basric: (LJIDOL MIRAGE)
[personal profile] basric
I have a bad cold with my brain feeling like mush. I have edited and edited. I glossed over or skipped the very gory descriptions of what occurs in triage. Hospitals like most careers have their own lingo. I tend to lapse into it go back and write verbs and adjectives.

I write four out, then go back and put in the helicopter is four minutes from arrival. I call fuzzy brain and please excuse me if I missed one. I really wanted to give you a real feeling for taking a body to the morgue but I don't think I pulled it off. Maybe I'll try again someday.


BLACK HAWK DOWN
Taking down a pilot, copilot and fourteen special forces men/women. Got on the radio, Pilot and Co died on impact, three others DOS (dead on scene) one still missing, others mostly broken bones and shakeups, two with massive head wounds, one with a crushed trachea and one with chest puncture wound.

“We’re forty-five minutes out."

I yelled from the radio, "Four incoming--get triage cleared out. Buddy? Have you found Bob?

“Tracked the urine to the fire door, don’t know how he opened it, but he went through,” he held up a finger to stop my question, “His Foley bag got caught in the door. Apparently he pulled until it ripped out--followed the blood trail down to the landing of 9North. He was sitting on the landing. He’s in a bed in the a trauma room, Shelly is replacing the Foley. They’ll keep him until we find where he belongs.”

"We’ve settled for now, take Carey and go floor to floor and find where Bob belongs. Skip the ICU’s and 10S (renal unit) he doesn’t have a stent or catheter so he’s not a kidney patient. Go to 8N first and make them check every single patient face to face. Call the SNF Unit. I don’t think Bob crossed the breezeway without a badge, or through the tunnels or across the plaza naked dragging a Foley but who knows.”

I called down to surgery to warn them of the impending arrival of the Ft. Campbell patients. “We need the Neuro-Surgeon in trauma in thirty for assessment. Will you have suites available.”

“We’ll notify the Neuro-Surgeon. His fellow is on-site I call and send him up. We may have to open day surgery. I'll call in the other teams.”

C*R*A*C*K*L*E


Car versus concrete divider, three on there way, one for the burn center, two for us. Eight minutes out.

I could hear Bob screaming “BOBOBOBOB,“ from the other side of the floor.

"BAR-BRA. Surgery calling report on John the six hundred plus guy."

“Tell me, is he an TIC-U patient or is he ready for the Ortho floor and you just don’t want to make the tunnel run,” I asked the surgery nurse.

Now I’m in a fight on the phone with surgery. The Ortho floor is in a building across the plaza, all of the medical center, its outbuildings, research center, University buildings, dormitories, Administration and Peabody College (Vanderbilt College for teachers across the street are all connected by tunnels and tunnels under tunnels. To get to Ortho you must go down one tunnel for about 200 yards at a 90 degree slant ending at a sharp turn left. The idea of taking a six hundred pound man down that is a nightmare. I’m not sure its possible.

The Surgical nurse was screaming at me so loud I held the phone away from my ear and could still hear her clearly.

The phone was plucked from my hand and startled I turned to watch the Trauma Attending, still rumpled with sleep. I listened to him soothe the woman on the other side of the phone, then move in for the kill, “If you send me a patient to take up one of my ICU beds unnecessarily, I will write you up personally. By all means, let me talk to him.”

I left him to battle it out with the surgical resident, for triage and the two MVA patients. The first, a young girl--eighteen, driving with a Snapple bottle between her legs. Lost control of the vehicle and hit the exit divider head on. Air bag inflated bottle crushed and sliced into her vagina.

She’d already coded once, blood loss was severe. Typed and crossed, we got an infuser pumping to replace the blood, ran plasma until results received. I left them to it and went to take another report from surgery. This patient could go to the step-down, so I transferred it. And turned AND there was Bob standing naked staring at me.

“I AM BOBOBOBOBOB.”

“Damn. Anyone heard from Buddy? Get Bob in a wheelchair. Cover him. Put him behind the desk and---you, sit on him, don't take your eyes off him. Call Shelly and tell her thanks a lot, she lost Bob and we’ll keep him.” Bob started singing a bawdy song. I just rolled my eyes and headed back to triage. We’ve got 5 minutes. Have you stabilized them enough to get them to surgery.”

“They’re waiting on a Uro (Urology) consult.”

The radio crackled, Ft. Campbell's helicopter was five out.

“Nick, Let Dale know so he can make room for them. (Dale is the lead pilot of the LifeFlight helicopters.)

I heard my name and turned. . .my boss WITH Flopsy, Mopsy and Cottontail.

He held up his hands and motioned over the commotion on the floor to follow him while they waited, to the stockroom.

“You know, I’m gonna get hell about this cabinet.”

That derailed my oncoming rant for another, “She acts like these supplies are coming out of her paycheck.”

“I told her to lock them up. They get borrowed out and never returned.”

“She assumes we don’t do anything at night and she doesn’t check to see if we have printer paper or ink and any other supplies before she leaves. She should leave the key with the charge and the charge answer to you if things come up missing. She is so territorial, are you sure she doesn’t keep her stash in there?”

He snorted. “We are short staffed. I NEED these new nurses to work out. I want you to put them with someone to follow.”

“Tonight? Cottontail is incompetent and the other two are possible but you took them off training too early.“

“Damn it, Barbra, I need these girls to work out, now. Make it work. Fix it,” now he was pissed at me.

“I’ve got Rangers coming from Ft. Campbell. Actually,” moving toward the door, “Now,” I pushed pass him.

He grabbed my arm, “That why the Attending is here?”

“Crazy night. I didn’t call him, I guess the resident did.”

“Take care of the nurse situation, first.”

Damn, damn and double damn.

Cottontail had a smirk on her face the other two look terrified. I put Flopsy and Mopsy with the nurses who had assumed their patients when I sent them home. Cottontail lost her smirk when I put her with me.

Everything was spinning in triage but in control. We took over care of the MVA victim--the mother who whose seat belt snapped and she was flung out of the vehicle. Greenstick fractures of the tibia & fibula.

A code sounded, the same patient who had coded earlier, I left Cottontail with strict orders-head to toe assessments q10m (every ten minutes) check lungs watch breathing for a fat embolism into the lungs. "Her breathing hitches, don't screw around yell for help."

We coded the man for 25 minutes when he flat-lined (asystole) this means there are no electrical impulses to run the heart. Although this looks great on TV to see the flat-line shocked back into a sinus rhythm, when in truth only one out of ten-thousand ever come back. All my years in the hospital or in the field I have never seen one. What you actually have (and I noticed show’s like Grey's Anatomy have started) is a rhythm called V-Tach. This is a prelude to asystole. He was coded another ten minutes then TOD (time of death) called.

I left them to prepare the patient for the morgue and went back to triage. The last soldier was just being pushed out for surgery.

Cottontail brought out the woman she was watching into the main arena.

“How have her Neuro checks been?”

“Fine.”

I got that feeling you get sometimes when something isn’t quite right. I checked the splint on her leg. Toes were warm, she had a good plantar reflex.

She was in a drugged sleep from the morphine, IV running well, good blood return...but her face didn’t look right. I checked her eyes.

“See if you can catch the Neuro fellow. COTTONTAIL!”

“What?”

“When did you last check her pupils.”

She shrugged. Then I noticed the paperback in her pocket.

“HER...RIGHT...PUPIL...IS...BLOWN. I can see it without a light. Where is your flashlight?” Each word distinct and punctuated. I think the word to describe my feelings was fury.

“I don’t have one.”

“Yet you wrote her pupils were equal and reactive. That's false charting. A felony.”

Whining, “Well, we never included that at...”

"You don't do it you don't chart it."

The fellow arrived, “How long has the pupil been like this?”

“Not sure, less than thirty minutes when last checked.”

I stood and let him ream me out about Neuro checks and so on and so forth then he called to find a suite to set up in day surgery to do a C.O.I.L. (I am a trauma nurse not Neuro. I cannot tell you what a C.O.I.L. is I just know they do them for stroke patients cutting into the brain.) The Trauma Attending gave me a sympathetic look and followed the fellow who threatened to have my job for incompetence.

I turned, “YOU, with me.” She slunk along behind me to David’s office. She said "You shouldn’t have left me alone, it was all your fault."

And she's been a nurse longer than I've been alive.

I walked out even though my boss called me to come back. Buddy jogged up, he had found Bob's spot. Bob belonged on the medical floor, he had dementia (you think?). His name was Billy Bob and they didn’t have any Bobs or Roberts. When they checked his room on bed checks someone was in the bed, turned out to be his brother.

The place was again loud and chaotic, I needed a few. I had Buddy take Bob to 8N and I volunteered to take the corpse to the morgue. Peace and quiet.

Waited for Security to bring the key. I Shut all doors to every room on the way to the elevators. Pushed the gurney into the freight elevator and went down, down, down, into the bowels of the Medical Center deep beneath the ground. The patient would be held for autopsy tomorrow.

I am not easily spooked but even I get the creeps pushing a dead man off the elevator into a dimly lit hallway to the left and then right into another darker hallway. Paused outside to fill out the logbook. Unlocked the door, icy air rushed out and I pushed the gurney inside. The only light from a refrigeration unit showed only one other gurney. Double checked the toe tag after I parked him and locked the brake. You can’t help but notice the refrigeration unit brightly lit glass doors and the banner taped to it. “FETAL REMAINS”; it was just depressing.” The room was very cold and it was spooky. Shadows danced, appeared to move. Real or shadowy mirages? Chills chased themselves down my spine. Shadows darkened, grew, flickered.

It was a relief to lock the door and start back down the hall. I heard the swish of what sounded like doors opening making my heart race. The clank of pipes above the ceiling. The lights I swear flickered and it took everything I had, first not to look behind me and then not to run. Run where? Wait for a slow elevator? Too many slasher movies. I did not breathe easy or maybe hadn't been breathing at all until the elevator doors shut and I was on the way up. I felt foolish. Tired and foolish.

I left chaos and returned to chaos. But it was my chaos and I stepped in and orchestrated it to the final note.

7 a.m. report. Heard the secretary scream in the stock room and took that as my cue to depart but got waylaid by David; back into the office for a reprimand.

He started in on how he put Cottontail with me to be with me and I left her...yadda, yadda, yadda. I didn’t defend myself with having to go to a code--I had known she was incompetent, even to watch a patient. I should have put someone else with her. So, I’d take whatever he decided to dish out as punishment.

Knock at the door and a pissed Trauma Attending entered. “Can anyone join this party. First, I don’t want that Cottontail on my ICU floor again. Put her on the regular floor but not here.”

“This has to do with my staffing. Nothing to do with you. Barbra was in charge...”

“You hired that incompetent nurse and turned her loose on my floor. Barbra sent her home, as she should have and you brought her back. Care to explain THAT to me?”

His tone made me glad he wasn’t talking to me. I can be icy and sarcastic but I don't come close to him. Everything suddenly went from being about me to being about David’s negligence at putting nurses on the floor before they were properly trained. I was dismissed.

Paula was waiting at the desk. “I desperately NEED food.”

"I.H.O.P."

Cottontail was lounging against the exit wall with another big smirk, "So, seems I got the last laugh."

“Really, I still have a job,” I told her. "You may have destroyed a woman's life tonight and yeah that's on me because I KNEW how incompetent you are. That woman still could die." Let her smirk over that. I'd reached my limit. The elevator opened and Paula shoved me inside.

“Bad night? I thought you were going to deck her.”

“I don't know what David's thinking, hiring these ready to retire nurses. This one is beyond incompetent."

"If she's challenging you, she's just stupid."

I laughed, “When you’re right. You’re right.”

Date: 2011-03-29 06:34 am (UTC)
From: [identity profile] agirlnamedluna.livejournal.com
Oh boy O_O I'd personally tell that woman's family probably, in front of David, exactly what went wrong.

Date: 2011-03-29 07:39 pm (UTC)
From: [identity profile] basric.livejournal.com
Wouldn't have made any difference. David would just say I was making excuses and as far as family I won't even begin to go into the nightmare of hospital politics, violation of privacy to it in front of an administrator. Anyway he was looking for a scapegoat because HE was putting nurses on the floor untrained. That's why I didn't bother defending myself when she blamed me.

Thanks for the kind words. I quit and was wooed back before the repercussions of this night were over.

Date: 2011-03-29 11:48 am (UTC)
From: [identity profile] imafarmgirl.livejournal.com
The trip to the morg sounds creepy! Jeez. I'm glad I don't have to do that as part of my job.

Is the snapple bottle for real? If so I'm not riding in a car like that again ever! Either that or I must give up my affection for snapple since they still sell it in glass bottles.

Date: 2011-03-29 01:21 pm (UTC)
From: [identity profile] comedychick.livejournal.com
These were the two things that grabbed me most about the entry that I was going to comment on, too!

Date: 2011-03-29 07:52 pm (UTC)
From: [identity profile] basric.livejournal.com
This one was Snapple though I've seen coke bottles, too. Just don't ride with drinks between you kegs. If it had been a man, it would have castrated him.

Thanks for commenting, it is appreciated.

Date: 2011-03-29 01:25 pm (UTC)
From: [identity profile] havers.livejournal.com
Oh Bob was Mr. Bob and his brother slept in his bed...hilarious.

What a crap that you have to deal in such a chaotic night with so much incompetence. It's not that you have to do your own work, you also have to check and double check their work...exhausting.

Great read like always.

Date: 2011-03-29 07:56 pm (UTC)
From: [identity profile] basric.livejournal.com
Thank you. Thanks for commenting.

Date: 2011-03-29 02:19 pm (UTC)
From: [identity profile] millysdaughter.livejournal.com
After all your hospital stories -- this one frightens me the most.

Date: 2011-03-29 06:47 pm (UTC)
From: [identity profile] basric.livejournal.com
The idea they put new and untrained nurses on critical floors all all floors scares you? It's going to get worse as the baby boomer nurses retire over half the nursing force...then its time to be afraid.

Date: 2011-03-29 07:18 pm (UTC)
From: [identity profile] millysdaughter.livejournal.com
Cottonmouth was over the hill and had lost whatever edge she once had, long long ago. I'd rather have a greenhorn -- at least they do not think they know it all!

Date: 2011-03-29 02:44 pm (UTC)
From: [identity profile] faerie-spark.livejournal.com
Ah, excellently done. I'll come back to say more later, but since you said you weren't feeling well, I thought I'd offer you an edit.

"I turned, “YOU, with me.” She slunk along behind me to David’s office. She simply said I shouldn’t have left her alone, it was all MY fault. And she's been a nurse longer than I've been alive."

I think you mean to say "I Simply said...."

Hope you feel better soon, Barbara.

Date: 2011-03-29 07:59 pm (UTC)
From: [identity profile] basric.livejournal.com
I should have made it a quote that she said "She shouldn't have left me alone it was all her fault." It does rad confusing. I'll see if I can edit it. Thanks

Date: 2011-03-29 03:25 pm (UTC)
From: [identity profile] adoptedwriter.livejournal.com
Exciting read as always. Great use of dialogue. AW

Date: 2011-03-29 07:33 pm (UTC)
From: [identity profile] basric.livejournal.com
Very kind of you, thanks for commenting.

Date: 2011-03-29 05:36 pm (UTC)
shadowwolf13: (Default)
From: [personal profile] shadowwolf13
First: Very glad I never ride with things between my legs ... well, other than skeins of yarn.

Second: Oh wow ... Please, please tell me Cottontail got canned for her crap.

Date: 2011-03-29 06:11 pm (UTC)
From: [identity profile] basric.livejournal.com
First thanks for reading and commenting then Cottontail was transferred to the medical floor where she and her paperback stayed until she retired.

Date: 2011-03-29 06:54 pm (UTC)
From: [identity profile] creature-girl08.livejournal.com
Man, to have to deal with such incompitence is horrid.

Wow, I will never be able to put any bottle between my legs like that again. Completely scary.

And the morg sounds like one place I think would not be able to go near and I feel I can handle a lot.

Great read as always.

Date: 2011-03-29 07:34 pm (UTC)
From: [identity profile] basric.livejournal.com
Thank you you are very kind.

Date: 2011-03-29 07:08 pm (UTC)
From: [identity profile] sipman.livejournal.com
This is the thing i fear most about getting older (& hospitals), the next generation...most of them jus scare the living hell out of me.

Glad the 'Bob' situation got resolved

Hope your feeling better soon <333 sending you waves of good vibes & chicken soup (((HUGS)))

Date: 2011-03-29 08:02 pm (UTC)
From: [identity profile] basric.livejournal.com
You aren't alone, scares me too.

Date: 2011-03-31 05:27 pm (UTC)
From: [identity profile] myrna-bird.livejournal.com
Yeee-ouch when that catheter pulled out!
Another exciting and chaotic shift.

Date: 2011-03-31 08:03 pm (UTC)
From: [identity profile] basric.livejournal.com
Thank you And a I inch balloon filled with sterile water being ripped through a whole a lot smaller, Yeah i bet it would have hurt most people but he wasn't even aware of where he was or felt any pain. We didn't know if he walked or fell down the flight of stairs to two floor landings below. Thanks for commenting.

I figure this is my last one as I did not connect the firs part with the second so mine will appear a little 'chaotic'. But going this round will bother me less than if my peers, the others who write with me had chopped me. But I think you will be fine.

Date: 2011-03-31 10:51 pm (UTC)
From: [identity profile] myrna-bird.livejournal.com
Don't bow out yet. No one knows till we know.
I appreciate your vote of confidence, though. We are all winners in my book. So many talented writers!

Date: 2011-04-01 01:04 am (UTC)
From: [identity profile] joeymichaels.livejournal.com
I always end up wanting to punch characters in your stories in the throat. Man, Cottontail doesn't just deserve to be fired - she deserves to be in jail. Did she end up losing her job or at least suffering in some way for this? Or David? Surely he got something worse than a verbal reaming for hiring incompetent people?

Date: 2011-04-01 02:23 am (UTC)
From: [identity profile] basric.livejournal.com
Cottontail was transferred to the medical floor--no repercussions except an incident report in her file in case the family ever sued the hospital could throw her under the bus. David got chewed by the trauma attending but that's as far as it went as far a I know. I paid for it. The hospital wouldn't do anything anyway. The public doesn't realize how bad the nursing shortage is and its going to get worse as the baby boomers retire and no one replaces them. Hospitals hire ANYONE the need warm bodies and expect the good nurses to be great and take care of it all.

Thanks for the comment.

Date: 2011-04-01 02:56 am (UTC)
From: [identity profile] joeymichaels.livejournal.com
Yeesh.

I just had a very positive hospital experience with a wonderful nurse and technician, but I know it could have been a nightmare if they hadn't been so awesome.

I hate that "its not my fault because you knew I'd fuck up" attitude. Shes lucky *you* didn't punch her in the face.

Date: 2011-04-01 03:57 am (UTC)
From: [identity profile] pixie117.livejournal.com
As usual, wow. Just so scary...

The Snapple bottle certainly makes me glad I don't drive with stuff between my legs too.

Date: 2011-04-01 08:05 pm (UTC)
From: [identity profile] basric.livejournal.com
I be been guilty of doing it myself, not thinking about the air bag. But I do not any more. Thanks for commenting.

Date: 2011-04-01 05:54 pm (UTC)
From: [identity profile] lawchicky.livejournal.com
Wow- you always have the scariest hospital stories!

Date: 2011-04-01 06:04 pm (UTC)
From: [identity profile] basric.livejournal.com
Thanks for reading & commenting

Date: 2011-04-01 08:07 pm (UTC)
ext_289215: (Default)
From: [identity profile] momebie.livejournal.com
I keep trying to come up with an appropriate comment, but all I can do is echo the faint cries of 'AGH, SNAPPLE BOTTLE'. D:

Date: 2011-04-02 04:05 am (UTC)
From: [identity profile] basric.livejournal.com
I understand, thanks for commenting.

Profile

basric: (Default)
basric

September 2013

S M T W T F S
1234567
891011121314
15161718192021
2223242526 2728
2930     

Most Popular Tags

Style Credit

Expand Cut Tags

No cut tags
Page generated Jan. 18th, 2026 07:04 pm
Powered by Dreamwidth Studios