While the venn diagram between hospital work & police work aren't 100%, they do share many similarities -- we're both forward facing to the public, we work with people from all walks of life, and we're both threatened with personal violence.

And, sometimes, sadly, people do lose their lives.

When you accidentally harm someone at the hospital, it's called an sentinel event.

Immediately afterwards a fleet of people step in and consider what happened, how to fix it, and how to stop it from ever happening again.

At my old hospital, we had a pediatric nurse float over to care for a pediatric burned patient.

She put oral oxycodone into an IV line.

Now, already, there's ways to prevent damage from taking place -- oral oxy is a vibrant pink-orange....

Because you're supposed to see the differences between the two and not accidentally give it IV, ever.

The patient's mother saw this pink colored substance creeping up the IV line, and said, "Wait a minute," and the nurse stopped it immediately.

It didn't reach the pt.

But the nurse still reported it, because we've inculcated a culture of self-reporting -- because reporting incidents that cause harm is more important than protecting ourselves from the possible flak from having harmed and then lied about it.


You can't fix systemic problems if no one knows they exist. (Or, in the police's case, actively lie about the situation that happened, etc.)

You have to be held accountable -- as an institution, if not on the personal level -- for errors.

Otherwise nothing changes.

In our case, immediately thereafter, we reconfigured the way that we gave oral medication, so that things drawn up in oral syringes could not luer lock onto IV lines and vice versa.

All oral meds had to be given via these new un-attachable syringes.

There was training, there were mass purchases of new syringes, and there were frequent reminders about how to do things the New Right Way....

All for a medication that didn't even hurt the patient.

That just came close to possibly-wossibly hurting a patient.

But, because we believed that all patient's lives were valuable -- because, uh, yeah, they are -- we bent over backwards to make sure that there was no way we could ever make that mistake again.

In my time working at different facilities, I realized that each facility had had its own reactions to their own sentinel events -- my new facility doesn't go to such extremes to make sure meds don't go down the wrong route.

Instead, my new facility has ammmaaazinnngggllly stringent blood hanging procedures -- because they once killed a person, by giving them the wrong blood.

And my old facility doublechecked even subq heparin -- because they once OD'd some kiddos.

So I get that there's not like a one-size fits all guidelines as far as 'exceptionally safe nursing' practices, and that it's highly dependent on what's gone down at the facility where you're at....

But what I do know is that each facility takes these instances unbelievably seriously, and that each facility strives in their own way for safety-perfection, ie, the state in which no one who comes in leaves the worse off for having come in.

Patient's illnesses might get them, but it's not-the-fuck because of us (as best as we're ever, ever, ever able to do.)

It is a shame that police don't have access (apparently?) to the tools that we do:

Personal accountability, encouraged at the local and managerial level
The ability to re-train
Re-purchasing appropriate equipment (and taking away equipment that no longer serves a purpose)

Until they can figure all of that out -- they really just need to turn in all their guns.

Any facility having this many sentinel events would be, very justly, shut down.


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More from @CassieY4

15 Apr
Trying to stay vigilant about recognizing my PTSD-hypervigilance is going swimmingly, lolsob.
Anyways, here are some plants from today:
This one is my current best "feed me, Seymour" out of a tough field:
Read 8 tweets
13 Apr
After having worked in an ICU this past year, I would literally get any vaccine on the market shoved into my arm, while I (& possibly the person providing it) were blindfolded, even if I knew it was mixed with lead & arsenic (which I know they aren't.)

Like they could spin the wheel of goddamned theoretical contaminants, and I'd be all, 'You know, guinea worms don't sound so bad, by comparison, shoot one of those fuckers in there too.'

We've left the ppl of Flint, MI waiting this whole effing time to get their pipes cleaned up, you drink water out of plastic bottles in neon colors all day, you think Starbux is healthy, and everyone likes to feed their livers wine.

Read 4 tweets
28 Dec 20
My mom does have covid.

Explaining to her how to prone herself.

Texting my dad with quarantine instructions for himself and everyone in my brother's household and everyone they saw over Xmas.

While at work.

Taking care of covid patients.
My current pt, I asked our MD what the plan is, and he was all, "find more people to carry the coffin" -- by which he means involve a few more services, so we can get this family to understand that the patient won't make it.
My husband asked if I should come home.

I can't.

Can't change anything for my mom, she's 3 states away.

Can't bone over my coworkers. My patient is a 1:1, we're gonna be short at 11 as is.

Told him my plan was just to be a mess on twitter so here we are.

Brace yourselves.
Read 13 tweets
27 Dec 20
My elderly parents, who I, even as an ICU RN, could not talk out of making a cross country move and visiting all of their relatives along the way, are in Texas now.

My aunt and uncle who they saw in AZ are now covid positive and my mom is sick.

I just want to throw up and cry.
If my mom does have covid, which seems likely, seeing as they visited my aunt/uncle 2 days prior to their positive diagnosis -- they hung out with my brother's wife's whole family on Christmas, including her elderly parents as well.
I try and I try and I do nothing but try and for what?

What is even the point of all this trying?

I am breaking myself and for why or who or who the fuck cares?
Read 4 tweets
7 Dec 20
I'm seeing a lot of trash takes on ICU capacity today, so here goes me explaining things (before I very much log off to write):

Yes! We have flu seasons here! And yes, our hospitals can get full during those flu seasons!

But what armchair ICU managers aren't realizing is

that it is unheard of for ALL ICUS EVERYWHERE IN THE STATE to be under thread of running out of beds (or currently out of them!)

Usually regions of the state can help one another. There's a fire, a disaster, the ambulances run, everyone pitches in.

I used to be a burn RN

And I got to see this collaborative process several times, first hand.

When there was that big gas explosion in Nor Cal a few years ago, you'd better believe every burn center in the state was overstaffed just in case.

Same same for the fires when the Camp Fire occurred.

Read 34 tweets
20 Nov 20
It's really frustrating to not have the right words to explain all this covid/nursing as someone who writes professionally.
When you're a writer you're used to thinking, 'There's some perfect way to explain this experience. If I keep trying, I'll get it right, and people will understand me. I can make this experience universal. I can change lives.'
I keep trying, and there's just...not.

I feel like a whiner. We're merely full, but not slammed. But I can't help but see what's coming for us. And feel how disposable our lives and the candlewicks of our souls seem to be.
Read 8 tweets

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