Duty · Having A Good Partner Is Very Important! · Life in Da City! · Pains in my Fifth Point of Contact · Protect and Serve · Sometimes You Get to Think That You Have Accomplished Something!

Sometimes, The Pucker Could Squeeze Diamonds

So, TINS, TIWFDASL at an urgent care out in Flyover Country. It was a typical afternoon, featuring a parade of sniffles, coughs, and poison ivy. Our clinic was on the south side of the road, east of Middling Sized City, and the Big Time Big Deal Hospital And Trauma Center. In other words, to get the the BTBDHATC, one would exit our driveway, and turn west (that is, LEFT!)

Abruptly, the registrar summoned me. My MA and I walked over, to behold a limp toddler. Very Not Good!

The MA escorted the male carrying the child to an exam room, and began to collect vitals. I examined the child, discovering a heartbeat (Crom be Praised!) and spontaneous respirations. The registrar collected demographic information, and I asked the adult what had happened, prior to arrival.

“Well, he started shaking, and then he stopped. He just wouldn’t wake up, so I brought him here.”

Well, the “wouldn’t wake up” part was still descriptive of the child, and I noted that I would have to call an ambulance immediately, because this could have several causes, none of them good. Indeed, “floppy child” is right up there in my Triage Catalogue Of Very Bad Things.

The adult male paused at this. “I don’t want to send him by ambulance. I’ll take him myself!”

I was surprised. I noted, “So, you *DO* realize that several of the things that caused this, could reappear, and he could stop breathing or his heart could stop. EMS is trained and equipped to deal with those things, should they occur. You, while driving, are not, right?”

He persisted. “I’ll drive him myself”.

We directed him to go there immediately, with no delay nor detour. We explicitly directed him to exit our driveway, TURN FREAKING LEFT (that is, west), and not stop until at the ED.

He stated that he understood, and would do so.

He scooped the child up, and exited the building. I sat down to chart, as well as call BTBDHATC, in order to provide them with forewarning of the sick, sick, sick child coming their way. That is, until my registrar called me, excitedly, to report that this sunovabitch had turned EAST! (exactly away from the hospital) upon exiting our driveway.

WTAF!

I had the clerk print a face sheet, and called emergency dispatch. I related the above information to dispatch, along with my concern that a critically ill child was *NOT* being taken to the ED. I provided the street address we had received, as well as the contact information.

I next called the child protective services emergency number, to report the above. I was assigned a report number, which I charted, and my own name and contact information was taken.

Several hours later I received a telephone call, from a gentleman asserting he was from CPS. I asked him to confirm the report number, the child’s date of birth, name and address of our record. He did confirm all these details.

He queried me about the particulars of the child’s presentation. I supplied the requested information. I asked how the child was. The worker paused, and said, “Well, I am not allowed to provide information regarding an ongoing investigation, particularly one where the child in question has been hospitalized. I’m sorry. “

My response? “Yeah, it’s too bad you couldn’t tell me if the child had been hospitalized or anything. I understand. Thank you.”

Duty · Having A Good Partner Is Very Important! · Sometimes You Get to Think That You Have Accomplished Something!

Above and Beyond

So, TINS©, TIWFDASL©…. Well, OK: REALLLLYYYYY!, I was holding up the counter, and awaiting my next patient, when one of the registrars came up and informed me, “Reltney, I’ve got this sick lady out in the drive up, and I really think you need to see her! Like, right now!”

To set the stage, my urgent care has (surprisingly!) urgent care patients, as well as folks who arrange to be tested for Da Rona. This latter group makes their appointment, drives up, telephones in to announce their arrival, and my registrar gowns up, registers them (now, THAT is a surprise, amirite?), and one of the MAs gowns up, strolls out, tests them, and hands a sheet of instructions (prominently featuring the admonition to quarantine for ten days, or until negative results are forthcoming) to the patient.

This particular soul had not made it past the whole “registrar registers them…” part. This particular registrar, let us call her Eloise, has been doing this for several months. She is one of those quiet, efficient, takes-care-of-business folks that make things in general, and our agency in particular, run. She is not a nurse, not an MA, may not have any “medical training” whatsoever.

Nonetheless, Eloise had appropriately identified that this patient, nominally here for coronavirus testing, was way, way, way sicker than (a) coronavirus testing was gonna help in a clinically relevant timeframe, as well as (b) way, way, way, way! too sick to be driving around. So, she came and got me.

I went to the patient, shortly afterwards followed by an MA who had overheard Eloise’s pronouncement. I was impressed by the fact that this woman reported chest pain, nausea. left sided neck pain, left sided jaw pain, as well as being unable to tell me her allergies, or medications, or medical history, and could not state the name of her boyfriend (whom she wanted called to retrieve her vehicle) as I shortly had determined that this nice lady was going to shortly be the recipient of over 50 years of pre hospital emergency care wisdom and experience, as well as diesel therapy. (ambulances nowadays generally run on diesel).

I told Eloise to get an ambulance, and the MA hopped in, to clear a room for this patient. Eloise evidently had delegated that task, as she returned promptly with a wheelchair, and I noted another MA on the phone to dispatch, as Mrs. Chestpain was wheeled in.

As I assessed this soul, engaging in conversation all the while, it struck me that her ability to track the conversation was deteriorating before my eyes. Not a good thing.

Soon EMS arrived, packed her up, and set about their own part of her care.

I called report to the local ED, explaining the above.

I then went in search of Eloise’s supervisor. I informed this worthy that, in my opinion, Eloise had saved this woman’s life. Had she not had her head in the encounter, had she not noted “chick don’t look right” (the fundamental item of nursing assessment), had she not sought me out and had she not compellingly made her case that this was a SICK person, well, Mrs. Chestpain might have driven off, to die from (her heart attack)(her stroke)(a collision from her impaired ability to navigate), or (all three).

For some reason, I had occasion to speak to my physician supervisor around that time. I repeated the foregoing story, as well as the foregoing analysis, to her.

“Well, you know, Reltney, you also saved her life!”

“Ma’am,” I responded, “I have dozens of years of schooling, decades of emergency and clinical experience to enable me to do that sort of thing: it’s kind of what you are paying me for! Eloise, on the other hand, has none of those things. You are congratulating me for doing my job. I’m applauding Eloise for thinking outside of the box, outside of her job description, and acting effectively to get this woman the help she desperately required. Thank you, but Eloise went above and beyond her job. She is what made everything else happen.”

As a side note, here’s what the preceding paragraph looks like, when your cat helps you:

“Ma’am,” I responded, “I have dozens of years of schooling, decades of emergency and clinical experience to enable me to do that sort of thing: it’s kind of what you are paying me for! Eloise, on the other hand, has none of those things. You are congratulating me for doing my job. I’m applauding Eloise for thinking outside of the box, outside of her job description, and acting effectively to get this woman the help she desperately required. Thank you, but Eloise went above and beyond her job. She is what made everything else happen.”pppppppppppppppppppppppppppppppppppppppppppppppp

Thanks, Kitty. i do believe that I have this under control.

Having A Good Partner Is Very Important! · Sometimes You Get to Think That You Have Accomplished Something!

“From the mouths of babies…”

Last week I worked with a resident. She had recently completed a rotation at The Big Pediatric Hospital, in the ED. One of her stories involved a child with a fracture. She related that, as she was showing this child her fracture on the x ray, the child exclaimed, “That’s the broken part, isn’t it?”

This stimulated me to recall a tale of my own (for, does not nearly EVERYTHING, stimulate me to recall a story?). Long ago and far away, I was working urgent care at a distant clinic. In this facility, my MA was an x ray tech, going to school for MRI. One day, a family brought in the matriarch, who had hip pain after a fall. Indeed, this elderly woman was pained by the movement elicited by the cracks in our flooring (our flooring was in very good repair!) Well, (let us call my MA…) “Ashley” determined that there was an x ray in this lady’s future, and figured that one movement onto the x ray table might be superior to a move into the room, an exam, another move into the x ray room, and THEN onto the table. Good call.

Ashley took only one image, before exiting the x ray room, at speed, and summoning me. “Reltney, you need to see this film”.

“Oh? Is it interesting?”

“Well, I believe you will be irate if you delay another minute before you see this film. I think that it will have a serious impact on your medical plan of care!”

Well, alrighty, then!

I had previously casually mentioned the concept of “the ophthalmologic fracture”. That is a break so obvious, so lacking in radiologic ambiguity, that should an ophthalmologist happen by, that physician would stop in his/her tracks, do a double take, and exclaim, “Hey! That looks broken!”

This lady had a ophthalmologic fracture of her hip. I had Ashley copy this image on a CD, and had my clerk summon EMS. I called The Local Trauma Center, and described the events to the attending physician. Once EMS had arrived, I invited them to view the film. They were, as well, impressed. She was backboarded, and transported to the hospital for further evaluation and care.

My physician colleague (remember her? She led me into this tale, after all!) nodded. I concluded, “You, doctor, have just introduced me to the concept of “the pediatric fracture: a break so obvious that a child can identify it”!

Having A Good Partner Is Very Important! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

Neighbors

One fine day, TDW-Mark II and I were at home, doing some sort of chore or another. Our doorbell rang, and I answered it, to find the neighbor girl, a seven year old classmate of Grand Daughter Number Two, standing there with her three year old younger sister, hands clutched one in the other.

“What can I do for you?” I asked.

“My grandpa fell, and he hurt himself, he’s not moving. Can you help us?”

I hollered, “Honey! Emergency at the neighbors!”, and headed out the door, TDW-Mark II watching me turn the corner into their yard.

The girls led me into their home, where I saw an elderly gentleman (now, THAT would be the pot calling the kettle over-the-hill!) prone on the floor, at the foot of the stairs, with a pool of blood about his head. The girls stood by, anxious appearing, until TDW-Mark II appeared, and led them into the kitchen, and attempted to distract them from the front of the house drama.

I asked the gentleman if he was OK, and his answer did not inspire confidence. Looking over the scene, multiple bad scenarios played out in my imagination, all leading to the conclusion that I did not want to manage this scene alone, and I really, reeally wanted EMS here, pronto.

I dialed up dispatch, and abruptly realized that I did not know the house number.

Fortunately, all those years of Street! Medic! Experience! started to pay off, as I realized that the house would have the number displayed prominently on the front. I walked out front to familiarize myself with that little detail. Oh, yes. AND the name of the street one block East of my residence.

You don’t have to say it, I already know. Bad Stretcher Ape! Situational awareness fail!

So, anyhow, I shared my new-found wisdom with dispatch, and summarized what I knew. She assured me that our little town EMS would be on the way, and then proceeded to start into pre arrival care instructions. I played along, until she paused, and I observed, “So, I’m an ER nurse. he is breathing, he is speaking, sort of, and I am reluctant to move him in any way, because it appears that he fell down the stairs.”

“Oh. Right. Well, if things change, call us right back!”

“Yes, ma’am, will do.”

The medics arrive shortly thereafter, and I reported the little that I knew. The one medic was surprised. “You don’t know any of his history?”

“Nope. We’re the neighbors. The little girl came over and got us, when he fell.”

At about that time, the mother returned home, and TDW-Mark II filled her in on what we knew. We turned the kids over to her, said our goodbyes, and departed.

Duty · Sometimes You Get to Think That You Have Accomplished Something!

“You’re Gonna Miss This”

Trace Adkins had a song, several years ago, entitled “You’re Going to Miss This”. The narrator recounts telling his adolescent daughter she will miss the security of having her parents around to take care of things. Another verse has him counseling his now adult, now married, now a mother, daughter, that “you’re gonna miss this”, “this” being her cramped apartment with her new husband, later her house with young children.

In the two years before my mother’s death, I remembered that song. During hour plus drives to visit Mom, in her apartment across the state. I told my wife, “ya know, I’m gonna miss this!”, followed by a synopsis of that song.

When, visiting Mom, she had Chris Cuomo (spit!) on her television, the volume set at “11”, likely to accommodate her diminished hearing, I breathed deeply, and thought, “You’re gonna miss this”.

(realize that I supported Mr. Trump, and thought that Mr. Biden ought to be allowed to spend his waning days in the company of his children and grandchildren, spending his Chinese money as he saw fit. Oddly, Mom had a different opinion. Who knew?)

With the above parenthetical comment in mind, when Mom would attempt to drag me into some sort of political debate, such as how Mr. Trump was ill mannered or something similarly important to me (or not. Please, Ghawd! More mean tweets, less food and energy inflation!), I would placidly respond, “Hmmm. Mr. Trump sure elicits controversy, doesn’t he?” And I would remember, “You’re gonna miss this!”

I would take my mother shopping. THAT was entertaining! If you have successfully committed every one of my posts to memory, you will recall my joy at obliviots who would threaten to collide their shopping carts with my children. I, naturally, *did* recall this experience, and noted assholes who appeared entirely willing to knock my century old mother onto her ass. Since that would would have elicited a General Nguyen Ngoc Loan aisle side justice response on my part, and, well, people would talk (And scream. and so forth), I felt that prevention was easier to explain. I redeployed my “Colossus With Bad Attitude” persona, and blocked the aisle upstream of where my mother was shopping. She, of course, required ONE PARTICULAR Brand of baked beans, in one specific size, none other would do. This required considerable searching. After that PITA, well, I’d drive Mom back to her apartment, thinking, “You’re gonna miss this!”

On one visit, I thought that it would be nice if I were to prepare some lasagna for my mother, placed in “unit dose”, single serving plastic containers. Thereby, she could fish one out of the frig, microwave it, and enjoy.

Of course, I did it wrong. She laughed, and asked me, “Do you think that I am some kind of helpless old lady, who cannot even cook?” (Not exactly, but, reports from my sister in law, Donna- Praise Be Upon Her for orchestrating my mother’s household, doctor visits, medications, dog vet appointments, and every other kind of appointment- suggested that burned pans were a foreshadowing of other culinary, and perhaps incendiary, mishaps to come)

Once we had eaten, and I was washing dishes, she asked me, “That was not my recipe, was it? I think I like my recipe better!”

And, I thought, “you’re gonna miss this!”

Trace Adkins was correct.

Fun And Games · Having A Good Partner Is Very Important! · Life in Da City! · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

First noc I wore fire boots at work: freeway run, on a snowy night.

TINS©, TIWFDASL©, and going to paramedic school in my off time (this was many, many years ago). In the course of this schooling, I spent some time in clinicals, variously in the local ED in a wretched hive of scum and villainy not so very far from Da City, or with one of the advanced life support crews running calls in the self same wretched hive.

It’s generally educational to spend time with other medics, as their organization’s culture, and lore, is likely to be kind of at a tangent to your home outfit. The education may run both ways. In any event, There I was, (studying) Fighting Disease, and Saving Lives in The Wretched Hive, and one of the host medics came on duty, ferrying his “load out” into the ambulance. I noticed that he tucked a pair of fire boots behind his seat, and asked him about them.

It being winter in The Northern Un-Named State, well, we were susceptible to receiving considerable amounts of snow from time to time. I believe the professional meteorological term is “ass loads”. My host noted that this could result in snowy shoes, and therefore wet feet, and that there were few things so miserable as cold, wet feet, in Da Nawth, in winter. Waterproof boots, that reached nigh up to one’s crotch, served admirably to avert this sort of undesirable outcome. I took notes.

Soon, I acquired my very own pair of “Storm King” (old standard) NFPA complaint boots. So, it happened that I wore them to work one snowy evening, and, early in the shift, Doug and I caught a run for “one down” on the expressway.

We pulled up behind the state police cruiser, and saw a figure prone in the snow and slush. The trooper told us that the patient had been struck by an overtaking vehicle, when the overtaking vehicle did not notice that our patient was bent over the lip of the trunk of his STOPPED vehicle, ON THE SHOULDER OF THE DAMNED EXPRESSWAY!

Our patient did not fare well in this exchange. I pulled up my bunker style boots, so that they reached nearly to my crotch, and knelt in the slush. Doug logrolled the man, and I slid the backboard beneath him, and logrolled him my way, so Doug and I could then center him on our spine splint. We buckled him in, collared him, schlepped him into our rig, and beat feet to TSBTCIDC, which happened to be one exit and a coupla turns away.

I remained dry and warm. If I had never worn those boots another day, that night, in that slush, they paid for themselves!

Duty · Sometimes You Get to Think That You Have Accomplished Something!

Parenting Win

This gentleman gets it, and kudos to him for Being The Dad.

https://ogdaa.blogspot.com/2021/04/sunday-video-2_01180543565.html#comment-form

As may prove to be no surprise, it reminds me of one parenting encounter of my own, years and years ago. One day, TDW-Mark I, our children and I were out someplace having dinner. It had occurred to me that TDW-Mark I might enjoy an evening NOT in the kitchen, and so we bundled up our brood, and went out to dinner. So, there we were, conversating and dining and generally having a nice time, when Number Two Son, whom we will call Charlie, apparently decided that he was not receiving enough attention. Now, Charlie was, at this point, something like 3 years old. I expected that he would know better, but, well, I was mistaken.

So, he was yelling, and standing up in his chair, and generally making a scene. I attempted to verbally redirect him, but, no-go.

My wife was not enjoying the shenanigans, and therefore I decided to remedy her dilemma. I stood, scooped Charlie up, placed him over my shoulder, “fireman’s carry” style, and walked out of the restaurant.

I could feel the eyes on me, as we departed, with a Bill Engvall-esque vibe of “somebody’s gonna get a whooping!” But, I had a slightly different plan. (don’t imagine that I was not tempted…)

Outside of the restaurant was a low stone wall. I sat Charlie thereon, and assumed my R. Lee Ermy persona. I placed myself nearly nose-to-nose with my son, and barked, “You are not a baby! You know how you are supposed to act! This acting up is NOT acceptable! You will sit there, quietly, until you are able to behave correctly! Do you understand me?”

His eyes teared up, and he replied, a quaver in his voice, “Yes, daddy.”

I snarled, “Very good! Now, you tell me when you are able to behave like you know you are supposed to!”

I stood, wrapped one hand in the other, behind my back, and paced back and forth before him, a scowl written large across my face.

After several minutes of this pacing, I turned to my son, and addressed him. “Have you had enough? Are you ready to act right?”

He sniveled, “No, daddy. Not yet.”

I had to abruptly turn, to hide the smile that burst across my face, and to hide my struggle to not laugh out loud.

Another couple of minutes later, he volunteered, “Daddy? I’m ready to behave, now!”

We re entered the restaurant and Charlie was subsequently the very model of proper toddler behavior.

Having A Good Partner Is Very Important! · Sometimes You Get to Think That You Have Accomplished Something!

The Apple Does Not Fall Far From The Tree

Long ago and far away, I married The Woman Who Would Become The Plaintiff. She brought two children with her, a son, hereinafter referred to as Adam, and a daughter, who we will refer to as Brenda. These children had two different fathers, Brenda’s being Of The African Persuasion, as an old medic partner of mine had termed it. TWWWBTP (“the plaintiff”) was, herself (as am I) of the white-bread heritage group.

This led, of course, to her mother referring to her brood as “My own little league of nations”.

Well, time passed, love bloomed (and, subsequently, withered), and my children (all four of them, notwithstanding that fact that two of them had my chromosomes, and two did not) all grew up, became adults, and set off to establish their own families.

Brenda had her own adventures, eventually settling down with a good man, who accepted her oldest daughter, treating her as his own. Brenda wound up having four children in total, ranging from melanin enhanced, to melanin deprived. (genetics can work out in surprising ways).

So, Brenda tells the story of having photographs of her mother (anglo), dad (anglo), oldest child (genes from 1/4 Africa, 1/2 Central America, and 1/4 Europe), and three youngest children (all of whom were paler, having no Central American genetics). You might imagine a picture gallery of “shades of gray”, if you wished.

Co-workers would wander past, and notice the chromatic array featured in her pictures, prominently displayed on my daughter’s (biracial her own self) desk.

“Who’s that?”, they would ask, gesturing at the children’s photos.

“My kids.”

“Who’s that?” they would ask, pointing at my photo.

“My dad.”

Who’s that?”, pointing at The Plaintiff’s photo.

“My mom.”

In Brenda’s telling, there would follow a metaphorical “tennis match”, and her interlocutor’s eyes would go from photo “A”, to her own visage, to photo “B”, and back to her face, and back and forth, for a couple of iterations.

“Were you adopted?”

“Nope.” (I never started adoption proceedings for my two oldest children, a failure on my part.)

More gaze-tennis, as they attempted to process this. And failed.

Brenda finished her tale, grinning. “I really enjoy spinning up folks’ minds! Most never seem to make sense of it!”

Which tale reminds me of another yarn, circling around my story of Carmen’s (the oldest child) surgery. I accompanied my daughter to Carmen’s pre op visits, both because she (Brenda) kind of wanted to focus on her child (imagine that!), as well as, I surmise, Brenda thought that having nurse-and-midlevel-Dad at hand, might be comforting.

So, TINS©, There I Was, sitting in the interview room as the intake nurse was interviewing Brenda, regarding Carmen’s medical history. The nurse asked Brenda, “Is there any diabetes, heart disease, lung disease in your family?”

Brenda responded, “Uh, no, no there isn’t”.

I chimed in (pay attention to this: Brenda is my STEP-DAUGHTER, recall!), “Honey, don’t you want to mention my cardiac stents?”

So, my daughter turned her gaze my way, and, gently, admonished me. “Uh, Dad? I really do not think that *your* genetics are going to affect Carmen. Do you?”

Brenda then turned to the nurse, and clarified. “He’s my step dad, you know.”

Duty · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

You Call Me “Packrat”, I Call Me “Well Prepared”

So, TINS©, TIWFDASL© in the little, rural ER at Erewhon Memorial Hospital (slogan: “Both Nowhere, and Backwards!”). Remember (because, after all, y’all have read, studied, and committed to memory Every Single One of my blog posts, of course!) that long ago, and far away, I had been an orderly on the gen med floor of TBTCIDC. In that capacity, I had been presented with two keys, one of which would unlock a Posey brand locking vest restraint, the other of which would unlock a Posey brand limb restraint. The key to this latter resembled a handcuff key, only on a considerably larger scale.

One evening, in Erewhon’s ER, a local State Police trooper entered, seeking some assistance. It seemed that out towards the periphery of our county, some child had found Grandpa’s antique handcuffs, and has secured himself to a radiator or some such immovable object. This child had done so, PRIOR to identifying the key required to unlock the handcuffs, and, of course, said key was nowhere to be found. The officer was on the verge of inviting the local fire department to demonstrate their extrication skills, featuring property damage, destruction, and loud noises, but wondered if we might have something less dramatic, to release the child. The officer noted that the key required resembled a handcuff key such as the key he, himself had, only considerably larger in size.

Fancy that.

I observed that I was in possession of something resembling that which he sought, and he could give it a try. I rummaged around in my Bag Of Tricks, retrieved my Posey key, and presented it to the officer. His eyes lit up, as he noted that this appeared to be just what he was looking for.

He returned, a couple of hours later, reporting that indeed, my key had unlocked the offending handcuffs, the child had been released, no property damage had occurred, and everything ended happily.

Contributing to my legend, of “If McFee doesn’t have it, You do not need it!”

Duty · Fun And Games Off Duty · Gratitude · Pre Planning Your Scene · Sometimes You Get to Think That You Have Accomplished Something!

PROFESSIONALISM

While my divorce was unwinding, I was working midnights in the ED of Mid Sized Hospital in the Adjacent Relatively Big City. I had a seven on/seven off schedule, which worked out pretty well for the week on/week off custody schedule for the youngest two kids.

So, TINS©, TIWFDASL© (well, to be precise, I was standing in my kitchen, looking around to see what I had forgotten to pack for the night to come), when my phone rang. My darling daughter was on the line. “Hey, Dad! How would you like to come over and take a look at your grand daughter?”

“I’m always up to visit my grand daughter, as well as her mother! What’s the occasion?”

“Well, Carmen is having some difficulty breathing, and I’d like you to look at her and tell me what to do.”

“Be right over. Unlock your door!”

A couple of minutes later, I was knocking on her door, stethoscope around my neck. Brenda opened the door, and I heard Carmen wheezing from across the room. “Call the ambulance, right now!”

Brenda was unconvinced. “Dad, if we call the ambulance, they will simply take her to Local Small Town Hospital. They will simply wind up transferring her to Next Town Big Hospital. Why don’t we just drive her to Big Hospital, ourselves?”

Good time for me to collect data. “Honey, do either you or baby daddy know CPR?”

“Um, no.”

“Y’all have oxygen in your car?”

“No!”

“You guys have any way to alert Big Hospital ED that you are coming in hot with a critically ill child?”

“You know we don’t!”

“So, let’s call EMS, who do indeed know all those things, and have all those things, so that they can treat Carmen properly, hmm?”

“We’ll just drive her over to Small Town Hospital, ourselves.”

“NOW, sweetheart. Right now!”

“I just have to…”

“No, you don’t. Get your ass on the way, right freaking now, and no more delay. Now!”

As they cleared the door, I phoned Local Hospital ED, where I had been an ED nurse, and provided a heads up. “Hey, my daughter is on the way with my grand daughter, who is in respiratory distress. Under a year of age.”

“When will they be here?”

“Open your door, now!”

I locked up, and made my way to Local ED. Once there, I saw the staff meeting that was a pediatric critical child. The ED physician was in the room, my daughter and baby daddy, two ED nurses, a respiratory therapist, the lab, and a couple of other folks that I could not make out in the crowd. I spoke to my daughter, and told her that I was off to work, and I’d stop by in the morning to see how things were going.

I called my daughter the next morning, on my way out of work, and met her at the Big Hospital Peds ICU. She told me that, unsurprisingly (to me), Local Hospital had tested, x rayed, oxygen-ed, and IV-d Carmen, and then transferred her to Big Hospital, via Peds Mobile ICU ambulance. Carmen was considerably improved over last night. I could not hear any wheezing, and she appeared to breathing easily within her oxygen tent. I said my hello to Carmen, ascertained if my daughter needed anything from me, and said my goodbyes to return home, and to bed.

Carmen was discharged the following day, and Brenda had a ream of instructions, as well as the opportunity to administer breathing treatments, as well as oral medications, to an infant several times daily. As a civilian, not a nurse.

A couple of weeks later, I was again preparing for work, and, again, received a phone call from my daughter, again inviting me to visit Carmen. “Always delighted to visit. What’s the occasion, this time?”

“She’s struggling to breathe, and the breathing treatment did not seem to help today.”

I instructed Brenda to immediately go directly to Local Hospital ED. “But, they will simply send her to Big Hospital again!”

“Yep, that is entirely likely. As is the fact that they will send her in a peds MICU, with a physician, respiratory therapist, and a couple of paramedics. All of which I highly approve of. Now, get going, right now!”

I, again, met Brenda at our local ED, again Carmen was the center of a veritable staff roll call in the treatment room, and, again, that evening she was whisked as described, approvingly, above, back to peds ICU at Big Hospital.

I stopped by the next morning. Brenda greeted me. “Dad, just like you said, they transferred her by ambulance back here. When we arrived, all the ICU nurses remembered Carmen, and were crying as they brought in the vent, the crash cart, and the intubation cart. Mom was here, and, gotta tell you, I was trying as hard as I could to keep it together for Carmen. The nurses’ crying was *NOT* helping! If mom had not been here, I would have lost my mind!”

I replied, “Honey, your mom is a pretty good nurse, and she keeps her head really well in a crisis. I’m really glad that she was here for you!”

And, at that point, I did the smartest thing I had done in a while. Right then, I shut up!