Quote from labman
Today I had a patient who has a previous MVA post 13 days from a different hospital for neuro declines and further exam from following commands to a GCS of 5, neuo exam L pupil fixed and dilated not reactive R pupil, no corneals, would flicker upper extremities to pain, lower left would flex toe to pain and right quad to pain, had many facial fractures which included a mandible which is floating, occipital bone fx, temporal and spenoid fx to name a few. Bilateral upper arm blood clots and that is it (no other history and his injuries was limited to his head). So the docs wanted to do a stat CT scan with perfusion to check for blood vessel abnormalities, hospital transport and we had no CNAs. So the charge nurse calls SOS which I had an issue with but different story different day.
Which the whole time this SOS nurse tells me that this patient should have been in the trauma patient because the nurses are better down there (which I guess whatever) he goes you neuro people are good with brains and that is not that critical (just rolled my eyes) and said you guys aren't ICU nurses because you don't take care of septic patients and multiorgan failure. Kind of made me mad.
What do you guys think of this?? Do your ICUs have this relationship where one thinks they are better then the other???
I would have told that person to get over themselves. Neuro ICU is real critical care. Brain not that critical Oh my oh my do they realize how dumb that sounds? Nope it only controls vital functions of the body
. Yes we do take care of patients in multi organ failure, and sepsis. I think this is a problem everywhere one unit always thinks they are better than the other. Their patients are always sicker. Even if our patients aren't on drips other than 3%, some of our house managers don't understand why we need to single the SAH in severe vasospasam. They only have q6 labs, q4 CVP and I/O boluses, constant lytes replacement. HHH pts can be a TON of work.
Some of our docs have went and transferred the trauma pt with head injuries to our Neuro ICU so that the pt receives better management of the head injury. When a neuro patient goes bad they go bad right away it isn't always a slow onset. You can be on top of those pupil checks, and all the sudden there is one fixed and dilated pupil.
I don't blame you for being upset. All nurses work hard. Critical care is critical care no matter if it is cardiac, trauma, or neuro. Neuro pts have many other problems as well as the problem with the brain.