I was standing in the trauma room, wedged in a space between the trauma closet and another patient bed, holding the penis of a rotund drunk who could not reach it himself. He possessed a perfumed aura of fermented dairy products and neglected hygiene and graciously obliged us with a true-to-life rendition of his favorite soundtrack of mating large mammals. As I nimbly caught most of his interrupted spurts of diseased brown fluid in a deluxe male urinal, the techs who were gossiping on the other side of the trauma room looked at me in disgust. Then, they turned away and continued their analysis of a co-worker's perceived slight in hushed tones, lest I hear too much. The absurdity almost made me laugh out loud. It was my second time holding someone's genitals that day.
The first was a very weak old man who could not move much. From behind the curtain, I had heard the doctors musing, 'well we definitely need a urine on him' so I quickly fetched a urinal. From across the room, I heard, 'Oh, sir, are you able to pee? Oh, he's going now.' Rushing in and pushing aside the curtain, I saw the doctors standing nonchalantly away from the bed. The looked at me and nodded as if it were a matter of course that I should be getting that urine sample now. I cut open the soaked diaper and despite that urine sprayed in uncertain spurts all over the bed, I managed to grab the slippery thing and get enough of a sample to send. Unfortunately, Mr. Peed-on-Me was soiled and nobody would come in despite my pleas, so I moved him, cleaned him and changed his linens by myself. As I was preparing to send the hard-won urine sample, a nurse popped her head in "Hey, what's your name again, can you go put bed 1 on a bedpan?" Before I could reply, she left, and the very obese lady in bed 1 refused to use the bedpan until I lugged a commode across the department to accommodate her. When I helped drag her body out of bed, I felt something in my mid thoracic back shift and twinge... so far, it's turned out to be nothing. (knock on wood)
The trauma room was uncomfortably warm and my drunk seemed to stop grunting.
"Are you about done, Mr. Drunk Half-Passed-Out?"
"LEAVE ME ALONE I WANNA SLEEP why won't you just... let me... go... ho... zZZZZzzzzzzzzzzzzzzzzzzz......"
I wheeled the sleeping Mr. DrunkHPO back to the hallway where I had first apprehended his "I NEED TO PEE NOW NOW NOW NOW NOW HURRY I NEED TO PEE NOW" request to find that the spot was already staked by a little old lady who looked like she had Death flexing his fingers over her shoulder. I left Mr. DHPO in front of a closet to assess Lady Shriveled and a transporter yelled into the phone next to me "I'm sorry, but it's crazy down here, I can't find her. They've got people in hallway spots that aren't even spots! Does that even make sense?"
I had more than 12 patients in my section of critical care, several of whom needed labs, several more of whom needed to use the bathroom/had already gone in bed and needed to be cleaned, almost all of whom needed vital signs charted, urines dipped and sent, a transfusion to pick up from the blood bank, and the nurses from the other critical care section asking me to do quick blood assays.
What's more, patients just kept coming into my critical care section, one after another, with no end in sight.
With each patient comes a set of duties that should be performed immediately, such as the vital signs monitor, bloodwork and an EKG.
EKG's can be difficult to perform with certain patients, but each patient needs to have an EKG within 10 minutes of being triaged. In the time it takes to be registered, triaged, then brought to our section, I am left with only a few minutes to undress, expose, and perform the EKG with nurses and doctors at my elbows trying to assess the patient. An EKG requires the patient to stay still, so this can be a challenging task if the patient is nervous and moving incontrollably. As I was doing an EKG on Lady Shriveled, a student nurse sniffed at me, "we've got this, can you go put bed 3 on a bedpan?" Bed 3 was a code-brown. As I gathered the materials to clean her/change her linens, a nurse from the other critical section team came to ask me to do a quick blood test.
I was wearing thin, and somehow, this helped me think more clearly.
S: "I can do it, but where is your tech?"
RN: "Tech Useful is doing an EKG in room 9."
S: "Wait, Tech Useful is extra today."
RN: "Oh, really? Who is our tech?"
S: "Actually, Tech Laid-Back is supposed to be in your section... Also, Trauma Tech Sour-face is supposed to be out here too. You have 3 techs, and they only have me. Nobody has helped me out all day."
RN: "Hm, let me go check."
He walked around the department and looked at the assignment sheet- nobody else was to be found. I ran the blood test anyway, but at least now, the charge nurse and team leader nurse became aware and concerned about the people missing in action, even prompting an overhead page, to no avail.
One patient began to code, and out of nowhere, Trauma Tech Sour-face, who had been hiding in the trauma room appeared, pushing us all aside to say, "I've got this," and jumped on the patient's chest to do compressions. Other techs appeared too, and suddenly, our department was full of dedicated, hard-working heroes. It wasn't the first time I laughed in absurdity that day.
It was, however, the first time I ever reported anyone to the managers. Tech Laid-Back had tried to do damage control with me, saying that she accompanied a helipad transport. However, helipad transfers usually take 45 minutes and she was gone for more than 3 hours. She offered me help when she finally appeared, but the rush was already over. My impending burn-out was still prescient, however, and it took all I had to finish the shift gracefully.
Believe it or not, the overall workload that night was only a bit heavier than it usually is for our busy sections. I was only subjected to the abuse that night because of the lack of teamwork that night. In my section, 2 of 3 nurses were new graduates and unused to the procedures and stress of treating of critical patients. Their preceptors unfortunately took their training status as an opportunity to gossip instead of helping. Between Tech Useful and me, the sections stayed functional, but barely. If any of the other techs had done even the bare minimum instead of hiding wherever they were, we could have functioned very smoothly. The coding patient in 9 might even have been caught earlier had another pair of eyes been watching. Ugh.
I carefully control my internal environment to exclude resentment, but it became very difficult that night last week. It took me a week to work through these emotions and I can only hope the new nurses don't learn to become complacent like their preceptors.
Meanwhile, here's to the successful completion of another week in the life of a ERTech.
S
As part of the ancillary nursing staff, the technician is a cover-all role for all the random and labor-intensive tasks of the emergency room. Being a tech is one of the most interesting and difficult jobs one can have and I hope you enjoy my stories from the bottom of the healthcare ladder at a busy city ER. HIPAA: None of the names I use are those of real patients.
Showing posts with label Toilet. Show all posts
Showing posts with label Toilet. Show all posts
Friday, January 13, 2012
Tuesday, August 16, 2011
The Little Old Man Who Said He Could
"Sir, can you walk?"
"Of course I can! I can walk."
"Can you walk well?"
"Can you walk well?"
"Yes, yes."
I had a feeling he needed assistance, so I wheeled him to the bathroom. He stared at me.
"Do you want me to help move your legs?"
"Yes. That would be nice."
I swung his legs over the side of the bed. He stared at me expectantly.
"Do you need me to pull you up?"
He nodded.
I pulled his hands so he could stand. His legs were very, very wobbly. I had half a mind to wheel him right back and put him on a bedpan, but he was elated at his success (probably at having manipulated me into giving him his way), so I made up my mind to let him enjoy his moment and catch him should he fall. With my two hands guiding his, I pulled him step by wobbly step to the toilet, where I put his hands on the guiding bars. Carefully, we bent him over so he could sit down.
Silently, I was worrying if he'd ever be able to get up. Call me if you need me, my name is S- I told him before I closed the door behind me. Presently, I heard him calling, and went back inside.
I pulled on his hands to help him back up to no avail.
I pulled after a countdown, but his legs wouldn't hold him up.
Finally, I bent my legs and put my arms around his ample waist and lifted him. He couldn't stay standing.
Worried, I tried one last time, lifting him up- 200lb of dead weight, before he could stay standing long enough for me to pull his pants up and start guiding him back to his bed.
The whole ordeal took me about half-an-hour on a day we had 27 patients for an area that only is supposed to treat 18. Oh Mondays...
Mr. Wobbly just made it to his bed when the transporter came to take him upstairs to his admitted hospital bed. Poor guy- the next time he needs to use the bathroom, I hope there is someone out there who will take the time to help him walk. He is right on the cusp of no longer walking around- the edge of ambulatory- the cliff of losing what little freedom he has left.
S
Labels:
Elderly,
Manipulative,
Toilet
Thursday, August 11, 2011
A Crappy Day
Others were just crazy, such as the whole shift when I worked critical care and trauma at the same time, handling over 15 very sick patients at a time.

My sickest patient was Ms. C-Diff. She was at home with her daughter when her daughter noticed she wasn't making any sense and called 911. The paramedics thought Ms. C-Diff was borderline between coming to the hospital and staying home, but luckily decided to take her along just to get checked out and maybe raise the census numbers a bit for their ambulance company. In the ambulance, Ms. C. Diff crashed and burned- when she arrived, her heart-rate was in the 20's and I was preparing the code-cart and gowning up for CPR.
Ms. C-Diff had shingles all over her face and a diaper full of ... C-diff.
She also had no veins to speak of and so received an IV in her neck and a central arterial line. She was breathing poorly with snoring respirations and we used a bag to push air into her lungs. Soon after, the doctors made the decision to intubate Ms. C-Diff.
Having a patient like Ms. C-Diff is very time-consuming. We needed EKG after EKG and everyone is high-pitched. They forget things or need more than one of something and I run across the department as fast as I can without startling other patients around me. The alarms are always beeping because her vital signs are unstable. There are plastic wrappers everywhere, blood flying everywhere, tubes, adapters, plastic parts, bottles, needles everywhere. And then the inevitable... "S, can you clean her up? Also, don't forget to take a sample."
(Disclaimer: You probably don't want to read this)
It was difficult to ignore the stench coming from her overflowing diaper through everything we were doing, but... It was time to clean her up. Armed with warm bath towels, various pads, blankets, and a new diaper, I cut it open to reveal vile, green, rotten liquid that just went everywhere. I scooped up a few q-tips full and put it in a specimen cup. (Showing the cup to an off-duty tech who just came in to see the action, I punned- You should be working here with me. You're missing a lot of good ****!) It was the consistency of pond scum and the subsequent double-handed scooping with a towel was terrible. I enlisted the help of another tech so we could turn her to clean her back side. "Make sure you wipe front to back like mother taught you, heeeheeheee..." ER workers have such warped senses of humor. It took us over half an hour to clean her up, then gown her, cover her with a blanket, sweep away all the debris, clean the blood from her face, arms, floor, and all the crap off her bed. The doctors were very thankful for my opening of 2 bottles of peppermint spirits to dispel some of the smell.
The effort was worth it. She looked like any other old lady with a tube down her throat. (You know, like they usually look.) Her daughter came into a very clean room, with her mother newly diapered and a clean, warm blanket over her poor invasively resuscitated body. The daughter was thankful and I was spent... but there were 7 more patients I had to see...
This morning, my Dove Chocolate had a fortune in the wrapper: You're invited to relax today.
I think I will.
S
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