Smack Talk in the ER

Smack talking is not just for athletes and sports fans.

The other night this patient in respiratory distress rolled into the ER around 11pm. This is during the three glorious hours when my 9p-7a shift overlaps with the 2p-12 midnight doctor and there is actually double coverage with two docs in the ER. I grabbed the chart and went into his room listen to his lungs and find the paperwork sent form the nursing home to try to figure out which meds he needed acutely to fix his breathing. I decided he was probably a mixed clinical picture with both CHF (congestive heart failure) and COPD (chronic obstructive pulmonary disease) contributing to his breathing problem, and I barked out a slew of orders to treat both.

I walked out of the room to chart all of my orders, and I saw my newest colleague and Gill the charge nurse standing there smirking.

"What?"

Dr. H was egging me on. "I was just telling Gill that I've never seen you intubate," he said with excited anticipation regarding what he thought was about to happen to my patient.

Gill was quick to get my back. "Oh she's good. She's good."

I just sat there and charted and said "No sweat."

I went and checked on the patient's breathing again, and Dr. H was still watching with baited breath. I couldn't resist... "Intubating's easy. You haven't seen me intubate because a good doctor can save a patient from intubation by fixing him."

"Oooooh. Touche." He feigned a slap across his cheek. The nurses laughed.

Nothing like a verbal bitch-slap to relieve a little tension. And damned if the patient didn't get better, and, yes, avoid a tube down his throat, shortly thereafter. Maybe I should talk a little smack more often.