Hello again,
This is Monday February 23, and today begins my first full week with Public
Health Nursing. Yesterday, Sunday, I spent my last day working in Acute Care as
a Charge Nurse. As you may or may not know Acute Care is a combination of
Inpatient and the Emergency room. As is very frequent we were short one nurse,
having three instead of the desired four. The day started alright with just
four patients on the inpatient side and the ER quiet. To those of you in the
know and are superstitious, the Q word is taboo. The day was going quite
smoothly and we discharged three of the four inpatients by noon. Glancing out of
the window I could see a light snow gently falling (straight down, not
sideways). I actually had time to stand there looking out the window for a few
minutes reflecting on how magical it was. For a southern boy like me, it is
still a novelty. (As I have stated before, we do not get a lot of snow as far
as the daily measurable scale goes. It's just that when it does come, sometimes
it's like the deluges we used to get when we lived in New Orleans, only this is
snow not rain, and it does not melt or go away.) I was filing this moment in the
back of my mind as a positive thing to write about for a change when I got a
call from a distraught family member of an elder. The elder had been a
frequent patient with us as she had metastatic cancer. She had just passed away
and her daughter was looking for support. A while later the ambulance crew
brought her to the hospital morgue. The family had only two ladies in
attendance to care for the remains so I went to help. I returned to the
department after a bit and had a female nurse go down to help. I felt this would
be a better choice as the deceased was female. Family started to arrive and the
task was then left to them.
The ER started picking up around noon as the folks just starting to wake up
with their sore throats and colds figured an ER visit would be just the thing to
start the Sunday off right. I had started the day with a light team of patients
figuring to move to the ER as the pace picked up and the discharges made it
possible. Not fifteen minutes after my arrival in the ER there was an ambulance
toneout for an individual who was not breathing. The hope was the family was
panicking as frequently happens and we would all have a chuckle, like the time
when the coach at the high school started CPR on an alert player who was injured
(wait-that's not funny!). Well, it was not to be. We got a call after the
ambulance arrived at the scene to have the MD pronounce the patient. It was
obvious to the crew that the patient had expired a numbers of hours prior. The
ER MD went to the scene to pronounce and it turned out to be a hospital
employee. About two hours later I was once again in the morgue, this
time helping the ambulance crew. John was on with the fire department that day
and he had made both runs. I looked at him and said, "you know things come in
three's" to which he responded, "I have been told that a number of times
already". After returning to the ER and the usual clinic complaints, the Alaska
State Troopers brought in a patient for a SART exam. This is a rape exam. No
sooner had we begun that process when the ambulance went out on a call for an
individual who was at the pizza house and had blood all over. Then the report
was the patient had left there and went to a private residence. My response was
it would be a drunken individual with a head laceration. On arrival it was a
drunken individual with a head laceration.
The only good thing is, it is now about 6:30 pm and my last day in this
department is coming to a close. I am starting to breath a sigh of relief.
About this same time two admin reps were in the ER concerning information
release on the employee who had died, and both of them looked at me. It was
obvious we all had the same thought, which was not long in being verbalized.
Whenever anything bad happens, I am usually within the vicinity-as I have said
in the past, I am a "sh-- magnet".
Then, with the shift almost over, the ER MD is called into the telemed room for an emergency. I go in after him and I am witness to the sight on video of the CHAPS in one of the village clinics, working on a boy that appears to be no more than 14. (CHAPS are Community Health Aid Practitioners, trained locals from the villages who operate on standing orders and treat the needs of the villagers. In essence an emergency room/clinic in the bush run by these folks who can suture, deliver babies, prescribe basic medicines.........all with less training than EMT's. Some of the clinics still operate without running water.) The boy was found hanging by the neck, an apparent suicide attempt, but was still alive. I shared the Doctors frustration at the satellite delay and the lack of a highly trained emergency team on the scene. Many of the doctors calmly given instructions were not heard or not understood. It was a horrible feeling to be standing there unable to do anything, watching the child posturing (a type of seizure indicating brain injury), and the MD trying to direct them on basic emergency life support. To their credit the folks on the other end were doing the best they could with what they had. We contacted the medevac crew and got them and the doctor on their way to the scene by around 7:15 PM. Arrival at the scene from the start of the incident would probably be around one hour. The boy is alive but the prognosis is not good. A very inauspicious way to finish my tenure with the department.
I have mixed feelings about changing jobs. I feel I am at least an average nurse and because of my experiences over the years working for East Jefferson, I feel my services are needed in the hospital. On the other hand, in order to maintain my own sanity, I feel at this time a change is needed. The Public Health position will give me experience on the front preventative end, and will make me a more useful individual in the future. Who knows, I might even do some good along the way. God knows with the suicide rates here, any improvement would be a step forward.
Carlo
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Last updated:
08/29/05