the 100% directionless thread

Peak said:
We do a full sign out of all of our hearts and complex patients at the bedside going to and coming back from surgery. Nursing to anesthesia, perfusionist to ECMO specialist, and medicine to surgery (and vice versa when they return). It has been a huge piece of how we keep our intra op codes and post op complications very low, it isn’t uncommon for handoff to take an hour between everyone. Chart review may work well for simple cases, but it isn’t worth risking patient safety by rushing through complex cases.
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Probably up there as the least favorite thing I've had to do is drop off in the PICU. "Hold on, you can't start we need to wait for the NP who isn't covering this patient's student's friend's sister to come before you can start presenting so they can ask a question."
 
jgmedic said:
From AZ to Bat 12? I mean I guess it doesnt matter when you work 21 days at a time! You take the FAE-Medic test?
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Naw. I passed it up.
 
I'm currently at a 5 minute walk. About to give that up for a 65ish mile drive.
 
Decent BP at my annual physical this morning, 114/72. 56 pulse rate, 98% spO2. Still need to lose some more weight though
 
Don't really know how to read the numbers on my hearing test and the Pulmonary Function Test other than they both say "Normal" (even though I always feel deaf AF in the booth lol)
 
Jim37F said:
Don't really know how to read the numbers on my hearing test and the Pulmonary Function Test other than they both say "Normal" (even though I always feel deaf AF in the booth lol)
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Try actually being deaf. I don’t hear out of one ear and the booth sucks cause I feel like I’m sitting there like an idiot for half the time. Can’t hear **** in my bad ear.
 
I know I'm late on the pop culture, but Bernie Sanders has already made this year worth it.
 
Jim37F said:
Don't really know how to read the numbers on my hearing test and the Pulmonary Function Test other than they both say "Normal" (even though I always feel deaf AF in the booth lol)
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pulmonary function test? For what? Do you have pulmonary dz?
 
luke_31 said:
Try actually being deaf. I don’t hear out of one ear and the booth sucks cause I feel like I’m sitting there like an idiot for half the time. Can’t hear **** in my bad ear.
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The tinnitus in my left ear alone is deafening.
 
E tank said:
pulmonary function test? For what? Do you have pulmonary dz?
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I think it’s an NFPA physical requirement, we also have to do it each year.
 
E tank said:
pulmonary function test? For what? Do you have pulmonary dz?
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Tigger said:
I think it’s an NFPA physical requirement, we also have to do it each year.
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Yeah I think its because of the SCBA and respirator requirements. They didn't do it last year but seems to be fairly standard for us, no special history otherwise
 
Jim37F said:
Yeah I think its because of the SCBA and respirator requirements. They didn't do it last year but seems to be fairly standard for us, no special history otherwise
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wow....don't you guys have to run up a bunch of flights of stairs in full turn outs/SCBA with a hose roll? Now that's a PFT.....cheaper too....
 
Hypothetical (based on actual event). You have a frequent flyer, 40 some odd F, who suffers from anxiety attacks, and some other issues. Pt usually calls 911 around 1700-1730 claiming anxiety attack. Pt is usually compliant with her meds. Local hospital knows Pt well, but will not give her meds. You pick up the Pt and take her to the ER. Visiting doctor is there getting a manicure, no other Pt's in the ER. (Small community hospital). Doctor tells nurse to send Pt to the waiting room. Dr. continues with the manicure. Pt calls back the next day, same time. Ask Pt what the ER did for her. Pt tells you that after a couple of hours she just walked out and went home, on foot.

Would you report this incident?
 
E tank said:
wow....don't you guys have to run up a bunch of flights of stairs in full turn outs/SCBA with a hose roll? Now that's a PFT.....cheaper too....
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Well we did something almost exactly like that (as one of the final stations) in our PAT, and we did do a 42 story stair climb in full gear, on air, with high rise packs a few months back.

But yeah this was more just the City Doctors office visit haha. Though I had to go to our SCBA shop to make sure all my masks were still properly fit tested. And somehow, that last N95 fit testing we did, those results were backwards, the two styles of masks I was cleared to wear then, I failed the fit test and should be wearing a different style (fortunately in stock at my station, even though N95s are still short supply dept wide)
 
Old Tracker said:
Hypothetical (based on actual event). You have a frequent flyer, 40 some odd F, who suffers from anxiety attacks, and some other issues. Pt usually calls 911 around 1700-1730 claiming anxiety attack. Pt is usually compliant with her meds. Local hospital knows Pt well, but will not give her meds. You pick up the Pt and take her to the ER. Visiting doctor is there getting a manicure, no other Pt's in the ER. (Small community hospital). Doctor tells nurse to send Pt to the waiting room. Dr. continues with the manicure. Pt calls back the next day, same time. Ask Pt what the ER did for her. Pt tells you that after a couple of hours she just walked out and went home, on foot.

Would you report this incident?
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Report what? To whom? Based on what? Anything else you'd do because of what this patient told you?
 
Old Tracker said:
Hypothetical (based on actual event). You have a frequent flyer, 40 some odd F, who suffers from anxiety attacks, and some other issues. Pt usually calls 911 around 1700-1730 claiming anxiety attack. Pt is usually compliant with her meds. Local hospital knows Pt well, but will not give her meds. You pick up the Pt and take her to the ER. Visiting doctor is there getting a manicure, no other Pt's in the ER. (Small community hospital). Doctor tells nurse to send Pt to the waiting room. Dr. continues with the manicure. Pt calls back the next day, same time. Ask Pt what the ER did for her. Pt tells you that after a couple of hours she just walked out and went home, on foot.

Would you report this incident?
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A “possible” issue that I did not witness and was only informed of by a single patient? No. I would tell the patient they may ask to speak to hospital management to file a complaint but I wouldn’t go about it myself.

I’m not saying she is lying but I know many patients who stretch the truth. “Hours waiting” very well could have only been 15 minutes.
 
“Hi, we don’t handle complaints about care at the hospital, but here is the number you can call to speak with someone about it...”

And that is where your involvement ends. Send a email note to your boss stating what you did so it’s documented. Done and done.
 
NomadicMedic said:
“Hi, we don’t handle complaints about care at the hospital, but here is the number you can call to speak with someone about it...”

And that is where your involvement ends. Send a email note to your boss stating what you did so it’s documented. Done and done.
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That's about how I'd handle it. Once you've turned the patient over to the hospital and they've triaged the patient, your involvement pretty much ends, and it sounds like that's what happened. You left the patient in the care of the hospital and you went back to your usual business. Since you didn't witness anything that happened after you left, you can't say for certain what did actually happen. She may be telling you the truth, she may not be. They could have done labs and whatever else (like the MSE) and decided the patient was appropriate to sit and wait in the lobby. They may have brought the patient into a room and did the same thing.

Patient then gets tired of sitting there for a couple hours while the ED staff does whatever they're doing, and then leaves. That's the patient's choice. Of course there could be an ED plan of care in place for that particular patient that gives guidance for how to deal with that particular patient. The ED won't tell you (or sometimes won't tell the patient either) if that is the case. Frequent fliers usually will have something like that in place because of ED abuse.
 
Why is my coffee cup always empty?
 
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