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As The Hospital Pervs

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My patient didn't want to sit upright in his wheelchair this morning. Then he didn't want to eat his breakfast, which was really weird. He wouldn't take his meds, either - they just dribbled out of his mouth. I told the LPN, "something is wrong." She thought he was just tired. I got the RN, who took another set of vitals. 37.9-125-22, bp 110/60, SpO2 64%. Yeah, he's just tired. Off to the ER with him, where it took 15L via nonrebreather to get him into the low 90s. He's been admitted to the pulmonary ICU.

The LPN is pissed off because I went over her head. I refuse to feel bad about this, in fact I'm feeling quite proud of myself. His color was fine and he didn't appear to be in any acute distress, but I could tell that something was wrong, and I advocated for my patient. That LPN can go suck a dick.
 
LongDrySpell said:
My patient didn't want to sit upright in his wheelchair this morning. Then he didn't want to eat his breakfast, which was really weird. He wouldn't take his meds, either - they just dribbled out of his mouth. I told the LPN, "something is wrong." She thought he was just tired. I got the RN, who took another set of vitals. 37.9-125-22, bp 110/60, SpO2 64%. Yeah, he's just tired. Off to the ER with him, where it took 15L via nonrebreather to get him into the low 90s. He's been admitted to the pulmonary ICU.

The LPN is pissed off because I went over her head. I refuse to feel bad about this, in fact I'm feeling quite proud of myself. His color was fine and he didn't appear to be in any acute distress, but I could tell that something was wrong, and I advocated for my patient. That LPN can go suck a dick.
Click to expand...
I am glad you know, that you did the right thing, and that you know it was the right thing. :)
 
sweepthefloor said:
I am glad you know, that you did the right thing, and that you know it was the right thing. :)
Click to expand...

:rose::rose::rose:
Thank you! This is the part of my job that I really enjoy, and that I think I'm really good at. Almost all of my patients are nonverbal, but they still communicate. I am the translator.
 
LongDrySpell said:
:rose::rose::rose:
Thank you! This is the part of my job that I really enjoy, and that I think I'm really good at. Almost all of my patients are nonverbal, but they still communicate. I am the translator.
Click to expand...

Sometimes when dealing with silent people, you need to think outside the invisible box.
 
Grandma got moved into extended/ acute care today. Hip is healing well and her spirits are high. The facility is for "OLDER" patients who either need extended rehab or constant care. I was having flashbacks to when my grandfather past away when I was about 5, the wife was in shock because she had never been in a place like that. Both of the kids were with us, so there was a lot of explaining and talking about some of the things that can happen as we get older.

Good news is the nurses already love grandma because she is coherent and motivated to get up and walking. The were pushing her really hard until they realized she is in her 90s and not the 70s that she looks.

On a side note. Any recommendations on how to prevent pneumonia in a facility like that?
 
AKGhost said:
Grandma got moved into extended/ acute care today. Hip is healing well and her spirits are high. The facility is for "OLDER" patients who either need extended rehab or constant care. I was having flashbacks to when my grandfather past away when I was about 5, the wife was in shock because she had never been in a place like that. Both of the kids were with us, so there was a lot of explaining and talking about some of the things that can happen as we get older.

Good news is the nurses already love grandma because she is coherent and motivated to get up and walking. The were pushing her really hard until they realized she is in her 90s and not the 70s that she looks.

On a side note. Any recommendations on how to prevent pneumonia in a facility like that?
Click to expand...
I wonder about things like that with my own family. My parents are separated and I imagine about what exactly will I do when they are older, and possibly needing my care.
Will I have them both at my house to care for them? Will they be throwing applesauce at each other?

Will I be married? Will my husband's parents also be with us?
---

I am glad the nurses love Grandma. The prevention for facility pneumonia: out of bed to the chair, no eating in bed, and breathing exercises like coughing and deep breathing and the use of an incentive spirometer.
:heart::heart:
 
LongDrySpell said:
The ED resident was fucking HOT.

I had fantasies.

:devil:
Click to expand...
I am glad you had some good fantasy! I am pretty mad at our residents this week. They ordered sedation off (to extubate) on a day two well known DTer. I turned my back and the ET tube was out. He sat up in bed in four point soft restraints and ripped the tube out.

With the tube out and sedation off-- the tremors looked like rhythmic waves under the skin. He was re-tubed on night shift for airway protection, and maxed out benzos on top of the maxed out propofol. We know him, he takes a week to detox.
 
sweepthefloor said:
I am glad you had some good fantasy! I am pretty mad at our residents this week. They ordered sedation off (to extubate) on a day two well known DTer. I turned my back and the ET tube was out. He sat up in bed in four point soft restraints and ripped the tube out.

With the tube out and sedation off-- the tremors looked like rhythmic waves under the skin. He was re-tubed on night shift for airway protection, and maxed out benzos on top of the maxed out propofol. We know him, he takes a week to detox.
Click to expand...

i love when you talk medical :)
 
LongDrySpell said:
My patient didn't want to sit upright in his wheelchair this morning. Then he didn't want to eat his breakfast, which was really weird. He wouldn't take his meds, either - they just dribbled out of his mouth. I told the LPN, "something is wrong." She thought he was just tired. I got the RN, who took another set of vitals. 37.9-125-22, bp 110/60, SpO2 64%. Yeah, he's just tired. Off to the ER with him, where it took 15L via nonrebreather to get him into the low 90s. He's been admitted to the pulmonary ICU.

The LPN is pissed off because I went over her head. I refuse to feel bad about this, in fact I'm feeling quite proud of myself. His color was fine and he didn't appear to be in any acute distress, but I could tell that something was wrong, and I advocated for my patient. That LPN can go suck a dick.
Click to expand...

The LPN needs to be slapped upside the head with a plaque that says "Patient care comes first".

You done good.
 
sweepthefloor said:
I am glad you know, that you did the right thing, and that you know it was the right thing. :)
Click to expand...

Balladeer08 said:
The LPN needs to be slapped upside the head with a plaque that says "Patient care comes first".

You done good.
Click to expand...

:rose::rose::rose:Thank you!:rose::rose::rose:

I actually got credit for the catch today. That never happens. From my nurse, my supervisor, two of our own docs, and the hospital's respiratory therapist and general med attending. The hospital doc even used it as an example to the residents and students on rounds with her this morning. (I got assigned to go up to the hospital and "advocate" this morning - since our patients are all nonverbal, we send a CNA who knows them to accompany them when they are hospitalized.)

I know I'm bragging here, but the CNA never gets credit!

Also, it makes the rejection letter I got earlier in the week sting just a little bit less.
 
sweepthefloor said:
I am glad you had some good fantasy! I am pretty mad at our residents this week. They ordered sedation off (to extubate) on a day two well known DTer. I turned my back and the ET tube was out. He sat up in bed in four point soft restraints and ripped the tube out.

With the tube out and sedation off-- the tremors looked like rhythmic waves under the skin. He was re-tubed on night shift for airway protection, and maxed out benzos on top of the maxed out propofol. We know him, he takes a week to detox.
Click to expand...

We've had some residents like that. Yes, you have your shiny new medical degree, but we know the patients.

Maybe it's just me, but it seems like the D.O.s are better about that sort of thing than the M.D.s.
 
Oh joy. I'm wasted with a bunch of nurses, and we are looking for the lactated ringers. WhAt a bunch of assholes.
 
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