"fan out and go" + alchohol

[Pepper The Cat]

OK - Here's a question I've been wondering about for a while, but don't want to ask for obvious reasons.

OK - I'm sure that all hospitals have this process - if there is an external disastor, our hospital has a process where all staff is called in - it has a code name, that I am reluctant to use it - lets just call it "fan out and go". Basically, its a process where all staff is called and expected to come in and help out because of some external disastor. Fine and dandy - I can come in if needed. But... (here's my question) what should one do if they have been drinking? Now, I would NEVER drink before going on duty, but we are talking about something happening on my day off.

do you

a) Say sorry I'm tanked, I can't come in = thereby giving you the reputation as the boozer nurse and basically destroying any chance of promotion.

b) Go in, but say "I've been drinking, I can't safely give meds, start IVs, etc, :saint:but can probably do basic nsg care, freeing up someone else to do what I am too tanked to do.

c) Go in, drink lots of caffeine and water in route, hoping that that plus the adrenaline rush of a true emerency will sober you up

or d) Just say, I've been drinking, I can 't come in, thereby basically destroying your chances for promotion as in # 1.

Don't say just don't answer your phone, lets assume your have answered and are now in this predicament.

Not that its ever happened to me! I'm just curious -(as I pour myself another rum and coke....)

[P_RN, ADN, RN]

Can I ask where the phrase "fan out and go" comes from? I'm assuming it's military.

I live over an hour away from where I did work and went in during hurricanes, tornado warnings, ice storms. I've stayed and worked 24h straight during snow storms and all the above......while people who lived within sight of the building "couldn't get out of their driveway, have no heat? at home etc.

The ONE code whatever (I don't really remember but it must have been a number) involved an actual Amtrak derailment. The ENTIRE staff was called in and the ENTIRE staff showed up. Our place-THE TRAUMA CENTER- got.................NO patients from the wreck.

I wonder what would have happened after 12 hours if we had gotten patients......who would relieve? We never needed all 45 floor staff there, and whoever activated the call tree didn't take that into account. I don't think they ever addressed that and it's probably going to happen again and again.

[Pepper The Cat, BSN, RN]

Can I ask where the phrase "fan out and go" comes from? I'm assuming it's military. quote]

Here's how it works at my hosptial.

Code is called.

Charge nurses on each unit get code list, call unit managers in first. Then call first person on list, first person answers - she then gets her list and calls second person. Second person calls thirds as so forth. You keep calling down the list until you get a staff member, who continues to call. Once you have reached someone, you come in. The list is organized, closest person first, working down to those farthest away. Casuals are placed at the very end.

So basically, the entire hospital can be called in very quickly. Admin people are called in - they would be assigned duties suitable to their skills - door duty, answering phones etc.

Hope you followed that! Its actally a great system because a large number of people can be reached quickly.

[P_RN, ADN, RN]

Oh I'm quite familiar with the call tree.

What I'm referring to is how it is decided how many people are needed.

In disaster drills you do a pseudo call in and of course people say yes to "if this were a real emergency would you come in?"

Then we get soldiers from Ft. Jax who come to the unit with a tag that says "fractured femur" or deep shoulder laceration........You do a quick assessment, write on the tag what you did, and send them to the cafeteria for lunch.

What I want to know is in an ACTUAL emergency who decides how many are needed. In my example 45 people showed up......then no one wanted to work their next shift cause they had already come in for 12.

[queenjean]

I don't live in a hurricane prone state; but we do get those pesky tornados. Ironically enough, we've never gone into disaster mode for them. We *have* gone into disaster mode for some other events, including a train derailment and a fire in a huge apartment complex that resulted in dozens of injured persons as well as a few deaths.

There is no phone tree, though. We are a smaller (a little less than 100,000) community with one hospital. The alert goes out over the main radio stations, the local TV stations, and on the newspaper's website. The hospital just states that a Code Orange has been called, and all available personnel are requested to present to the hospital immediately. In the case of the fire, it happened during the noc, and a few phone calls were made to get the ball rolling. The hospital is working on an auto text-message system that will send out text messages to everyone in the event of a code orange.

And once, during an ice storm when we needed help and help couldnt' get there (downed power lines, 2+ inches of ice on the roads) the fire department went around and picked up in town employees (but did not take them home....we had to find our own rides home!). In the event of terrible, ongoing weather conditions, the fire department will give our hospital employees a ride to work. The hospital, fire department, and ambulance service are all owned by the city.

Finally, yes, I have been called in during a weather disaster, and because there was 2+ inches of ice and then about a foot of snow on top of it, I stayed at work for over 24 hours until I could get home. I just slept a little, and then worked more.

[squeakykitty]

I think I'd end up on team B, since there is a bridge I'd have to cross on the way in and it's not up to seismic standards. I live in earthquake country, so if the quake was that bad, the bridge would collapse onto the railroad tracks. And I would have to walk ten miles to town.

[yadda_yadda_yadda, LPN, LVN]

You could always give a glossed-over response.. something to the effect of, "....my husband has the car & has gone fishing (hunting/bowling, whatever works) & won't be back until ---xxxx----"

or that you're baby-sitting someone's kids & do not have alternate arrangements.

I personally, feel no obligation to give any of my coworkers that glimpse into my personal life. Familiarity breeds contempt.

Keep it neutral & plead the 5th.

Yes..I've used the above before...when the occaision required.

[JustMe]

I actually had something like this happen to me. My husband and I were in Las Vegas. We went to one of those lounge shows and before the entertainment was even on stage I had had two drinks. When the dancers came on stage one of them actually went head-long over the end of the stage! Thank goodness there was an ER nurse and a paramedic in the audience because I don't think I would have been much help. Medics showed up, collared her and carted her off--we got a refund. At least I wasn't so smashed as to know my nursing limits!

[Warpster]

You could always say you are unwell, technically true.

You're right about not pleading alcohol. Managers expect us to be bucking for sainthood 24 hours a day, just in case they need us at their convenience, not ours.

Lincoln freed everybody. Your life outside work is your own. However, going in to work in an impaired state should never be considered. No disaster is worth putting patients in danger.

[twinkle222]

in consideration that an emergency requiring a staff wide 'fan out and go' response is likely an emergency of greater than 8 - 12 hours duration, i would likely answer than i am unable to be available at this time, however i will come as soon as possible and will phone prior to leaving to ensure that the need still exists. protection of privacy extends as much to nurses as it does to patients and i do not feel i am under any obligation to give chapter and verse as to why i cannot attend. sufficient to say that i am a professional and as such, were i capable of responding to the emergency i would. ipso facto, if i decline to attend, i have a valid reason and extenuating circumstances that i am under no obligation to disclose.

[Soozul]

I would say I had been drinking, but ask supervisor to keep it confidential. Where I work, almost noone drinks or uses drugs-the 1 girl that drinks will wind up loosing her job eventually IMO, & some nurses talk about her.I take 1 prescipton drug for depression that I've kept secret for years 2' I'd be harshly judged where I work.Same happens for drinkers.

[bluebellslane]

Tracylvn,

I sawfrom your post that your are DD/MR. Help! My medically fragile day program opened this week and I'm a wreck with so many questions, concerns. Can you correspond? I'm really bad with the computer.