Saturday, January 22, 2011

The joy's of the ICU

This past weekend I was unlucky enough to have one patient plus the admit bed.... which means I am "open for a hit" as we say in ICU terms. If there is a patient that decompensates in the hospital or comes in from the ER and needs to be admitted to the ICU, I am the one to receive that patient. Sometimes its a simple admission... someone we just have to monitor overnight and sometimes it can be a complete train wreck and I spend the entire shift catching up and getting the patient stable and settled in. Well, as luck would have it I ended up getting an admit that night. (I am definitely known to be a black cloud at work) 

It wasn't completely awful but it was busy and it was my least favorite type of patient... neuro. yuck I hate neuro... ok, I don't hate neurology patients... I just don't feel as comfortable with them as I do say... cardiac or CT surgery patients. Every subtle change in an assessment of a neuro patient can mean something very drastic clinically speaking... so you have to do frequent neuro checks... every hour at least. 

Pupils, motor function, sensory, symmetry, alertness and orientation... its exhausting and when you don't get them often it can be a little intimidating. The patient I had was a rapid reponse call from the surgical floor. He had an evacuation of a subdural hematoma (brain bleed) and was now starting to show signs of a change in neuro status. Couldn't talk, wouldn't follow commands... not good stuff and his CT scan showed signs of a re-bleed and a mid-line shift in his brain. 

Long story short... this guy was probably gonna head back to surgery within the next 24 hours. So... it was my job to watch him very carefully for any further changes and then we were to take him back to CT scan at 2:00am to make sure there hadn't been any worsening of the new bleed. Bummer.

So... we call the radiology attending and schedule for the on call tech to come in to do the scan at 2:00am. As I come back from break at 1:45am and I'm prepping the patient to go down to the scanner I hear my friend P. on the phone with the tech... it wasn't a friendly conversation... I could tell she was frustrated by something. Turns out this particular tech who works on call gives everyone a really hard time if you aren't at the scanner EXACTLY when he wants you there... doesn't matter if its 15 minutes before the appointment... in fact doesn't matter if the patient you have is coding and unstable... this guy does not like to be inconvenienced and he will let you know... for sure.

Well... having that in mind... when we get down to CT... I see the tech and I smile and say hello. His response "YOU'RE LATE! I called 20 minutes ago to tell you I was ready! I'm supposed to be scanning the patient at TWO!" 

Wow... ok buddy... you're being a jerk but I'm still gonna be professional and explain that we are here at 2am because that's when the appointment was. He continues to berate P and I about it as we're putting the patient on the scan table... being incredibly unprofessional and rude in front of the patient. At this point I'm starting to get really annoyed too... this guy was rude to my co-worker and is apparently always rude to them and on top of that this guy is getting paid a TON to be an on call tech. I'm thinkin'... if you don't wanna be on call then don't sign up for the job.

Ok whatever... is all I could think to myself.... let's just get this done with right?

Oh no.. this guy had to take it to another level. As we are walking out of the scanner and he passes through the super heavy doors that block out the radiation from everyone else... he SLAMS them in our faces. Hits the automatic shut button and tries to lock us in the scanner!

Oh HAIL no!!! You did NOT just do that?! My buttons were officially pushed and this over-protective, ICU nurse decided she had enough of this guy being rude to her co-worker and friend and especially her patient! For the next 3 minutes of the scan I proceeded to spew an entire monologue about how incredibly rude he was and how it was  "2:06AM and the patient is on the table getting scanned!"

"If 5 minutes is SUCH an inconvenience for you and you cant handle working with an ICU schedule than you are in the wrong profession! It is NOT about you! It's about the patient and I don't care if we are 30 minutes late! If we have a patient that is unstable you WAIT until we can bring them down or you don't be an on call CT tech! I don't care if it's an inconvenience for you... this is about some one's LIFE here!"

Phew... totally did not see that coming. See... I know I can be feisty and all but I don't usually say what I'm thinking to the person... I usually just think it in my head and then go vent about it to a co-worker or friend. Ohhh no... not this time though... this guy made me MAD.

The entire trip back up to the third floor I went off about how that guy was ridiculous and how someone needs to write him up... blah, blah, blah. The best part of the story comes next though. 

By the time we get back to the room and we're getting my patient settled... I'm finally calmed down and P is sharing with everyone how I told off the mean CT tech (not gonna lie I got some props for that one even though I might not have been the most professional about it myself :/ )

Finally I look down at my patient... this man who has not said an entire word or responded to an entire thing I've said the WHOLE night.... I look down at him and say, "Mr. H. have you just been sitting here listening to me complain about this CT tech the entire time?"
The man looks at me and smiles... nods his head and with a slight giggle goes, "haha.. yeah"

P and I instantly broke into laughter.


  1. good for you for telling that guy what's up! he is obviously in the wrong profession, for sure!

  2. Glad you told him off. I stew silently a lot of the time and wish later that I had said something. Way to go :)