I'm staying out of the fracas... let me know when it's time to duck the slung mud! (Or is it truly over?) Meanwhile, you asked for input about a patient scenario, and I have 2 cents I'm not using right now, so here goes.
In response to your Haiti patient... yikes, what a mess he was! Regarding the MD in charge of the flight, perhaps he didn't understand your terminology when you reported the "PIPs". You were referring to peak inspiratory pressures, right? Or I might just be revealing my ignorance about abbreviations commonly used in a field other than my own.
Anyway, perhaps you may have gotten further with the doc if you'd pointed out the patient's symptoms, like the shifted trachea, and tactfully suggested a careful reassessment of the patient's airway/breathing. I'm no doc, but I've known a lot of edgy and threatened ones in my career. Sometimes we need to carefully lead them where they need to go. (Just as my partners have carefully led me many times, I'm sure!) Unfortunately, your patient had to wait till the thoracic surgeon got there to have the situation remedied. And meanwhile, your doc may have felt a bit foolish for missing this critical problem. (Which leads to you getting reprimanded just because he thought he looked bad in front of another doc.)
It's hard to be tactful when your patient's crumping, but as they say, you catch more flies with honey than with vinegar. Especially in our field.
On our flight team, we have no RT, just two RNs. If this had been our patient and he'd crashed, we'd ALL be on the chopping block. It's a team effort. And just as my partner is not "the team," likewise no RN or EMT (with or without P) or RT or MD is "the team." When the patient crumps, it is THE PATIENT who is on the chopping block, and we need to remember that, and function together for the patient's best welfare.
I guess maybe that was 3 cents' worth. I owe ya.
Best regards and fly safely,
Cece Peterson, RN, BSN, yada yada
LifeFlight, Pittsburgh, PA
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