Crazy Talk

Here's a sample of me getting report from the float nurse on a "heavy" patient I haven't had yet this admission: keotube feeds, IV heparin drip (not on the right IV pump, but whatever), wrist restraints, lethargic yet combative and howling when not lethargic, going for a PICC this a.m., blah blah blah blah blah.

FLOAT NURSE:
So this patient is MMSA positive.

JAMIE:
Uh? Sorry? Is that like MRSA? I've never heard of MMSA.
[asks another nurse standing by]
Have you heard of MMSA?
[talking to float nurse again]
Do you know what it means, is he a contact precautions guy or...?

FLOAT NURSE:
[in tone that suggests it really isn't a big deal, can we please move on now?!]
I don't know. He doesn't seem to be on contact precautions.

JAMIE:

[not trying to be bitchy, but thinking This is starting to piss me off a little bit, maybe I should just read through his chart instead of getting this lame ass verbal report]

Uh. Did you check his labs? Did he have a MRSA swab done or something?
Did they tell you what it means in report or maybe it's in the chart?

FLOAT NURSE:
[listlessly]
I don't know; that's what I got from report. last night

JAMIE:
Uh huh.
[now totally pissed, as she realizes she's going to have to treat the patient as contact precautions even though he hasn't been all night/whenever and it might take half an hour of research to figure out what MMSA means]

Okay, so I go into the room because his tube feeding pump is alarming, and notice he's not on the right pump for his heparin, and it's been running all night/for God knows how long. I have no idea if this guy has a nosocomial infection or not, and now I'm going to have to 1) fix the tube feed pump 2) find the right pump for his heparin gtt 3) figure out whether or not MMSA is some new scary disease that will render you blind or something, in which case I can file a lawsuit against the hospital, or at least fill out worker's comp papers.

I'm not even half way through report, it's 7:30 a.m., and already I have three issues to investigate and correct on one patient, plus I've got to hang two units of FFPs on another patient I haven't even seen yet. I'm way passed pissed off at this point: I'm angry, but in that muted, repressed, teenage angsty, "Whatever" way I've gotten about shit like this.

Like, okay, I'm not Supernurse. I pass on information that I haven't had time to properly research. But I like to think that when I pass this info on, I'm usually pretty confident that whatever it is I'm passing on is real, legitimate "stuff" and not just "I don't know, someone appears to have made that up and I had eight hours on the floor and didn't bother to check it out. because I was too busy improperly hanging his tube feed and continuing his IV heparin on the wrong IV pump." But maybe it would be valuable to know if the guy has a superbug, as he did present with bacteremia and a UTI for which he is currently receiving, and will continue to receive, IV antibiotics."

Luckily, we had a clinical nurse specialist there to lend a helping hand, and she said, "You mean MSSA? Methallicin sensitive staph aureus?" So she went and researched his labs to find the answer, while I ran around doing other things, acting like a brand new nurse two days off orientation with her head stuck up her ass. (I found it ironic she had to go through all his blood cultures, and it looked like this information was eight days old, and wondering for how long had we been passing off MMSA bullshit in report and everyone just shrugging and going, "Uh, I don't know. Whatever." And the next nurse going, "Okay. Whatever.")

But seriously, with nosocomial infection rates soaring nationwide, you'd think you'd take the time to check to see if the guy had some superbug we don't want giving to every other patient we touch, right?

Whatever.