basric: (basric candle)
basric ([personal profile] basric) wrote2011-11-05 04:39 am
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LJIDOL SEASON 8 PROMPT 3

Welcome to week three


PROMPT: CORPORLITE
Middle-age Crisis versus Granny Raptor

John stood with three high school friends in the center of the rock quarry. Twenty years and 25 pounds ago they’d scaled the rock sides finding hand and foot holes as they went, no gear back then, just hands and feet. As they reached the top they’d heft themselves over, run to the back of the quarry and jump a hundred feet into the icy quarry lake below—good times.

Now the quarry lake was gone to evaporation or re-absorption into the earth and erosion had filed away the handholds.

He’d added twenty-five pounds and yes, he wasn’t a kid any more, but by damn he could climb the gravel heap to the top. His friends, two who were now fifty pounds over-weight and his single friend who was still athletic marched toward the heap -- a hundred feet of loose rock piled against one granite wall. . .his wife called out for him not to be a a damn fool, when she said he was getting a little paunch she meant he needed the gym not do some idiotic stunt. It just made him even more determined. He shot the wives a dirty look when his friend Tom's wife yelled out asking if his life insurance was paid up to date then laughed hysterically.

At the base the four look up, up, up. “Are we sure about this?”

“Well I am,” and John began his ascent. The others followed. A third of the way up two of the most over-weight gave up and slid back to the granite floor. John and Dave kept climbing. John felt a rush of adrenaline as he neared the top. . .he’d show his wife, he reached for the grassy top to pull himself up and over, thinking he was going to lay and look at the sky until his wife drove up here and got him.

He didn’t have it in him to make it back down. It was hard to breath and his heart was trying to escape from his chest. Unfortunately the grassy edge crumbled beneath his fingertips and he felt his footing slip and he started the terrifying slide a hundred feet down the mountain of crushed granite rock.

Paul made a grab for him but missed.

Though it happened in seconds, it seemed forever for John since he felt every tiny shard of granite embed itself beneath his skin. About halfway down he tumbled over on his back, so now the shards had new soft points of tissue to enter. He covered his face and prayed.

John would have ended with a granite rash and embedded rock and a trip to the an E R., but when his feet hit the granite floor he flipped in the air and landed with great force backwards his head thrown back the single little sapling that had taken root in the quarry, broke up his fall and now a stake of sapling trunk impaled him to the ground in the right side of his neck.

As LifeFlight took off to retrieve John, things in trauma were prepared.

My wonderful boss, who hires people for reasons known only to herself, hired a seventy-two year old nurse. She was VERY old school. She still wore her white dress, white hose, white nursing shoes (no cross trainers for her) and even her nursing cap. She refused to wear the black and gold of the unit. She was rigid, did not approve of change of the last fifty years or any manner in which the Trauma unit was run. She didn’t walk—she shuffled bent over.

My beloved boss put her on the regular trauma floor—patients start in Triage, surgery, ICU Step Down then end on the Trauma floor before going home. We are self-contained department, so you reach each unit by making the huge circular floor. She had been told when things were slow for her she could lend a hand elsewhere.

Tonight in triage I have three externs (the nursing equivalent to interns) the clinical part of their Master Degrees. Our head resident tonight was a very competent Asian doctor, Dr. P. We were gowned and ready. I reminded my girls they did not touch unless the resident or I instructed them specifically.

John was brought in, leaves still dangling from his sapling. He was conscious and talking. His clothing was bloody, we cut everything away. Paula came to assist placed the Foley catheter and instructed the externs on how to remove the shards, drop into the metal bowl irrigate, pat dry and if no bleeders, spray the antiseptic and use the hospital superglue to pull the gashes together then steri-strip them (special short pre-cut strips of tape). If they find a bleeder let the resident know. There were dozens of shards to be removed.

I assisted with intubation and sedated the patient, while the resident, reluctant to put a Central line in his left subclavian, because of the position of the aorta, placed a PICC line (peripheral intravenous catheter) in his left Brachial vein in his upper left arm.

Into the midst walks let’s call her “Granny Raptor”.

“Gown or get out, you are going to contaminate the sterile field.

Dr.P. and I trimmed the stake through his neck while trying to keep it stable. He had arrived with a neck cushion holding his head back and secure. (FYI if you are attacked by some knife wielding lunatic throw your head back. This moves the carotid arteries and jugular veins on both side of the neck back, this is why assassins pull the neck forward, they can use a thin stiletto and make a quick kill.)

When John fell back—-he was very lucky. No severe bleeding just capillary blood from the puncture, the sapling either missed the vessels or scraped into them and were keeping them sealed. I registered the oohs and ahs of the externs as they removed this or that sliver of stone. Then the surprised "OH" when the glue worked.

“Granny” looked him over and said, “Waste of your time, he’s as good as dead.” My externs gasped. I exchanged looks with my resident and Paula, thought of her age and swallowed the scalding set down she deserved, “If you want to be helpful go and assist Paula and the girls.

Granny, “Don’t believe in this newfangled glue crap, stitches are what he needs."

I heard my very patient friend Paula’s rarely frustrated voice, “JUST DO WHAT YOU’RE TOLD OR GET OUT.”

I assume she did as told since there was silence. We finished stabilizing the impalement and had the charge nurse call surgery to come get him. “You have fifteen minutes to finish."

One of the externs found a bleeder between his toes and the resident moved to clamp it.

This is about the time “granny” found the hemostat (clamp) on his inner thigh and as she unclamped it said, “What’s this doing here?”

Ever seen a garden hose on full blast dropped—-watched it rise like a snake and spray everyone with water in a whipping circular pattern. That hemostat was clamped on the femoral artery in the field—-forgotten to be noted to us in report by the EMT. About six inches of the vessel was exposed and I’d say the lumen (Hole, tube, inside the vessel) was wide open for the artery rose up like an angry cobra, all six inches and had made at least four circular wide open sprays of blood around the room spattering everyone and everything within reach including walls and the ceiling -- with probably two pints of bright blue/red arterial blood (oxygenated). De-oxygenated blood (venous) is red.

I'd heard Paula yell "Duck" and the three externs went down to the floor with Paula saving them from most of a blood shower.

Still being painted with blood, I handed the resident a clean pair of goggles and a sterile hemostat, John lost another pint while Dr.P. struggled to grasp the whipping vessel and clamp it without destroying the integrity of the vessel. I had a bag of O negative blood hung by then (Universal donor is O-).

Dr.P. removed his goggles, looked at Granny and said in a deceptively mild voice, “Please leave my triage."

She sniffed and huffed and remarked she knew more about medicine before his daddy was an itch in his granddaddy’s pants. I believe the word whippersnapper was used but I'm not certain.

Dr.P. looked at me, “I have been raised to honor my elders . . . but must admit that
woman. . . even my mother would have a difficult time with respect.”

Paula tossed her bloody debris in the trash, “She's dangerous.”

“But that was some fancy moves capturing that artery without shredding it." He bowed to us and retreated to the doctor’s lounge.

We hurried to wash away the blood and change the sheet before the techs arrived to take him to surgery.

I walked the family down to the surgical waiting room, where his wife told me how this started and ended.

“He’s entering that middle-aged crazy stage. I hope this cured him.”

Back in trauma I found “Granny” regaling tales of the horrors of nursing to my young, wide-eyed externs.

She shuffled out to go back to her patients with a nasty look sent my way.

“WOW! She really knows stuff. Fifty years! What do you think of her?”

Taking a sip of coffee I opened the door and looked back at them, “I think she’s one of the last of the nursing dinosaurs edging toward extinction, medicine is about change -- daily, hourly, by the minute, the second and I think she’s prehistoric in her thinking of our purpose in nursing. I think she’s full of coprolite.

“What’s that?

“Look it up.”


The accident is my fictional account based on facts told by his wife.

The final word, our prompt, I am ashamed to say was not in my vocabulary, but the word I actually used was.

I used the prompt instead of something metaphorically because I like to use new words. I wish I’d known it then.

John survived for those who wondered. “Granny” moved the medical floor.

Names were changed and even the Dr.’s initial to protect the innocent and not so innocent except my friend and cohort Paula and she gave me permission.

[identity profile] similiesslip.livejournal.com 2011-11-05 11:21 pm (UTC)(link)
I'm really glad John made it! That's nuts that someone would just unclamp without asking!

[identity profile] basric.livejournal.com 2011-11-05 11:50 pm (UTC)(link)
You would be shocked to know the answer to that. I can't even remember the number of times I've heard, Hey what's this? Why was this on there? Wasn't I supposed to put that in that port, Was I ever that stupid, I don't think so. Thanks for commenting.

[identity profile] gingergirlslove.livejournal.com 2011-11-05 11:31 pm (UTC)(link)
Incredibly wonderful, once again! I'm glad she is out of trauma. I'm also glad John survived. That would be an awful way to go. Sounds like Paula is an awesome friend, and I commend Dr. P on his calmness in his request of her to leave his trauma. I don't know if I would have been that calm about it, although I realize he probably has to maintain a certain demeanor to keep the patient stable.

So...has anyone told you you're awesome today? You're awesome! You are. In my state they are actually trying to pass an issue to reduce the pay for police, firemen, & nurses. They're crazy! NOT THE PLACE TO MAKE CUTS!!! All over the state little signs "Vote NO on Issue 2". I had already decided I would be making sure that I get out there on the right date and do it. This just reinforces that decision. I started some schooling, wanted to do nursing, got tired of the wait list & went for Resp Therapy, then couldn't finish. I'd give anything to be a nurse these days. I was going to do ER, b/c I know I'd want to be in a fast pace environment & not "just doing rounds". I've learned from reading your work that triage is more specifically what I want, I just didn't know the term yet. That's awesome! Thank you so much for sharing!

[identity profile] basric.livejournal.com 2011-11-05 11:44 pm (UTC)(link)
The one thing I'd change in fact if I weren't forty I'd still do it. First get your RN, then specialize in a masters with Emergency medicine , and take the paramedic course. That's the one thing I didn't do.Then I could have done LifeFlight,

An easy way to get into trauma is while in your second year of nursing school find a teaching hospital, get a job as a tech on the floor. That guarantees you an RN position and you know the floor.

Then you can write your own ticket, I make $35 hour $50 over 40 hours bringing home over $1500 A week.
I do travel nursing making $59 to $75 straight pay for 40 hours time and a half for over 40. Plus per deim.

Up north the money is even better, the problem is with baby boomers retiring they are over half the nursing force there is going to be huge shortage in a few years.

Thanks for the kind words, I almost took a bye since I lost a day and had to write in between patients last night and try to edit it. I was afraid it was horrible and expect tickets from the grammar police.
Edited 2011-11-05 23:45 (UTC)

[identity profile] sweeny-todd.livejournal.com 2011-11-05 11:46 pm (UTC)(link)
this is really well told! a great read.

(given I made 2 spelling mistales in 8 words I have no judgements about any typos. I didn't even notice any, or grammar stuff :-)
Edited 2011-11-05 23:48 (UTC)

[identity profile] basric.livejournal.com 2011-11-05 11:57 pm (UTC)(link)
You are very kind, thanks for taking time to comment.

[identity profile] imafarmgirl.livejournal.com 2011-11-06 12:07 am (UTC)(link)
Great story as always. It amazes me how many of these people live after such horrific accidents, plus in this case a really stupid medical person.

[identity profile] basric.livejournal.com 2011-11-06 12:34 am (UTC)(link)
As I said before people amaze me at ways the find ti inure themselves. This guy hand an angel with him and a devil. The only sapling in the area and he falls on it, the guy has a thick neck so it misses his vessels and larynx and esophagus.

And you wouldn't believe the number of incompetent nurses out there. There's a nursing shortage so they don't get the time with a mentor they need to be fully trained.

Thanks for commenting.
Edited 2011-11-07 18:38 (UTC)

[identity profile] iamthesea.livejournal.com 2011-11-06 02:17 am (UTC)(link)
I'm so glad to read that John survived :)

And yet again, I loved your entry!

[identity profile] basric.livejournal.com 2011-11-06 03:53 am (UTC)(link)
It is nice to write a happy ending occasionally. Thanks for commenting.

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[identity profile] irishrosedkm.livejournal.com 2011-11-06 02:40 am (UTC)(link)
talk about an oops moment. "What's this hemostat doing here" *unclip*

[identity profile] basric.livejournal.com 2011-11-06 03:35 am (UTC)(link)
I wish it was the only time I'd seen it happen. Thanks for taking time to comment,

[identity profile] majesticarky.livejournal.com 2011-11-06 05:03 am (UTC)(link)
That nurse sounds very old-fashioned and strict, but she can really get the job done. I like how you gave background for the patient.

[identity profile] basric.livejournal.com 2011-11-06 03:50 pm (UTC)(link)
Medicine is abut constant change. If you aren't willing to change your are eventually going to kill someone, thanks for commenting,

[identity profile] myrna-bird.livejournal.com 2011-11-06 07:45 pm (UTC)(link)
Once again you have given us a fabulous story with lots of details of your trauma work. I think your 'Look it up' ending was splendid!

[identity profile] basric.livejournal.com 2011-11-06 09:28 pm (UTC)(link)
You are very kind, thank you.

[identity profile] noodledays.livejournal.com 2011-11-06 11:36 pm (UTC)(link)
I'm so glad to hear John made it too, despite "granny" and her meddling.

[identity profile] basric.livejournal.com 2011-11-07 01:07 am (UTC)(link)
Thanks for reading and taking time to comment.,

[identity profile] shimmerdream.livejournal.com 2011-11-07 01:35 am (UTC)(link)
I really enjoyed this, I liked how you told the story from both John's and your point of view. I'm also glad that John survived :)

[identity profile] basric.livejournal.com 2011-11-07 06:36 pm (UTC)(link)
It was suggested I add a little structure--not just trauma, I wasn't certain it would work. Thanks for commenting.

[identity profile] whipchick.livejournal.com 2011-11-07 05:01 am (UTC)(link)
Fascinating! Love the detail about the assassin, too. You remind me how much I loved the Sue Barton books growing up :)

[identity profile] basric.livejournal.com 2011-11-07 06:16 pm (UTC)(link)
You RE VERY KIND, THANK YOU SO MUcCH AND for TAKinG THE TimE TO COMm4nNT. (CAPS lock ProBLEM. nOT scrEAMING

[identity profile] cloworora.livejournal.com 2011-11-07 10:15 am (UTC)(link)
For once, I didn't feel clinically depressed simply by reading your entry. That's an improvement; you have no idea. As always, you have very interesting stories. Kudos.

[identity profile] whirlgig.livejournal.com 2011-11-07 04:52 pm (UTC)(link)
I know exactly what you mean!!

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[identity profile] whirlgig.livejournal.com 2011-11-07 04:51 pm (UTC)(link)
Another great entry; I loved the description of the artery-very lifelike!! I hate nurses like the one you described and it makes me sad that I hate tem but Paula is right, they are dangerous.

[identity profile] basric.livejournal.com 2011-11-07 05:22 pm (UTC)(link)
As the nursing force diminishes it's going to get scarier and scarier. Thanks for reading & commenting.

[identity profile] jem0000000.livejournal.com 2011-11-07 09:38 pm (UTC)(link)
Poor guy! I'm glad he lived.

[identity profile] basric.livejournal.com 2011-11-08 10:11 am (UTC)(link)
Middle aged crazy. Lucky he survived. What was he thinking. men! Thanks for taking time to comment.

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[identity profile] rabid1st.livejournal.com 2011-11-07 11:34 pm (UTC)(link)
Whoa! Talk about drama. I'm glad to hear the "John" survived and "Granny" was moved to a less critical floor.

[identity profile] basric.livejournal.com 2011-11-08 10:04 am (UTC)(link)
Thanks for reading & taking time to comment. means a lot to me.

[identity profile] blythe025.livejournal.com 2011-11-07 11:50 pm (UTC)(link)
My jaw kept smacking against the floor as I read this. What a story. Wow. I'm glad the guy made it.

[identity profile] basric.livejournal.com 2011-11-08 10:02 am (UTC)(link)
Thanks for reading and taking time to comment,

[identity profile] solstice-singer.livejournal.com 2011-11-08 12:17 am (UTC)(link)
People shouldn't be climbing huge rock piles. This just doesn't sound like a good idea. I'm glad he survived though, and that the nursing dinosaur left your floor.

[identity profile] basric.livejournal.com 2011-11-08 10:00 am (UTC)(link)
People do really stupid things. You would not believe. Thanks for taking time to comment. Always appreciated.

[identity profile] phoenixsansfyr.livejournal.com 2011-11-08 01:20 am (UTC)(link)
Ah, I love the nurses who refuse to lose the old white caps.... Not. Sigh.

And yes, let's remove the clamp from something that is probably protecting something IMPORTANT. I absolutely HATE arterial spray.

[identity profile] basric.livejournal.com 2011-11-08 09:57 am (UTC)(link)
Covered head ti toe you still end up with blood on your skin. The neck is particularly vulnerable. And arterial spray is so very fast, its hypnotizing and deadly.I blame the EMT as much as the dumb ass nurse. Thanks for commenting.

[identity profile] ariesathena.livejournal.com 2011-11-08 04:21 am (UTC)(link)
I really love reading your stories every week! Even if they're starting to make me a little scared of the ER with people like "Granny" running around...

[identity profile] basric.livejournal.com 2011-11-09 04:39 am (UTC)(link)
Be afraid, be very afraid.

Thanks for commenting.

[identity profile] sarcasmoqueen.livejournal.com 2011-11-08 03:57 pm (UTC)(link)
Wow! Just... wow. That was very well written, and it totally made me want to bitch slap Granny!

[identity profile] basric.livejournal.com 2011-11-08 08:26 pm (UTC)(link)
Thanks for reading & taking time to comment.

[identity profile] karmasoup.livejournal.com 2011-11-08 04:13 pm (UTC)(link)
I would say yours is a very interesting world, but, really, that's no surprise. I have in my life been surrounded by members of the nursing world (as in, more than 5 family members), and we are never left wanting for dinner conversation (though some of it mght not go over very well at other family's tables!).

[identity profile] basric.livejournal.com 2011-11-08 08:25 pm (UTC)(link)
It is really something when a group of nurses go out to eat we try to remember the people around us. My family cannot stand to hear anything medical st all

Thanks for commenting.

[identity profile] wolfden.livejournal.com 2011-11-08 06:41 pm (UTC)(link)
I always love your entries.

Glad John survived and glad "granny" went elsewhere.

[identity profile] basric.livejournal.com 2011-11-08 07:58 pm (UTC)(link)
Thanks and thanks for commenting.

LJ Idol Posts of Note for Week Three

[identity profile] pingback-bot.livejournal.com 2011-11-08 07:30 pm (UTC)(link)
User [livejournal.com profile] blythe025 referenced to your post from LJ Idol Posts of Note for Week Three saying: [...] s entry [...]

Re: LJ Idol Posts of Note for Week Three

[identity profile] basric.livejournal.com 2011-11-09 04:39 am (UTC)(link)
Thanks for the rec

[identity profile] draconic-rogue.livejournal.com 2011-11-08 10:26 pm (UTC)(link)
Nice use of the prompt! I'm really glad to hear John survived.

[identity profile] basric.livejournal.com 2011-11-09 03:17 am (UTC)(link)
Thanks

[identity profile] sorchawench.livejournal.com 2011-11-08 11:21 pm (UTC)(link)
Sometimes it seems like you have the worst luck with nurses. Great entry!

[identity profile] basric.livejournal.com 2011-11-09 03:55 am (UTC)(link)
I have a lot of great one too I just figure the bad ones make for better reading(+ Thanks for commenting.

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