Wednesday, October 24, 2018

Bra-vo!

Work has been a real bummer recently - courtesy of Manglement (TM pending to Jo at Head Nurse), we've been chronically short staffed, in the middle of a mass exodus of experienced staff, and mass hiring of brand new nurses. Some nights, entire sections are staffed with nurses who have less than a year on the job. Don't get me wrong here - I love new nurses. Shit, I was one once upon a time. They're fresh from learning the newest research, excited to start working, and it's thrilling to watch them come into their own and become highly competent people. A good hospital ER balances the influx of new grads with a bevy of experienced ones, and makes sure to have enough support staff to keep the department running while they learn. Our place does not, and the short staffing means it's demoralizing and a beatdown many, many nights.

I reached a new low the other day when it came to barely having enough resources due to low/new staffing, but at least I get this blog post out of it!

My otherwise stable trauma patient needed a chest tube for a hemo/pneumothorax, and the doc finally was able to get into the room to place the tube. I had multiple other critical patients, so wasn't going be in the room for much of the procedure. A tech was there to help, but she was going to be opening the chest tube tray, taping tubes down, and generally functioning as a circulator nurse. There was no one to hold the patient's giant boobies out of the sterile field, though.

The doc, myself, and the tech stood in the room for a minute to try and figure out what to do. The patient was generally a badass with everything, and was like "do what you guys need to, I'll be fine." I looked at the chest tube set up. I looked at the patient's boobies. I looked at the doctor. I looked at the boobies again.

"Soooo...how awkward will it be if I tape your boob to the siderail? Are you cool with that?" I asked the patient. She laughed and then was asked if I was serious. I was.

I sure did get a roll of cloth tape and secure her tit all the way over to the contralateral side rail. I felt like a fucking MacGuyver. I'm sure the OR does this kind of shit all the time, but it was a first for me. I got a round of high fives from the doc, tech, and even the patient, and then I ran out of the room to go make sure my other patients were all still alive.

If low staffing weren't an issue, all of these patients would have been taken care of and no one's boobies would have been taped to any sort of ER item. I guess this is our department life now?

3 comments:

Aesop said...

Brava!

"If it's stupid, but it works, it's not stupid."

24K Truth.
Learned in the Marines, validated in the ER.

ROWYBS.

So, shouldn't you be moving up to Charge Nurse, for $1/hr extra, and all the crap sandwiches you can eat?

Or have you taken the Aesopean route of making sure management is aware of what a poor choice you'd be because you like the bedside without the b.s.?

EDNurseasauras said...

I have taped many and many a bulbous butt cheek to the bedrail for the I&D of a pilonidal.

Old FoolRN said...

Sometimes it's difficult to adhere the tape to the pendulous mass (butt cheek, breasts, or pandus). The secret ingredient to making adhesive tape stick to anything is tincture of benzoin-apply liberally and let it dry.


In the OR some Marque De Sade minded docs would plunge a towel clip into the obscuring flab and use the instrument handle as a fixation point for traction.
Obviously this trick is only feasible if patient is deeply anesthetized.