Nursing Q Word

The other night started off like any other. Got my assignment, looked...OK, at least everyone is A & O and mostly independent. "So far so good." I thought to myself. It's funny, I no longer look to see what the actual reason they are admitted for anymore, just if they are going to either:

a. curse me out
b. try to get out of bed and go boom
c. yank at their lines
d. all of the above (usually the most popular.)Good nursing practice? Maybe a little judgmental, yes, but this is tempered by experience. I figure, more than likely, I can deal with their admitting diagnosis, but if they are demented or delirious or just plain psychotic, that task just became a whole lot harder. But I digress.

So I was going along, and everything was actually OK. Then someone mentioned the "q" word. A chill swept over the nurses station as we all looked at them and in near unison said, "Did you just say the "q" word?" Mentioning the "q" word in the medical world is akin to mentioning "MacBeth" to a stage actor. Not sure what else we could say, for sure the alternative for the actor is far worse. Who really goes on a nursing unit and tells someone to "break a leg?" No one in their right mind. But it brought me back to the time that I had used it.

I was a senior nursing student doing my senior preceptorship in the ER of a smallish rural hospital. On the night shift. At the beginning of the month. During a full moon. Surrounded by black cats and broken mirrors ( OK the last part wasn't quite true.) But there I was. It had been a slow night, nothing too crazy. So I said it. the "q" word. No more than 30 seconds later we heard the tones come over the radio,

"Rural ER, this is unit 55, how do you copy?"

The nurse sitting there, "We copy, over:"

"55 y/o male, found down in apartment, in full arrest, we're coming code 3."

I looked over at my preceptor, she said, "You're on compressions, OK?"

As the thought ran through the back of my head that this was all my fault for saying that dreaded word, I said, "OK." Lead vest on, shoe covers, gown and mask, gloves and goggles. We had just barely gotten the trauma bay ready when we heard the sirens outside in the bay. They piled out of the unit, one in front, one in back, one surfing the gurney performing compressions. Rolled them into the trauma room, stopped compressions only to transfer to the table.

Now it was on me. I started, feeling the ribs grate under my hands, just keeping my mind on the rhythm, 80 a minute. I heard report in the background.

History of esophageal varices and alcoholism. Found down in apartment after wife had called it in after the patient had passed out while talking on the phone to her. 80 a minute.

1 and 2 and 3 and 4 and...keep the rhythm.

7 french ET tube, 21 at the lips. Left and right EJ IVs, got 3 liters in the field. RT is standing to my left bagging as I do compressions. The doc holds compressions for a moment to find the femoral vein. Then back at it. 1, 2, 3, 4...

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