Tuesday, June 1, 2010

Dialysis patient....and staff

So, today I am working on a basic transfer unit for the private ambulance service. We get called to a local dialysis center for a prescheduled transfer of a patient going back to the nursing home after dialysis treatment. This patient is one of our regulars and we know her well. She is normally nonverbal, but responds to basic commands.

We arrive at her chair to find her flush in color, breathing at about 30 times a min and shallow, and it sounds like she is drowning in her own fluids. I mean she is outright gurgling.

The dialysis tech and the RN on duty want her to go back to the nursing home and don't seem even a little concerned about her current state. Of course we tell the staff that we are taking her to the closest ER. They seem dumbfounded by our assessment and decision.

We promptly move the patient onto our cot and sit her almost completely upright. Next we put her on 15 liters per min of O2 via mask and take her priority one to the ER. When we arrive at the ER they take her right back to a trauma room, perform RSI intubation and place her on a vent. She is later transferred to the ICU.

My question is "How long was she like this prior to our arrival?". Why didn't anyone at the dialysis center seem concerned about this? Why didn't anyone call 911? Do some of our fellow healthcare providers care this little about the patients we treat? What blows my mind was that the RN and tech were more concerned about us not getting a post treatment weight than why we were rushing her out of the center... What do you think? JS


Epijunky said...

I wish that I could say that I'm shocked by the way the staff acted, but I'd be lying.

It's criminal.

I'm just grateful that your patient had you there. I know that some of those out there believe that they are above the dialysis runs and transfers in general, but the truth is that these people need us just as much as someone having a massive MI or the patient who was just in a serious MVC.

Great job, JS... If myself or my family had an emergency, I'd be relieved to see you walk in.

Rudee said...

It's a good thing you were there. Having a degree does not guarantee one has common sense, as evidenced by the serious lack of same in that RN. I hope your patient fares well.

JS said...

Epi and rudee,
Thank you for the undeserved ego boost. JS

emsbear said...

I'm not surprised one bit by how the staff behaved. I've done 100's of those transfers and for the most part all dialysis staff is concerned with is turning over the bed to be ready for the next patient.

I'm not sure if it's their fault or not....they deal more with volume than anything. Usually, from the places I've seen, they do 3 full rounds a day and if they get delayed for any reason it snowballs. They really don't have the time to care as much as they should about the patients.

Screw the staff...you did the right thing.

Hydrant girl said...

I replied to your comment under my comments. Check it out....