Mythology epiphany
I've always had a problem with the mythological concept of bailiwick (or sphere of control). Why do so many (mostly ancient) religions have a pantheon of deities each of which holds sway over only a small portion of the universe. If the gods are all powerful and are constantly getting in each others' way why don't they all just do everything. I'm sure that Neptune gets sick of seeing water all the time. I can imagine him offering to trade with Pluto for a century if Pluto will just talk to their brother Jupiter about rotating responsibilities occasionally. Kind of a divine time-share arrangement.
Even the Judeo-Christian faith has a similar concept. Those who believe in choirs of angels of "patron saints of..." might understand. I mean a saint's responsibility isn't even assigned until well after his or her death implying that they could do pretty much anything, they're just waiting for their papal orders.
Tonight I had a brush with understanding.
A patient was brought up from the ER on a stretcher that evidently was fairly special. As soon as the patient arrived the nurses who had brought her up requested that the patient be immediately moved to another stretcher, they wanted theirs back. Had the patient's injury not been an un-splinted, unstable compound fracture of her femur (thigh bone) I might have been happy to help.
I diplomatically explained that no amount of narcotic could prepare a patient with such an injury to be manipulated in any way, and we always anesthetize patients with orthopedic injuries prior to moving them to the operating table. The ER nurses were perfectly reasonable, but I had to repeat the entire explanation over the phone with their charge nurse (who also seemed perfectly reasonable but informed me that he'd have to talk to his superior).
Sympathizing with the predicament of the ER staff I lobbied the anesthesiologist to accelerate the process and was soon directed to take the patient to the operating suite. Before I could get out of pre-op however a woman in scrubs arrived and immediately started with the hostile rhetoric. I guessed that she was someone superior. Diplomacy got nowhere (however it gave her no ammunition to use against me), but there being no available stretchers to transfer the patient to in the immediate area I was able to slip past her and through the door marked "surgical attire only past this point". I was after all demonstrating progress.
Imagine my surprise as I was pushing the patient through the doors of the OR when I looked up to see the same woman chugging down the hall having added only a hair net to her ensemble. In the room I watched as she donned a face mask and tried to come through the door.
I drew my fiery sword.
There is surprisingly little authority given to the title of Registered Nurse in a hospital. Quite simply doctors and administrators just don't want to cede power to someone with only an associate's degree (the lowest possible college degree required to be an RN). What power I do have however is damn near absolute.
This director was still wearing the same scrubs she had been wearing downstairs. She'd never had any direct responsibility for care of this patient. Sterile supplies had already been opened in the room, and though I did in fact have not inconsiderable experience in an ER I was willing to bet that the superior had no real experience in an OR.
Believe it or not I was able to fit all these points into an uninterrupted comic book style monologue. The fact that I did it from the top of my 6' 6", 270 pound frame and in the voice of James Earl Jones was what probably put her at a loss for words (for those who don't know me that's seven inches and fifty pounds bigger than I usually am; I did manage the voice though). I used the words of power "take it up with my charge nurse" and "I'll get security to escort you back to your department" to really add effect to the display.
Big eyes and stunned silence, and an invisible barrier was erected at the doorway to the room she couldn't breach. It couldn't silence her voice though once she found it again. She admonished anesthesia for dragging their feet, she scolded us because she had a patient dying downstairs because she didn't have that stretcher, and she threatened to call Dr. "Red" Duke on us "because he'll have a shit-fit." My charge nurse and the anesthesiologist stood by me however.
For those who might be curious Dr. Duke and I get along very well, and no, he didn’t.
Even the Judeo-Christian faith has a similar concept. Those who believe in choirs of angels of "patron saints of..." might understand. I mean a saint's responsibility isn't even assigned until well after his or her death implying that they could do pretty much anything, they're just waiting for their papal orders.
Tonight I had a brush with understanding.
A patient was brought up from the ER on a stretcher that evidently was fairly special. As soon as the patient arrived the nurses who had brought her up requested that the patient be immediately moved to another stretcher, they wanted theirs back. Had the patient's injury not been an un-splinted, unstable compound fracture of her femur (thigh bone) I might have been happy to help.
I diplomatically explained that no amount of narcotic could prepare a patient with such an injury to be manipulated in any way, and we always anesthetize patients with orthopedic injuries prior to moving them to the operating table. The ER nurses were perfectly reasonable, but I had to repeat the entire explanation over the phone with their charge nurse (who also seemed perfectly reasonable but informed me that he'd have to talk to his superior).
Sympathizing with the predicament of the ER staff I lobbied the anesthesiologist to accelerate the process and was soon directed to take the patient to the operating suite. Before I could get out of pre-op however a woman in scrubs arrived and immediately started with the hostile rhetoric. I guessed that she was someone superior. Diplomacy got nowhere (however it gave her no ammunition to use against me), but there being no available stretchers to transfer the patient to in the immediate area I was able to slip past her and through the door marked "surgical attire only past this point". I was after all demonstrating progress.
Imagine my surprise as I was pushing the patient through the doors of the OR when I looked up to see the same woman chugging down the hall having added only a hair net to her ensemble. In the room I watched as she donned a face mask and tried to come through the door.
I drew my fiery sword.
There is surprisingly little authority given to the title of Registered Nurse in a hospital. Quite simply doctors and administrators just don't want to cede power to someone with only an associate's degree (the lowest possible college degree required to be an RN). What power I do have however is damn near absolute.
This director was still wearing the same scrubs she had been wearing downstairs. She'd never had any direct responsibility for care of this patient. Sterile supplies had already been opened in the room, and though I did in fact have not inconsiderable experience in an ER I was willing to bet that the superior had no real experience in an OR.
Believe it or not I was able to fit all these points into an uninterrupted comic book style monologue. The fact that I did it from the top of my 6' 6", 270 pound frame and in the voice of James Earl Jones was what probably put her at a loss for words (for those who don't know me that's seven inches and fifty pounds bigger than I usually am; I did manage the voice though). I used the words of power "take it up with my charge nurse" and "I'll get security to escort you back to your department" to really add effect to the display.
Big eyes and stunned silence, and an invisible barrier was erected at the doorway to the room she couldn't breach. It couldn't silence her voice though once she found it again. She admonished anesthesia for dragging their feet, she scolded us because she had a patient dying downstairs because she didn't have that stretcher, and she threatened to call Dr. "Red" Duke on us "because he'll have a shit-fit." My charge nurse and the anesthesiologist stood by me however.
For those who might be curious Dr. Duke and I get along very well, and no, he didn’t.