So here's what went down: last night I came in and went straight into an inservice. As I made my way out, into the break room, several people came up to me and said "Oooh, you've got the VIP!" Now, I don't have a single clue what they're talking about. I go into the break room to get my assignment and my charge nurse tells me I've got the relative of a very famous person. Let's just say that dealing with families is not my strong suit at the best of times - I (semi) joke that I've got a case of Asperger's. The idea of having this much scrutiny on me turns me pale, then red and breathless, according to those who were present. So I turned to the nurse nearest me and beg her to switch. She doesn't seem to care, so we all go on our merry ways. I have no idea what's wrong with the pt; I figure it's nothing big.
Cut to a short time later, when VIP is crashing and that poor girl is getting slammed, and I feel really bad, think about all the times I haven't been as nice to her as I should, etc. And then... my whole night goes to the hot place down below. My assignment is fairly busy but fine. My pod-mate goes on break and HER patient promptly crashes. I've got an intern on his first day in the ICU, who has to have the vent and monitor waveforms explained to him, and a fellow who is swamped with crises all over the unit. Then MY kids start acting up; nothing serious, just lots of little piddly things that require immediate attention. Leaking ostomy, a vented kid who would very much like to be suctioned NOW, thank you, lab says my samples weren't labelled properly and have to be resent, and that kind of stuff. Oh, and all three kids (mine and the other one) are on contact isolation. One of those nights where you leave feeling totally inadequate, even though you handled everything as best you could, you know?
So I figure the Assignment Karma gods, which I've just made up, got me.
Liz--I really think you should report them to JACHO. It won't change unless the plebecite revolts, or some big cheese comes in and TELLS them to change. Keep trying!!
Seriously!!!
It's part of our admit order sets for fentanyl prn (usually just 1mcg/kg/ q2h prn) for any baby under 26 weeks. If they need more than that, our docs have no problem upping the dosage. Whenever a baby is on the HFOV they are always started on a fentanyl drip - and usually more. Our docs usually want then sedated to the point where they're not breathing over the HFOV at all...
Our docs usually want then sedated to the point where they're not breathing over the HFOV at all...
I'm sorry, I know this isn't that funny and I'm tired, but... :lol2:
That would... never happen. Ever.
I really should report them, huh? The problem, as I see it, is that they have what SEEMS like solid medical reasoning for not sedating. I wonder how that would hold up to JCAHO's decision to make pain a priority. Hmmm. ::elizabells makes thinky face::
Sweeper933
409 Posts
Seriously!!!
It's part of our admit order sets for fentanyl prn (usually just 1mcg/kg/ q2h prn) for any baby under 26 weeks. If they need more than that, our docs have no problem upping the dosage. Whenever a baby is on the HFOV they are always started on a fentanyl drip - and usually more. Our docs usually want then sedated to the point where they're not breathing over the HFOV at all...