Unit Council? Me?

Getting started is sometimes the hardest part.

Do I write about the weekend at the lake house?
Do I write about my quick surprise trip to Springfield?
What about making nursing unit council?
The past three days at work?
My silly cat?
What about almost beating Super Mario Galaxy 2?
Sigh, so much to say.

I love Sunday mornings, sitting around, drinking a latte, browsing reddit. It's relaxing.
The past few days of work were...interesting. We're under-construction (they opened this new ER less than a year ago. WTF?) Well, they did the flooring wrong so they're tearing it up and replacing it. I think I've talked about this before. Anyway, my understanding is pod 2 will be out of commission for another week or so. Right now the fumes from the sealant are atrocious. They're causing respiratory problems for just about everyone on staff, patients and family members are having allergic reactions, plus it's enough to make ME gag. Not good.

Ah yes, the interesting story of how I found out about unit council.
I was really surprised and nervous to learn I was nominated. I had been there 2 weeks by this point and wasn't even off orientation. However, once I was on my own and the voting was taking place I was starting to see all of these areas for improvement. In the past few days I've seen a LOT of areas for improvement. So I was really starting to want the position. I know I'm young and naive and I think things can actually change for the better, but maybe that's what this needs. Someone who hasn't been around long enough to know nothing will ever change. I can be an optimist, I don't know any better.
So, the tale.
I had a patient with a dislocated shoulder. Obvious before xray. I got everything set up for a conscious sedation so we could pop him back in place. I was looking for the correct documentation for this procedure and no one seemed to know where it was or what it was. There were no consent forms either. I was a little freaked out. No one thought it was a big deal that legally we were missing several components I thought we needed. I asked the charge nurse where their protocol was so I could do it per hospital policy. He informed me they don't do that kind of thing, just make sure he's "fine" before he goes home. How nice and vague.
So, while I'm discussing why there should be protocols for procedures with the charge nurse, the physician comes up and tells me he wants me to use propofol for this patient. To which I reply,
"Only if you give it to them. It's illegal for me to push that medication."
"But we do it all the time."
"I don't. I could lose my license."
Our charge nurse was shocked. Apparently these nurses do bolus propofol. Not me.
All the while, our manager was standing behind me. While I was describing as to why I won't give a medication that could end my career she speaks up and says,
"Those protocols sound like a good idea, you should bring that up at our council meeting. Oh by the way, did anyone tell you yet you made it?"
Instant red-face. No, I hadn't heard. I was very happy.

There are a few things I would love to change about my work environment. Sometimes it feels like doing what I consider a "standard" is way beyond what they feel is necessary. Like putting someone with chest pain on a cardiac monitor. Or checking someone's vital signs again before they leave. I'll never forget the look on their faces when I took the crash cart into the room when I was administering adenosine. Well, since it's a medication that stops the heart, I thought I would like to have a back-up plan.

Maybe I am type-A and neurotic, but I get things done and I feel safer about them. Later I printed up a bunch of articles for the physician about the hemodynamic effects propofol can have on patients and a few on etomidate as well. (He didn't want to use etomidate because he'd never heard of it.) The patient had a resting heart rate in the mid 50s. I didn't want to give him a medication that could slow it down more. I don't know if he appreciated it or not. But he did thank me with a joke about his current amount of free-time.