Wednesday, February 26, 2014

Head colds

I hate head colds.  You know what I'm talking about.  Your nose runs like a faucet with a slow leak.  Your head feels like someone is blowing a balloon up inside your face.  None of your thoughts seem to be clear and you have that nagging, tingling itch in the back of your sinuses that is driving you insane.

That is not an excuse to go to the ER.  Unless of course, you work in the ER.  Then it is not an excuse NOT to go to the ER.  Staffing for a shift is usually pretty tight anyway.  If one person calls in it usually means everyone else has to take an extra patient or two and when patient to nurse numbers go up, outcomes are pretty well correlated to go down.  We all know this.  So just try calling in to work with anything that doesn't involve needing to go to the ER, some other ER because you wouldn't willingly show up at your own (I fear they might create new and inventive ways to use catheters).  Sinusitis?  Bronchitis?  Ha.  We train to not get sick from contacting sick people.  The reverse is true as well.  Besides, as a traveler, I don't get PTO.  Don't work, don't eat. 

Usually you just slog around the nursing station like the zombie you are until you need to go into a patient room and then marshal all your energy so you can appear like a normal human while you work with the patient.  Wash your hands, wash your hands, wash your hands.  Then, as soon as you leave the room, you re-zombie and trudge about your business. 

Then they bring me a code stroke.

This is a patient that has developed symptoms of a stroke recently.  Like, within the last hour.  You see, if you have signs of a stroke, it is a race.  There is a medicine we can give you if you are having a certain type of stroke, but we can only give it to you if we can start it within around 4 hours of the onset of symptoms.  Later than that and the risk outweighs the reward.  The drug tPA essentially dissolves all blood clots and prevents new ones from forming for a period of time.  This can be detrimental to you, so the decision to use it is not taken lightly.

By the time the patient is in the room, they have been in the ED for 40 minutes or so, getting triaged and then taken to CT to rule out a bleeding stroke.  They want the medicine administered within 60 minutes of arrival.  The guy at triage has tried three times to get a line on the patient and failed, they are a hard stick.

So, there are 20 minutes to get two IV's started, administer a stroke scale, get the medication from pharmacy  and about a hundred other things.  Do you think anyone cares about that head cold?  Nope.

I got two lines in two sticks, we beat our target times and got the medicine in...with help from the stellar crew here.  Then I had to stay in the room with the patient for the next hour to make sure nothing more drastic than bleeding from those three missed IV's earlier happened.

So, I'm happy to have a couple of days off.  Head colds suck.

1 comment:

  1. Of course you got two lines in two sticks...because WE are awesome like that! Get well soon.