What’s RIGHT in the ED? KP McLaughlin, RN, invites you to look around.
Self-proclaimed “odd optimist” KP McLaughlin, RN, penned this letter for his fellow ED staff over the holidays. It may take a few minutes, but his message is worth reading. Thoughts? Make sure to comment at the end of the post.
As I was starting my shift as a float this morning at 1100, I was cleaning some stretchers and generally preparing for the onslaught, my thoughts mixed with The Holiday spirit and some things occurred to me so I just had to pass them along.
I was looking around for some supplies for the back hallway and after attending the staff meeting this morning my thoughts were churning on how we could improve things around the department, looking for “broken windows” in Sally’s parlance. While there are some things to think of in that regard I happened upon a series of things that drew my mind in another direction.
My wife calls me “an Odd Optimist” because I tend to think of the strangest reasons to think of the positive despite sometimes overwhelming evidence — or at least more apparent reasons — for concern. In this case maybe she is right. Maybe it’s because there was not enough daylight on the shortest day of the year. Maybe I’ve cracked just a little in my 13th year of nursing or because I worked until midnight and came back for the staff meeting at 0730 and didn’t get quite enough sleep or because my electroshock therapy has finally gotten to an adequate dose (okay that one may or may not be true -at least HIPPA sees to it that you can’t prove it and I am not copping to ANYTHING). Perhaps it is because today is my High Holy Day.
Whatever it is, I’ll leave the looking for problems to the rest of you for the time being. Today this is what occurred to me:
As I was putting stretchers in empty rooms I started to notice that almost all the rooms had IV pumps already in them. Have you noticed that lately? Do you remember the time not too long ago we couldn’t bribe someone with a Romney $10,000 bill for a pump? Now it’s routine for them to be plentiful. I found six in storage rooms in addition to the ones in almost every room.
How about PCA pumps? If you need one there are four on the unit right now – I counted.
Remember when we had to beg just to borrow a GYN stretcher from Clatanoff, afraid if we lost it we’d have none and have to face the indignity of having to tell them we lost theirs? Now we have TWO. Not to mention all the equipment in room 56 as back-up.
We have all around us tons of evidence of solutions to previous problems, answers to previous pleas, actions addressing previous grievances, and changes in systems that used to falter and sputter that are now working much better.
These examples not enough? How about:
-Having the right size BP cuffs in every room or at least readily available, in stock, on the unit and accessible for putting into rooms when we need them. Notice that lately?
-Visitor chairs, two for every room. PLUS a rolling stool to boot.
-Blankets. Seems to me they’ve been pretty well stocked these days for our cold patients and family members.
-The med boxes. Now we can clearly see when our admitted patients’ meds are there or not. NO MORE running around looking for meds hither and yon when the poor floor nurse or pharmacy tech are calling with little or no hope of finding them but you had to look anyway despite the futility. Bygones.
-Airway Boxes X 4. That’s FOUR airway boxes on the main side. And you know where they are now – one on every corner of main side.
-SEVEN (7) Glucometers (do I even have that right or is it 8?) throughout the unit. Goodness, there are even two in one spot when there used to be just two in all of known captivity. Today they each have their own home, with a numbered street address in every zip code of the ED.
-Private area to counsel patients in Transit area. It may not seem like much until you realize that without this accommodation YOU could be on the hook for a $25,000.00 HIPPA violation. One of those here, another one there and pretty soon you’re talking about some real money.
Not enough examples? How about:
-Having 6 or 8 techs on the floor these days on a regular basis. I’ve even heard tale that we actually had the right number/a full complement of techs once or twice. I may be crazy but I do seem to recall that literally happening. Four months ago did anyone dare to believe we’d actually see double digit techs on duty at the same time? Don’t lie, you history re-writers, Santa’s coming. You know very well you thought you’d see a Unicorn doing surgery with the DaVinci machine on a dragon in the parking lot first. Honestly, did anyone think we’d even have double digits on the payroll at one time – let alone actually working at the same time – with the way things were going?
Then there’s the presence of a Pharmacy tech daring us to think of the possibilities. I spotted three Bair huggers at our fingertips. There’s a patient lift on the unit – ANY TIME WE WANT TO USE IT- to save our backs. Not that we are too stubborn to use it (or bother to learn to use it) or anything. Guess we like our chiropractors, accupunturists or spine surgeons too much. Then there is the little known Hoverjack as a permanent resident ally. If you have to ask what this is . . . (well, I have never used it either but when the time comes I’ll be ecstatic it’s around).
You can complain about whatever you want but first I invite you to look around. You can and should find things to improve. Please do.
Just don’t pretend that nothing changes or gets better.
As the world renews its promise of new life, turns toward more light, and days of re-birth I wish all of you and your families the happiest possible Holidays. -KP Verow McLaughlin, RN (AAMC Emergency Department)