Announcement

Collapse
No announcement yet.

Was I right to ignore the ‘nurse’ and rely on my own training?

Collapse
This topic is closed.
X
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Was I right to ignore the ‘nurse’ and rely on my own training?

    Update

    So the man’s wife came in today. Apparently the truck driver hasn’t filed with ICBC yet and, get this they are now trying to claim the old man was drunk and already down in the parking lot before they hit him.

    I can say he was stone cold sober.


    So we had someone get hit by a truck in the parking lot... yet again (because the drivers in this city are some of the worst in Canada). I was the First Aid attendant on duty. He was an older gentleman so I treated him a bit different then I would say, a healthy 20yr old.

    By the time I got out there the driver and bystanders had already moved him so he was sitting in the back of his van. Yes I know not to move someone who has possible back/neck/ head trauma.

    Unfortunately there was a lady there who claimed she was a nurse (I don’t know if it’s true or not) but ‘nurse’ can apply to a lot of different fields if you really want to push it.

    This is the following order of events.

    M:Me P:Patient N:Nurse person D: Driver of the truck B:my boss (who happens to be the SM)

    M: “Has anyone dialed 911?”
    D: “yeah, they said 15min.” (I should have clued in there that they may have downplayed what happened. Since a accident like that would rate higher on the priority list)
    M: “police and paramedics?”
    N: “Just an ambulance.”
    M: hello, my name is [akaikitsune] can you tell me your name? (Simple question to see if he is cognitive enough to know who he is without outright saying, hey I think you hit your head let me check for concussion!)
    P: “hello, I’m ———”
    *puts on gloves*
    M: “Can you tell me what happened?” (Again, to assess his awareness and to find out from the patient what happened. And thus what I might need to check first. Since he is at this point talking just fine I know his airway and breathing are fine)
    N: “well——”
    M: “ma’am, I asked the gentleman. I need to hear it from him first.”
    N: “I’m a nurse.”
    M: “and he’s the patient. Not you.”
    P: *proceeds to tell what happened*
    M *to truck driver*: “Did he lose consciousness or seem disoriented when he tried to stand back up?”
    D: *points out short term memory loss*
    M: *checks pupils, sees they aren’t doing the tango*. “Sir, may I touch your head?”
    *finds contusion, skin broken but no blood coming from the wound. Suspected Head trauma confirmed*
    *coworker has ice bag wrapped in towel which I get him to apply to head*

    At this point, knowing that it’s an older gentleman I prioritize. He is still able to hold a conversation easily and is still reacting to random questions. Knowing when someone falls their first response is usually to put their arm out to catch themselves I first do a visual check, then a touch-does-that-hurt check.

    The whole time N is muttering about how I don’t need to do that. When I reach his wrist I descreetly take a pulse while checking his palms for damage. Which was not quite as good as I’d like in a man that old. I finally clean and bandage his hands (which N informs isn’t necessary) which were scraped from the fall. Because he’s older I wanted to ensure he hadn’t broken or dislocated anything obvious. At this point he complains about his leg hurting. So I check that, but I don’t remove the boot as I don’t want to disturb anything under there if the right fitted shoe is keeping pressure on something. I don’t have the tools to deal with setting a break or if there’s a bleed. He claims his leg was run over, but he may have just twisted it in the fall. Either way, better safe then sorry.

    I keep up with seemingly pointless questions (mostly to ensure he is still conscious And coherent) and occasionally slip in something important (ie are you on any meds, allergies, anyone we can call, feeling pain-nausea-dizzy-etc) while continuing care.

    I notice he is trembling so I ask my boss for assistance in getting him to lay down in the back of his van and cover him in a blanket, while raising his foot. Basically the standard shock treatment.

    N:maybe a warm drink should be offered as its cold out here (which is why I wondered if she was actually a nurse or not. You don’t give a person in shock something to stick in their mouth.)
    Me: “Sir, you may be going into shock. Are you feeling feint or dizzy?” Meanwhile I’m checking the peripheral limbs for tempature. They seem far colder then they should be when minutes ago he was fine, lucid, with a normal body temp to touch.

    I had thought he would go into shock given his age and the crowd of people and his head injury... I just didn’t like how quickly he was declining.

    I wrote down on a piece of scrap in my apron to get the defibrillator JIC. I didn’t want to turn it into self-fulfilling prophecy by having the patient hear me ask out loud. And I tried to give my keys to bossman but he seemed to freeze up at the sight of shit hitting the fan.

    So I kicked him... I will not admit to taking any pleasure in the act.

    I told him to go to my car, pop the trunk, and grab the FA kit there (I have a better one then the store keeps) along with the aptly labeled “oh shit bag”. Which contains supplies not available to anyone except military and first responders. It is too be noted that my car happened to be parked two cars down because I don’t like walking all the way across the parking lot to the employee parking spaces (which are always full anyway)

    M (to boss): Can you call dispatch and tell them that I need to talk to the paramedics on route for the hit in the parking lot?

    Which where we found out they had only said that a man had fallen down not that he had been hit by a car. Took a bit of talking to figure out what we meant. My intention had been to give them a heads up and ask for further instructions, until...

    M (to N): are you comfortable setting up an IV if necessary?
    N: ——
    M: *shows coworker how to hold airway open JIC*
    M: “insert many creative expletives here” *patients heart stops beating* (a habit I picked up from the military was that when at rest ie waiting to see what new hell breaks loose or assisting an actual medic but with nothing current to do, keep fingers on a pulse. Either radial, or in the neck preferably, because lawsuits... nobody wants your fingers on their thighs)
    M: *chest compressions done to the tune of oh shit oh shit oh shit* (hey I could count but that works too)

    Let’s just say you don’t ever forget the sound of a rib going snap. Damn old people and their old people bones.

    P: *regains heartbeat*
    M: “Thank Eir” (yes I’m a ‘heathen’ deal with it. Though I was accused of practicing witchcraft yesterday because apparently being ambidextrous is a sign of being a witch... and she was serious about it to. I found it hilarious but had to wait until she was gone to burst into giggles in the cash office.)

    Someone else updates the ambo while I come to terms with the whole lazarusing someone up and snapping a rib in the process.

    N: “you broke his rib. I heard it!” (In accusing voice)
    M: “pretty sure that’s not the biggest problem here”.

    Since N only seems to want to criticize and tell me what to do (much ignored advice) I set about putting in an IV line and hooking up fluids (after double checking the date because I haven’t had cause to use anything in my kit since my last resupply). And hooking him up to O2 mask (IV and oxygen, affectionately referred to as the hangover helper set).

    Yes I’m aware I have some weird shit in my car. Yes I’m also aware that carrying a level 3 First Aid bag, O2, and IV fluids are not normal people stock for the car.

    If you think that’s bad, you should see my basement. Since I’m part of the emergency hub I have all kinds of weird shit the govt. pays to have in my basement for in the event of a citywide disaster first responders can use my house as a resupply station/triage centre. This is particularly important if the roads aren’t passible. I’m not the only one in the city who has it. It’s generally for people who live above flood areas and who already have the training to handle emergency situations, but also have a yard to act as a trauma bay. And it’s tax deductible too.

    And his heart stops... again. And again I do chest compressions.
    paramedics arrived and took over.

    Shows how quick someone can decline in 15 (probably more like 20) min.

    If the callers had been honest at the beginning then they would have been there quicker. But because a fall doesn’t rate as high as old person hit by truck has head trauma... they weren’t in hit-the-oh-shit-pedal mode.

    I got a ride in the ambo because they hadn’t fixed him enough to help me (definitely headed into deep shock territory there. I’m fine in medical emergencies so long as I keep going. So long as there’s another person waiting to be patched up even if it’s just the walking wounded... it’s afterward when I stop that is the problem) beyond the basics of lay down, blanket, elevate feet. Pretty sure I spent the entire time staring at his chest. And as I’m not a grave robber it’s safe to say he wasn’t nearly attractive enough to warrant the attention paid there.. Thankfully he regained and kept his heartbeat the second time at least until we hit the Hospital and were separated.

    Should I have ignored the so called nurse? Honestly just because your job discription says nursing doesn’t mean you work as the hospital/doctor type nurse. By the way she was acting it sounded to me like she didn’t know what she was doing in that particular situation. Hey, maybe she’s the more careaid type nurse who wouldn’t usually be called into a situation like that. How the hell was I to know.
    34
    Yes
    100.00%
    34
    No
    0.00%
    0

    The poll is expired.

    Last edited by AkaiKitsune; 01-23-2019, 06:12 AM. Reason: Can’t spell worth shit.
    Don’t worry about what I’m up to. Worry about why you are worried about what I’m up to.

  • #2
    You are a highly trained first responder that has been in 'training' since childhood given your families extensive armed services history. I would rather have had you treating me than the nurse.

    If she was trained in anything outside a hospital setting, I would be surprised. If she had been, she would have made sure that the approx age of the patient and the fact he was hit by a car was passed onto 911. Even for a fall, letting 911 know that he was elderly and hit his head would have gotten the paramedics there earlier.
    A good bookshop is just a genteel Black Hole that knows how to read. - Terry Pratchett, Guards! Guards!

    Comment


    • #3
      That nurse was actually interfering with your examination, not to mention botching the initial 911 call!

      Ignoring her at the moment was entirely appropriate. Now that the crisis is over, you might consider filing a complaint with her employer.

      Comment


      • #4
        Nurse. Right. She sounds like a Candy Striper with ambitions (and delusions of competence).
        AkaiKitsune, I don't know just what all credentials you have, but there's enough trauma/triage credentials in there to suit anybody. Rank/seniority rules, and the little 'nurse' can cram it.

        Comment


        • #5
          I think the "nurse" should consider herself lucky you didn't bite her head off and s**t down her neck.
          “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged.
          One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world.
          The other, of course, involves orcs." -- John Rogers

          Comment


          • #6
            I haven't even taken Red Cross first aid classes (really should sometime), and even I know that cracked/broken ribs are far from uncommon as a result of CPR, even in young patients, let alone the elderly.

            Too bad we can't find out what diploma mill issued her credentials (if any) or where she works (again, if any).
            "Crazy may always be open for business, but on the full moon, it has buy one get one free specials." - WishfulSpirit

            "Sometimes customers remind me of zombies, but I'm pretty sure that zombies are smarter." - MelindaJoy77

            Comment


            • #7
              When I did my first aid refresher it was taught by a former EMT who said if you break a rib you know you're doing CPR right.

              Comment


              • #8
                Quoth KuariKaydrith View Post
                When I did my first aid refresher it was taught by a former EMT who said if you break a rib you know you're doing CPR right.
                Oh I know it’s far from uncommon but it’s still...when you hear a crack sound because of something you’ve done...
                Don’t worry about what I’m up to. Worry about why you are worried about what I’m up to.

                Comment


                • #9
                  Quoth AkaiKitsune View Post
                  Oh I know it’s far from uncommon but it’s still...when you hear a crack sound because of something you’ve done...
                  Unnerving? I can only imagine.

                  By the way... Great job.
                  Life is too short to not eat popcorn.
                  Save the Ales!
                  Toys for Tots at Rooster's Cafe

                  Comment


                  • #10
                    I'll take the rib over a coroner, ANY DAY. Hell, take 2 if need be. They'll heal.

                    Carry on, AkaiKitsune.

                    Comment


                    • #11
                      If somebody knocks me down with a car, I want YOU there. Not that "nurse".

                      Comment


                      • #12
                        "Nurse." Riiiiigt, no, she just watches too many medical dramas. I'd have detailed someone with some actual sense to chase her off the first time she tried to interfere and showed she didn't have a freakin' clue.
                        You're only delaying the inevitable, you run at your own expense. The repo man gets paid to chase you. ~Argabarga

                        Comment


                        • #13
                          I'm not medically trained but it sure as hell sounds to me like you knew what you were doing. I had some basic CPR training years ago and I remember they told us that ribs might crack when doing compressions. It doesn't sound like Nursie even knew that much, and suggesting you give the guy something to drink? Hell no.

                          Thank the gods you were there. You did good.
                          When you start at zero, everything's progress.

                          Comment


                          • #14
                            It could be that the nurse was someone who worked palliative care or as a care aid. Technically they are just as much a nurse as the ones in the hospital but they are trained in a completely different way as their job has different needs. You don’t exactly get hit by a car problems in the palliative care or if she worked with elderly people with declining physical and mental health.
                            Don’t worry about what I’m up to. Worry about why you are worried about what I’m up to.

                            Comment


                            • #15
                              I'd say that "nurse" is Nurse Ratched. You had far more knowledge of what needed to be done, and if you weren't there, and if only the "nurse" were there, he would be in a morgue.

                              You were 100% in the right.
                              "Life is tough. It's even tougher if you're stupid" Redd Foxx as Al Royal - The Royal Family - Pilot Episode - 1991.

                              Comment

                              Working...
                              X