Sunday, February 11, 2007

Trauma and Drama

Another Sunday mornin’ comin’ down. This one came down a little harder than most. I got and “URGENT” message on my cell from a number I recognized as coming from the ED. Getting called on a Sunday with an urgent tag on the message didn’t bode well. Before I could get the number dialed my land line rang. On the other end was my assistant supervisor telling me we had “some trauma and drama working.” Turns out one of our night shift nurses had worked Saturday night and had an MVC (motor vehicle collision) on the way home from work Sunday morning. In addition, two other nurses scheduled to work tonight (Sunday) had called in sick. So with those two, plus our trauma victim we were down three nurses out of the five originally scheduled. Not good under any circumstances.

So my concerned self and my managerial self (“good grief…what are we gonna do now?”) got in the shower, threw on some jeans, forgot about the make- up, said a prayer for our nurse with my husband and went in to work. First order of business was to see about our injured night nurse whose spouse also happens to be a nurse on our mid shift. Now I’ve known this nurse for well over 20 years. In fact I was one of his paramedic instructors when he first got in “the business.” So this is as near enough to having this happen to my brother as you can get. I entered the trauma room and helped the team as they log rolled him to change wet and bloody sheets. His head was wrapped chin to scalp in bloody kerlix and besides some bruises and bumps he otherwise looked intact but hurting pretty good. I couldn’t do too much other than get a blanket out of the warmer and put on him.

The story was he had fallen asleep at the wheel and woke up as his vehicle was heading into what we call in Texas a “bar ditch”. He tried to correct and get back up on the road and when he did, the truck rolled. Thank goodness he had sense enough to be wearing his seat belt, but the sense pretty much stopped there. He got out of the truck, walked at the scene, refused collar and backboard and arrived in the ED pale and sitting upright. He had nearly scalped himself and actually took a huge divot out of his scalp down to shiny bone. He bled like stink thanks to Plavix and natural scalp vascularity so he didn’t have much in the way of a blood pressure on arrival.

By the time I got there, our great staff had given him enough blood and FFP (plasma) to get his blood pressure where it needed to be. He’d been through cat scan until he glowed and he was almost ready to be flown by helicopter to a Level 1 trauma center. Besides the huge scalp laceration that will require a skin graft and plastic surgery, he had a contusion to the frontal lobe of the brain , contusion of the chest from the seat belt and a hairline fracture of the spinous process on the C5 vertebrae of the neck. Pretty lucky that’s all there was. I talked to him and in true ED nurse fashion, he was griping about the money he would be missing by not working tonight and worrying about the fact that we are already short staffed. I assured him that we already had tonight covered and would be just fine. His job was to take care of himself and get well, to which he replied, “I’ll be back to work next weekend.” Whatever! Only an ED nurse! How can you not love and be grateful for people like that?
The copter crew came and whisked him away in the sky. I thanked the surgeon who responded and gave hugs to the two nurses who took care of him and told them they’d done a good job….which they had. I’m sure they kept him alive.

Now on to the staffing problems for tonight. My assistant supervisor had already called everyone who was a remote possibility and left messages. Oh the blessings of caller ID!
So far we had a 12p nurse willing to work 7p instead, another night nurse willing to come in at 11p and another “possible” for 11p-7a….Still short….too short for flu season which hit us with a vengeance about a week ago. One of the nurses working a short shift today volunteered to come back and work 7p-11p and another nurse working 7a-7p today said if I could find someone to come in for her today, she would go home and come back at 7p. That also would mean I’d need to find coverage for her 7a shift tomorrow. So I called one of our 7a nurses who was off. She agreed to come in and cover for my day nurse who would come back tonight and my assistant supervisor agreed to work 7a tomorrow. Whew! I couldn’t tell you how I kept all that straight. It was quite a piece of art.

These people I am blessed and proud to call “my staff” constantly amaze me. I know they’re really not “my” staff, God’s just loaned them all to me for awhile. They go “above and beyond” on a daily basis and are especially prone to pull together when one of our own need help. Right now we have two open positions on night shift and now we are down another one for awhile. Everyone has worked and worked until I don’t know how they keep it up. I used to stress a lot about staffing, but I’ve learned over the years that the great people in our department will step up to the plate when they are needed most and somehow it all works out. That’s what teamwork mixed with a little divine intervention is all about.

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