Thursday, November 17, 2011

The art of diversion

Recently I started working full 12 hour shifts in triage, which is still new and exciting and butt-clenchingly scary most of the time. It's a whole different world than working in the core. In the core I get 3, 4, maybe 5 patients and when my rooms are full I don't get any more, unless it's a hall patient in which every one helps on. I always have lots of other people around me, and if I find myself in the weeds I can always call charge and either get extra help or block a room for a bit to catch up.

Not so in triage. They keep coming in the door and you keep quick assessing and you make the decision to sit them in the waiting room or bring them back with a fire under your ass. It's hard! I'm terrified of missing something, or not assessing a patient well enough - which is scary enough seeing as I have to triage without ever laying a hand on them. In all fairness though, I expected triage to be difficult.

What I did not anticipate was the stalling skills required for families of Very Sick Patients.

Take the other night. We get a real sick patient, in her 30s, who ended up arresting. Right after everyone starts working on her, the husband strolls in the front door and asks for his wife - you see, when she left the house she was awake and talking, albeit sickly looking. He had no reason to suspect anything had changed.

I was not prepared for this. What do you say to someone whom you know is losing their other half but you can't tell him yet? I know she's dead, but I have to stall until the nursing sup can come and collect him. How do you deflect the request to go back and see her? I don't know. It's hard. I really don't know how to handle this yet, but I guess it will come with time. This is very humbling though. Just when I was starting to feel like I might be okay at nursing, I get bumped to a new level and discover that my deep dark suspicions were right - I've got a really long ways to go.


sweetmonkeycheese said...

Oh man, you would think "they" would have given ya some tips or maybe even having a protocol in place.

hoodnurse said...

My go-to for critical ambulances is that they haven't been assigned a room on the tracker yet and to give us a few minutes, or that there is a procedure going on. But if I know Jesus is coming for them- yeah, I'm all on getting the chaplain down there stat to handle that situation.

jberry said...

Totally with you there. I just started as an OR nurse and we've only had good outcomes, but when a bad one comes along I feel ill prepared for that conversation with the family.

These are the moments that tell us we are doing our best and not burned out. Keep on keeping on.

Dana said...

I think that is just how nursing matter how long we've worked somewhere, there will always be situations that bring you back to reality...we all have a long way to go!

canoehead said...

"The nurses are still putting things together back there, I'll let them know you're here."

or "The doctor wanted to talk to you before you went in, let me just get him. Would you mind coming in this room so the two of you will have some privacy?"

and "I don't have the whole story, just come in here, and I'll make sure someone brings you up to date as soon as possible."