Code Rainbow

We don't have security.  When there is trouble the local police are but a 911 call away.  They are always prompt in coming to our aid to either kick ass or talk people out of a tree.  They also know what time we close, and unless they are really busy there is always an officer waiting for us as we alarm the bulding and disperse to our cars in a dark and secluded parking lot.

 It is nice that they are protective like that even if we rarely get the aggressive or dangerous patient.  Drunks?  Never come by ambulance.  Overdoses?  Occasionally thrown out of cars onto our doorstep, but they are the exception rather than the rule. I truly don't miss that about working in a city hospital. 

One night we got a 6 ft 2 inch 18 year old male whose parents had come home to find him lying on the floor, " not responding".  I don't know how, but he was  carried in by his father.  He could walk, but wasn't really doing what he was told; he also had slurred speech and was "not really cooperative" (he took a swing at me).  He was drunk, of course.  Shocker.  So I was concerned enough about my/our safety to call dispatch and have them send over some hefty police presence. 

Cripes: "Why did you do that?  Don't we have any leather restraints?"
Funny.  Real funny.

Cripes told us, "When I was in residency, I tackled a psych patient in the hallway.  We were wrestling around, and I yelled for the nurse to call a Code Grey for security.  She got all huffy and said, 'Well, that would be a Code Green'.  Seriously?"
Me: "Ha.  More like a Code Black and Blue".

I get it.  What Cripes was referring to was the method utilized by most health care facilities to immediately broadcast some sort of internal threat or emergency situation which are often color coded so that visitors and patients aren't  freaked out.  It would be chaotic and dangerous, especially to bed-bound patients if some things were broadcast in an overhead page like, "Bomb Threat, GET OUT IMMEDIATELY", or "FIRE!  As if anybody is fooled by an overhead "Code Red!  Code Red!  Code Red" even if it is just the ICU nurses burning popcorn. 

"Did you order the Code Red?"
"Your damn right I did!  But the popcorn is inedible!"

 A Code Red in our community also means a  reverse 911 system to notify citizens of school closings, tornadoes, or local flooding with road closures which we are prone to, and other natural and unnatural impending disasters.  I generally have a surge of adrenaline when I pick up the phone at home and hear "This is a Code Red alert!" when the water is up to the door of my barn and the road is impassable.  This usually means I have to find another way to get to work, but I can generally just look out the back door to determine that the creek is overflowed.  The car lying in a puddle up to its roof is a dead giveaway.

These codes are not standardized from place to place.  This makes it confusing so other than codes for a cardiac arrest or a fire I can never remember what some of the colors are. A Code White, Grey, Green, Yellow or Orange might be  used for different emergencies or not exist at all at some of the various facilities I have worked over the years.   Obviously we never use them where I am working now, but if I had to work at the Big House I would need a cheat sheet.  Good thing the codes are printed on my ID badge.

Super-secret codes for emergency situations in the hospital undoubtedly fool nobody.  The cat is kind of out of the bag when  "Dr. Ambu", "Code Blue", "Doctor Blue, Stat", and "Code 99" is paged for a cardiac arrest, especially when a dozen people rush by with an automotive cart trailing jumper cables.  I worked at the "Code 99" hospital for many years, and had more than a few adrenaline rushes at the  local supermarket when they paged "Code 9" for a manager check approval. 

There are codes of various colors used for things like Haz Mat alert, Internal Disaster, Mass Casualty, Missing Infant from the nursery (in which the entire hospital goes into immediate lock down), and others. Some of us added to the list over the years during times of intense boredom.  "Code Rainbow" referred to the choice of a liver entree in the cafeteria, notable for the lovely rainbow colors it took on when sitting in its un-appetizing-looking liquid.  One of the lab techs had an odd habit of wearing an entirely color-coordinated ensemble from head to foot.  If she was wearing red, for instance, she would have on red hose, shoes, jewelry, slip, hair appliances and underwear (we took her word for that).  We referred to some of her more bizarre outfits as a "Code Puce and Chartreuse" as she had a weird penchant for those particular shades of purpley-brown and yellow-green.

Among the  re-tooled  emergency codes include  "Code Squirrel",  when we are overrun with drug seekers, "Code Blah"  for something boring in the cafeteria, and "Code Chicken Little", which meant that the charge nurse was spinning in her own orbit and the sky was falling.

The latest code is an ID-10t.   Lisa started using it when dealing with persons of less than average intelligence.  I have since learned that it is actually a tech term humorously used to describe user errors in individuals with limited computer skills.   I have no idea where this originated, it wasn't me but I like it a lot.  Look at it.  It spells.....

That's Why the Lady is a....

I got an urgent phone call from Ellen on my day off.
"Hi, EDNurseasauras?  Sorry to call you but the nurses were very busy and asked me to go down the list.  Is there any possibility you could come in and help out?"
Me: "I'll be right there".

I have only gotten a call like this once at my current job.  My name is at the end of the alphabet and they usually find someone before they get to me. Usually Second in Command, whose name is at the beginning of the alphabet, gets this type of urgent call and jumps right on it because she is an Overtime Whore.  Me, not so much.  Except lately because Kate has been going through some health problems and I have pretty much made myself her personal bitch when it comes to covering her time.  Also because it annoys the crap out of Second in Command. 

I made it to work in about 7 minutes, expecting that there would be 2 Medflight choppers circling, simultaneous codes, any number of disasters.

Instead, I walked in to find 4 patients awaiting transfers because Inappropriate Drop paramedic was working today.  Among the things that shouldn't come to us but did thanks to Inappropriate Drop paramedic:
Head injuries
Probable hip fractures
End Stage COPD'ers (unless coding)
Transfers from doctor's offices with beds at the hospital.  The OTHER hospital
and.........
The Lady on Elm St. with vomiting.  I fu*ing hate Inappropriate Drop medic sometimes.

Not just regular vomiting.  Lying flat on her 400 pound back and just letting it rip like Mt. Vesuvius.  Because, she said, "Whatever I put in just comes right back up".

When things come right back up, it is probably an indication to stop putting stuff in.  Like Cheeto's.  Not a concept she'll be getting any time soon

Lady was the straw that broke the camel's back, a clean-up job requiring reinforcement nurses.

Quote of the Day

I still don't understand why people come to the ER in search of a pelvic exam.  This, the most personal and private exam a woman can be subjected to, and you want a total stranger to do it?  I guess some people just don't care and consider it the price to be paid for a prescription for Percocet for their 10th visit this year for "painful periods", "my ovarian cyst is bothering me", and "painful intercourse".

Seriously? 

I have had a run of days working with Gil, who is an older guy.  After setting up the 4th patient of the night for a pelvic for a frequent drug seeking squirrel, Gil rolled his eyes.  "Doing a pelvic", he said, "is like going on a treasure hunt for really bad treasure".

Yup.

What Happened to September?

 Happy 2012 to all.  I don't know where 2011 went. 
I guess I have been slacking the last couple of weeks although the holiday season gave me plenty to write about.  I have tons of material, stacks and stacks of notes and pithy observations (ha!  I am not sure I am capable of such).  Some of them are actually humorous and possibly worth reading. 

It is equal parts lack of motivation, time, and resources.  It doesn't help that my laptop is on its last legs.  I have spent the last 4 1/2 years pounding the crap out of it and I have decided not to keep it alive with heroic measures.  I will eventually bury it at sea or run it over with my car. 

More soon.

 

Status Update

Our electronic patient status board lists all patients in the department so we can tell at a glance  which ones are  waiting to be seen, who is in what room, which doctor or nurse is assigned, what tests are finished or pending.  Kind of like Facebook.    It is the nurses' responsibility to discharge the patients off the board when they leave the department for good.  For added fun, last week the word "dirty" popped up on the status board when the patient was discharged.  Just to add 20 more steps to an already cumbersome and non-user friendly system, this necessitated entering "clean" when, obviously, the room was ready for another patient. 

We complained, of course, since the nurses at this facility have to do the discharging, cleaning, and removal from the status board.  The Information Techies must have been having a slow week taking turns offering Kudos to themselves on the Bitch Board about  how awesome and effective their department is because they got right on it. 

Now, to enhance the happy, happy, joy, joy, how wonderful for us to use only positive language, our status board no longer pops up the "dirty" notation.

Now it says "Unclean". And we still have 20 oh-so- convenient steps to change it. 
Dislike.  Bastards.