Saturday, September 10, 2011

Luck of the Draw

For some patients, coming to the ER can be a wonderful experience.  The team that is taking care of you might be the A-team, a well-oiled machine that provides conscientious, pleasant, professional, and indulgent care of you. Not only are things done immediately and with great skill and precision, the bedside manners of the doctors, nurses, and staff are warm and reassuring.  Especially if you are in critical care, this can make a huge difference for your nerves, happiness, and prognosis during your considerably shorter stay.  Don't worry, a few hours is normal- if you had the L-team, you might have to suffer through many more hours of discomfort, though.  Working with the A-team is an incredible learning experience; we are calm, at ease, and responsible.  Therefore, when working with the A-team I might even venture to ask and doctors might even approach me about the biology behind what is happening to a patient. On these days, I don't even mind working double-shifts. It's such a good experience.  And even crabby patients leave us with a grudging respect, because everything that could or should be done, was. (picture of lucky cat)

There are other teams, of course, made of a mix of these personalities:

Some teams are all-business. Things get done, but you leave feeling a little cold. Other teams are anything but professional; the staff is "personable" but you can't help but question if they know what they are doing.  Then, there is another category entirely- team-Lazybones.

I had to work with the ultimate L-team the other day.  Between the three nurses, Nurse Negative, Nurse Airy Fairy, and Nurse Lazy, all of whom liked to disappear into the ether when the trauma drama died down, I could not find a single one for an hour and a half at a time when my trauma patients were begging for legitimate pain relief.  Then, they ignored my request on behalf of the patient until the resident asked them directly, and disappeared again.  The surgical resident was more frustrated than I- the medications were ordered as she was suturing pieces of torn muscle and skin and the patient was crying out. But for the life of me, I again could not locate a single nurse from my team.  Then the O.R. secretary called me, livid, to pick up a stretcher that Nurse Airy Fairy had left there on purpose, covered in blood, bloody vomit, and other bloody gore.  She decided she didn't want to clean it.  Nurse Lazy couldn't get an IV in a patient and stuck him 5 times with the same needle, ripping off the blood pressure cuff sloppily every time I applied it. We never got a good blood pressure reading until it was absolutely required when the unstable patient went to CT scan, and then he asked me to draw all the labs with a butterfly.  Meanwhile, I was still the only one doing all the vital signs every hour, stocking the room, cleaning the rooms, helping the residents with the patients.  Where did they go for the whole shift? I still have no idea- maybe taking smoke breaks.  It's scary to imagine anything serious coming in that trauma room with such a dysfunctional team of nurses; thank you, white cloud! I can't imagine that any of them actually consider themselves competent with such attitudes towards working.
(picture of doom cat)
How to avoid such craziness when or if you come in as a patient? How do you make sure that we don't harm you more than whatever had happened to you already?

The details of the room you enter might give you a clue: if the johnny coat is strewn across the bed in a haphazard way, if the bed wasn't cleaned and newly made from the last patient, if there is garbage on the floors, if the drawers aren't stocked, you might be out of luck. That or we're just having a busy day. Nothing is for certain in that crazy place, after all.


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