Saturday, December 30, 2017

The Show That Never Ends

So, with the entire hospital full and packed to the rafters this week, X number of E.D. beds, and 4X number of waiting room patients all friggin' night, I walk into my shift after clocking in early, because of the page of a violent patient in the E.D.

Four hard restraints, three assaulted staff members, two police responses, one bite mark, and a cuckoo in a bare room later, and that issue is settled while the meds kick in.

Oh, and no points for guessing who's getting that patient as part of their assignment.
So as the night wears on, Fate has firmly tattooed her heelprints on my backside, because I'm getting my ass thoroughly kicked, and even though we're closed, we get a call we can't turn away, for a STEMI inbound in 5 minutes.

And I'm also doing the critical beds tonight.


That'll be me in the white tonight.

So our patient arrives, with the paramedics having done damn near everything (mad props, guys), he's got a STEMI on the field 12-lead, tombstones on the 3-lead monitor, and a STEMI on our 12-lead. And a classic CP presentation. So we're pretty sure it's a heart attack. We dotted all the "I"s and crossed all the "T"s, and we're just waiting for the cath lab doc's arrival to move him over, when the little stinker patient codes. Fifteen seconds of compressions and one defibrillation later, he's back, with the wife biting her fingers off watching, and off he goes to cath lab, finally.

Where it turns out he's got one coronary artery 99% occluded, and another distal one that's at 90%, both of which they stent.

So as I leave, the family is in the ICU waiting room, and I've already talked to his ICU nurse, where the patient is smiling and joking with the nurses, and liable to get a few more decades with his family, after getting to the hospital just in time.

Because everyone from the paramedics to the E.D. to the cath lab to the ICU are badass rockstars, on their "A" game.
And I get to leave the family with smiles, instead of tears.

That'll be me as I walk to the parking lot that morning end of shift.

Saturday, December 9, 2017

Stream Of Subconciousness

welcome to Hell I'll be your tour guide I love the sound of a waiting room full of screaming babies at the beginning of the shift because at least you know it has to get better everything's done on all your patients but the entire hospital's full so let me make sure everything's really all done oh look, a few details missing hey we're just waiting for beds and waiting for beds and waiting for beds and I don't know how long it's going to take another call light ma'am the alarm goes off because you keep bending your arm and playing with the pulse ox why haven't I sent my patients up maybe because you gave us bed assignments that still have the old patients in them oh hey they moved all their patients out now so all your beds are ready simultaneously but you'll have to transport them all yourself because we have no tech and there's no transport are you ready for report see you in five minutes are you ready for report see you in ten minutes are you ready for report see you in twenty minutes are you ready for report see you in about half an hour tell triage all my beds are empty clean and ready for the next batch ready for your lunch break see ya so we loaded up all your beds but one full arrest found down doing cpr eta five minutes out they're here PEA stop compressions vfib CLEAR we've got a pulse vfib CLEAR PEA resume compressions pulse check vfib CLEAR we've got a pulse get me an ekg right away doc vfib f**K! CLEAR we've got a pulse vfib CLEAR PEA resume compression pulse check we've got a pulse here's the EKG if that pulse holds we can get them to cath lab vfib F**K! CLEAR pulse is holding cath lab is here yes sir you can go with her there's a waiting area the surgeon will come find you right afterwards ICU is still full so cath lab is bringing the patient back here after they're done surprise the cardiac stuff wasn't the reason at all but your patient isn't going to make it and there's nothing else we can do great I'll just tell dad to explain to the four young kids that mommy's never coming home again with only two weeks from Christmas that should really cheer them all up but the chaplain's here Holy Father, we ask you to please ICU is sending a nurse to monitor your patient until something opens up in the unit, so you can just take care of the other patients you have while the twelve family members are sobbing their hearts out across the hall from the crazy patient we just gave you who decided he's fine and wants to elope because he's crazy whatever and hey look the docs ordered food for everyone and thank god it's two hours until day shift and the waiting room is finally empty and now I only have twelve patients in that room and the one the ICU nurse is taking care of is the only one in there with nothing to worry about if I hear one more heart-wrenching sob I'm going to completely lose it myself and then I'm no good to anyone and why isn't it shift change yet my knees were over tonight five hours ago free at last free at last and how come the shittiest nights ever in recorded history are always the first of three in a row instead of the last one, every single time, forever and Dear God, WHY? WHY? Just WHY...? hug your kids and WTH? how am I ever going to see to drive home when it's so damned dusty inside my eyeballs

So, how was your night?

Some days, I actually get home with enough energy to go do a couple of miles of jogging, have a nice shower, and go to bed.
Other nights, I get home with enough energy for a short bike ride, then have a shower, and go to bed.
And then, thank a merciful heaven not too damned often, are days like today: when I'm putting on the gloves, and beating on the heavy bag until my arms are too numb to hold up, and my soul stops hurting, so I can stumble to sleep from exhaustion, and hope I don't wake up until it's time to get up again for the next shift.