All call cases are emergencies. I admit sometimes they are emergency adjacent but still the case must be done. There are the rare exceptions when the call team did a total knee in the middle of the night and then discharged the patient because the surgeon, who was 5 hours late, insisted. That’s for another time.
All call cases are emergencies. To that end, it is okay to tell another department who has their gurney waiting outside the room when you go to pick up a patient that their non-emergent test is just going to have to wait.
Yes, that happened.
Another nurse and I were up on the 4th floor picking up a patient. We packaged the patient up. This means that we removed all the monitors, and replaced them with our own, we cleared all the stuff from the bed that wasn’t the patient. We unplugged the bed and told the family to follow us to the elevators and opened the door.
To be confronted by a worker from another department, ready with a gurney, to take the patient to their department for a non-urgent test.
Um, no you may not have the patient for your non-urgent test.
No, I don’t care that this patient is next on your to do list.
No, I don’t care that it looks badly to your supervisor if you don’t get the test done in a timely manner.
This patient is ill, ill, ill and requires emergent surgery to fix what is wrong with them. Well, not fix, but to remove the offending body part that was making them so sick.
No, we have to rush down to the OR and start the surgery.
No, you will have to do your non-emergent test on them after surgery.
No, I don’t know how long the emergent surgery will take. Surgical cases take as long as they take for the surgery.
No, I don’t care that this is the last thing on your to do list and you get to go home after the non-emergent test.
Sometimes you just have to say no and mean it.
Even if it means blocking another department from getting their hands on the patient for a non-urgent test that could wait until morning. But they don’t want to tell the hospitalist the non-urgent test wasn’t done.
Sorry for delaying this non-emergent test for a real, honest to goodness emergency surgery without which the patient has a good chance of dying.
Nah, not sorry.
I’ll probably hear about this later from my manager.
Oh, well.
At least we saved that patient’s life.
Dispatches from the Evening Shift 