7/27/2013
I am a few days late posting the events from my last shift. My family and I went camping on Orcas Island for a few days. What a beautiful place to visit.

I am flying solo. No more orientation. No more preceptor to back me up. My first night was chaotic as can be expected any time one is working in one of the three trauma zones. I had multiple cases that were at times stressful and yet intellectually stimulating. My night started with a patient who decided to punch through glass and ended up severing his radial artery and causing multiple lacerations to his hand and wrist. The man told the doctor that the blood was gushing out and being a teaching hospital, we have medical students and residents who some times see the patient first. The resident undressed the wound and the blood was pulsating like a two year old playing with a water fountain button. They stitched him up and decided he needed to go to the operating room.
In the mean time while he was at xray I had two burn victims from Alaska come in. They were flown from Alaska after being burned from a boat that exploded. Both were luckily stable with no airway involvement. However, both dad and daughter had severe burns to the face, arms, and legs. The thing with burn patients is the scent. It can take up to a week for the scent of burning flesh to go away. While I was caring for them I had a 2 year old come in to my zone. He was struck by a car and had multiple fractures of the upper body. What is tough with pediatric patients is medications. I want to keep the child comfortable without causing them to go into respiratory depression. Sometimes there is a fine line between comfortable and decreasing oxygen saturation. This kid had already been given morphine and now the doctors at my hospital wanted to do an exam on the kid and resplint his right humerus. I dosed the kid once more with a small dose of morphine just to help get him through the exam and splinting. The parents of pediatric patients can either be very helpful or turn out to be challenging. In this case they were very helpful and involved in the childs care. Right after getting another IV in this kid I got another 2 years old kid who was backed into by his mom. The child again had fractures of the upper body and this time lower body as well. Now in this case I am not only caring for a kid but a parent who is distraught. As a nurse we have to reassure the parent in this case. Let them know that this happens and she isn't the first person to do this. Also let her know that we are taking care of her child and he is OK. We do a lot of things to patients without explaining to mom, dad, or the child. It is very important to explain everything we are doing and giving.
At a certain point during the night the drunk patients begin to role in. Let me tell you something. If you read this and you drink you are increasing your risk of falling while you are intoxicated. I have seen some pretty nasty facial fractures and nasal bone fractures from people who drink and then fall face first. This night I encountered three drunk patients. All three were not nice people. They tend to spit, kick, punch, swear and for some reason in Seattle they like to call you racist. This seems very strange to me. I have dealt with many drunk patients in CT who never called me racist. Here I am a racist POS.
Needless to say my night was never boring until around 0500 or 0600.

7/23/2013
My name is Tom and I am a nurse in the ER at a level 1 trauma center. I started this job 6 weeks ago. I moved to Seattle from Connecticut where I worked at a level 2 trauma center for 3 years. 2 of those being in the ER. The biggest difference I have seen up to this point is the amount of trauma patients I see on a nightly basis. The trauma beds are never empty for more than five minutes. Helicopter teams are constantly coming and going. This makes for a challenging and exciting atmosphere.