Subtraction

[minoanmiss]

Of course there are plenty of things we hospital workers can do.

Probably to wake us up after the WAY BORING infection control speaker, we just got a video on how a sweet young Black woman named Whitney went to the hospital for appendicitis, got MRSA in hospital and died. (I appreciate that our sympathetic sweet relatable patient was Black).

How this happened:

*Bob down the hall had MRSA
*Bob's daughter Nancy held his hand with gloved hands
*Nancy did not remove her gloves and wash her hands when leaving the room as she should have
*Nancy put her gloved, MRSA-contaminated hands on the Nurse's Station counter while talking to anurse
*Amy, the Nurse Nancy was talking to, saw her put gloved hands on the station counter did not say "WTF" OR clean the counter OR get a passing housekeeping staffer to do so ASAP (she doesn't know Nancy is Bob's daughter but she doesn't know she's not if you see what I mean. If a visitor is wearing gloves there's.a *reason*)
*Newbie Nurse put her bare hands on the same counter, then put gloves on her hands without washing them, then put a new IV in Whitney's Left arm, noting in the chart that Whitney had a rash from being scratched by her cat on her Right arm.
*Kiara the night nurse noted Whitney's temp was still up, but only said something about it when giving end of shift report to the Intern and the next nurse.
*The Intern noticed redness on Whitney's Left arm but the attending looked at her chart and said "she reported a cat scratch on her arm." not realizing that was her Right arm. intern was too awed to point this out. They continued giving her methicyllin for the appendicitis, thus clearing the way for a methicyllin-resistant infection such as MRSA.
*Whitney became confused and her temperature went down to 97. Intern quailied and did not call Attending because it was the weekend.
*Michelle the hospital infection control lady came by to chat with the nurses who were poky to her instead of Cheerful To Coworkers Like We Should Be. (Michelle was played by a fat Black actress woot woot)
*Whitney was sent to the ICU
*There the staff found the Methicyllin-resistant SA partying hard in her blood and brain
*Michelle came back to tell everyone Whitney died.
*Everyone was sad and Whitney was dead and Michelle was going to have to interview them all.

And thus a protocol mistake, a bit of contamination, and several people not speaking up killed a sweet young woman.

*goes to wash hands*

PS as may be noted I delighted in the video's diverse casting, ahahahah . I should have written everyone down.

Comments

[asakiyume]

HOLY CRAP
***I'm*** going to go wash my hands now.

... that's great about the cast though, truly.

[minoanmiss]

Hehahe I am amused at my own delight in the casting.

[amaebi]

Nice about the casting!

But man, it seems par for the course that it's a Black woman dying.

[minoanmiss]

It's one of those situations like "does this female character benefit or lose by being assigned a love interest?" Since Whitney was clearly doomed by the narrative, I found it an advancement that the people who made the video knew we'd find a Black girl sympathetic. It's a weird kind of advancement to be valued enough to be killed off, but it's better than being so undervalued that one's death isn't even viewed as sad.

*rereads, laughs sardonically*

[amaebi]

Oh, yeah, I get it, and she's got a name and a personality!

I just didn't want her doomedness to go by unmentioned. And I gather that of medical personnel only the disrespected infection specialist was Black?

[minoanmiss]

Actually, three whole nurses were Black and a passing doctor as well! Woot!

Oh yeah, she was so doomed. It was totally a For Want Of A Nail plot. It was a kind of awful fun watching her doom unfold.

[lemonsharks]

she could have been the girl who left the glove on the nurse's station, or the person who didn't do anything about that; that's both narrative importance and having both Black women in roles of narrative value and competence

[minoanmiss]

True, but then she would have played someone who was partially at fault. I liked the way the people in the Chain of Disaster were cast and arranged, to keep from implying innate qualities rather than medical culture caused the disaster. I am probably being a ridiculously Romantic teenager, but I liked casting the Beautiful Doomed Innocent Who Is Worthy Of Our Tears as a Black girl. ahahahaha

I may get a story idea out of this video yet

[lemonsharks]

She got to be the youthful victorian heroine, all ashy and tubercular, sinless and too good for this world, too pure

[minoanmiss]

YES EXACTLY. aahahahahahaha

(y brain is so sore from learning Epic)

[kore]

Yay diverse casting!

.....HOLY FUCK everything else

[minoanmiss]

She was such a sweet kid, pretty and darling! And then she was DEAD.

I will wash my hands!

[acelightning73]

During the COVID thing, I figured out a few ways to time washing my hands for 20 seconds. The canonical is to sing "Happy Birthday", but I discovered that singing the chorus to "Jolene" (filked to "Vaccine")was perfect. And recently I'm using the chorus from "Gospel Night At The Strip Club".

I'm still trying to figure out how and why I got gastroenteritis last week, and my husband who ate the same things I ate was perfectly fine. And all my tests for pathogens were negative.

And after I came home from the ER, I took off my clothes, put them in the wash, and took a hot shower.

And every time I go to start cooking, I wash my hands with antibacterial soap for 20 seconds. And when I've been handling raw chicken or hamburger I wash some more afterwards.

[minoanmiss]

At my last workplace we did the Litany Against Fear from Dune. Ahaha

[lemonsharks]

having not watched the video...I can see two places that are straight up Doctoring Culture:

*Kiara the night nurse noted Whitney's temp was still up, but only said something about it when giving end of shift report to the Intern and the next nurse.

There's an unspoken law of Do Not Page The Doctor Unless Someone Is Bleeding Out, They Need Their Sleep. This needs a systemic change to correct--how long and for what doctors are scheduled--as well as a cultural change--page the doctor even if it's "sleeping hours"

*Whitney became confused and her temperature went down to 97. Intern quailed and did not call Attending because it was the weekend.

Intern had already been shot down by the doctor, and probably would have been shot down again + scolded for interrupting the attending/making them look or feel incompetent. Because the attending was incompetent in that moment of not checking both of Whitney's arms. This is how people end up having the incorrect limb amputated.




More feasibly, if anything changes related to body temperature +/- 1*C/or other common signs of staph aureus (or c.diff or other common hospital acquired infection) happens to any patient (which signs and what microbes above my pay grade and beyond my expertise to decide), that needs to trigger a mandatory hospital acquired infections panel. And those standards need to be stricter if there's a hospital acquired infection patient in the ward somewhere.

[minoanmiss]

Yeah, the video came after a description of hygiene practices but THAT came after a very long talk about speaking up and reporting stuff and not deferring to Doctoring Culture. It will be interesting to see how much they mean that.

[lokifan]

That's actually really good, yeah. That the ingenue (might be too strong a word, but 'sweet sympathetic relatable' + tragically doomed young woman usually = ingenue) was Black, with all the confidence that implies in the audience being like "omg no we must do better!" And yay for a fat black medic :)

[minoanmiss]

Ingenue is the perfect term, yes indeed!