06 March 2006

Derelict Duties

It has recently come to my attention that I have not been diligently updating my current situation. This is a result of many factors, not the least of which is my midterm examinations of which I am currently in the middle. To date, sadly, I have not had many exciting experiences, although I did receive an awesome package from members of the trifecta. As we had our biochemistry exam today (I personally believe that is the definition of starting out with a bang), and I got an 'A' (I can't believe that A's are attainable in biochemistry, much less by myself, but I'm intensely proud of it and wanted to share), I thought I would take a little break to talk about the trifecta and how it might affect life at St. Michael.

To start, the trifecta is a collection (oft disputed) of characters on the 2nd shift (or PMs). It usually only presents itself on Mondays, which coincidentally is, anecdotally, the busiest day of the week. Oftentimes, beginning PMs at 3.00pm is not a terrible thing. Day shift has usually done a stellar job stocking the rooms are preparing us for the thousands of patients that will come strolling through the door from 4.00-5.00pm.

This is approximately the same time the trifecta kicks into action. Normally, the charge nurse will take a call from 'Paramedic Base'. Paramedic base is located at Froedtert, and coordinates the pick-up and transport of critically ill patients from their 911 call to what is usually the closest hospital. Since only RN's are allowed to take this call, I will often stand over the shoulder (much to the supreme annoyance, no doubt) of this charge nurse, who will be writing information regarding the incoming patient.

The trifecta affect is official once the charge nurse writes the letters 'PNB' on the paper. This stands for Pulse-less, Non-Breathing, and means CPR/intubation and a 'code'. To complete the trifecta action, the patient will be sent to a room on the side with by far the most admissions, the newest RNs and me (This is rarely anything other than the B-side, and especially Trauma 5). In fact, on one occasion, I was the most senior personnel involved in a trifecta incident. (That is not to say the most knowledgeable, just had the longest employment at St. Michael.)

Possibly the greatest all-time trifecta moment occurred during CPR:
- "Do we have a pulse??"
- "I don't know, but we've got a hernia."

Now, I'm not aware of further developments of the trifecta since having left, but I can say that I'm sure it’s not the same. I know that certain RNs will readily fill the vacancy I have left behind (and I think it would be safe to say that certain people are their own trifectas, and you know who you are). But, to make an incredibly long-story pertinent, in the package I recently received, there was a t-shirt. Written in block letters across the front is the phrase, "Trouble Finds Me."

And finally, because everyone should learn something new everyday, here is an interesting piece of trivia: Rouleaux - A French word meaning "stack", e.g., The erythrocytes form stacks called rouleaux which settle faster (impress your friends!).

4 Comments:

Anonymous Anonymous said...

It's ironic that I read this post tonight that we had a stellar shift on PMs tonight. GSW (Rita) and a PNB. GSW went to Froedtert with Rita and Wendel - must ask Rita about that excursion. It just wasn't a complete chaotic event without you! Hope all is well and our weather is coming despite the 4inches of snow that fell on us Sunday and the 50 degree weather that is due to hit us THursday/Friday.

Good luck on Midterms!

Jen P

2:38 AM  
Anonymous Anonymous said...

Much agreed with Jen. Somehow codes are just not the same without you. also note that it does not take the letters PNB to put the trifecta into action. Would have loved for you to have been with us on the latest ride to Froedert.

PS: Please remember that a pulse is something you feel and not something you see on a monitor.

PPS: Score K=2 R=0 (at least to the best of my knowledge)

1:10 AM  
Anonymous Anonymous said...

Patrick, Congratulations on your grade. Well done. I assume you are very happy. Enjoy the rest of your exams. Love Dad

6:10 PM  
Anonymous Anonymous said...

I'm glad you finally explained the phenomenon we call the trifecta. Its a sick little club but it works. I would also like you to know that the score as of now is K - 2 and R - 0. Which means that the trifecta's total score is 2 at this time. Im pretty sure the trifecta beat that in a week this summer :) I'm glad things are good (haha - well). Congrats on your A!

4:25 PM  

Post a Comment

<< Home