Tuesday, December 6, 2016

It's been a minute. Let's catch up!

Which excuses should I offer this time for the sparse blogging?

Alas, I have none to offer other than lack of motivation - it's been quite the eventful few months, both at work and in home life, but I just haven't found the energy to blog regularly. With that said, let's update!

The biggest news pertaining to this blog and work life is that I am officially done travel nursing. I've been getting closer to that over the past year or so, but it's set in stone now. I completed my last travel contract a couple weeks ago and signed full time with that hospital. There are still places I wanted to travel to, but life took me this direction instead. At this point, I needed a stable job and health insurance more than I needed the freedom of travel nursing. Because...

We bought a house! Well, we're buying a house. Title papers aren't signed yet, so technically it's not our house, but we're getting there. Next week is closing, and barring disaster it will be ours. I am SO EXCITED! It's a fantastic place - except for lacking a screened porch, it checks off on every single wish list point we had. Larger property? Yup. Two story? You bet. New? Damn right! Multiple other things we wanted? Definitely. It's amazing. And thus begins the home ownership phase of life, appropriately referred to as "Coping with the Joys of Home Ownership" on our inspection binder.

Married life has been well. We've had four excellent months so far and still like each other, so that seems like a plus. Everyone is asking when we're going to have kids, but at this time I just seem to be accumulating cats and I'm totally okay with that.

Work has been good - this hospital is far less dysfunctional than most places I've worked. There will always be negative aspects to ERs, but this one seems like they've got their stuff together. Problems exist but at least management seems to recognize that those problems are real and attempt to address them, instead of pretending everything is fine. The staff is pretty excellent, and the docs are overall great to work with.

The patient population is a mix of bougie upper class snooty people, trauma, psych, and 10% totally normal people. It's a weird mix. But overall pretty enjoyable, and I get plenty of exercise in eye rolling at the BS that goes on. I haven't actually started in trauma yet since I'm fresh off the travel nurse gig, but that will hopefully be phased in over the next few months. And don't tell anyone, but I'm secretly excited to start working triage again. As hellacious as the front can be, deep down I love it because the blogging shenanigans well runs deep out there.

I think that's just about everything for now. I keep telling myself that I need to start exercising again and blogging more, so hopefully I can stick to at least one of those. At any rate, if you don't hear from me soon it's probably because I picked the gym over this blog and am gettin' swole*.

Cheers!




*HAHAHAHA that's a lie; I'm definitely sitting on the couch eating triscuits at the exact moment you're reading this...and nowhere near the gym.


Thursday, September 8, 2016

Overheard

Overheard on night shift:

Coworker: We're just gonna put a dressing on this and then you can go home!
5 year old: Is it ranch?! I like ranch dressing!

Thursday, September 1, 2016

Different hospital, same BS

I think one of my greatest irritations as an ER nurse is when a patient and their family can spend literally all day in the department asking when they're going to be sent home, and then four seconds after I remove the IV to finally discharge them someone says, "can you ask the doctor about this one thing?"

FOR FUCKS SAKE, people?! If you've been in the department eleven hours, and you've only just now remembered this complaint, I can guarantee you it doesn't need to be addressed emergently.

Like this lady the other day. She was there, no joke, through multiple nurses. I finally get the joy of discharging her, and as soon as I pulled the 22G intensely-difficut-to-place IV she goes "you know, I forgot to ask the doctor about this issue. Can you tell me what could be causing it?"

I politely answer that it could be many things, and that her recent bloodwork via PCP showed it to be normal but that we didn't test for it today because wouldn't ya know, she didn't complain about it. What then ensued was a prolonged request for the doctor to come back in to address it. I'm new at this hospital, so I don't know the docs very well yet - thus I was dragging ass to relay this request. As much as I can't stand not being able to discharge someone, the docs hate it even more. Top it off with a strange nurse asking them to come do my work for me...it's not a good combination.

The doctor was fortunately very nice and came back in, and had a good long conversation with this lady about multiple things. His poor scribe, who had already clocked out, very kindly stayed late to document all this foolishness. After they both wandered away, I went back in with the discharge paperwork. "Oh!" she said, "I forgot to ask him about the main thing I wanted to know!"

I can't win.

Friday, August 5, 2016

I'm still alive!

It's just been a month since I've been on blogger. But forgive me, I've been busy getting married! Cross country, no less, which required dragging everything over a thousand miles and forcing an entire side of the family to fly to the nuptials, then driving all the way home again afterwards. Good times!

But now I'm married and I go on a relaxing vacation this coming week and then, maybe, I'll be back to blogging. I will have a new assignment and all, which should be a real good time.

Saturday, July 2, 2016

Justice

So you all know I've been burnt out a bit recently. I love the ER, I really do, but my fuse at work has become so short. Rude patients and inane orders and the general bullshittery of hospital admin used to roll off my back way smoother than it does now. Some days are better than others but more often than not I have bad days with good moments as opposed to good days with bad moments.

That said, tonight was a bad day with a bad moment in the midst of general admin BS. I had discharged a patient and admitted two others within about 15 minutes of each other, so obviously on a busy Friday night those three rooms immediately got slammed with new patients. One patient was super sick, one patient was meh but required a large workup, and one had acute on chronic back pain. Guess who rang the callbell within the first five minutes to ask for pain medicine?

I went into back pain guys' room with an entire armful of stuff and told him that I had just gotten slammed, needed to give some meds next door, and would be back as soon as I could to get him settled. He mumbled something that sounded suspiciously like "bitch," which I ignored. Ten minutes later I'm knee deep in saline bag wrappers and tubing bits and second IV starts and blood cultures on the sick patient, and my phone rings with a message from the secretary that chronic pain guy has called multiple times wanting his medication.

I finally make it back into the room and start to apologize for the delay, but the guy says "just get me my fucking pain medication, you told me you'd be back like twenty minutes ago." I started to explain that the ER is busy, I have multiple patients, whatever, and he cut me off to berate me for not being in three places at once and also to call me a cunt. I just turned around mid-sentence and walked out, where I ran into the charge nurse - let me tell you, fucking no one gets to call me a cunt and get away with it.

Charge was great, and after hearing me rage volunteered to go start the IV and medicate since I refused to deal with the guy. I got the call a few minutes later that it was okay to go back in, and upon doing so I noticed that the patient had the most beautiful IV ever. It was a gorgeous orange 14G jelco right in the forearm. I nearly cried. It's good to know that my charge nurse will defend my honor with a giant needle.

The charge nurse also told the doc what was going on, who unbeknownst to me went in and read the riot act to this guy. I have no idea what he said, but when I came back in later the patient was apologetic and super polite.

Honestly, it was unbelievably refreshing to have a charge nurse and doctor stick up for me, and it felt even better that the message got through to the patient. Or maybe it was just the garden hose in his arm. Who knows.



*it's late and I'm tired, so this post needs some serious editing but idgaf. deal with it!

Friday, June 17, 2016

Trolls

In nearly all scenarios, I loathe the ER trolls who seem to spend all their energy just trying to demoralize me. But sometimes the rare troll comes along who I not only mind, but find hilarious. This week, that rare patient was a very elderly, demented Hispanic man. Not the normal troll flavor, trust.

He was in for the usual "history of dementia but is extra confused today" chief complaint that is so prevalent, and my first interaction with him via the translator seemed to solidify that story. He was talking nonstop but making little sense, and the only thing the translator could firmly get was that he wanted to go home. Until his daughter, who kindly translated everything for us, arrived. He then transformed into a troll in front of my very eyes.

I was pulling supplies from the cabinet when I heard him, quite clearly, call me crazy. My Spanish fluency can be qualified as nonexistent hot garbage, but there are some words I can pull the context clues from and when I heard this I whipped my head around the cabinet door to look at him. He made eye contact and just grinned, like he was testing the waters to see if I was paying attention. That bastard.

This was pretty much the face that greeted me from around the cabinet.
While I was drawing bloodwork, he very emphatically called me a vampire, and when I started laughing he told his daughter "Why's she laughing? Vampires are not funny!" I felt bad momentarily for laughing at this guy, and then caught him smirking at his daughter. She was also clearly trying to hold back sympathy laughter as she recognized exactly what was happening, but also seemed like a good sport so I decided to mess with him back. I happened to have an extra blood tube in reach, so after drawing the necessary blood I made sure he saw me draw the last extra one and not-at-all-subtly slip it into my pocket. Fortunately I didn't freak him out and he decided I was hilarious, then kept laughing and calling me a vampire the rest of the night.

I changed his pull-up before he went upstairs, and he kept telling his daughter "she's not strong enough to lift me up!" and that I would need help to roll him. Of course it was a crazy busy night so it took a few minutes to get another staff member in to help. As soon as my coworker gets ready to roll him, he starts cackling and lifts his bony ass up off the bed so I could slide the brief out. Literally it was the easiest pull-up change ever and my coworker clearly thought I was crazy for needing help with an almost totally independent old man. 

Seriously. He was a steady stream of trollery, far beyond what I've listed here. I'm a proud person but I know when to admit defeat. And defeated I was. Well done, old man. Well done.


Wednesday, June 1, 2016

Another ER milestone

Well guys, it finally happened - after many years, I finally got caught by a family member for shaming a patient about their visit. It was bound to happen eventually. But before you get on my case about being rude or mean, hear me out.

I had a guy come in for a ridiculous reason. Like, even the standalone clinic would triage him an ESI 5 and roll their eyes. To make matters worse, he was also a middle aged guy who brought his mom with him so she could be his mouth and ask for pain medication for him and also relay his medical history to the doctor. Sidenote here, the only time it's appropriate for the mother of a grown ass patient to be speaking for their child is if the chief complaint reads "my mouth fell off and now I can't talk." But anyway, I went in to do my assessment and tell them that it was a super busy night so expect to be waiting for a while. The mother asks me if I can give him pain medication, and I explain that I can't give anything until the doctor sees them, which again, might be a while. Five minutes later she's back up at the desk to ask again, and I explain through the entire process a second time. And I shit you not, but five minutes after that she's up again to ask.

Right then another nurse steps out into the hallway from the room next to mine, with a look of...not panic, but severe alarm on her face. I excuse myself from my patient's mother and step in to help with this guy who EMS just dropped off and HOLY SHIT IS IN VTACH RIGHT NOW. He looks like absolute garbage even though he's got a pulse and is awake and talking, so she starts triaging while the tech grabs an EKG and I drop an IV and grab the ACLS box full of fun medications. We get the guy moved over to a critical bed, and while hooking him back up to the new rooms' monitor and pads, another nurse pokes her head into the room and says, "hey, do you have room 43? His mother is out here asking if he can have pain medication?" I super bluntly just said "yeah, he's here for a hangnail*. He's gonna have to wait."

Long story short, she overheard me say that and got super upset. In the past, I probably would have been super apologetic and attempted to get the doc in their room quicker, but now I just doubled down and told the patient and mother to their faces that actual emergencies get taken care of first in an emergency room. They were super mad, asked to speak to the charge nurse, who told them the exact same thing. Then they eloped from the department with the promise "to come back again in the morning when someone here will actually help my son!**"

Bye!

*Not the real chief complaint, but I couldn't think of a generic enough absurd minor one so as not to violate HIPAA.

**They came back eight hours later, sat forever in the waiting room because it was the day after a holiday, and then got discharged immediately without pain medication. It was awesome.

Thursday, May 19, 2016

I mean, he's not wrong.

Last night at work gave me possibly the best description EVER of the fuzzy head feeling morphine can give you. Upon administering 6mg to a burly guy in his mid 30s, he exclaimed "holy shit! This must be what Stevie Wonder feels like all the time!"



Sunday, May 1, 2016

Parking

I was shuffling down the eternity number of stair flights in the parking garage today, and mentally girding my loins (and also thinking about how weird that phrase is) to go in to work on a gorgeous Saturday. I get to the bottom of the garage, and there's two women standing in the middle of the exit out of the stairwell. "Excuse me," I say as I try to edge around them. They look at me blankly. I look back at them, and repeat myself because while I don't want to go to work, I also don't want to be late because of two dummies blocking my way.

They stare at me a few more seconds, and then go "ma'am? Which floor did we park on?" I must have given them this look:



because they get all butthurt and ask me again, loudly, which floor they parked on. I responded with "uhhhhhhh" because these seem like real adults who can function in society, but I guess I was wrong. These two women get even more frustrated and loudly ask "there wasn't a number on the floor! We don't know where we parked and don't want to forget it when we come back! Why can't you help us?!"

I continued with the quizzical look and eventually replied that the parking garage has 10 floors, I wasn't there when they parked or walked down and thus have no fucking* idea where they parked. They continued to be mad at me so I finally just elbowed past them and kept walking.

Is it really this hard to adult? I mean, I've lost my car in a parking garage before, but because I'm a grownup I just kept mashing on the panic button until I heard something. I guess there really is no hope for society anymore. I feel like this shouldn't be that hard, and I also feel like I shouldn't be so irritated, but it is and I am.

*I didn't really say that, but I thought it, loudly.

Thursday, April 21, 2016

Unity

It's a rough time in politics to be a moderate liberal, as I am. The dominate rhetoric by "the other side" is that gays are ruining family values, Christians are being persecuted in our own country, build a wall so Mexico can't get here, fuck yeah guns, and that Islam is a dirty religion full of terrorists who should be forcibly rounded up and kicked out of this country because MERICA.

Obviously you can see which side I lean towards on the political fence. But I generally feel that there isn't room in the country for all the hate, especially with everything else that is going on. I wish more people could see the good in others. I wish, so stereotypically, that everyone could just get along.

I had a patient yesterday who is dying. A young, vibrant, should be in the prime of his life nice guy. He'll be dead in a few weeks. I read his admission notes and noticed this one from the chaplain:

"Chaplain extended spiritual care at which time discovered patient/family are Muslim. Chaplain inquired if the family would like the Imam called. Family declined as they have already called their own, but expressed gratitude for the offer. Chaplain and family celebrated the unity in one God and requested the clinical teams' prayers for the patient. Family in vigil at bedside and remaining reflective and humbled by this moment. Prayers coveted for the patient as plan of care is determined. Imam to provide ritual at bedside."

I wish more people were like this chaplain. If everyone could see the good in others, this world would be so much better. I know there will always be the radicals, in every religion and area, who want nothing but chaos and death - but we don't need that in our everyday life here in America.

Monday, March 7, 2016

Thanks for the advice?

I've been busy recently. Who knew wedding planning was this all-consuming?! Anyway, I wear a cheap ring to work in place of my engagement ring, so that it doesn't get junked up with sanitizer residue and god-only-knows what else. A patient of mine asked when the wedding was and why I wasn't wearing a real ring. She then explains that the way to make sure my man stays interested in me is to occasionally cheat on him so that in turn he doesn't feel like he's too good for me. Apparently it's a fool-proof way to keep him from leaving.

The reason for her visit? Chlamydia.

If I'm lying, I'm dying.

*side note, it took me five tries to spell that particular VD correctly. If only she had been there for herpes instead.

Friday, February 5, 2016

Overheard

"I don't mind doing the butt stuff with patients..."

They were talking about guiac tests.

Thursday, February 4, 2016

Texas

Well guys, it's official. I've changed my residency to Texas. I cried for a good long time about it last week, starting with the moment the lady at the DMV threw my old license in the shredder bin without even a moment of silence for it. I've re-titled and registered my car, updated address listing for various important things, and started the process of changing my nursing license to this state. It's really sad. I'm very happy to be in Texas, because I have wonderful friends here, a fantastic fiance, and a good life. None of those things make it easier to be away from my friends and family back home on the East Coast though, and it's definitely been a struggle to find a balance between living a comfortable life here and craving the adventure that travel nursing inherently is.

For the time being, I'm going to travel locally. I'm not quite ready to take a permanent job yet, but we'll see how that goes. I don't plan on being in Texas forever, as this country has too much to offer to be in a state as limited as this one is regarding outdoorsy things. Growing up on the water near the mountains has forever skewed my opinion towards geography, and Texas just doesn't cut it - although to be fair, their patio-weather is pretty excellent.

So yeah. That's my big news. I'll get back to blogging about relevant nursing things soon.

Saturday, December 26, 2015

Prayer

There's a lot of saints out there if you're up to date on your catholic knowledge (I'm not), and many of them are excellent for ER nursing. The most important, especially for getting those obnoxious patients out of the department? The Patron Saint of Goodbyes, Felicia.

*I can't take credit for this. It came from, amusingly enough, one of my patients.

Tuesday, December 22, 2015

Transports

I am not exaggerating this story in any way.

Last night at work I'm on the phone to call a transport company to get a patient back to their residence. It's typically a beating to have all the information for these calls, from figuring out what insurance the patient has, if I need to call company A or company B because it's Sunday, exactly how much the patient weighs, if the patient can cover the copay or not, and whether I'm willing to wait four hours for them to come pick up vs calling down the list of family members at 0100.

Long story short, these calls usually take forever. Much of the time is spent on hold while the company farts around with an ETA, and I slowly die inside because there's so many other useful things I could be doing.

Until last night. The most encouraging moment ever: As I'm languishing on the phone, I realize the jaunty instrumental music blaring in my ear is Don't Stop Believing.

So fitting. I sure did keep on believing for ten minutes, right up until the transport company declined the transfer due to it being Sunday at 0110, and thus not really Sunday but Monday morning and I should call company B even though they don't start running until 0500. Assholes.