ARCHIVES - 1996 to FOREVER

I think that I didn't hit the snoozebar at all, but it just took 90 minutes for the alarm to wake me.

Got to work on time, of course, and it wasn't really a bad day at all. We had a meeting at 12:30 with the supervisor, and that was OK, but it will resolve nothing, as usual. I'm just so damned negative about everything at work any more that it's depressing me.

One thing that we talked about was the fact that our patients for angiographic studies don't have proper IV access.

We've found that anything less than a 20 gauge IV in the AC (AnteCubital)(that's the inside of the elbow) does not give us a good angiographic exam... there is just too much dilution of the contrast. So we changed the protocol so that the nurse responsible for the patient ensures that there is a good IV available.

It just doesn't happen.

And my co-workers think that it *should* happen, and I agree with them.

But it ain't happening.

And you know? It will never happen.

And we are not there to educate nurses. We're there to get the job done.

And if the nurses can't, or won't, do what's necessary, we should just do it.

This is a battle that I've been fighting for fourty years, and I'm tired of it.

It takes five minutes to start a large-bore IV most of the time. I can usually do it in about two. Unless I have to write the nurse up, which takes about an hour.

Dammit, I always have five minutes, especially if the patient is in distress and on the table... I seldom have an hour.

And if I can't do it, I know the people that can.

And if it can't be done, I know how to get a neckline placed, or how to get the patient taken care of otherwise.

And it does absolutely no good whatsoever to write the nurse up... they will not learn anything at all from that, only that the CT department is comprised of a bunch of pricks. And about half of the nurses are not long-time employees anyway, so even if we do educate them, they're gone in two months.

I like starting IVs in these situations. I know that it will be good, and that I will get a good exam. I don't have to trust anyone else.

Do what's necessary, get the exam done, do the best thing for the patient, get the diagnosis. I don't care that someone else drops the ball, I'm not gonna. That ball is important for the patient... and the patient's care is what's important.

And the rest of this shit? I'm not gonna worry about anyone else not doing their job... I'm gonna do mine.

Big storms north of us, might or might not make it down here. I'm going to bed with the sun, and I don't care unless the house blows away.

Uh, I don't want y'all to think that I got a thing going with the sun... we're just friends, OK?