A Decent First Night Shift

It started off a little bit wild... during the transitional phase between day and night shift, there was a cardiac arrest in the medical ICU. We don't technically have to help with the cardiac arrests that take place there, but hey... these are our colleagues who are also starting their first night in the MICU, so I went up to assist. The daytime consult resident was also there, so we were in the same mindset. We did our bit there and he passed me the consult pager. In the midst of things, I unknowingly left the pager somewhere in the MICU.

Another consult and a rapid response and some nursing requests came through (which I somehow managed to do without this pager), then I went on the hunt for the pager. Couldn't find it anywhere, and I even tried to send a page to determine whether I could hear it. No luck.

I had a feeling it was still in the MICU, so I asked my chief to page while I was standing in the area I thought it would most likely be found - plus I asked a nurse in that area. She had seen it, and the page went through. I heard it, and voila! The pager was back. Glad I didn't lose it - that would have made the night far more difficult.

The remainder of the night consisted of one more consult, and the rest was... well, rest. A decent transition into the night shifts.

The aforementioned rapid response was silly, by the way. These are supposed to be activated to call in a bunch of physicians when a patient is unstable. This one, however, was called for a seizure. Seizures do look scary (and certainly are scary for those experiencing them), but as long as a patient is stable, require only one doctor to be alerted. They can place an order and observe for efficacy. This rapid response was called after 1 or 2 minutes of a seizure for which medication had not yet been given. That's an inappropriate usage of a rapid response; it betrays incompetence, and results in excessive unnecessary paperwork and communication with attending providers. The only situation in which this should be called for a seizure is if a doctor cannot be reached to order medications at all, or if the patient is unstable. Our nurses get scared, however, so I expect this will continue. It certainly has been the case ever since I started working here over 23years ago.

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