Friday, July 2, 2010


When your patient has a blood pressure of 69/30 with a MAP of 49 and you've given 3 liters of LR to no avail.....

Time to try something new?

Maybe... just a suggestion.

Apparently the new team of residents we've got didn't agree, so I stood there with an absolutely awful, compelety unmanageable, horrendous assignment with two sick, intubated, unstable patients and watched as my patient was on the verge of coding.....
thank God she was being completely 100% paced.

My redemption?

Our wonderful attending...ugh can't say enough great things about this man...
comes in and notices how flustered and angry and frustrated I am and asks me ever so gently...

"Are we doing anything for her blood pressure?"

I smiled...that, "im-not-happy-with-this" smile

"Yes, we are on our 3rd liter of LR"

(this woman is so small that her lungs are probably already backed up with fluid at this point)

"How long has the blood pressure been like this?" Dr. M is looking concerned now.

"Oh about two hours, I've been asking them to start some type of pressor but they want to continue to give fluid." I continue to smile.

He looks at me and gives me that nod that says everything I needed to hear without words...

"We will take care of this in just a few seconds here." Dr. M gives me a quick pat on the back and heads off to round up the docs.

"Thank you!"

I just need to acknowledge how thankful I am for doctors who listen. How thankful I am for doctors who treat nurses like they are an integral part of the medical team and who don't treat us like we became nurses because we were too stupid to go to medical school.

Don't treat me like I'm an idiot and I won't give you attitude... capisce?

I've been finding myself really frustrated with a lot of our docs recently.... product of being in a teaching hospital I guess... but I have to step back and just say out loud (or to the internet) that I do have some really incredible physicians in my hospital. Interns to attendings... there are good ones all along the ranks and for the most part every single one of our attendings are wonderful.... our surgeons are amazing and I feel honored to work with them.

Its days like this that I have to stop and remember that... not all of them are bad, in fact many if not most are great.... and for the times where it seems like there are only the bad ones around... well that's where the Dr. M's come in. :)


  1. I can imagine how frustrating that would be. Happens to me too in the dental field, but it's a lot less life threatening when I'm dealing with cavities and such rather than blood pressure and breathing issues. :)

  2. First time commenter. :)

    As a patient, and the mother of kids who have been patients at one time or another, I have already learned my lesson that 9 times out of 10, the nurses know as much (usually more) than the doctors.

    Case in point: I was rushed to the ER (teaching hospital) one night several years ago with bladder retention. Had been straight cath'd by a doc that day, given meds, but physically could not GO, and was in a lot of pain. The nurse gets a catheter in me with a quickness while two residents "play doctor". (Sorry, that's what it felt like!) At one point, the nurse cuts the catheter off, and one of the residents asks - sounding very annoyed - what she is doing. And then she calmly tells them that if they pull any more fluid out of me that quickly, I could go into shock.

    Cue residents frantically checking my pupils with their pen lights. It was so stupid that it was funny after the fact, but I can only imagine the frustration that that poor nurse felt.

    My apologies for the super long comment, but some of us patients know that you guys are usually the most knowledgeable in the room. ;) I'm glad that there are doctors that know that as well!

  3. Welcome naturally single mom! Loved the long comment :) I always appreciate people who value nurses and see just how hard we actually work and how much we do know! Thanks for stopping by!

  4. You know I love the nurses, Andi! :)