EMS has gotten pretty frequent with bringing in asystole> 25 min (CPR the entire time with no response to any intervention.) Said person is dead and long gone. We drag in the crew, do a cardiac ultrasound to confirm lack of activity, and call it. And then.... Guess who is stuck with all of the lengthy paperwork and prep? Can't time of death be determined in the field?? I realize there are special circumstances or that this can occur occasionally...but it seems they are trying to pass the buck :/ Thoughts or experiences with this? Is there a legal way to tell EMS to not be lame and just call it before the piles of paperwork have to be done on our end? It's not that I'm inhumane, but for the time being, that body takes up a room. Time has to be spent away from my other conscious patients to deal with family, lifenet, etc etc.
How do you deal with the AttendingMD who works up a f*****g papercut and puts in orders for blood cultures an hour after the fact? When (professionally) questioned about his rationale, he tries to play the "I'm more intellectual than you" card. It's gotten to the point that I'm getting a stool, urine, sputum, strep, wet prep, blood cultures, an ekg, peak flow, abgs, and dopplering for pedal pulses on the 18 yr old with n/v x 1 day who is sitting in bed talking on the phone and chowing down on funions.
Even the more experienced RNs get extremely irritated by him. I don't really mind when things are slow, or I feel said testing is warranted. However, when we're working up a stubbed toe and I have someone near dead next door...I have trouble dealing with said person.
FYI: Aside from these little things, I'm really enjoying my time in the ED and am in awe of how knowledgable my coworkers are. :) I only hope to have the knowledge base some day.
