A friend and I were talking not long ago about skills we appreciate in other nurses. One of the most important things in the ER is being able to ascertain “sick” and “not sick.” Granted, this is not super objective nor easily measurable, but some nurses I trust to know just by a cursory glance which patient needs to see the doctor…like nowish. :P
The patient admitted yesterday was sick. Several noted it. Her x-ray showed bilateral pneumonia, her lungs sounded junky. We started her on IV antibiotics, breathing treatments, etc, but today she was satting 65-70% on room air, 80% with 5LPM BNC, barely 90% with a non-rebreather. Febrile, tachy, and breathing 62 times a minute. I asked the doc to come and he looked at me and said, “I think she needs critical care. Would you be able to take her to the government hospital ER in the ambulance?”
Would I?! Yeah baby I would! *grin* I was so pumped to be able to play paramedic, see the local ED, and, oh yeah, get the patient the care she needed. ;)
I asked the doc if he had called ahead for admitting and he chuckled. “Oh no, if you let them know then they never accept. Just show up.” He did, however, know that the ED had opened back up following a fire a couple days ago (longer story, things are okay now, will share that later :P).
The ambulance is basically a van with a stretcher and oxygen (hey, if you have to have a couple things, those are good ones ;). I took David, a new RN grad, with me on this jaunt, but he rode in the front with the ambulance driver because it would be inappropriate for guys to be in the back with the difficulty breathing female patient, of course. :P But it was really great to have him along because not only is it nice having a couple medical people when you have a sick patient in an ambulance, but he’s also fluent in Arabic!
I’m also not being derogatory when I use the term ambulance driver. The guy knew how to turn the siren on, but was NOT a paramedic, EMT, or medical at all, just drives hospital staff to and from town with a bus and drives the ambulance as needed. :P
I strapped the 39-year-old fast breathing lady onto the stretcher, connected her to the portable oxygen, and found a place to nestle the IV bag (thinking of my Southern Hills and paramedic friends the whole time!). It was a relatively uneventful drive there, praise God, as I could jack the portable O2 flow higher than her bedside O2 so we were at a WHOPPING 92% (even though she was still gasping quickly with every inhalation).
We pulled up to the hospital and I told David to get a wheelchair and oxygen (ours weighed like 80 pounds). He was informed that there were no wheelchairs, but we could get a stretcher. They rolled a stretcher out with – I kid you not - fresh blood splattered it. I was like, okay, I’m not putting my lady on somebody else’s blood. So we figured out how to unleash the cot from the ambulance and took her in.
Cots sectioned off by drapes lined the ER wall. I, of course, glanced in each open one to 1) see what kinds of patients they had and 2) look for the bleeding person. There were a bunch of police in one area with a patient I couldn’t see Maybe that was the bloody one. Who knows.
What I do know was that all of a sudden not only was I the one checking everything out, but everyone was staring at me. Whether it was because I wasn’t wearing a head covering (I normally do in town but not at the hospital), or was the only fair-skinned on there, or because I had on awesome teal scrub pants, I’m not sure, but I was definitely cognizant that it was one of those “all eyes on the foreigner” moments. :P
We put our patient in a bay and asked if they had a non-rebreather mask so we could take ours back. The closest they came was a regular face mask. Heading out to the nurses’ station, we gave report to the doctor who appeared to be about 23-years-old. She said it was her first year there and was very impressed with the report (“Such a good history!”), so I thank all my paramedic friends who have been examples to me these years on that.
The day got even better when we realized we missed the lunchtime window at the hospital and stopped for shawarma on the way home and then an hour later my Yemeni patients cooked for me. *grin*
So please pray for S*, this woman with pneumonia that appears to be going into ARDS, that God would heal her and receive all glory for it!
I love you all!