In what will likely be a futile effort to stay awake. Here it is, 11:36PM on Thursday. It hasn’t been a particularly bad or busy day, but the potential for it to turn over the next 7 hours.
The calls we’ve done today have ranged from an 85 year-old male patient who had an external pacer placed to deal with the chronic atrial fibrillation issues (and Lidocaine running when we arrived to deal with the runs of ventricular tachycardia that he was having) to the 61 year-old female with the shoulder separation and the deep vein thrombosis in one of her legs to the 23 year-old male with chronic ulcerative colitis having flare-ups.
Of the three, the only one with the potential for having had anything bad happen was the first one, only because he was so sick. History of Diabetes, a below the knee amputation, and an extensive cardiac history are among the things that could contribute to all things failing miserably for him. However, he was alert and oriented and able to answer my questions and talk to me. I was extremely happy about that.
We did have one weird situation happen during the day, though. Called to the Faulkner Hospital to transport a patient to the Hebrew Medical Acute Care Unit. The only reason an ALS unit was requested is because this patient, a 91 year-old male, required deep suctioning through the tracheostomy he had. History of end stage dementia and a likely undiagnosed case of Parkinson’s disease, among other things. He’d had episodes of decreasing Oxygen saturation at the MACU, and he was originally going to be transported to the BI for this, but at the time he was taken the crew on board must have believed that this patient wouldn’t survive the ride because he ended up at the Faulkner. To the Hebrew the trip is a little less than a quarter mile, so bring him there had to be a no brainer.
The weirdness started just as we were about to put him on the stretcher. The Hebrew called the clinical leader at the ICU telling her that they didn’t want the patient until 4:30. At that time it was 2:15. As we hadn’t put him on the stretcher yet, it wasn’t a stretch to disconnect him from our equipment and put him back on their high pressure Oxygen unit, their monitor, and whatever else he was connected to. Once we were done, we left the unit, and just as we were getting on the elevator the unit coordinator flagged us down to go back. When we got there, the clinical leader told us that the Hebrew called back and moved his admission time up by an hour. That still did us no good because we couldn’t stay and wait. Plus, the call was sent to us by Fallon (we subcontract Partners calls from them) and it was likely that another ALS unit – a Fallon unit – would be available at that time. So, needless to say, at 3:30 we didn’t go back to get him.
The telephone calls this week have started in earnest from my other employers. I’ve already gotten 7 calls so far with inquiries as to my availability. Flattering, but I’m really working hard at not putting myself in the position I was in before I was hurt. I can’t do that again, and I will be much more discriminating with respect to work I take on. And I have to start looking at what I need to do so that I can get admitted to nursing school. But – more on that in another post. Right now this boy is ready for bed. Hopefully once I go I will stay. But I won’t believe that until I see it...