Monday, December 31, 2007

Return trip

I was on call last night, just third call but there was a donor in progress so that put me to run referals so that the next day's 1st call could go and do OR fresh in the morning. Just as my head hit the pillow, my boss called me. She needed me to go see on old man across the city in a hospital about 50 min away. I pulled my body out of bed, I was so tired, and threw on a sweatshirt and scrub bottoms and jumped in my car and prepared myself with my ipod for the long drive. Once I arrived, I did my business. The pt wasn't brain dead, we would just follow. I left and thought, looong drive home and when I am almost home, my boss calls me again. Same hospital is calling in another referal. I scream WHAT?! into the phone and exit the next exit. I'm told to turn around and go see him, the nurse says he is brain dead and absent reflexes... oh wow, another 40 min back. I drive back feeling dejavu in my return trip, get out of my car and paste a smile on my face as I walk back in the ICU. I was just here, they could have called me then but they didn't. I walk back in smiling and the charge RN notices and apologizes and says she is sorry, and thank you for still smiling. I shrug, its my job... I can't be mad. Its what I do and I know they are busy... I can forgive it once. So I sit down to look at the chart and talk to the nurse. So they pt is brain dead I say, she says yes. I go through all the reflexes with her. Cough? No. Gag? no Corneals? no. Is he breathing on his own? No. Flexing? No. I chart all this but something tells me to go see first hand. Usually I dont do this, as there are 10 family members in the room, two in wheel chairs and its just cruel to ask them to leave sometimes. But I needed to know for sure and something in her affect tells me to double check. Once family is gone, I head in with the nurse in tow. I start with corneals. Yes they are there. I sigh... ok next. He has a STRONG gag and cough and continues to cough after I suction. Ok. He postures when I suction. Big sigh... ok. He isn't brain dead and I educate the RN on the nuero assessment which I feel should be something she is capable of doing correctly in an ICU? Correct me if I am wrong here. I talk over the plan, leave a note and head back home, praying I will make it back to my bed. 3 hrs later after I am originally called, I am back asleep. Little do I know the same ICU calls in another referal! My boss tells them, forget it. We have had someone there twice already tongiht, someone will come by in the morning first thing. Thank god because I would've had to go postal on them, and no smile this time.

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