. So what was his temperature?

Pt's mother: Scoff. Well, I didn't take his temperature, I mean, that's why I brought him here.

He didn't have a fever. But he did have Cheetos!

Logic

Me, to patient being seen for abdominal pain as she was about to chomp into a double cheeseburger: "Ma'am, you really shouldn't eat until we have the results of your CAT scan back. That's the reason I wouldn't bring you coffee when you asked me for it earlier. I'll let you know as soon as we know something, though."

Patient:"Well, if I can't eat my cheeseburger then I need more pain medicine. I haven't eaten all day. This shit is ridiculous!"

It was a ten. Obviously.

Step Away From the Laptop

Late middle-aged lady comes into triage last night with chief complaint of bilateral leg numbness and inability to walk with spontaneous resolution about an hour prior to arrival. Concerned, I started asking more questions. FAST screen? Negative. Any other symptoms when this happened? No? Any medical problems? No. What were you doing when this started?

"...Well, I had been lying on the couch with the laptop on my legs for an hour or two, and when I got up, my legs felt all numb and tingly and it was hard for me to walk. So I looked up leg numbness on my laptop and it said on the internet I might be having a stroke."

Uh. I think there was a message in all this somewhere, but it is definitely not getting across.