Monday, June 22, 2015

Foot in mouth

Oh man. After all these years, my brain-to-mouth filter finally shit the bed at the most inopportune time. A couple of us were taking care of this critically ill dude in respiratory distress, and having a tough time of it. Everything that could go wrong at first was - the EMS initiated IV line blew while the mag was infusing, I had to drag in the sono-site for another line because he had shitforveins, and the horde of residents were generally the worst.

We were trying to get an EKG after they had refused to let us give even the tiniest bit of ativan to ease the stress of BiPAP, and it was going about as well as one can guess. Meaning it wasn't going at all. We're struggling to keep the guy from anxiously moving and pulling his mask and leads off, and he just can't sit still. This continues for at least five minutes. We get a sort-of okay EKG and hand it over to the resident. He glances at it and announces to the entire room that "this EKG is terrible, you all need to get a better one. Or go get someone who can."

Of course, of course, I'm the most senior nurse in the room. The other two nurses with me are super intelligent and great nurses, but they're still new. And nice. So they say nothing. And of course, of course, I'm also the biggest dick in the room because I mutter, "you can see that we're obviously doing our best with this guy, but please, continue to stand there and criticize without doing anything. Or fuck off, which would actually be more helpful."

I'm not sure if the patient heard me or was able to comprehend anything. But the rest of the room sure as shit heard it. I did see one of the other residents trying to hold back a laugh, and both of the nurses had looks of either horror or awe on their faces, but I'm wondering if this will earn me a write up. The EKG resident didn't say anything, but he didn't stick around for long after that. We got the guy up to the ICU shortly thereafter anyway.

Ugh. I get that you can't read an EKG full of artifact, but I also can't magically pull a beautiful tracing out of my ass when the guy is too sick to sit still or comprehend why we're telling him to. But whatever. I'm not sorry.


Gelfling said...

My filter kicked the bucket a few years back too. You will be a folk hero in that ER long after you have moved on to your next job!

Shash said...

Sometimes, just sometimes, the doc needs to hear that sort of talk for a reality check.

I do hope it doesn't get reported.

Anonymous said...

*cues up Bette Midler*

Did you ever know that you're my heeeeeero!

Seriously, that was a moment of greatness. I hope he was chagrined enough to keep it to himself.

Aesop said...

The duty of people with time and experience is to step up and hang it all out, by taking one for the team when they're being maltreated.

True in the military, true in the hospital.

That was f**king awesome of you.

Nursing is a lot like baseball in that respect:
The only way the batters will respect the pitcher is if once in a while a fastball comes right under their chins;
and the pitcher will only respect the batters if once in awhile someone charges the mound and shoves the bat up their @$$.
Once the lines are drawn, everyone can get back to playing the game.

The slap on the wrist one may occasionally get is worth it in the long run, and the truth is, to write you up, the offending a-hole would have to defend his asinine comments beforehand as well, which is impossible, and after your smackdown, the dirty little secret is he'll never care to bring up the incident again. He'll probably crawl under the porch until the scars toughen up. It's like that when someone throws scalding water on your crotch.

Congrats on delivering today's lesson plan in Resident Post-Doctoral Medical Team Interaction & Professional Etiquette. As Machiavelli noted, it's better to be feared and respected, than loved.

Finesse- An old nickname given to me ironically as I seem to completely lack it. said...

one word "YES"!!!!!!!!!!!!!!

...and I hope you don't get into too much trouble. After all, you did the guy a favor. If he thinks he can go through his career *easily* with this shitty attitude, he is mistaken! You just saved him from an uphill battle... if he is wise enough to get the gist and not just think you are a cranky bitch!