Can't ANYONE take charge?

I went to one of the offices I work at yesterday. I was going there to do some cardiac stress tests (I’m a doc) like I do once a week. That’s my only responsibility there, making sure the tests are performed safely. They’ve got whole layers of administration to run the place and be responsible for anything that might go on, including lengthy protocols which theoretically must be obeyed.

Anyway, I arrive at 12:30 pm, to a scene with much wailing and gnashing of teeth! They were waiting for me to arrive so I could tell them what to do! At 9:30 AM, a blood-pressure meter had broken in a patient room spilling mercury. The medical assistant, thinking quickly, but none too clearly, felt she must get the poisonous material away from the patient. Does she take the patient out of the room and close the door? No! She takes the BP meter out of the room, drags it down a 50 foot long corridor where staff and patients travel, spilling mercury all the way, and parks it in the patient dressing/undressing area.

OK, bonehead move, but let’s face it, the MA was not given a lot of training or supervision on how to do things. She reacted, made a bad call, messy, but not the end of the world. A supervisor is notified. The supervisor (a former RN) says “well, clean it up!” My nurse tries to, using a syringe to suck up the mercury from linoleum and carpet. No go. Tells supervisor. Supervisor says “tell maintenance to clean it up”. Maintenance man is on hands and knees, pushing mercury globules around, while patients and staff wander by.

It’s now 3 hours later, there’s still mercury balls around, and I show up. My radiation techs, who inject our patients for their myoview stress tests, (and whom I refer to as Nuclear Girl and Beta Babe) grab me and tell me “you’ve got to do something! These people are idiots!” Nuclear girl is pregnant, and while lead aprons and knickers keep out the radiation, it won’t keep out mercury poisoning. Maintenance man tells me “I think I’ve got most of it, but I really don’t know what I’m doing”. How risible. I can’t reach any administrators, they’re at lunch.

Quick, Batman! To the Search Engine! Google comes thru nicely, giving me a host of mercury containment procedures, all pretty much in agreement. And they all start with “if the spill is larger than a thermometer, it’s considered a large spill. This includes blood pressure meters. First, evacuate the building, then don your HazMat suit and mask, activate the mercury vapor detector, and summon the full HazMat team. If the mercury gets into carpeting, it’s especially problematic”. Shitpissfuckcockcuntmotherfuckerandtits.

Okay, kids, out of the pool. I inform the entire wing we’re halting patient care, cancelling office hours, and getting out of the area! One secretary looks at me and asks on whose authority we’re doing this! “Mine! I take full responsibility! Let us go now!” She looks at me, then says “Oh, thank god, someone knows what to do. Thank you, thank you!”. And noone gives me any shit (other than a few patients who didn’t want to leave). They’re all going “thank god, our nightmare is over! No longer are we breathing mercury fumes with noone to tell us to stop it!” (OK, a little hyperbole on my part).

So I call the HazMat team, they come in full splendor and regalia, suits, masks, vapor detectors, mercury precipitators and get to work. Our risk-manager person is contacted, and given a lecture on the appropriate way to deal with toxic spills, and we waste about $3000 in unused nuclear stress test doses. The corporation works thru the night to decontaminate, remove carpeting, and restore the clinic in time work work the next day.

My Rant (at last, you might say). At least 6 people recognized a hazardous situation, and noone would do anything other than to refer it to a supervisor who wasn’t even fucking there, and stand around worrying about the toxic effects on themselves and our patients! Everyone turned into mindless drones, who knew something was amiss, but couldn’t use the least bit of sense to take action! I had to physically order the pregnant Nuclear Girl to leave, 3 times, which was obviously what she wanted to do from the get-go, before she went out the door! My nurse is saying “I’m so glad you did this, but I’m worried admin is going to be upset with us”. Hot Puppies Grub, people! Only when I said I was taking full authority and responsibility (which technically I don’t even have, being just a hired doc brought in to do tests) before people calmed down and partied it up in the parking lot.

So far,no comebacks from admin, neither an “attaboy” or a kick in the ass. I really don’t care either way. But man, what is wrong with people?

Lame rant, I know, but I had to get it off my chest.

I also know the actual health risk wasn’t real high, but it wasn’t zero either, and protocols call for the HazMat approach. Failure to respond this way would have looked real bad in the local medical community, press, and the courts.

Not remotely.

There seems to be a terrible fear of taking personal responsibility in many people. I don’t know what to blame, but I’m going to say the schools. Educate people to be drones working by rote, and what you get out the other end are…drones.

In my experience thus far, layers of administration to be responsible, results in an organization which is anything but responsible.

The more depressing theory is that schooling has nothing to do with it, and this is simply how people are.

Attaboy, Qadgop! Ya took responsibility and quick action, avoiding the possibly serious danger to your co-workers. At the least, it’s time for that department to review their hazardous materials education.

Heroic action like yours deserves notice. I hope you get it, but if not, here’s a warm hug for standing up and getting it right.

Oh,la, this is the Pit… for gripping the mercury by the balls and getting it shitpissfuckcockcuntmotherfuckerandtitsingly correct. :slight_smile:

Well, people really aren’t very bright.

A few years ago at a client site, we suddenly started getting really acrid fumes through the ventilator with some not too noticeable tendrils of “visible air.”

I called the front desk (with the “trained security guard” and the resettable fire alarm–as opposed to the alarms in the hall that must be broken to start and must be replaced to be turned off) and explained the situation.

Guard: “I’ll come down and take a look at it.”

I: “Why don’t you push the fire department call button with its alarm, first?”

Guard: “Oh! OK.”

I, then left the building while the occupants of the three adjacent offices wondered aloud what they should do.
It turned out that a welder had decided to set up shop at the intake duct for the HVAC unit and there was no fire. OTOH, how many fires do we hear about each month that were started by a “welder’s spark”? The building had three exits that were quite adequate provided people started to evacuate at once. The programming area was in the basement (with no windows) closest to the HVAC unit, so we smelled the smoke before anyone else in the building.
“I’ll come down and take a look at it.” Sheeeesh!

Well, geez. Every job that I have ever had has seemed like it was staffed by total lackwits that were born to follow my orders. But I’ve always secretly hoped that once I start working places that pay more than $7 an hour, things will start to look up. Thanks for ruining my optimistic outlook, Qadgop.

But, mad props for taking hold of the situation and getting Nuclear Girl to safety. Even if the Powers that Be forego giving you a medal, I’m sure Nuclear Lad and Nuke Jr. are grateful.

The city I work for had a water leak and was forced to post a boil water notice for a week or so. People called all the time for advice on the situation. My favorite:

Question: Is it safe to use the toilet? Answer: “As long as you don’t drink from it.”

You can stress my test anytime.

When I was seven or so, I found a drop of an odd silvery substance on the heater in the science classroom. It was like a liquid, yet it formed droplets that didn’t flatten or disperse very well. I tapped it, breaking it up into smaller droplets, then put those droplets back together several times.

Some months later I mentioned the incident to my Dad. That’s mercury and it’s very toxic he told me. Oh.

How poisonous is it, really? My uncle had about two cups of it he kept in a mason jar, and I used to play with it, years ago. Did I hurt my brain or something and not know it?

–Tim

There’s a straight line that obviously came directly from the hand of God…

:smiley:

jayjay

there used to be little rivers of mercury running down the gutters of the streets in some parts of San Francisco from time to time, several years ago. It was fun stuff. (not kidding)

I don’t know why this would make you feel any better, but I had to face down a security guard at a well-known cable modem company when the power went off and the air conditioning stopped. I propped open the doors, since there were customer support people who were not allowed to leave their desks. This monumental doofus with a security uniform told me I was creating a security risk. HuH? There’s somebody sitting as usual at the reception desk to ask people without badges what they’re doing, and you think it’s necessary to cut off people’s oxygen supply because it’s a situation you don’t understand?
*Quick, take my blood pressure, don’t worry about the mercury loss!

I don’t think “people are stupid” is the answer. Prompted by the murder of a woman named Kitty Genovese in full view of several neighbors, two social psycholgists named John Darley and Bibb Latane studied what they called diffusion of responsibility. IMHO, diffusion of responsibility is why no one did what they should have in the case you talked about, Quadgop.

In their classic studies in the 1970s, they staged situations in which someone needed help, varied the conditions, and then observed when people helped and when they didn’t. For example, they played a recording that sounded like someone falling in the next room. They found that if there were several people waiting together, none of them were as likely to help as one person waiting alone. Why? The hypothesized reason was that that everyone looked to the others, saw that no one else was doing anything, and assumed they should not do anything either. Sort of “oh, he doesn’t seem to think this is an emergency, so if I do, I am overreacting.” This effect was stronger the more ambiguous the situation was and the higher the costs of helping. One cool variation was when they pumped smoke in the room. Subjects would sit and cough–and potentially risk their lives–before they would do anything. They called this phenomenon of being less likely to do anything the more others are present diffusion of responsibility.

In the situation you describe, the stage is set for big time diffusion of responsibility. The situation was ambiguous (how dangerous is mercury?), no one was designated as being in charge, the course of action was unclear (what should we do about it?), the cost of doing the right thing was high (what if I shut down this place and they fire me? what if everyone gets mad at me?), and there were lots of others who could take responsibility (they aren’t acting like this is an emergency, so I shouldn’t).

So why did you act when no one else did? I would argue personality and training/experience. You chose to become an MD, which says you are willing to make difficult decisions. Your training and experience has been to make decisions, even though they might have serious consequences.

In any case, kudos for doing the right thing.

First of all, I think that Qadgop The Nuclear Baby is a FINE name !!! :smiley: You should accept the honor with grace and dignity as befits your position. In other words, wear a Hawaiin shirt to the Christening :wink:

Now then. Right ON, Doc. It frightens me actually that people are incapable these days of taking control. It seems that only in the White House can you have lunatics like Alexander Haig running around PREMATURELY screaming, " I’m in charge, I am in charge". Otherwise, people are sheep.

I was shooting a job yesterday, and literally said “cut” in the middle because I saw something that I believed did NOT belong in the shot. So, I looked like a nitwit because it WAS supposed to be in the shot. At least I wasn’t afraid to SAY something.

Hey, you recognized a dangerous substance and responded appropriately. It’s part of your job, actually. What grieves me here is that any R.N. SHOULD have also had that basic HazMat information, and therefore should have taken the same steps as you did. They were afraid for their jobs, because after all - no matter how dangerous the situation- nothing’s worse than being fired by an angry administrator for daring to cost the bottom line a few grand :rolleyes:.

They’re NOT called Protocols just to make pencil-pushers happy. The people in that building owe you a debt. They should pay you. Preferably in cash :slight_smile:

Cartooniverse, now at the 15-Days-To-EMT-Card-Countdown

Thanks for you comments, all! Many great truths were brought out. I think one of the great problems is that routine has tremendous inertia. And everyone is fearful of risking the wrath of the corporation that pays the salary. Including myself. I do remember thinking (or rationalizing) to myself during all this that “I am the most experienced and knowledgable person here as regards public health and safety. I have ultimate responsibility for patient care here. My actions are appropriate and defensible.” So even I was worried about rocking the boat.

I’m still interested in seeing how this all plays out, and if I hear anything about it. I’m certainly not indispensable, but I am a key player in the current organizational setup, which is also something I reminded myself of during my decision-making process.

But there was also a bit of a thrill in just taking charge, and having everyone fall in line behind me, and do what I told them. OK, more than a bit. So much different from the behavior of my patients. :slight_smile:

Qadgop

“If there’s anything in this room more important than my ego, I want it taken out and shot!”
Zaphod Beeblebrox

The security officer was misinformed. It’s not a security risk (ok, it might be, but that’s not the reason he should have given you), it’s a fire hazzard. Don’t ask me why, that I don’t remember. I just know that was one of the things I learned when I was working in (commercial) property management. I had to enforce that rule a few times myself.

Oh, I think I remember why. The doors in commercial buildings (at least ours) were fire-rated. They could withstand the heat and the flames more than your standard residential door. Therefore if a fire started and your door was propped open the fire would be able to just sweep in the open doorway. But if you kept it shut, then you’d have a better chance of surviving a fire until the FD arrived.

Once upon a time, I was in Indianapolis with a group of about fifty Air Force enlistees holed up in a cheap motel waiting for a bus to the airport, thence to Lackland AFB (don’t ask- I flunked out of basic training, it was a painful experience I don’t like to talk about)but this diffusion of responsibility vs. take charge discussion reminded me of something.

Anyhoo, we were waiting for a bus, as well as intelligent instructions, and I was sitting chatting with three guys, and one of them said, “You know, if we got up and walked out of here, I bet a lot of people would probably follow us.” I asked him why he thought they would. He told me that if you have a large group of people gathered in an area waiting and a small group of maybe four or five of them gets up and leaves, many of the rest of them will assume they know what they’re doing and follow them.

We led about twenty of these new recruits for a short walk around the block.

That’s when I realized that human beings are basically cattle.

Mercury is a toxin that affects your nervous system – if you want to know exactly how it works, let me know and I’ll be happy to go do some research. Even though playing with it was a really bad idea, it probably didn’t hurt you too much. The biggest danger to humans comes from prolonged breathing of mercury vapors (which is why a carpet spill is a HUGE deal) and eating mercury-contaminated fish.

Okay, since this is the pit …
WHY WHY WHY are people not trained to deal with this stuff, especially in a hospital / health care facility where it’s really common? Fuck the administrators – your health and safety and that of others always has to come first. And even more to the heart of the problem – why are hospitals / health care facilities* still using mercury devices? There are safe, accurate, reliable alternatives out there. Sure, they aren’t cheap, but they are sure as hell less expensive than cleaning up a spill, not to mention the risk to human health.

*Hospitals and health care facilities are not the only culprits, but it’s the subject of Qadgop’s rant and I thought I’d at least try to stay on topic.

<---------cautiously examines tongue in mirror…sees silvery globules from when he was licking the floor…

:smiley:

Call the HazMat team, Toonie! They’ll evacuate your mouth for you, and take your tongue in for testing.