patient-care

today was the shift that broke me.

I spent the past 48 hours questioning whether I should actually be a nurse. Wondering if I actually ended up in the entirely wrong profession. 

I cried today at work. Completely broke down. I looked at my coworker and confided that I hate being a nurse. I was just so sick of all the *bullshit* that seems to grow by the moment on our floor. We are so critically understaffed that we are simply treading water every shift. NOT caring for patients; we are simply treating them. Unable to take the time to truly personalize their care. It is beyond frustrating. 

I have 4 days off from work. And I’m going to spend those 4 days desperately trying to remember why I chose this profession in the first place. 

Right now I just feel broken. 

↳ Bold what applies to your muse!

Natasha Romanoff/Black Widow

╳ Flaws

moody | short-tempered | emotionally unstable | whiny
controlling | conceited | possessive | paranoid | lies
impatient | cowardly | bitter | selfish | power-hungry
greedy | lazy | judgemental | forgetful | impulsive
spiteful | stubborn | sadistic | petty | unlucky

♔ Strengths

honest | trustworthy | thoughtful | caring | brave
patient  | selfless | ambitious | tolerant | lucky
intelligent | confident | focused | humble | generous
merciful | observant | wise | clever | charming
cheerful | optimistic | decisive | adaptive | calm

TAGGING: @stealthsuitofsin @jerseysass @the-mjolnir-owner @khakeravdova @ask-the-assistant-darcy @hoouna @techmaestro @thatiscolonelrhodestoyou @guiltybydissociation @lilxlionxman

TAGGED BY: @ouronlyhope

Repost,don’t reblog.

Act. No Matter What.


We are just going to keep coming back stronger…


EVERY.


SINGLE.


TIME.


The Senate is on the verge of voting to demolish health care for millions and cut off Planned Parenthood patients from care. Let’s keep their phones ringing off the hook. Call your senators now and tell them to stop this bill.


Call 202-804-8210 or use the form on this page to call your U.S. Senator.

Exclusive art made for Planned Parenthood by Tumblr Creatr Gabby Sanchez
Patient Care

This may well be a rant but something that I feel needs to be made very clear is that being a paramedic is more than skills and knowledge. Just because you are trained in pre-hospital emergency care does NOT make you exempt from being caring because you’re “not a nurse” (and oh how I hate that statement, but another time).

If you’re doing a transport right before your shift ends and your 80 something year old patient has their catheter removed and has blood running down their arm, clean it up. Respectfully. The extra two minutes it takes to take their watch off, wipe their arm and wrap them back up so they’re warm before you go outside is NOT a waste of your time. Talking to your patient while you do things is NOT “above your pay grade”. We are there to care for people.

The reality is that paramedicine is a community based role. If you want to excel as a clinician then you need to cover all aspects of your job, from assessment to treatment to patient interaction to cleaning up after yourself. Obviously there are times where it’s not appropriate or possible to do so (ie. emergencies, unsafe scenes) but choosing to leave your patient cold, uncomfortable, messy or distressed rather than try and alleviate where possible it is absolute crap. 

Be better than a robot. 

1st House - your Ascendant, your worldwide persona

Aries Ascendant - outspoken and very sensitive. They are called warriors of the zodiac and for a good reason. They always fight to the end for the cause they believe in and will do everything what it takes to win (literally). They are really smart and inventive. They like to instigate things and cause drama. They never take your advices. Honest and stubborn. They tend to take things to their heart (except advices) and they easily get offended. They crave romance and true love but they are way more shy about those things than people think. They really can get shy in love! But they want to be always considered strong so it is hard to see that side of them. They have a tendency to delete people from their life too fast, without giving it a second thought. Strong minded. Helpful. Sassy. They easily get jealous of others.

Taurus Ascendant - protective and sexy. Their presence is not that intense like Scorpio but still they are visible and hard to miss. Very sensual people. Their sexiness is more subtle and their beauty is very earthy like. They go back and forth with being economical and  impulsive with spending money (they might buy things they think they need when they really don’t). They are argumentative and tend to instigate things. They are really protective of their surrendings and people. Generous with their time and money unless you make them doubt your intentions. They can be very cold, calculative and emotionally detached when they need to be. 

Gemini Ascendant - funny and welcoming. They are very warm and always make people feel good with them. They will help you with opening up. They can be flighty and overly dramatic. Emotional people. They love diversity in every form. They love to learn new things and help other learn it too. Very helpful, they really want you to feel good around them. They do not want to negativity win over positivity. They can find hope and good in people everywhere. This does not mean that they are naive, no - they are very observant people and very smart. They need a lot of changes in their life. Freedom is their stability. They despise routine but they need it a little bit more in their life to keep their restlessness away from them.

Cancer Ascendant -  caring and proactive. They get things done. They are very emotionally and mentally strong. They really can get through a lot and stand still. Patient and caring, they treat their friends as their family members. They will always make sure that you will know how much they love you. They have good intuition and are people smart. They are creative and may appear more innocent that they really are. They will always encourage you to be better. They are very hard-working, they make sure to do things the best they can. Very goofy (when they feel comfortable with you). If you break their trust they will get very cold, logical and ruthless. They will call you out on the things you have done. They will never forget.

Leo Ascendant - generous and witty. Very loving and protective of their loved ones. The unique mix of softness and strength. The royal baby. They will rather die than let you win an argument. They tend to forget about their own worth and look for validation in the wrong places. They are very detail oriented about how they want to appear to the world (especially when it comes to their fashion choices). Creative, smart and devoted to their own art and style. They do not like changes and can be too much stubborn to admit that they need them. Very sensitive but they have amazing fighting spirit.

Virgo Ascendant - competent and charming. They are very sophisticated. Naturally smart, patient and observant. They have a lot of hidden charisma. They know how to act in social situations and keep their image clean. Creative. They are emotionally self-sufficent and they keep people at distance but they know how to appear friendly and welcoming. Other people may often come to them for their knowledge which they like to share. They usually have god complex and dislike when people act like they really know them. They like competent people. Meticulous and can be mean. They want to show the best of them to the world. 

Libra Ascendant - thoughtful and intuitive. They care about justice and balance and they can easily sense when something is “off”. They are really good at finding solutions. Impartial, they look at two sides before judging. They are people smart and helpful. Emotionally strong but when things go wrong they rely more on logic than emotions. They can get cold and distant when they feel they cannot trust someone. Trust is really important for them. If you break your word to them they may forigve you but will never truly forget. They are stylish, aesthetically pleasing and easily make people like them. They can become the ultimate queen b. They get things done and they do not like to sit and wait for things to escalate. 

Scorpio Ascendant - passionate and watchful. The infamous “mysterious and intense” ones. They definetely bring a lot to the table. They do not care much about others opinions but others tend to care about theirs. Beside the obvious sexiness, strong aura and intensity they have a lot of sensivity and thirst of knowledge inside of them. They like to discover secrets of the world and they are really good at it. They are careful and like to plan things. They observe people and rely on their instincts when judging them. They like to laugh with others and be more laid-back and goofy but only with those who gained their trust. They have strong convictions that they know how to defend. They are really caring and generous, they have this softness inside of them which they always choose not to show to the world. They are true fighters; they will not back down and run away from a fight but they really not aim to create everything into the battlefield. Ambitious, smart and really adventurous people.

Sagittarius Ascendant - jovial and intense. They have strong, warm aura that that attracts others to them. They are extra about every aspect of their life. Bold, independent and sometimes a little bit intimidating. They make a conscious effort to be funny (they prefer things be kept this way) but they can get serious very fast and when they do they become scary. They have short temper and sharp tongue. They will not tolerate any baloney. They will scream about it to the world if they have to. They will make a fuss about something but five seconds later they will act like nothing happened. They prefer to look at the bigger picture but still will check every little detail. They really do not know how to deal with sadness inside of them so they choose to ignore it and keep themselves busy on something “more interesting” than negative feelings.

Capricorn Ascendant - bold and confrontational. They do not back down from a challenge an actually are more drama prone that they will admit. They are passionate and very emotional but they do not show it easily to the world. They are diligent and prefer to keep the image of  professionalists. Independent, sassy, curious and smart, they know how to handle things. They despise incompetence but they are more forgiving if this incompetence come from other people and not themselves. They like affection and compliments especially about achievements, less looks. They are constantly misunderstood and people try to simplify them to being heartless workaholics but they are way more complex. They tend to be more confident when they got older, they need some time to asset themselves in the world but when they do they become ultimate bosses.

Aquarius Ascendant - serious but charming. They are a unique blend of a social butterfly and strong individualist. They like people and spending time with them but they also need a lot of solitude. They often feel outcasted because of their contrasted personality and are considered weird. They are not weird - they are just unapologetic about who they are and you have to deal with it, whether you like what you see or not. Aquarius will not change anything about themselves to make things easier (even when they crave to be understood they will stand still with who they are)They are very curious and have many interests. They need some time to really open up but when they do you can see their passionate, vulnerable and caring side. They really like and need affection. They are smart and blunt. They appreciate unconventional forms of romance. 

Pisces Ascendant - smart and incomparable. People see them as this weird, sad guys, who do not comprehend a normal human language. This is not true - they are complex and have many sides to them to show to the world. They easily get inspired by everything around them. They think they know how to blend in but the truth is that somehow they always stand out. They are intelligent, have unique sense of humour and way of looking at the world. They are brave, can get very argumentative when someone is talking about things they are passionate about. They can be both very logical and emotional, serious and goofy, loud and quiet. They are never one thing, they could never choose to be one. 

Hospital Jargon (as explained by an American floor nurse)

Writing something that takes place in a hosptial? Consider this list of phrases to add a sense of realism:

HOSPITAL LIFE:

Report/ in report: When one nurse hands their patients off to another

PACU can f*ck right off until 1930, we’re in report.

Sign-Out: When one doctor/resident hands their patients off to another

*returning page* “Are they dying? I’ve barely gotten sign-out here

EPIC- Electronic charting system. Literally any electronic charting system. Does not have to be Hyperspace/supplied by the EPIC corporation to be called this.

Hey, could you put those vitals in EPIC for me since you’re already logged in?

Bed 45/46-2/47-1/48/etc…: how we refer to patients, by their bedspace number, denoted “room-bed”.

Hey Nikki, do you remember what 45-2′s blood sugar was?

Assignment: The patients any one particular medical professional has responsibility for- be they a nurse, doctor, aide, respiratory therapist, physical therapist, etc…

My assignment is rooms 43-45, how about you?

The Board: Where the status of the patients on your floor get listed, including who is to be discharged, who has certain needs, and the day’s expected admissions. Used to be a physical white board, but now is electronic. Usually used to talk about how many patients a floor is about to admit.

“Jeeze, did you see they just put four new patients on our board? We’ve already got 16- call the nursing supervisor.”

Flexed up: Taking more patients than you’re staffed for on a floor

Well, we’re staffed for 15, but they ‘found’ three more bedspaces so they’re flexing us up tonight.

Code/Call a code/They’re coding: A Code Blue. When a patient’s heart stops on The Floor and everyone shows up to practice CPR and transfer them to The Unit.

They’re coding, get a crash cart to 75-2 and call a code blue

Rapid/Call a rapid/Rapid response team: Almost a code, but their heart is still beating. For hospitals who have a separate “Rapid Response” nursing team. Two Crit Care nurses show up and handle things. Also who you call if you and everyone else on your floor can’t get an IV.

They have an INR of 9.5 and the doc doesn’t want to do anything- I’m gonna call a rapid.

Float/they’re floating you: When you don’t have enough patients on your floor so the nursing supervisor sends you to a different, unfamiliar one.

They’re making me float to 9C. Again. Can you believe that??

Full: Can’t take any more patients, either due to physical space or nursing staff.

Tell the nursing supervisor to stop putting patients on our board- we’re full

Clinic: Outpatient. Where you want your patients to be.

Tell them we’ll see them in Clinic in three days. They have no medical need to be here anymore and they know it.

KINDS OF PATIENTS:

Contacts/isolations: Any patients who’s rooms you have to don a gown, gloves, mask, and/or respirator to enter.

Are you sh*tting me? I have five patients today and four of them are isolations.

Frequent flyer- Someone who, for medical or social reasons, just can’t seem to stay out of the hospital

Did you hear Darlene is back?” “Yeah, we’re officially engraving her name on the Frequent Flyer wall of fame

Crump/Crumpy/Crumper: Colloquial term for patients who are medically unstable/at a lower level of care than they need/will be transferred to The Unit when a bed becomes available or when the inevitably code, whichever comes first.

73′s a crumper if I’ve ever seen one. Rapid’s in there working her now.

‘Seeker: Someone in the hospital with their own agenda, but who largely has no medical need to be there and will threaten to sign out AMA (even though they’ve been discharged four times and keep refusing to go) if they don’t get what they want- be it drugs, social interaction, or over-the-top waitressing. Will probably threaten to give a horrible review of the hospital on their social media platform of choice and mention you by name if they don’t get what they want.

49′s a total seeker. When she’s not begging for pain meds, you’re getting her crackers, juice, tea, hot packs, cold packs, everything you could think of. I didn’t sit down all night and my other patients slept pretty much the whole night. Give her some percocet and get her the hell out of here before I have to deal with her again tonight.

Heavy: A patient that takes up a disproportionate amount of your time, but usually for a legitimate reason.

Dr. P’s patients are really heavy. Something’s always going on with them and they have tubes coming out of everywhere that need care of some kind every hour… I had two of his patients today and I’m so tired… could we break up the assignment for the next shift please?

HOSPITAL PLACES:

The Floor: Medical and Surgical floors, sometimes specialty floors- basically anywhere that’s not the ED, Psych, or The Unit. These have higher staffing ratios (more patients per nurse) and lower patient acuity than The Unit

They didn’t really need a bed on the Unit so they were transferred to the Floor

The Unit: The Intensive Care Unit. Where crumpy patients go, comes in the following flavors (though smaller hospitals may have just one): MICU (medical), SICU (surgical), PICU (pediatric), TICU (trauma), NICU (neonatal), NICU (neurological), BICU (burn), and Stepdown (in the days after an ICU discharge).

They weren’t doing so hot, so we called a rapid and had them sent to The Unit.

The ED: The Emergency Department. Oh dear lord it is not called the ER.

They’re sending up that new admit from the ED in like 5 mins, do you have the room ready?

PACU: Post Anesthesia Care Unit, where people are stabilized after surgery.

PACU’s calling again, they’re backing up and need to give report.” 

THE NURSING HIERARCHY:

Director of Nursing: One Nurse to rule them all. Directs all facets of nursing, from training to hiring to staffing to quality improvement.

Nursing Supervisor: One nurse to rule them all… on a given shift. The nursing supervisor assigns patients to nursing units and makes sure everywhere is staffed accordingly.

Nurse Manager: In charge of the general staffing and personnel management of a particular floor, including scheduling, patient satisfaction, staff development, and service recovery.

Charge Nurse/Charge: The “shift manager” of nursing. Has final say on a lot of things you don’t want to be the bad guy on, as well as creating assignments/checking the crash cart, and submitting service requests when the nurse manager isn’t there. Also has a patient assignment.

Staff nurse: The nurses who do assessments, pass meds, start IVs, carry out orders, give updates to doc’s, chart, manage a patient’s day, make sure they get to tests/procedures on time with the right paperwork, and are overall responsible for managing patient care and providing first-line response to issues that arise throughout the shift.

Nurse Aide/Nurse Tech: Provides the majority of basic patient care. Counts intake and output, gets blood sugars and vital signs, sets up rooms for new admits, cleans and clothes patients, gets blood and urine samples, transports patients if necessary. Staff nurses are responsible for this when aides/techs are not available.

Would someone please add the Medical Hierarchy if you know it? I don’t feel I know it well enough to do it justice. Thanks!

3

If Republicans succeed in “defunding” Planned Parenthood, where will transgender patients go?

  • Karyn Logan, a 38-year-old veteran, came out as transgender in 2013 when she was living in Colorado Springs, Colorado, home to both conservative Christian ministry Focus on the Family as well as Army and Air Force bases. When she sought hormone replacement therapy as a Medicaid patient, she came up empty handed every time.
  • She inquired with the local Veterans Health Administration center — which only just began covering HRT in 2011 and didn’t create an LGBT health services program until the following year — but their response was “very terse, almost dismissive,” Logan said. And while she did find online specialists who could treat her, she either couldn’t afford their services or had to sit on months-long waitlists before she could get an appointment.
  • The process of finding a doctor who could help Logan in her transition stretched over roughly a year and a half, she said, before a friend told her about Planned Parenthood
  • Having long promised judgement-free care to LGBTQ patients, the health care giant has, in recent years, began offering HRT and other transition-specific services at certain centers. Read more. (7/15/17, 10:05 AM)
2
Let me tell you something about Gillian Anderson. This woman is genuinely the sweetest person I have ever met. I’ve had the privilege of meeting Gillian three times: at Toronto Fan Expo in September 2015, after Streetcar in 2016, and again at Toronto Fan Expo in September 2016. 

So, I have panic disorder. I’m really bad in big places full of people, which essentially describes a convention. Needless to say, the first time I went to a convention to meet Gillian, I had a really severe panic attack. I was shaking and crying and I sweat all of my makeup off. Anyway, when it finally began to subside, I decided to wait in line to get an autograph from Gillian. I gave her a handwritten book that I had put together full of letters that people wanted me to give to her. She was so incredibly grateful and kept telling me how sweet it was that I had taken the time to write all of the letters out in the book. At this point, I was still completely red and shaking a little and you could tell that I had been crying. You know what Gillian did? She just reached out her hand, with the most compassionate look on her face, and just held my hand in hers. My hand was shaking a ridiculous amount and she just held it so gently and looked at me with the sweetest, most empathetic expression. I think it’s extremely important to remember that she, too, suffers from anxiety attacks, and yet she still goes to events like Fan Expo to meet us.

The second time I met Gillian was on my birthday in May 2016. She signed after her performance of Streetcar - which, by the way, was the most incredible performance I’ve ever witnessed. Now, it’s important to note that the theatre had a rule about the actors not writing anything for their fans other than their signature (weird, I know). I figured I’d try anyway and when it was my turn to go up, I asked her if she could write “I want to believe” for me. She apologized and said that she couldn’t, and then signed my program. I wasn’t really expecting for her to be able to write it for me anyway, so I just shrugged it off and gave her the gift that I had for her: a first edition, first print copy of A Streetcar Named Desire. When I gave it to her, she was completely floored. She kept laughing in disbelief and leaned forward and rested her head on the counter for a bit. She was concerned because “this would have been so expensive!” but I told her that I wanted to give it to her because of the huge impact she’d had on me. Once again, she held my hand in hers, and told me that she would write “I want to believe” for me. She did, and I now have it tattooed on my ribs.

The third time I met her, at Toronto Fan Expo in September 2016, the first thing she said when I went up to her at the autograph table was, “have I met you before?” I said yes and she told me that she remembered meeting me. She then told me that the first edition of Streetcar was one of the sweetest gifts she had ever received. Then, I told her that I was fully prepared for her to roast me for it, but I showed her my tattoo of “I want to believe” in her handwriting. She was really sweet about it and told me that I’d chosen a good spot. She also brought up the book that I had given her the year before (how on earth she remembered that, I do not know). It is also so incredible to me that, out of literally hundreds of thousands of fans, she remembered who I was.

I’ve left out so much, but in conclusion to this long-ass post, Gillian Anderson is literally the kindest human being I’ve ever met. She’s so patient and empathetic and caring. She is one of the reasons that I’m alive to this day.

I need a minute

The nature of our healthcare system has changed. It has become less about making patients better, comfortable, and ensuring they get out of the hospital to go home and not leaving in a casket, to only caring about what they have to say about their “experience” during their stay. Might as well start putting hospitals on Yelp and Tripadvisor. Our system focuses too much on patient satisfaction and less on medical skill. Less about doing what is necessary to improve someone’s medical state and more about doing everything in our power to keep them happy. And worse is Administration across the country is all about this model of practice. So the healthcare systems slap down regulation after regulation to automize us basically turning us into robots. When the medical staff isn’t walking around on their tip toes trying not to break these outlandish rules that help keep pressgany scores up the level of medical care provided improves. Currently if our system performs poorly we lose all of our incentive bonuses at the end of the year. Last year we didn’t get anything yet everyone in admin got over a million dollars in bonus pay. Nurses and Doctors both get fired from patient care because “she didn’t have a pleasant look on her face” or “they said I had to stay here another night when another doctor said I could leave I want them and not you,” or “you’re too young to be a well doctor get me someone with some actual experience in here and don’t you come back.” Yes patients deserve to be happy and well taken care of obviously. But when it comes to a point that getting a bad review because we forgot to bring you water due to the fact another patient was actively dying, and then we get more of a lecturing about the negative review instead of figuring out what we could of done better for the other patient…is absurd to me.

Originally posted by allreactions

youtube

“I just think that it’s really important especially for the LGBT community to also rally around Planned Parenthood. There is no separation between reproductive rights and trans rights and LGBTQ rights. They are literally one and the same and if there is an attack on one of us it is an attack on all of us.” -Brooke, 22, Planned Parenthood patient

Positives and Negatives of Venus in the Houses

Venus in 1st:

positives: charming, fun, popular, warm, magnetic, harmonious, loving

negatives: passive-aggressive, indecisive, superficial

Venus in 2nd:

positives: tasteful, loyal, generous, honest, reliable, purposeful, protective

negatives: picky, critical, unreasonable expectations

Venus in 3rd

positives: social, spontaneous, verbally expressive, peaceful, kind

negatives: manipulative, easily bored, ingenuine

Venus in 4th:

positives: nurturing, sympathetic, values comfort, peace-seeking, loving

negatives: overly-attached, smothering, passive-aggressive

Venus in 5th:

positives: creative, flirtatious, playful, romantic, fun, sensual, loyal

negatives: dramatic, over-bearing, promiscuous

Venus in 6th:

positives: patient, caring, appreciative, artistic, helpful

negatives: self-doubtful, perfectionist, critical

Venus in 7th:

positives: harmonious, charming, social, caring, accepting, loving

negatives: indecisive, quick in love, co-dependent

Venus in 8th:

positives: intense, loyal, intuitive, thoughtful, mysterious, passionate

negatives: lustful, overwhelming, secretive

Venus in 9th:

positives: adventurous, fun, interesting, independent, free-spirited, playful, flirtatious

negatives: accidentally leads others on, impulsive, indecisive

Venus in 10th:

positives: successful, supportive, team-player, motivated, values their good reputation

negatives: cold, detached, success over relationships

Venus in 11th:

positives: social, creative, enjoys learning, trusting, derives happiness from friendships

negatives: tries too hard to be unique, cares too much about social status

Venus in 12th:

positives: sympathetic, loving, sensitive in love, appears strong, sacrifices things for loved ones

negatives: attracts unhealthy relationships, hides emotional nature, insecure or lonely

this is one of my first posts! if you liked it feel free to check out my blog ❤ 

oxymitch  asked:

Hello there! There are questions I like to ask....What would happen to the coma patient(s) when there's a power outage on not only the hospital but also the nearby areas of the town/city? And since the coma patient is kept alive by machines, would he/she die when the power is out? Also, what can the hospital staff do during the power outage for the coma patients?

Hey there @oxymitch​! Thanks for the ask! This is an interesting one :) 

First: I’m going to assume that your situation is going to last more than a couple of days, that they’re going to be isolated, and also that it will happen with no warning. Why? Because that’s the model I have to build an answer on. 

Easy ones: If the backup generators work, the power stays on, and the patients will be fine. If the loss of power is transient, less than a few hours, staff can be used to take over the machine functions in the short term. If the hospital has notice and they think they’ll lose power, they can actually transfer out their sickest patients to other facilities. Even if they lose power but the hospital is still accessible, they can request transfers for their sickest patients. Critical care transport units will transport those patients as far as needed to get them an ICU bed somewhere. 

Now, let’s look at the truly catastrophic scenario, because of course we should. 

So, first things first: hospitals have backup generators. As long as t he generators work and have fuel, your hospital will generally function in its usual manner, excepting that they will not permit surgeries in case of a total power failure. 

However, these generators are typically kept at, or even below, the level of the hospital, and flooding can knock these out. It happened in New Orleans during Katrina and I believe it happened in New York during Sandy, with a couple of major hospitals closed due to flooding. 

Let’s assume the power goes down completely – the worst possible case. Worse, help isn’t coming or can’t arrive any time soon – the true disaster scenario. Ambulances can’t get there by ground, all the air support is tied up on other missions or the storms are too bad to fly a helicopter. 

So, what happens to the coma patient in the ICU? Honestly, their outcome isn’t going to be great, and they’ll likely die. 

Ventilator-dependent patients require a machine to breathe for them, with very specific settings: volume, pressure, PEEP (positive end-expiratory pressure, essentially the “pushback” from the vent), etc. If the machines go down someone has to ventilate them manually, squeezing a bag 10-20 times a minute, indefinitely. It ties up staff that could be utilized in other places. Hell, that staff member can’t even leave the room for five minutes to pee

The other big issue is that IV pumps go down, too. Most IV pumps have some battery life, and some will last for hours, but many – especially those that are used strictly in-hospital, and have batteries only to get the patient to the bathroom and back – won’t work after 30-180 minutes. So the medications that are keeping most ICU patients alive won’t flow, and getting correct doses by drip – by pure gravity and the graces of a drip set – is next to impossible, especially in the dark. 

So these patients – many of whom are on 3, 8, 10, a dozen medication drips (plus their ventilator), are in deep, deep shit. 

[There is an  ABSOLUTELY PHENOMENAL podcast] about what happened in a hospital in New Orleans during Hurricane Katrina, based on a book [Five Days at Memorial by Sheri Fink]*. The hospital lost power, lost backup power, were isolated, lost radio contact, kept hearing stories about looting. They were surrounded by water and couldn’t leave. And, surprisingly quickly, the doctors began to euthanize. 

Their logic was this: these patients need machines to breathe for them, to pump them full of medications. Hell, most medication dispensers – the mini-pharmacies on units – absolutely require power to dispense any meds at all

These patients were going to gasp to death without ventilators, or were going to drown in their own fluids from heart failure, or meet whatever end the ICU was barely keeping them from. So doctors decided to give big doses of fentanyl and midazolam – a painkiller and a sedative – and ease their patients’ suffering once and for all. 

Right or wrong, the intent was kind. Right or wrong, their actions probably meet the legal definition of homicide. (Right or wrong, we do this for our pets all the time.) 

The concept of triage is about the greatest good for the greatest number. A fictional hospital might make the choice to allow all ventilated patients to breathe on their own – or not, but to not give them any support. That frees the staff up to save the patients they know they can help. Save who you can, and let go who you can’t. This is done in disasters every day by EMS. 

I’m not saying what happened at Memorial was right, or that it was wrong; that’s not my place. (The NPR podcast goes into that at length.) I’m just saying that it happened, and that you might find it an interesting reference point for your story. 

Hope this helped! 

xoxo, Aunt Scripty

[disclaimer]

Patreon: a magical land where the ask box never closes. Care to visit?  

Ebook for Free! 10 BS “Medical” Tropes that Need to Die TODAY!

*Affiliate link. 

TSK: Chief Complaint “Yellow liquid coming out of belly button.”

60-something Patient: IT’S NOT EVEN MY ORIGINAL BELLY-BUTTON, IT’S A NEW BELLY-BUTTON THAT JUST SWELLED UP A FEW DAYS AGO!

Patient: NO, IT CAN’T BE AN INCARCERATED HERNIA ERODING THROUGH MY BELLY SKIN, HERNIAS ONLY HAPPEN IN YOUR PRIVATES!

Patient: I AIN’T GOING TO NO EMERGENCY ROOM FOR POSSIBLE EMERGENCY SURGERY, JUST GIVE ME A CREAM TO PUT ON IT!

Patient: FINE I’LL GO TO THE ER.

Patient: BUT AIN’T NOBODY DOING SURGERY ON ME TODAY!

3 HOURS LATER - Operating Room Board: “[Patient] Emergent Add-On, Incarcerated Ventral Hernia, Abd Wall Abscess”

Trust is one of the most valuable things in nursing. The fear in the eyes of patients as they look up at you when you meet, the trust that you’ll take good care of them… the trust their significant others & families have that you won’t harm their loved ones…the trust that you have in your coworkers as you go on break, placing the care of your patients in their hands…the trust you struggle with - within yourself; if you’re making the right decisions, if you’re doing the best you can each day. And, as valuable as trust is, it is also fragile, and can be lost
—  The delicate balance of trust