Permission to vent

OK, so this isn't going to be knitting related. I just really need to vent here. Thanks for listening.

So, let me start by saying that work since the move has been good. I am doing agency work (rent a nurse) but doing it all at UNC hospitals (no hospital hopping) AND I am working all the hours that I make myself available. Everyone I have worked with at the hospital has been very nice and welcoming. No problems with coworkers.

Yesterday however I had an "issue" with a physician (of course a physician) at work. First of all, why is it that all Cardiothoracic surgeons are A$$es???? Where in their training do they pick this trait up? Or is it the nature of that specialty that only A$$es would go into it? Maybe all the current A$$es drive all the HUMAN docs out of that specialty. Maybe they all just learn to be A$$es during their work. I don't know what it is but I must say that after 18 (almost 19) years of CT nursing, I have only met ONE CT surgeon who was a decent human being. SERIOUSLY.

So, anyhow, yesterday. Yesterday I got to work and upon receiving report I quickly realized that 1 of my 3 patients was in seriously bad shape. SERIOUSLY bad. Now, problem here being that I was working on the CT stepdown unit and not in the actual CTICU. So, I knew that I had to do some work to a) get this patient better quick or b) get this patient to the unit quick. I went into his room first.

Without getting into all the specifics of the case let's just say that this patient was post-op Thoracic surgery and was now in a state where his respiratory rate had been deteriorating throughout the night and was now coming to a head. Respiratory rate rapid and labored, oxygen status low, obvious pulmonary congestion, decreased urine output, increased heart rate with borderline blood pressure.

As I was finishing getting report, the resident and interns on the case asked me how long he had been this way. I relayed the info I got from the night nurse and the resident was obviously not happy that she had not been fully kept up with the patient's status throughout the night. But she was not inappropriate with me. She told me what her plans where and what she needed from me. The intern assigned to the case and I got to work. (Remember, I have 2 other patients as well).

I suctioned the patient's lungs out, repositioned him upright in bed, removed his nasal feeding tube, inserted a nasally inserted GI drainage tube (to empty his stomach in preparation for his being put on a breathing machine in the ICU), drew stat lab work, had his oxygen changed from a venti-mask to a CPAP mask (gives increased pressure while delivering oxygen to 'force' oxygen into his lungs), did an ECG, gave a stat dose of diuretic and a stat dose of a beta-blocker (for his increased / irregular heart rate), got an xray to verify the placement of his nasal drainage tube AND assessed him completely. After assessing the patient, I informed the intern and resident that the patient was now febrile. I received orders for blood cultures and stat antibiotics (for possible pneumonia). All this while I was waiting for a bed to be available in the ICU.

I had not gotten a bed so I was doing all these things to help this man and keep him stable until we could get him to the unit. I was drawing his first set of antibiotics when the secretary called out to me that the unit nurse was on the phone for report. I called out "tell her that I am drawing her first set of blood cultures and I will call her right back". Reasonable enough I thought since I physically had the needle in this man's arm and was in the midst of drawing the blood when they called.

So, not a minute passes when the secretary calls out to say that my intern was holding on the phone. Now, I am STILL actively drawing blood here so by the time I get done and get to the phone, she's gone. (BTW, this was all in a matter of 2 minutes TOPS - drawing blood isn't a long procedure but 2 mins. is about right). Next thing I know, the secretary tells me (as I am about to call the unit nurse) that my intern had called back to say that my priority should be to get the patient to the unit instead of drawing a blood culture.

Uh, DUH! I didn't have the bed when I started to draw the blood and then I had a needle in the man's vein as the unit called for report. I was NOT going to stop drawing blood and have this man stuck again (for the 5th time). I thought this was strange as the resident and intern I was working with seemed to be very cool and worked well with me in the room. I was pissed.

I called the unit nurse and the first thing I did was explain the above. She said she was cool and that it wasn't me. I started to give report. As I was telling her the events of the previous night the team of MDs came onto the unit. I looked up to see the intern I had been working with mouth the words "I'm sorry" to me and realized that among the group were the resident, a couple of interns and the CT surgery attending (the A$$ of the story).

So, as I am giving report I say something to the effect of "so, obviously he's been going downhill. . ." and the attending interrupts me to yell at me "he needs to be going downstairs (the ICU) instead of downhill!"

I stopped my report, pulled the phone from my ear and said to Dr. A$$ "and I am GIVING report right now" motioning to the phone in my hand and continued to give the report to the nurse. I then hear him complain to our charge nurse that the transfer was taking too long and we needed to be more "expeditious" in cases like these. Didn't we know how sick this man was? AUGH!

Mind you, all the above occurred between 0745 and 0945. 2 hours but a LOT of stuff done in that time. When you are doing all that, 2 hours goes by in the blink of any eye AND my two other patients where on pseudo-auto pilot (thank God for my coworkers).

I was glad to hear the charge nurse say that we had JUST gotten the bed not 10 minutes prior to "Sir A$$'s" arrival on our unit. He went on to say "well then this place needs to figure out how to expedite the availability of beds for these patients" - uh, hello, dipshit - it was YOU who needed to move someone OUT of the ICU to get this patient INTO the ICU since the ICU was full. A$$hole.

Needless to say, both the resident and the intern apologized for the incident and both told me "it wasn't you" and we all know where all the hell came from.

My point is, WHY of WHY do these types of doctors (CT surgeons) always have to be such A$$holes?? I know that nurses don't make all the final decisions with patient care but I can not tell you how many times it's been ME or another nurse who has picked up on some sort of subtle change in a patient's condition which then lead to a change in the patient's treatment.

As PROFESSIONALS, nurses are well educated and trained in patient assessment and care. I get so SICK AND TIRED of all the "holier than thou", God-complexed, egocentric F***ers who think that we sit on our asses and eat bon-bons instead of taking care of our patients.

Who the F*** do they think they are??????


Thank you for your understanding.


p.s. Grey's rocked last night. I knit on Arwen and my Mom will be here in less than 2 hours. Woo hoo!