The ICU

I worked in the ICU for a long time and decided baths, turning q2 and bunny boots weren't my thing anymore. Don't get me wrong, I did it because I loved it.

Precepting new nurses can be a challenge and I always admonished them to listen to what is being said in report, do a head to toe assessment upon arrival and take it from there. Somewhere along the line, or maybe it's the East of the City White Bread hospital I'm working in, the ICU has decided that the ER nurses are stupid, clueless and basically lazy.

Case in point: 54 y/o presents sitting up 90 degrees, retracting with a sat of 81%, respirations around 40. Two hours after Lasix, Bipap and multiple Nebs, he's on a cannula , looking reasonably comfortable, though not out of the woods, yet. I call up to the ICU to give the report. The first question out of ICU newbie nurses mouth is "where is the IV?" I mean come on, you really think I'd send a patient up there without two 18 gauge needles in each arm? I mean, Hahaha! But, I digress. The last statement ICU makes before I pack up the patient is for me to be sure and tell the paramedics to bring an Ambu bag with a peep valve on it. ICU newbie nurse tells me they gets "lots" of patients from the ER who come up needing to be tubed the instant they get there because the medics brought the patient up without a peep valve on the Ambu.

Driving home I'm trying to make sense of the need for said peep Ambu bag. The patient wasn't intubated, did he think we were going to bag him all the way up the elevator to the 5th floor?

I can hear it now while I sit in the puke green chair in my manager, Mrs. W's office, explaining how it was all my fault that a patient on a nasal cannula whose respiratory rate was 22 was not being bagged with an Ambu that had a peep valve on it and he suddenly needed tubing upon entering the doors of the ICU.

Next they're going to want them bathed before transport.