Small Town Patient Privileges

Patients in a small town hospital like the one I work happen to be a totally different animal than the ones in the bigger cities. This idea I'm pretty sure Freadom over a Respiratory Therapy Cave and agree with me about because it seems that he is in this same small town hospital category.

Some of the differences I have noticed are the types of reasons that people come in for are pretty simple compared to larger hospitals but there are exceptions also to this. There are the injuries that can be more local to the type of hospital you work in. For example where I work is a large farming community, we have had rolled over tractors, getting kicked by horses, falling off of barns, and my favorite the guy who him and a couple of buddies were drinking out in the cow barn and had a little to much and passed out and coded right in the middle of cows, down in the hay and manure. The EMT's said they were worried that the cows would kick them while they were working on the patient. This guy smelled awful and had cow manure and hay all over him, unfortunately he didn't make it and the ER room smelled and had hay all over the place. Then there was the Ethenol Toxicity patient who decided to drink some straight ethenol from the ethenol plant, yep not smart it's 200 proof!!!! He was quite red.

Tonight I had another one of my small town patient who received a privilege that I have not come across so far in my 12 years as a RT.

I was on my way to do a breathing treatment with a older patient at around 8 pm and when I got to her room there was no one there. Fine I thought she must be walking around the unit, we do encourage our patients to get up and walk. I see her nurse and ask if she is out walking and I'm told no she isn't, she is - get ready for this -

Ok here is the dialog:

Me: Hey Nurse Betty do you know where Mrs. Bing is at, she is due for her treatment?
Nurse Betty: No she isn't here right now, she's out.
Me: Out, not here, is she at a test?
Nurse Betty: Uhhh nope, she is at a Wedding.
Me: She is what??? (confused look on my face)
Nurse Betty: Yep you heard me right she is actually at a wedding, she left about 1 pm.
Me: Really, is she coming back?
Nurse Betty: Yea the doctor said she had to be back by 9:30 pm.
Me: So she is gone to a wedding and has a curfew. She is really sick isn't she. (dumbfounded)
Nurse Betty: (sarcasm) Oh yea she is so totally sick.
Me: Did she wear a dress? Get all dolled up?
Nurse Betty: No Idea I just go here at 7 pm.

Ok this I found interesting as she must not be very sick at all, send her home and have her follow up with a doc at the clinic. Your wasting our time.

So about Midnight I have to go assess her for respiratory status and she is there finally and I can give her the treatment also now.

Me: So I hear you went to a wedding today?
Mrs. Bing: Oh yes I sure did.
Me: Was it a good wedding?
Mrs. Bing: Yes very pretty and the reception was a lot of fun to.
Me: So what time did you get back?
Mrs. Bing: A little before 10pm, the doctor gave me a curfew. Can you believe it, I'm 86 years old and I was given a curfew. I really don't remember ever getting a curfew.
Me: Yea that is pretty funny, well glad you had fun and made it back before the doctor grounded you. Alright here's your neb.

I just really found this interesting that a inpatient is released to go to a wedding or really anything while they are sick. Granted we cannot hold someone against their will but why not just discharge this person, they seem to be okay. Oh well I thought it was funny.

Then tonight there is this younger 20 something in the ER who I had to do a EKG on. The police were here for this one because he was a bit unruly. Seem like he had a couple to many drinks or drugs of some sort. So anyways I'm in there and he threatens to spit on people so the conversation proceeds:

Big Dork: Get away or I will spit on you and give you the SARS I have!!!!
Me: I don't really think you have SARS.
Big Dork: Yes I do get away.
Me: How did you get SARS?
Big Dork: I don't know, how can you get SARS?
Me: It's not in the United States, have you traveled overseas recently?
Big Dork: Yes I've traveled overseas recently.
Me: Where to, because there are not to many places that have SARS?
Big Dork: What places have SARS?
Me: Japan, China, over in that area.
Big Dork: Well yeah exactly, that's were I went to Japan.
Me: Yea Okay, if you spit on me SARS or not I will let that cop beat on you.
Big Dork: I'm not really going to spit on you.
Me: Ok hold still so I can run this EKG, thanks all done and good luck with your SARS.
Big Dork: Thanks, can I have a glass of water.
Me: Let me ask you nurse, cya.

That was just plain funny, I like funny drunk/high people you can mess with then and they will never even really notice you messing with them.

Well hope this was as entertaining to you as it was to me tonight as it did make the night more interesting because I actually had no patient that were due anything overnight. Easy night

Drive on RT's

Whoa It's been awhile, people are still nuts.

OK so I have to apologize for not posting for like 2 months now, I became a little busy with life and this was put on the back burner. My hospital started blocking personal (BLOGS) sites from viewing on the internet so I wasn't able to log onto Blogger here and post anything because I usually did it from work. Home has been a bit busy and there just wasn't enough hours in the day to do much posting.

So here I am posting again, my hospital set up a WIFI network for patient and others to use so I bring my laptop into work now and can have some time to post again. So stick with my I'm able to do this again.


Now on to more pressing matters, OK so it's only what I think is a funny little story about a patient at work who really either had no clue, or she just wanted to be difficult and not have to the my therapy.

We RT's here at my little hospital have to start and do Incentive Spirometers with every surgical patient for 4 times to make sure they are doing it correctly and acheiving 50% of there predicted volume, which I personally think should be 50% of their PRE-surgical volume they were able to acheive and not the predicted. Some people have trouble getting 50% of predicted without the surgery. So anyways if the patient cannot get 50% of predicted we start EZPAP until they can acheive this goal. OK now off to my story.

I walk into Mrs. White's room to do round 2 of her I.S. and it goes like this:

"Hello Mrs. White I'm with Respiratory Therapy and I'm here to work with your I.S."
"OK, hand it here and I will do it."

I hand her the I.S. and she of course blows as hard as she can into the mouthpiece and of course nothing moves.

"Umm your doing this wrong, you need to suck in on the mouthpiece to make it move"
"Oh OK I remember."

Now mind you she has been previously instructed on this, I'm there for round 2. She goes ahead and blows on it.

"No remember suck in on it like you would when drinking from a straw."
"I can't, I hate using straws, I don't use them."
"Ok well have you ever used them, while drinking some pop or soda?"
"Nope I have always hated them and have NEVER used one."
"Well how do you know you hate them then."
"I just know I do."
"Well lets try breathing on this again, OK"

So off she goes blowing in and out on the I.S. and it's doing nothing.

"Mrs. White, try to take a deep breath through the tube like you would if you were going to go swimming under the water."
"I don't know how to swim, I don't swim."
"Umm, you have never gone swimming or wading in a pool?"
"No, I'm from the Southwest there are no pools there."
"I used to live in the Southwest for a couple years there were pools there, it's hot and people have to cool off."
"Well not in my time there were no pools in the Southwest."
"OK, I see, lets try sucking in on this tube again."

So now she is like panting on the tube, quick short breaths.

"Now take the tube out of your mouth and put your hand in front of your mouth and blow out."

She does

"Did you feel the air on your hand?"
"Yes."
"OK do the opposite of that, ya got it"
"OK I see."

Back with the I.S. she if breathing deeper in and out of it.

"Did you see it move up there?"
"Yes I did."
"OK now do what you did to make it move up only do it bigger!"

FINALLY SUCCESS, she hit 1500 ml's on the I.S. and her predicted is only 2000 ml's so she is over the 50%, NO EZPAP, whoo hoo.


The next day I come to work and find out the day shift was having the same issues that I did with this patient, so like I said she either has:

A) No Clue
or
B) She is jacking with us.

Either way I didn't have to see her again. You can always find humor in this job. Actually I think you have to have a sense of humor to work this job.


Thanks for reading.