Potentially graphic

I'm going to talk about my frustrating day today, and it involves the burn unit at the hospital, so please be aware that I may sound off with some things, or descriptions that may not be pretty. The burn unit is not a pretty place to be, unfortunately.

My assignment was the burn/trauma unit today. Third time in two weeks I've been assigned there. That is not a problem, but it's a floor that can get to you; it happens more so if the patient load is more burns than trauma. Many of the burns we see there are severe burns, but are over a small percentage of the body. A burned arm or hand, a foot, etc. is not pretty, but is not horrible either. The patients are there for a few days to get the pain under control and to begin the debriding process and make sure they are hydrated and back in working order as much as they can be. Then they can be released to out patient status.

Today was not the "minor" burns. (Keep in mind that there is no such thing as a minor burn.) Four of the nine patients I had had 50% or more of their bodies burned. The first patient I had was burned from the waist down. A man. He couldn't stand to have clothing touching the burns. I've never seen that particular area burned. Yes, it was bad. No, I won't describe it. But, I know the guys will wince when they read this, and believe me, the women should too.

The last burn patient had severe upper body burns, including his face. I've learned to make a concentrated effort to *look* at the burns, really check them out. I do this because I feel that too many of the medical professionals forget they are dealing with a human being and instead only think of them as the disease. Anyway, after I look at them, I focus on their eyes. I make sure I always look at them squarely, but I pay attention to how comfortable they are with my gaze.

My irritation with the day began in this last patient's room. As I said, this guy had upper body burns, including his face. He had a NG tube in his nose for food, and he was also on a respirator because there was some fear his vocal cords had been damaged. And his mouth? Well, multiply the actress with the biggest Botox lips you've ever seen times three and you'll understand why the mouth trauma was so bad.

As I'm working with this patient, the head of the medical team comes in to discuss a procedure on this patient. But, he quickly changed the subject to something else. He obviously thinks of his patients as the disease, not the being. He began talking about a patient who passed away overnight. Though he was respectful in tone, I just don't think a man who is in critical condition needs to hear about whether or not a dead patient had an autopsy ordered. I also wasn't impressed when he began talking about another patient - who happened to have her accident while under the influence of meth - and how even though her drug assays were clear, she still wanted the drug, and "maybe we should just go down to the local truck stop and score some meth for her to shut her up". I mean...duh....doesn't Dr. JerkOff know that meth is so addictive it doesn't MATTER if your body is clear? Your brain still wants the stuff!

I was glad to be done with that floor.

Anyway, I headed to the second floor, also a challenge. Today was no exception. However, what sent me over the edge was the total disregard some of the "clique" have for the efforts we put out to train them.

This ended up being the straw that broke my camel's back. I came close to quitting on the spot today. My boss looked at my face when I came back to the lab and said, "Kate - labcoat on hook - office". So, I removed my labcoat, went to her office and shut the door. I told her that I was so angry I was ready to quit on the spot.

Why?

I was in a room directly across from the nurses station. The doorway to the patient's room was immediately across from the area of the station we do our paperwork at. So, I'm in the middle of a difficult draw and my back goes into spasm, from right below my bra to my pelvis. I'm stuck, basically, as I have a needle in the patient, and I can't stand up straight, or bend over more. There's nothing but the pain screaming through me and I'm doing my level best to focus on the patient till I can pull the needle out of him.

Then I hear it. Two of the other phlebs come to check on things. I can hear every word they say. I'm waiting for them to stick their head in the door to check on me. Then, suddenly they're gone.

When I finally managed to go to the nurse's station, there's a note: "We looked for you and couldn't find you anyplace".

Uh huh. Right. I could SEE the door and your lack of appearance in it, you morons.

My boss was upset about my threat; she was almost on her knees begging me not to quit. Before I left, we had it put together that there would be staff meetings (where none are non-existant now) and that the manner that I TRAIN these people would continue to be implemented FOR EVERYONE even after training. It should eliminate the continuing problems with this very thing. I've got some other ideas that I'm going to email her with this weekend.

Now, in all fairness, the two of 'em went to the other side and did the draws there. However, the until now underenforced rule is that when you go to help someone you physically *find* them, and help them finish the patients they have. I still had three more to go and those labels were in my pocket. I found out after I got back to the lab that these two came back, said they'd checked on me and I was done.

I truly appreciate the help they did give today. But, if the rules are not followed by everyone, you end up with situations just like this. And that leads to a breakdown in trust with your co-workers. I honestly don't understand how people who are primary medical workers forget that the patient is the central figure. Everything else is secondary.

At any rate, at least for this brief moment in time, I felt appreciated at work. That doesn't happen too often!