basric

WARNING: YOU'RE OKAY UNTIL YOU REACH "TRIAGE :" Then the weak stomachs and medically nervous may wish to skip to the !!!!!!!!!!!!!!!!!!!.
***********************

They found a body outside the ER and after careful examination determined it was a nurse. How did they know?

The stomach was empty, the bladder was full and the ass was chewed off.

That about sums nursing up.
***********************

Ever since the heart massage situation the new night manager had a bug up her butt about me. To ‘punish’ me and thought she'd exert her authority over me she, so she took me off triage and charge and just gave me patients. How did I feel about this? All I had to say, “Oh, please don’t throw me in the brier patch.” Sorry if the phrase is too old for some of you but taking me out of the high pressured areas of the floor and giving me two patients to watch over all night. . .let’s just say its like a vacation no matter how critical the patients.

You see, we’d had a confrontation, the night manager and I.

“I’ve READ your file.”

“Really? I thought David kept those locked up for his eyes only. Does HE know you’ve been rifling through his files?”

“Don’t change the subject. You walk around with this great aura of mystery, never talking about yourself; you think you’re better than me; God’s gift to trauma.”

SIGH, I really hate insecure people “What exactly in my file has you so upset? That I’ve turned down the job you have---three times, that I belong to the U.S. Trauma Team, have more trauma experience or that I have more education?”

“You have a Physician’s Assist License, for Christ‘s sake. A Master’s in emergency nursing making you a nurse practitioner and a fucking PhD in Organic Chemistry. For what your parents paid for your schooling don’t you think you should be at the least in administration or teaching? Or working for a surgeon?”

“First, this is none of your damn business. Second, I paid for my own education not that it’s any of your business either and third, stay out of my fucking file and life.”

“I’ll have your job for that insubordination.”

“Before or after you tell David you went through his desk and files?”

Things have not been good between us since. I answer her questions like I’m on the witness stand--yes, no--only the fewest words to make her go away, and I avoid her.

Tonight she had given me a GSW to the back; he was shot running away from a holdup in the lower spine paralyzing him (another bad guy now going on relief that we, the people, can support him and his medical bills for the rest of his life.) He was post-op and intubated so respiratory took care of his airway. Basically he looked like a train-wreck on paper but actually was a piece of cake to care for. My second was a homeless man who was walking on a concrete slab behind a warehouse and somehow fell onto the side of a moving freight train.

He was lucky not to have gone under the clacking wheels on the rails but bounced on the sidecar and back against the slab. A few broken bones, but the vapor of alcohol and stench rose from him like dirt from Pigpen on Peanuts. This is why she gave him to me without a care partner to help.

However, unlike many nurses with more than an associate degree think, the “I didn’t get a bachelor’s degree to change diapers” nurses. I’m of the old school a nurse’s’ job encompasses all patient care.

Although every care partner on the floor offered to help me clean him, two offering up their lunch breaks; I knew she would make them pay for it,later. Therefore, I refused all help, even from my buddy Paula. Anyhow care partners long ago gave me the remove the stink secret.

EDGE shaving cream. Really. Squirt it on a washcloth, wash and rinse. Use the mild on sensitive areas. It works every time. Have stinky feet--I promise this works every time. However, even though I soaked his hands and feet and removed layers of filth along with dead skin they still looked dirty. Smelled good but looked nasty. Mouth care was a little grosser.

Halfway through the night I had washed both patients, re-enforced bandages and now sat back to chart at leisure.

SHE saw me, came over and examined my patients (Like she’d know if anything was wrong anyway) and stormed away without a word.

An hour later she tried to give me a patient from surgery. I refused. I told her it was against protocol. She said at night she made protocols and if I refused I could get my things and go home.

I replied, “Or I could call David for your breaking HOSPITAL protocols.”

“He’s out of town.”

“I know. I have the number where he is in case he was needed.”

“He gave it to you and not ME?” The ‘me’ was screeched. Again she stormed away. I told you I have a tendency to piss people off.

Peace reigned for a couple of hours when I heard a loud crash and one of the residents scream, “GET OUT! GET OUT! YOU DON'T KNOW WHAT THE HELL YOU’RE DOING!” then cane “BARBRA.” This was not good for me, since I saw her in tears and disheveled leaving triage. She stopped long enough to shoot me a look that should have blown me to pieces.

Triage :

It was a farming accident. He was a 40 something year old male who turned the tractor too sharply beside a gully and tipped it over. Not only did the tractor pin him but a dead tree stalk acted like a stake going through his neck. Only by the grace of whatever you believe in, even if its luck did it miss his spine and carotid arteries and one jugular. The other jugular we found later was pierced but sealed around the wood, why he hadn’t bled to death.

He’d laid there for most of the afternoon unable to move or call for help, until his wife went looking for him after dark which was about eight p.m.

Took the flight paramedics an hour to cut and secure the ‘stake’ not knowing what damage was inside around the stalk and another two hours for firefighters to get the tractor off him and get him to the helicopter, another forty minutes it took to get him to us.

First thing “Ding-A-Ling” night manager did was reach to pull the stalk out. Really? A first year nursing student knows better. A resident literally slapped her back and down onto the floor, then yelled for me.

Okay, I admit it. I am guilty of the number one deadly sin. PRIDE. But it doesn’t take the residents long to learn who they can depend upon when things go South. I am the go to gal in trauma whether in the field, on the road, or on my floor. Some nurses and residents may hate me because I don’t tolerate lackadaisical patient care but let them get in trouble and my name is the one they yell.

But back to our farmer. Though his neck wound was stabilized; he had crushing injuries to the remainder of this body. He had a spiral fracture to one arm and a compound fracture to the femurs, the long bone of the leg. His right pelvis was crushed and his right ribs cracked. Somehow they’d managed not be break and pierce his lung; then he would have died in the field.

We gave him five units of blood while we had him along with three thousand liter bags of fluid and two six-packs of platelets.

The resident was on his game and stabilized him--chest to toe with the assistance of two residents, three nurses and an RT. (I won’t bore or confuse you with the tests & scans.)

!!!!!!!!!!!!!!!!!!!!!!!!!

After an hour in triage he was off to surgery with the stalk still wedged in his neck.

I went back to my patients and rode out the night in peace. Never saw the night manager again though I expected her to make a scene because she loved the drama.

Our farmer came back four hours later in critical but stable condition. I heard his little wife never left his bed until he was discharged from the hospital.

The night nurse wrote me up for abandoning my patients, a Nursing Board Offense.

The Resident wrote her up for incompetence and nearly causing a fatality.

I wrote up the Resident to the Trauma Attending for the outstanding work I thought he had done, along with the RT, and the nurses involved.

The next weekend the manager called me into the office. Showed me the Night Manager’s complaint against me and said he told her if I had been called to Triage on an emergency; it was her job to see my patients were cared for especially since that emergency was caused by her. O--Kay.

She resigned, (rumors said she was given an either/or) not because of me; because of the resident's report. My manager asked me why he even bothered to have a night manager if I kept running them off. I just happened to be wearing the “I DON’T PLAY WELL WITH OTHERS” shirt Paula gave me, so I opened my jacket and showed it to him. He rolled his eyes. I suggested he could run me off and he just snorted and told me to go to work.

So you are thinking about nursing? The money is fantastic after a few years, but if you don’t have the ‘calling’ you won’t last. I still haven’t yet gotten into family of patients and only touched on residents. Maybe you will give me a chance? And BTW you make the same money with an associate degree as a Master's on a floor in a hospital. Their pay scale is based on years of service and raises are all usually 3-5% whether you are good or bad. That's why nurses usually only stay at a hospital 3 years before moving to another (at least in a large city) to get a large raise.

**Again I disclaim all knowledge of the above, if you think its you, it isn't. I am still a space traveler using the Stargate.