Wednesday, November 2, 2011

Even the best of them need a bit of WD-40!

I'm pretty sure if you've read this blog for any amount of time that it is clear I love my job.

I LOVE my job!

One of the reasons is that when people come together in the PICU we work like a well oiled machine. Our team of PICU doctors, nurses, respiratory therapists and nursing assistants just know our role and responsibility and make things happen. It's quite magical : )

Sometimes though, this "well oiled machine" needs a bit of WD-40!

I was reading another nursing blog the other day (you can check it out here) and her post reminded me of times that just make you think, seriously!?

Exhibit A (yes, you can call me Magnum, R.N. today!): Respiratory therapist is doing a breathing treatment in the patients room. She apparently calls out for the nurse (that's me) twice. Loudly. So loudly in fact that a physician walking by asks if everything is ok. When she says "No, I just need the nurse" the physician walks into another patient room where I was doing something important. I'm told the therapist really needs me next door. Upon rushing in there, she tells me "The patient has a poopy diaper. I mean REALLY poopy!!"

SERIOUSLY!?!? You take me away from doing legit patient stuff to TELL me there is a poopy diaper!? Since when am I the only one qualified to change poopy diapers. Last time I check there is all of the diaper stuff at the end of the bed.

And nowhere in my job description does it spell out that I am a diaper changing champion (though I am that good!). Thanks for letting me know. As soon as I'm done making sure the kid next door is breathing appropriately, I'll get right on that poopy diaper!

Exhibit B: Anesthesia brings my patient in from the OR. In order to get them out of the room the quickest, we have to take a temp and tell them what it is. Then they leave, which is nice...really folks, there's only so much space in these patient rooms! Upon taking the temp, I state that it's 35.4C- well gee, there's a surprise. A patient coming from the OR is cold!

The anesthesiologist says, "Wow, this patient needs warming!" Thanks! Good thing you got your big doctor degree, b/c I would never have figured that one out with only my nursing degree!

So I tell him "The warming blankets are right outside the room to the left. Right next to the sink. In the metal warming cabinet." I also threw in "Or we have warming lamps in our equipment room" for good measure, but figured he wouldn't have a clue how to meander over there.

After a few minutes while I'm still getting the patient settled, the anesthesiologist who disappeared for a bit comes back in the room. He looks at the patient and says "Why is this patient not being warmed!?"

To which I say, "Umm, I gave you perfectly good directions to find the warming blankets. Everyone in the room currently has hands on the patient and is actively involved in care. When you walked out I thought you were getting the blankets."

He walked out of the room looking a bit sheepish.

Two minutes later, a near-by nurse walked into our room carrying a big bundle of warming blankets. I looked at her dumbfounded! Apparently Mr Anesthesiologist went into the hall and told the nurse that I was in need of blankets. He never came back in!


Exhibit C: A resident walks into a patient room (oh wow- this could take about 100 different directions, and have equally as many punchlines!). Anyways, the resident walks into the room VERY early in the morning to do her assessment. She un-swaddles the baby that I just got back to sleep after master-swaddling, rocking, and "shushing" back to sleep. The baby of course cries. Scratch that...he screams! And with that, the resident completes her exam and she walks out.

It's then that she tells me, "Umm, your baby is crying. A lot."

Ya Think!?!?

Upon entering the room the patient is flailing around in the crib. With his diaper hanging on by one velcro snap. He is definitely not bundled, and the blanket whereabouts are even yet to be determined! What in the world did this resident DO during the exam!?

And yet, instead of following the motto of Leaving Things As You Find Them (or Better, as my mom always taught me. Or maybe that was Girl Scouts. Either way, its important!) the resident just walks away.

Thanks! Because I didn't seriously just spend 18 minutes trying to get this kid quiet and back to sleep. And because you didn't just ramshackle his entire world in a matter of 2 minutes which will now take approximately 47 minutes to pull back together!

*Unfortunately this resident story could be told in about 25 different ways probably by every nurse that ever lived, replacing the word "resident" with "fellow" "attending" or any doctor for that matter! I have about 30 of my own!


But every great machine needs greased every once and while, right? Certainly, the PICU is no exception.

Once that WD-40 is sprayed on, things begin to move a lot smoother. So is true with the PICU....give us a good dose of nursing calling it like it is and coordinating optimal patient care (b/c really that is the oil in the PICU), and we can go right back into our routine!

What a fine "machine" we are : )

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