Thursday, January 12, 2023

January 12

A half-naked lady is brought in by EMS after being picked up from outside a gas station. She's loud and twitchy and disheveled but also surprisingly re-directable and coherent. I'm trying to figure out if she needs to go to a room immediately or if she's stable to park on the wall for a bit since we're super busy. The EMS crew is reading off her vitals and mention a blood sugar of >400. I ask her if she has a history of diabetes, and she nods in between wild arm flails. "Have you been taking any diabetic medicines?" I ask.

"I've been blazing and stargazing, baby! No time for meds, only time for meth!"

Gotta respect the honestly, seriously.


Aesop said...

I was precepting (finally!) a new grad, and we had an ICU patient, and couldn't get orders from the intensivist on call. Multiple calls. Very tachy and low BP. "Pt. is septic and gonna die!" messages. Still no orders.

When we do close-call write-ups, we get 3000 characters for the narrative. I used 2988 the next morning.

Warned the director what was coming down the pipe at them.

That was on a Monday morning.

Pt died of multi-system organ failure three days later.

Immediate fallout: I'm not allowed to precept new grads any more (because why would you want the nurse with 20+ yrs in the ED showing the new kids how it's done, right?).
But I'm not losing my license (and neither is my preceptee) because some intensivist is a lazy douchebag.

I'm trying to make it intact to retirement, at this point.

The only thing that keeps hospitals from killing people more often is nurses, and in this state (the only one out of 50), by-law nurse staffing ratios.

And even that's not enough.

Hang in there, but when it's time to go, go.

Oldfoolrn said...

Patient honesty can be amusing, alarming, shocking, but always memorable. My very favorite honest patient was an inpatient at Downey VA Hospital in the early 1970s. He had been in full leather restraints in a grim, depressing little room just off the ward where the bed frames were bolted to the floor. I hated wrestling patients into restraints and was eager to get them out as expeditiously as was prudent. This particular patient was restrained because he was bayonetting another patient with a pool cue and attacked the attendant when he tried to break it up. He was looking very sedate and peaceful so I asked him if he would resume the fighting if I released him from the leathers. A smile crept across his face as he enthusiastically replied, "Yes, I sure would."