Thanks USA

This post ,about a family's ER and hospital experience, made me thankful that I live and work in America.

Can you imagine working in a third world country's medical system?

Dump Run

I had my first dump 'n run a couple nights ago.

The front desk calls,
"Do you know about a pt. Xxxx, that's a direct admit to CT?"
"Um, No?" I want to say, 'Why would anyone be admitted to CT?", but whatever, the front desk wouldn't know that, anyway.

I warm the scanner up and wait. About 40 mins later 3 EMTs come racing into the dept. with an unconscious elderly woman on their gurney. They're shouting some stuff about low blood pressure, V-fib, O2, something, something - and they rush past me into the CT room.

What I see is a cyanotic old lady actively seizing.

I follow them into the room, "Um, she's having seizures.", I say.
They roll their eyes at me, like duh.
"Yeah, that's why she's here.", one of the EMT's says, while they're moving the pt. on to the CT table.
"Has the ER nurse looked at her?", I ask.
"No. Direct admit to CT.", the EMT says, while they're wrapping up their stuff and heading out the door.

OK - So here I am alone with a cyanotic, seizing old lady. The ER is on another floor. In fact the only other depts. on my floor are housekeeping and HR. They're all gone for the day anyway. There isn't any crash cart or even a blood pressure cuff in our dept. Not like I would know how to use one, right? Actually, for a Rad Tech, I'm very good at taking blood pressure by palpation. Thank you EMT training. Anyway, back to my story. Thankfully, the ER nurse came to my rescue and with her help I tried to scan the pt.'s head. CT and seizures don't really work well together. After the third try we gave up and the ER nurse took the pt. upstairs to be admitted to, get this, a real hospital room, where they gave her some nice Ativan. And I finally got the CT done.

Later on I went up to the pt's room to do a CXR and EKG and the pt's Dr. popped in.
I hate this Dr. Deeply, deeply dislike him. If I were dying, and he was the only Dr. that could save me, I would rather die.
I have the pt's chest uncovered to do the EKG and the Dr. waltzes in, flinging the door open and not shutting it. Granted, she's unconscious, so she doesn't know that her boobies are exposed to the world passing by outside, but gross!
I shut the door.
The Dr. snaps on a glove, "Well, as long as you have her gown open, I'll do a breast exam!" He proceeds to vigorously squish her sagging, floppy breast tissue. "Her family's very worried she might have breast cancer."
She's 88 y/o and unconscious. Hmm, breast cancer may not be her worst problem right now. Then the Dr. grabs my hand, "Here feel this! I think it's a lump. What do you think?"
Eww! I do mammograms, but I DO NOT grope unconscious old ladies!
So I say diplomaticlly, "I feel some tissue, but I don't know what it is."
He snorts, "Well, it feels like a lump to me."

Time Waster

The hopital admin. are instituting another time wasting protocol.

It's called SBAR. Anybody use that at their hosp.? Did it work?

SBAR stands for Situation-Background-Assessment-Recommendations

Basically, as they've discribed it to us, the pt's nurse fills out a 'ticket to ride' every time the pt needs to leave the floor for a procedure. The questions that they fill out are like,

Wheelchair? yes/no (duh, every pt gets a wheelchair ride)

O2 y/n

Circle O2 level: 1 2 3 4 5 6 7 8 9 10 12

circle one: pt stands alone, two person lift, pt immobile

Location of pt pain?:

Level of pain:

Does pain move around?:

Pt confused/disorientated?:

IV: y/n

IV Location?:

IV taped in place? y/n

IV gauge?:

Multiple IV tries?

If so, are repeat IV locations bandaged?

Pt wearing any jewelry?:

Pt provided with slippers and robe?

RN/LPN to sign:

RN to sign if pt changes noted:

OK this is silly!

Sure I want to know if the pt is on O2 or if they're confused. I also would like to know if they are a 2 man lift(so I can bring the strong man we keep in the hallway closet ha,ha), but I can ask the nurse these questions!

Also, I can, instead of reading a piece of paper that was filled out the night before, by the previous shift, talk to the nurse or aide or whoever and tell them, "Oh by the way I'm taking 314 for their x-ray. Do they need O2? Are they combative?" Ect.

That way they won't freak out when they see an empty bed and think the pt. has escaped!

It's not like we are a huge hospital - there are 21 beds in med/surg, 4 in Ob, 4 in ICU, and 15 in the locked mental health ward.

It's just one more piece of paper the nurse has to fill out.

And our hospital is supposed to be paper-less!

Why don't they put this info into the digital chart?

Then before we go to pick the pt up off the floor (sounds bad) we'll know that they need O2 , ect.