management - got to love 'em ... or laugh at 'em

So about nine months ago we were told two things in staff meeting.

#1 Everybody is working mandatory overtime and we are not paying as much for it as we used too

and

#2 oh, and here is a survey the corporation would like you to fill out concerning our management style.

Now you would think they would separate these two things by, say, a month or two. But our management does not necessarily see the connection of things. Needles to say our department came in rock bottom of the whole damn corporation. Rock bottom.

Einsteins that they are decided the problem was that we, as therapists, didn't feel recognized enough. So how to solve this? Of course! Send out another survey.

Low and behold in my box this morning is the survey. The very first question is something like "what does recognition look like to you?"
I put down, "a really big banner, a 14 and1/2 inch trophy, confetti, and possibly a parade."

Hope it puts an end to idiot surveys. Yeah - I know - wishful thinking.

I hate my job.

Okay not really the job. I hate this hospital and all the f%$#$% PA's who think they are God and don't want to listen to a damn thing any of us have to say.

So here's the scenario. Big freaking fat guy. 400 pounds. (Okay I exaggerate he's only 395). We have to do a lumbar puncture and the PA wants him prone. I strongly suggest that's a bad idea. PA argues with me. I say, "What I'm telling you is he is a big guy and he can't breath proned". I am totally ignored. So we prone the guy. Yeah I know damn stupid of us. I know better. Within seconds dudes blood pressure is 200 over something - he's tachying along at 160, spo2 67 and cyanotic as hell. PA wants to "give him a minute". RN says we have to flip him now! We overrule the PA because how you going to run a code on a prone guy????????

He did recover. But man it pissed me off so bad. I knew it was a bad idea. I told him it was a bad idea. Rn agreed it was a bad idea but no- stupid ass PA has to play big shot and damn near coded this guy.

I hate this job.

My brother loves these hunting / fishing shows. He watches them for hours. I think I could watch them if they were more like this guy....


www.youtube.com/watch?v=KUowyTE-X10

funny stuff this.

still not in Kansas

Weird. Still out of my comfort zone. Getting more comfortable though. Still in the Trauma unit. Weird. so many people WANT to work in this unit. They see it as th pinnacle of their career. Okay maybe flying on the chopper is a smidge higher - and they get cool uniforms. But for most folks working the Trauma unit means you have arrived.
Me. I just don't care. You can have the trauma unit. WAAAAYYY to many egos for my taste. And Heaven forbid a doc actually writes an order in the chart. They discuss things amongst themselves, sometimes letting the nursing staff in on whats going on.... sometimes not. And if I'm lucky - I catch wind of it. I asked someone about this odd thing about not writing orders. I was told trauma surgeons are "too busy to write orders".

Reminds me of a joke. What's the difference between a doctor and god? God doesn't think he's a doctor.

Were not in Kansas anymore....

Well I was pulled from my usual comfortable routine and sent to the trauma unit. Not usually a big deal. But today was travel day. Let me correct that... travel without any notice day. I walk into my first room for my first vent check and the there is an anesthesiologist, a transport tech and several other people. I know I'm going to look dumb but still I had to ask, "Are we going some where?". "yes the OR... now" Okay, okay I stuff my pockets full of all the crap I might ever possibly need and off we go. I leave them in the OR and come back to the unit. Walk through the doors and a nurse assails me, "Are your ready?" Me (looking dumb yet again) "Er, ready for what?" "We are taking bed four to the cath lab... now" Damn. Lucky though, I still have pockets full of all crap I may need. I never really get caught up... but you know eventually you get so behind your on schedule again! The afternoon was a repeat performance. Another transport ... which I actually got told about. And then I am doing my vent check and two nurses are talking "... and when you get back we will..." One more time I look dumb, "Are we going somewhere? " "Yes, CT ... now". You know I should have just walked out and not said a word and when they were ready to roll out the door and realized the guy is connected to a ventilator THEN maybe they would think about giving the RT a heads up!!

But then again. They might not have noticed and extubated the guy.

What do you need ....a banner that says hey I'm dead!!!

So after three apnea tests (all verifying brain death), the cholinergic tests (all verifying brain death), several eeg's (all verifying for brain death) the doc refuses to declare the patient brain dead becasue he may or may not have seen some minute possible, (most likely imagined) millimeter of eye movement. No shit. So we keep the dead guy alive on a vent, all the while giving the wife false hope, and at the same time maxing out her Visa.

We here in Neuro icky u hate this. We begin to hate the paitent. We totally hate the doc. And no one has the balls to over rule the doc and walk in to the wife and say "dammit, man's dead - pull the frggin' plug." For twenty seven days we play this hellish game - only to finally transfer him today to a long term care unit. Can you believe that?

Wht the hell does the doc need to verify brain death??? A friggin banner over the guys head? Does he need the patients ghost to come tap him on the shoulder? Does God himself need to come down and tell him to knock it off?

And what is really chilling is this is a new doc, now working in Neuro a lot (where, by the way there is a LOT of death and end of life decision making) - and apparantly a psycho doc who has end of life issues . God help all his patients from now on.

What happened to personal responsibility?

I was watching a tv the other night. Some documentary on how the health care system fails the "average person". They showed this man ... this whale of a man - 450 pounds I think they said. He was uninsurable (they didn't say why he was uninsurable, just suggested that the wicked evil no good greedy insurance companies wouldn't insure him.) He had diabetes, a bad heart, cellulitis, gangrene in his foot, hypertension, and every other malady that comes along with morbid obesity. My question is this? Why the hell is he 450 pounds and whose fault is that? If he chose to be 450 pounds (which apparently he did) then isn't his health his problem? Why should insurance companies insure you if you have a lifestyle that will inevitably cost them money? And who ultimately pays for that? You and I jack - in one form or another. Either we pay higher premiums to compensate or higher taxes for federally subsidized programs

I had a patient bragging about how good her health insurance is. "They paid for my glasses, They paid to get all my teeth fixed. I only pay 3 bucks for a prescription and only a max of twenty bucks a year. I don't pay nothing for the emergency room or the hospital...." Perplexed I say "wow - what insurance do you have?" She replies "I'm on Medicaid!" I had to bite my tongue because I wanted to scream. So because she has smoked like a chimney and now has advanced COPD at the ripe old age of 40, she is on disability (which we pay for), she gets to sit at home and smoke more while I work my ass off, and they ravage my check to pay for her health insurance to pay for her health problems that SHE caused AND I pay a shitload for my own health care insurance AND she gets better benefits than I do!!!

That is what's wrong with government running health care.

There is no responsibility factor. There is absolutely no incentive to work, stay healthy, or not visit the ER unless it's a real emergency. There are no co pays, and only minimal prescription prices. There is nothing that curbs massive widespread use and abuse.

I don't have any solutions. I just feel used.