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- Oct 10, 2003
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It's 0445 a couple of days ago and I'm rounding on my patient that just got moved up from the SICU to the Intermediate Care Unit (IMCU). And when I say "just moved out" I mean I wrote transfer orders at 2000 the night before. According to the chart, the IMCU nurses received the patient at 2200. This particular patient has a few orthopedic injuries to his LE; and by a few I mean distal femur fx, tibial plateua fracture, etc...he has a zipper from groin to maleolus. Now, even though the patient is GCS 9 he can still feel pain, right?
So, I spend 15 minutes checking the chart, chatting up the nurses, and then go examine him. He says he is in a lot of pain. "I'm sorry. When was the last time you had some pain medicine?" "A long time ago. I think it was before I got to this room." I tell him I'll take care of it.
So I go review my orders written 9 hours ago and sure enough, I had written for some pain meds: a PCA, some morphine for break through, some Vicodin. So I go back into the room expecting to explain to the patient he needs to push the little button on the...wait a minute...where is that little button thing?
I come out of the room and the two nurses that are sitting at the computers (1 playing solitaire, the other is surfing to find a cute tank and shorts to match) finally look up and say, "We were yelling at you but you didn't hear us. That patient is contact precautions for MRSA." 😱 I'm thinking in my mind, "You know, that might be something to get off your butt for and come into the room and make sure I hear you! You were really screaming as if my life was hanging in the balance, weren't you?!🙄" After scrubbing myself and stethoscope down, I politely ask if they could put up the usual signs that indicate we need to be a little more careful when we go into this patient's room and touch him. After the initial 😕 look, they were like, "Oh, you're right. We should put that up."
I ask which one of them has my patient... they say the nurse just went down for his nicotine break. So I ask them both if they knew what time the patient arrived. They said 0100. Now I'm irritated. "Well, the chart says right here in this nursing note, 'Pt received at 2200.' Even if he arrived only 4 hours ago instead of the 7 hours ago like it says in the chart, why isn't his PCA hooked up?" "Oh. Here it is," she says as she picks it up off the desk right next to her mouse. "It must have just arrived from pharmacy. He's a GCS 9 anyway...and he was moving his leg around alot so it can't hurt that much." "I understand that he's a GCS 9 and not all there, but he was complaining of pain from the big 69cm incision running down his leg and his multiple fractures. Can you please follow the orders I wrote for my patient 9 hours ago?" And what I want to say is, "How would you like to be treated like that?...or how about if we treated your spouse or another family member like that? You'd be outraged at the indifference and insensitivity.
Fast foreward to this morning....I was rounding on my patient and the nurse announces to everyone as I walk into the IMCU, "Look! There's our favorite doctor" spoken with condescending tone.
Whatever. At least I'm aware of my incompetence and can swallow enough of my pride to ask for help when I don't know the answer to something. And apathetic I'm not. It's not like we're affecting people's lives or anything.
Sheesh!
So, I spend 15 minutes checking the chart, chatting up the nurses, and then go examine him. He says he is in a lot of pain. "I'm sorry. When was the last time you had some pain medicine?" "A long time ago. I think it was before I got to this room." I tell him I'll take care of it.
So I go review my orders written 9 hours ago and sure enough, I had written for some pain meds: a PCA, some morphine for break through, some Vicodin. So I go back into the room expecting to explain to the patient he needs to push the little button on the...wait a minute...where is that little button thing?
I come out of the room and the two nurses that are sitting at the computers (1 playing solitaire, the other is surfing to find a cute tank and shorts to match) finally look up and say, "We were yelling at you but you didn't hear us. That patient is contact precautions for MRSA." 😱 I'm thinking in my mind, "You know, that might be something to get off your butt for and come into the room and make sure I hear you! You were really screaming as if my life was hanging in the balance, weren't you?!🙄" After scrubbing myself and stethoscope down, I politely ask if they could put up the usual signs that indicate we need to be a little more careful when we go into this patient's room and touch him. After the initial 😕 look, they were like, "Oh, you're right. We should put that up."
I ask which one of them has my patient... they say the nurse just went down for his nicotine break. So I ask them both if they knew what time the patient arrived. They said 0100. Now I'm irritated. "Well, the chart says right here in this nursing note, 'Pt received at 2200.' Even if he arrived only 4 hours ago instead of the 7 hours ago like it says in the chart, why isn't his PCA hooked up?" "Oh. Here it is," she says as she picks it up off the desk right next to her mouse. "It must have just arrived from pharmacy. He's a GCS 9 anyway...and he was moving his leg around alot so it can't hurt that much." "I understand that he's a GCS 9 and not all there, but he was complaining of pain from the big 69cm incision running down his leg and his multiple fractures. Can you please follow the orders I wrote for my patient 9 hours ago?" And what I want to say is, "How would you like to be treated like that?...or how about if we treated your spouse or another family member like that? You'd be outraged at the indifference and insensitivity.
Fast foreward to this morning....I was rounding on my patient and the nurse announces to everyone as I walk into the IMCU, "Look! There's our favorite doctor" spoken with condescending tone.
Whatever. At least I'm aware of my incompetence and can swallow enough of my pride to ask for help when I don't know the answer to something. And apathetic I'm not. It's not like we're affecting people's lives or anything.
Sheesh!
