I'm going to be working back at home hospital this summer in a per diem position, which I'm pretty excited about. Mostly I'm excited to be back with staff I know and trust, and who trust me. I'm also looking forward to the amount of good natured needling that I can expect. So with that in mind, a story from the last go-round there...
We're standing around, waiting for the massive trauma that is a few minutes out. Everyone is there - us ER nurses, techs, and registration. Of course there is the ER doc. The OR team is there, including anesthesia. Even the grumpy trauma surgeon has made it in before the trauma gets here.
All of us are making comments, trying to guess the injury beforehand, and talk turns to other types of injuries. I forget the comment that I made, but I imagine it was something straight out of the gallows humor textbook. This was the response to that comment:
ED doc: you're a heartless soul-eating bastard.
Grumpy trauma surgeon: Man, that is cold. Even these crusty OR nurses wouldn't take that shit from me.
ED doc: Whatever. She knows it's true.
Yup. I miss these peoples.
Tuesday, May 14, 2013
Friday, May 10, 2013
Exit
So, my assignment in Texas has ended and I'm back at Home Hospital for the summer. I missed my parents, I missed my friends here, and I missed my coworkers - not taking anything away from the people I've met while traveling thus far...but there's no place like home.
It was hard to leave Texas though. I loved everything about it, from the people to the delicious food to the warm weather. I've already decided that I'll be back there, and sooner rather than later. Thus far my plan is Home Hospital part time this summer, then hopefully Colorado or California or Hawaii until the spring - then back to Texas. But enough about future plans. Let's talk about exit strategy. Not by me, but by a patient of mine on my last shift there. Because this is a blog about nursing, remember?
As with any ER, we are bed & breakfast to many a drunk moron. Some of them we allow to sleep off their alcohol because they're nice and polite to us and never piss on the floor. Others we'll kick out as soon as they can stand or start throwing the f-bombs around. If they cross the line and start to get punchy, we have them escorted out by the nice gentleman in uniform. But every now and then, a patient leaves in style. Like my patient.
He's the sadly usual variety of ER dreg. He vacillated between outright sexual harassment of the female nurses and antagonistic fighting attempts to the male nurses. When he was informed that he was discharged and free to exit the ER without the meal tray, percocet, or ginger ale he so kindly demanded, he started to escalate. The police were brought to stand by the room in case of explosion. When he saw them he picked himself up and walked out of the room without any further bitching. We were all utterly shocked as he walked by our nursing station and out of the ER without another word. "This never happens, ever," said Charge. We were all perplexed at the lack of style in his departure, but shrugged and started to move to the next task.
And then we smelled it. And kind of tasted it. The worst fart I have EVER been subjected to. It was like a bum took his stanky feet off, marinated them in C.diff, wrapped them in used perirectal I&D gauze, and left them in the hot sun for a week with a sprinkling of gangrene seasoning for extra flavor. This fart violated every code set forth in the Geneva convention. Mother Theresa would have wept in agony. God smote a kitten when this thing erupted. It was, ugh. I can't. I can't even.
Seriously, this MF'er cropdusted us with no mercy. No one saw it coming. No one. It was even more insulting because we thought we had won the battle of ER eviction, but truly. He won the war.
It was hard to leave Texas though. I loved everything about it, from the people to the delicious food to the warm weather. I've already decided that I'll be back there, and sooner rather than later. Thus far my plan is Home Hospital part time this summer, then hopefully Colorado or California or Hawaii until the spring - then back to Texas. But enough about future plans. Let's talk about exit strategy. Not by me, but by a patient of mine on my last shift there. Because this is a blog about nursing, remember?
As with any ER, we are bed & breakfast to many a drunk moron. Some of them we allow to sleep off their alcohol because they're nice and polite to us and never piss on the floor. Others we'll kick out as soon as they can stand or start throwing the f-bombs around. If they cross the line and start to get punchy, we have them escorted out by the nice gentleman in uniform. But every now and then, a patient leaves in style. Like my patient.
He's the sadly usual variety of ER dreg. He vacillated between outright sexual harassment of the female nurses and antagonistic fighting attempts to the male nurses. When he was informed that he was discharged and free to exit the ER without the meal tray, percocet, or ginger ale he so kindly demanded, he started to escalate. The police were brought to stand by the room in case of explosion. When he saw them he picked himself up and walked out of the room without any further bitching. We were all utterly shocked as he walked by our nursing station and out of the ER without another word. "This never happens, ever," said Charge. We were all perplexed at the lack of style in his departure, but shrugged and started to move to the next task.
And then we smelled it. And kind of tasted it. The worst fart I have EVER been subjected to. It was like a bum took his stanky feet off, marinated them in C.diff, wrapped them in used perirectal I&D gauze, and left them in the hot sun for a week with a sprinkling of gangrene seasoning for extra flavor. This fart violated every code set forth in the Geneva convention. Mother Theresa would have wept in agony. God smote a kitten when this thing erupted. It was, ugh. I can't. I can't even.
Seriously, this MF'er cropdusted us with no mercy. No one saw it coming. No one. It was even more insulting because we thought we had won the battle of ER eviction, but truly. He won the war.
Sunday, April 28, 2013
Trauma priorities
So this ER that I'm in right now is all about trying to become trauma-certified. We had this big long lecture from management today during our pre-shift huddle regarding how we're pretty much awesome and a trauma center already and the only thing we lack is the designation.
During this lecture a few people were singled out about how they filled out the trauma charting wrong, by putting "4 hours ago" as the time of injury as opposed to "Sunday 4/28/13 @ 0400." Not a huge deal, and something that seems easily remedied by a quick mention instead of a berating. We were also all given a stern talking to about how the triage nurse and the secondary assessment nurse cannot under any circumstances be the same person. "These are huge issues, people! This is the kind of stuff that makes us trauma!" said Management.
Except, not.
Eight hours later, when my room gets a direct bed from triage, I find a little girl sitting in a wheelchair because her drunk friends got in an accident and were too scared to call an ambulance. They called another friend to come pick her up and drop her drunk self off at our door. I'm like, "hey girl, I see your obviously fractured femur, and I'm gonna help you."
I'm gonna help by putting on that Hare traction splint. But wait! There isn't a single traction splint to be found in this ER. Anywhere. I had to borrow one from EMS.
Because we're a trauma center. Except, not.
I can't even imagine how terrible we'd be if I had also charted both a primary and secondary assessment under one name. Oh, the horrors.
During this lecture a few people were singled out about how they filled out the trauma charting wrong, by putting "4 hours ago" as the time of injury as opposed to "Sunday 4/28/13 @ 0400." Not a huge deal, and something that seems easily remedied by a quick mention instead of a berating. We were also all given a stern talking to about how the triage nurse and the secondary assessment nurse cannot under any circumstances be the same person. "These are huge issues, people! This is the kind of stuff that makes us trauma!" said Management.
Except, not.
Eight hours later, when my room gets a direct bed from triage, I find a little girl sitting in a wheelchair because her drunk friends got in an accident and were too scared to call an ambulance. They called another friend to come pick her up and drop her drunk self off at our door. I'm like, "hey girl, I see your obviously fractured femur, and I'm gonna help you."
I'm gonna help by putting on that Hare traction splint. But wait! There isn't a single traction splint to be found in this ER. Anywhere. I had to borrow one from EMS.
Because we're a trauma center. Except, not.
I can't even imagine how terrible we'd be if I had also charted both a primary and secondary assessment under one name. Oh, the horrors.
Tuesday, April 16, 2013
Here's another blogger to read since I suck at timely updates
Oh hai everybody! Remember that time I got lazy and only blogged like twice a month? I bet you do remember, because that time is now. Sorry about that. I've got a bunch of amazingly witty and heartwrenching stuff drafted out that will probably win me the Pulitzer or something, but, yeah. Laziness.
So in the interest of good interwebz reading, I bring you this: Shepherd of the Gurneys. Go forth and read now. Srsly. Don't believe me? Here's a little excerpt of the fun, from "Diagnosis of the Week:"
Like I said. Comedy gold.
Also, I promise I'll get myself in gear and start writing regularly again soon because I have lots to say about this travel assignment and how much I'm going to miss it and how fast six months flew by. I'll be back, but probably not until next March or so. I'm gonna miss Texas something fierce, especially the friends I've made here.
So in the interest of good interwebz reading, I bring you this: Shepherd of the Gurneys. Go forth and read now. Srsly. Don't believe me? Here's a little excerpt of the fun, from "Diagnosis of the Week:"
That fact notwithstanding, please accept as gospel, that unless you produce either the winning Powerball ticket, serial 24K solid gold nuggets, or the body of Jimmy Hoffa, there is nothing in your barf that I, the other staff, the doctors, or anyone in North America wants to "take a look at". I don't care if you ate alphabet soup and coincidentally horked up the entire Revelation of St. John, in Greek, or launched out something that's the spitting image (you should forgive the pun) of DaVinci's Mona Lisa. Keep it to yourself, and leave it at home. Don't even use a clear bag.
Like I said. Comedy gold.
Also, I promise I'll get myself in gear and start writing regularly again soon because I have lots to say about this travel assignment and how much I'm going to miss it and how fast six months flew by. I'll be back, but probably not until next March or so. I'm gonna miss Texas something fierce, especially the friends I've made here.
Monday, April 8, 2013
Thanks?
"You're the nicest little white girl with red hair that's ever taken care of me!" - My patient tonight, who had an oddly specific control group for nice/not nice. I didn't tell her my hair isn't naturally red, since I figured that would throw the p-value way out of line.
Saturday, March 30, 2013
Pest control
Let it never be said that I don't care about my patients' wellbeing.
Four AM today found me frantically swinging a large blue disposable (clean) diaper at a humongous fly buzzing around the room of a demented little old lady. Naturally because she's demented, she thinks it's not a fly but instead a bat with an appetite for her head. She starts crying and calling out for help and hiding under the covers because it's going to swoop in and eat her hearing aid any hot second. I'm trying to either shoo it out of the room or crush it into oblivion with this sad diaper. Obviously there is no fly swatter to be found in this high tech ER so a Depends it is. Then the diaper starts to fall apart and fling little bits of stuff everywhere, because of course, so I move on to a weaponized towel in hopes I have better aim with that. I don't.
The security guard walks by and spends five seconds convinced I'm crazy, then takes pity on me and joins in the fight. By now this debacle has attracted a crowd of nurses and techs and even a doctor who have pulled up chairs, made popcorn, and are holding up signs ranking our swings on a scale of 1-10. The son of the patient is standing just outside the door and is laughing hysterically at me. Like, tears running down his face, might possibly pee his pants laughing.
This fly has now taken up residence in the very top corner of the wall, out of reach of every implement of destruction we can find. So the security guard makes a ball out of gloves and starts throwing it at the fly to make it come down lower. I catch the glove rebound, take aim, and let loose a MLB-worthy pitch. This time my aim is true and the glove hits this fly square on. When it falls to the ground, sure enough there is a smooshed insect outline up on the wall and I am not even kidding when I say it was twice as big as the already-huge live fly was. A cheer goes up from the staff gathered, the son pulls himself together enough to start clapping, and I mop the sweat off my brow. Thank God this ordeal is finally over.
And I'll be damned if the patient doesn't pop her head out of the blanket shield and ask me why the hell I'm just standing there in her room. "If you're going to sneak in here, child, at least bring me a breakfast tray!" she says.
You guys, I can't even. I CAN'T. EVEN.
Four AM today found me frantically swinging a large blue disposable (clean) diaper at a humongous fly buzzing around the room of a demented little old lady. Naturally because she's demented, she thinks it's not a fly but instead a bat with an appetite for her head. She starts crying and calling out for help and hiding under the covers because it's going to swoop in and eat her hearing aid any hot second. I'm trying to either shoo it out of the room or crush it into oblivion with this sad diaper. Obviously there is no fly swatter to be found in this high tech ER so a Depends it is. Then the diaper starts to fall apart and fling little bits of stuff everywhere, because of course, so I move on to a weaponized towel in hopes I have better aim with that. I don't.
The security guard walks by and spends five seconds convinced I'm crazy, then takes pity on me and joins in the fight. By now this debacle has attracted a crowd of nurses and techs and even a doctor who have pulled up chairs, made popcorn, and are holding up signs ranking our swings on a scale of 1-10. The son of the patient is standing just outside the door and is laughing hysterically at me. Like, tears running down his face, might possibly pee his pants laughing.
This fly has now taken up residence in the very top corner of the wall, out of reach of every implement of destruction we can find. So the security guard makes a ball out of gloves and starts throwing it at the fly to make it come down lower. I catch the glove rebound, take aim, and let loose a MLB-worthy pitch. This time my aim is true and the glove hits this fly square on. When it falls to the ground, sure enough there is a smooshed insect outline up on the wall and I am not even kidding when I say it was twice as big as the already-huge live fly was. A cheer goes up from the staff gathered, the son pulls himself together enough to start clapping, and I mop the sweat off my brow. Thank God this ordeal is finally over.
And I'll be damned if the patient doesn't pop her head out of the blanket shield and ask me why the hell I'm just standing there in her room. "If you're going to sneak in here, child, at least bring me a breakfast tray!" she says.
You guys, I can't even. I CAN'T. EVEN.
Tuesday, March 12, 2013
Demands
Look, I can appreciate a well-spun tale of woe. If you really put some effort into it, mention all the right things, shed a tear or two and cleverly zero in on a single complaint we might reward your effort with a work up and a single dose of that D medicine before booting you out. CYA medicine at it's best, y'all.
But if you list eleven chief complaints, and one of those is literally "I want some dalaudah or I'll sue," well....
I'm still quaking in fear over whether or not she's gonna get my license revoked as threatened when security escorted her off the premises.
But if you list eleven chief complaints, and one of those is literally "I want some dalaudah or I'll sue," well....
I'm still quaking in fear over whether or not she's gonna get my license revoked as threatened when security escorted her off the premises.
Saturday, March 2, 2013
Vouchers
There are some things that I for sure don't like about the hospital I'm at now, but I gotta say...on the whole, it's a fairly sweet place to work. They just don't take bullshit from patients. At all. I've seen patients get arrested for threatening staff, get arrested for trespassing after being discharged, thrown out of the waiting room for harassing other patients, and discharged from the triage window by the doc after a medical screening exam. I see patients get discharged scrip-less when they demand more dilaudid. I've watched a doc lay a verbal smackdown on a belligerent family member who had reduced a tech to tears. But the best thing I like? They don't tolerate handing out taxi vouchers to just everyone...you've gotta have a damn good reason for needing one. And for the chronically taxi-needy...well, they only get one a year.
The taxi issue might seem like a minor thing compared to the rest, but trust me - when you're trying to discharge that malingering patient, or the guy who's been here 17 times already this year for the same complaint, it's so nice to be able to emphatically decline the request for a taxi voucher. I had this happen to me last night. A frequent flyer patient was angling hard to get a voucher, and Home Hospital would be all like "well okaaaayyy I guess you can have another one but this is the LAST TIME, mmmkay?" and they'd get one three days later anyway. Not this hospital. Not this time. He asked for one, I looked up his chart history, and was like "Sorry Charlie, you had one ten months ago. See ya!" And he left! No argument!
It's the small victories, folks. Seriously.
****
Also, because I'm obsessed with this website...
When my patient thanks me for all that I do
I'm just like
[credit #whatshouldwecallnursing]
The taxi issue might seem like a minor thing compared to the rest, but trust me - when you're trying to discharge that malingering patient, or the guy who's been here 17 times already this year for the same complaint, it's so nice to be able to emphatically decline the request for a taxi voucher. I had this happen to me last night. A frequent flyer patient was angling hard to get a voucher, and Home Hospital would be all like "well okaaaayyy I guess you can have another one but this is the LAST TIME, mmmkay?" and they'd get one three days later anyway. Not this hospital. Not this time. He asked for one, I looked up his chart history, and was like "Sorry Charlie, you had one ten months ago. See ya!" And he left! No argument!
It's the small victories, folks. Seriously.
****
Also, because I'm obsessed with this website...
When my patient thanks me for all that I do
I'm just like
[credit #whatshouldwecallnursing]
Thursday, February 21, 2013
But wait! Call now, and we'll send you two!
Patient at triage: So I bought this new thing, called flexiseal, so I could use it at home. But it's not working right and I think I have mold on my carpet now and that's why I'm here.
Not gonna lie, I'm glad I watch infomercials a lot in the wee hours of the morning, because I sure would have been confused otherwise. Seriously. Flexiseal. Flex Seal. Two real things...very very different uses.
Although, on second thought, I suppose they do both prevent leaks if you're up shit creek.
Flexiseal:
Flex Seal:
I hope you were eating breakfast while reading this, suckers! Google images for the disgusting win.
Not gonna lie, I'm glad I watch infomercials a lot in the wee hours of the morning, because I sure would have been confused otherwise. Seriously. Flexiseal. Flex Seal. Two real things...very very different uses.
Although, on second thought, I suppose they do both prevent leaks if you're up shit creek.
Flexiseal:
Flex Seal:
I hope you were eating breakfast while reading this, suckers! Google images for the disgusting win.
Monday, February 4, 2013
Straws
I'm pretty sure when I dropped my patient off in the ICU this morning, as soon as I left they were just like
[credit to #whatshouldwecallnursing for the ICU-inspired gif]
Sorry, guys. I really didn't mean to be a dick about that. Just...some days are worse than others. And some patients are way worse than others. And sometimes I just reach the end of my rope and call it a night.
My breaking point was probably somewhere in the patients' kayexalate explosion and subsequent fingerpainting, ER vs Admitting doc literally screaming at each other over requests that could not be accomplished until one of them acquiesced to common sense, me being caught in the middle of the ridiculous arguments via constant conflicting orders, the requiring of four-point restraints for behavioral reasons, the admitting doc losing the chart and all the restraint documentation, family members cussing me on the phone because I wouldn't let them come visit the patient during the shitsplosion, discovering that the patient had given a fake name to the police resulting in a completely incorrect chart history, and the realization that somehow I had gotten poo on my scrub pants even with the protective gown firmly in place.
So, my apologies for not doing the one order that you think should have been done in the ER. It didn't have STAT written next to it and thusly I was like NOPE.
Sorry, guys. I really didn't mean to be a dick about that. Just...some days are worse than others. And some patients are way worse than others. And sometimes I just reach the end of my rope and call it a night.
My breaking point was probably somewhere in the patients' kayexalate explosion and subsequent fingerpainting, ER vs Admitting doc literally screaming at each other over requests that could not be accomplished until one of them acquiesced to common sense, me being caught in the middle of the ridiculous arguments via constant conflicting orders, the requiring of four-point restraints for behavioral reasons, the admitting doc losing the chart and all the restraint documentation, family members cussing me on the phone because I wouldn't let them come visit the patient during the shitsplosion, discovering that the patient had given a fake name to the police resulting in a completely incorrect chart history, and the realization that somehow I had gotten poo on my scrub pants even with the protective gown firmly in place.
So, my apologies for not doing the one order that you think should have been done in the ER. It didn't have STAT written next to it and thusly I was like NOPE.
Wednesday, January 30, 2013
Two roads diverged...and it hurt!
"What if he had quit when he didn't make the team? He would have never made Space Jam...and I love Space Jam."
"But what if there really were two paths? I wanna be on the one that leads to Awesome."
Kid President, you have my vote.
"But what if there really were two paths? I wanna be on the one that leads to Awesome."
Kid President, you have my vote.
Monday, January 28, 2013
Every day, a losing battle
"Thermometer goes under your tongue for a moment with your lips closed around it" means keep the thermometer under your tongue for a moment with your lips closed. Not between your teeth, or with your mouth gaping open as if Hugh Jackman just walked by naked, or trying to make it touch every single taste bud in under 15 seconds, or under your tongue then beside it then above it, or attempting to put it under your tongue with your tongue outside your mouth, or making out with it like this is your first game of 7 minutes in heaven, or staring at me like you have no idea what your tongue is.
FFS, people.
FFS, people.
Wednesday, January 23, 2013
Ya done messed up
I'd say staffing is about 75% travelers at Travel Hospital #2, so it's understandable that we're viewed with caution at best and pure dislike at worst. It's tough trusting the care of most of the department to people you've only worked with a couple of times. I'm hoping my stock has risen slightly though, after I took care of a patient and made some solid decisions for her.
I had a lady who came in for typical vertigo - she'd had a few similar episodes years back which resolved quickly with po meclizine and a work note. When she came in this time though she was vomiting, pale as shit, and had that vertigo lean-to-the-side-like-you're-drunk hold on the bedrail. I hit her with meclizine, valium, zofran, and a liter of fluid which seemed to help her quite a bit. Her head CT was also negative. I came back in later and she was starting to feel really terrible again. I went to her doc, who also happens to be the ED director, and got some orders for another dose of meds. Again she felt better for about 20 minutes. The doc had gone in to reeval at that time, so seeing that she felt better he wrote her up for DC. When I got her up to see how she did, the vertigo came back full force and she couldn't even make it the ten feet to the bathroom without hugging the wall. I got her back in bed, and went back to the doc. He was actually really nice about everything, and agreed to call the hospitalist to admit for obs. The lady's ride home was kind of peeved that she had driven to the hospital to pick up the patient only to find out she wasn't needed anymore, but overall was fairly pleasant about it.
A couple of days later the doc came up to me and was like, "hey, remember that vertigo lady you couldn't discharge? She had an MRI in the morning, and guess what? Cerebellar infarct. Thanks for not making her go home."
He was already pretty nice to me, but I'm hoping he realizes I'm not totally incompetent and spreads the word among the docs so some of the others will quit being dicks.
***
On a side note, I really wanted to work the phrase "Ya done messed up" into this post, but I couldn't make it fit well. So I'll just show you the video it came from, and that should suffice.
Makes me laugh every time.
I had a lady who came in for typical vertigo - she'd had a few similar episodes years back which resolved quickly with po meclizine and a work note. When she came in this time though she was vomiting, pale as shit, and had that vertigo lean-to-the-side-like-you're-drunk hold on the bedrail. I hit her with meclizine, valium, zofran, and a liter of fluid which seemed to help her quite a bit. Her head CT was also negative. I came back in later and she was starting to feel really terrible again. I went to her doc, who also happens to be the ED director, and got some orders for another dose of meds. Again she felt better for about 20 minutes. The doc had gone in to reeval at that time, so seeing that she felt better he wrote her up for DC. When I got her up to see how she did, the vertigo came back full force and she couldn't even make it the ten feet to the bathroom without hugging the wall. I got her back in bed, and went back to the doc. He was actually really nice about everything, and agreed to call the hospitalist to admit for obs. The lady's ride home was kind of peeved that she had driven to the hospital to pick up the patient only to find out she wasn't needed anymore, but overall was fairly pleasant about it.
A couple of days later the doc came up to me and was like, "hey, remember that vertigo lady you couldn't discharge? She had an MRI in the morning, and guess what? Cerebellar infarct. Thanks for not making her go home."
He was already pretty nice to me, but I'm hoping he realizes I'm not totally incompetent and spreads the word among the docs so some of the others will quit being dicks.
***
On a side note, I really wanted to work the phrase "Ya done messed up" into this post, but I couldn't make it fit well. So I'll just show you the video it came from, and that should suffice.
Makes me laugh every time.
Tuesday, January 22, 2013
Number two
I have never understood what it is about the emergency room that automatically makes patients have to take the biggest poop of their life immediately after rolling through the doors. I'm not even kidding. The likelihood that they'll birth a food baby is exponentially higher if their chief complaint is syncope, afib with RVR, vertigo, or anything involving being strapped to a backboard.
The only patients who are excluded from this phenomenon are the ones who come in for not being able to poop, or for pooping too much. It's almost a guarantee that if the cc is diarrhea, they will stay dry the entire time. And if it's being backed up...I'm gonna hand you a bottle of mag citrate and hope you stay that way until getting home.
This morning I had a guy with syncope and chest pain who desperately needed to drop his kids off. He begged and begged to be allowed to walk down the hallway to the bathroom. I'm trying to explain to him why it's a bad idea, and he's just not down with the whole bedpan plan. "But come on, it's not that far! I'll only be a few minutes. I'll be fine!" he says. I finally got fed up and was like look, dude, I understand that it's pretty embarrassing to have to take a dump in the ER room with just a curtain between you and mortification. But just look at it this way: Elvis died while taking a shit. And that is how he will forever be remembered. Do you want to be that guy?
He used a bed pan.
The only patients who are excluded from this phenomenon are the ones who come in for not being able to poop, or for pooping too much. It's almost a guarantee that if the cc is diarrhea, they will stay dry the entire time. And if it's being backed up...I'm gonna hand you a bottle of mag citrate and hope you stay that way until getting home.
This morning I had a guy with syncope and chest pain who desperately needed to drop his kids off. He begged and begged to be allowed to walk down the hallway to the bathroom. I'm trying to explain to him why it's a bad idea, and he's just not down with the whole bedpan plan. "But come on, it's not that far! I'll only be a few minutes. I'll be fine!" he says. I finally got fed up and was like look, dude, I understand that it's pretty embarrassing to have to take a dump in the ER room with just a curtain between you and mortification. But just look at it this way: Elvis died while taking a shit. And that is how he will forever be remembered. Do you want to be that guy?
He used a bed pan.
Monday, January 21, 2013
Mogwai madness
So last night was pretty hellish. Like, every single one of my patients were crazy escape artists who ran me ragged or were sick as all get out or all of the above. For example: my little demented nursing home lady with altered mental status (new? chronic? who really knows...not the nursing home, that's for sure) who was very pleasantly confused. She would answer questions about medical history with, "oh no sweetie, I just like carrots," and reply to inquiries about her pain level with, "that's nice, a large hat." Because she had all the medical problems ever, her Hgb was 6.4 and Hct was 21 and urine looked like cottage cheese and lungs sounded awful. Hello, blood transfusion and foley and antibiotics, because she was also a full code and do everything per family. I get the catheter in, two IV lines placed, blood transfusion going, antibiotics infusing, pillows fluffed, sheets tucked in, curtain pulled open, and monitor wires neatly hidden. She smiles at me and closes her eyes for a little nap.
Not even six minutes later and I'm standing in the next room doing another workup, when the monitor alarm goes off. I head back into the room, and I swear to you it's like gremlins came in and tore the place apart and then disappeared back into the great beyond. The pillow was on the other side of the room. The monitor wires are dangling from the screen. The foley is laying next to her on the bed. Both IV lines have been pulled out and the blood is infusing onto the tile floor, the antibiotic into the blanket which is on the chair. It was fucking armageddon in there. And the craziest part? Lady looks like she hasn't moved one bit. She is still laying in the same position as when I left, eyes serenely closed. I am still flabbergasted how that whole disaster happened.
I also had a big burly psych patient attempt to escape. He almost made it because I'm like 5 foot 3, and he was Ray Lewis. He also probably almost made it because there aren't actually any real psych rooms in this ER and it's a pretty short distance from the rooms to the exit. I wish I'd had a haldol blowdart gun, because we (and by "we" I mean Sa-curity) pretty much had to then sit on him (literally) to IM med his ass until we could drag him back into bed.
And oh yeah, there was the lady who came in for "insomnia" and then complained to me that she didn't want to sleep on the stretcher because "those beds are uncomfortable." You know what would have been more comfortable? Your bed at home. And also, probably don't drink a red bull at 01:30. You make me wish call bells had never been invented.
All I'm saying is...I might have had two extra large glasses of sangria this morning when I got home. And made the most banging egg breakfast ever, because nothing says "de-stress" like heartburn.
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Nighty night, yall'z.
Not even six minutes later and I'm standing in the next room doing another workup, when the monitor alarm goes off. I head back into the room, and I swear to you it's like gremlins came in and tore the place apart and then disappeared back into the great beyond. The pillow was on the other side of the room. The monitor wires are dangling from the screen. The foley is laying next to her on the bed. Both IV lines have been pulled out and the blood is infusing onto the tile floor, the antibiotic into the blanket which is on the chair. It was fucking armageddon in there. And the craziest part? Lady looks like she hasn't moved one bit. She is still laying in the same position as when I left, eyes serenely closed. I am still flabbergasted how that whole disaster happened.
I also had a big burly psych patient attempt to escape. He almost made it because I'm like 5 foot 3, and he was Ray Lewis. He also probably almost made it because there aren't actually any real psych rooms in this ER and it's a pretty short distance from the rooms to the exit. I wish I'd had a haldol blowdart gun, because we (and by "we" I mean Sa-curity) pretty much had to then sit on him (literally) to IM med his ass until we could drag him back into bed.
And oh yeah, there was the lady who came in for "insomnia" and then complained to me that she didn't want to sleep on the stretcher because "those beds are uncomfortable." You know what would have been more comfortable? Your bed at home. And also, probably don't drink a red bull at 01:30. You make me wish call bells had never been invented.
All I'm saying is...I might have had two extra large glasses of sangria this morning when I got home. And made the most banging egg breakfast ever, because nothing says "de-stress" like heartburn.
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Nighty night, yall'z.
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