You thought your Mondays SUCK!

This past week was on of those ones that I hope I don't get to experience any time soon. It all started around 1900 Monday.

Another night on diversion! 

One of our many senior nurse managers followed by the very angry chief attending called the resource nurse less than 30 seconds after our request went to CMED. They wanted to know why he was requesting diversion if we still had beds available in the hospital. 

I was in the 7 bed trauma section where the two hardcore rock star nurses I was working with  were pretty much one to one with two very sick PTs while their other PTs harassed me with every request from doctors and doses of pain meds to the Russian looking for her seafood salad sandwich. 

The department as a whole was drowning in a sea of level 1-2s. ICH, Stemi, Acute GI bleed, three tubed ICU players, Sepsis, yup we had em all. It was an acuity party and the ED was the only department invited. Consult teams and floor nurses were avoiding our calls and pages like a resident avoids a call bell. A particularly ugly Monday meltdown.

And then the dreaded radio call arrival alarm went off. Several nurses and doctors cursed aloud. 

Medical Student (b) speculates " I thought we were on diversion"

 The double doors from triage opened and in rolled two cops and two paramedics with a stretcher.

 Pedestrian struck around the corner from the hospital on a busy four lane parkway.  This guy is in rough shape delta O2 and BP. The recording nurse makes a second overhead call for nurses to the trauma bay, The PT goes into cardiac arrest, intubation turns into a 5 minute ordeal for the senior resident. Despite everything the PT is revived and stabilized enough to be rushed to CT. The Trauma team wants the PT to go directly to SICU to be prepped and further stabilized for the OR. As they leave with the PT in a giant gaggle of equipment, RT and, trauma team the nurse shouts to me to call the SICU and inform them of whats going on and to have them call her in the CT control room for report. 

I pick up the phone and dial the SICU and explain to the nurse on the other end what is going on. She bitches to me that we should have given the SICU a little more notice than this. The PT has now been on the property for just over 15 minutes. 

Rock star nurse calls from CT she needs two bags of blood and more sedation meds "Please hurry!" she pleads. I tell her I am all over it like white on rice. as I move down the hallway I poke my head in her other PTs room to see why the alarms are chiming the monitor reads 68/- and HR hovering around 30. I overhead the attending to the room.

It is true Mondays really do suck!

The following week the resource nurse who was on duty that night is sat down for a formal Inquisition by a panel of senior management to explain why diversion was requested.