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.


Monday, December 14, 2015

Fortunes

Good to know the universe thinks so little of nursing. 

Although to be fair, this profession is rather entertaining sometimes. 




Wednesday, November 25, 2015

The joy of life

While looking for a sono IV the other day on my no-veins dialysis patient, his adorable six year old kid piped up and excitedly asked me "is it going to be a boy or a girl?!"

All I could do was laugh. And get the hell out of the room before those parents had to explain just how babies get into people and why they most definitely won't be in dads arm.

Tuesday, November 17, 2015

Nursing is weird.

I think one of the weirdest things about being a nurse is the ridiculous conversations I have which would be horribly inappropriate or hilarious to laypeople but are just everyday talk to me. Today I was sitting in lab orientation, and the educator was going over using the nitrazine strips and range of values and all that. He's probably in his mid-thirties based off the comments about his young school aged kids, and was overall a funny guy who was on point with his social skillz. He seemed like the type of person who would go out with everyone post-shift and tell the best stories after he buys everyone a round. We're talking over the details of these test strips, and have a full conversation about vaginal vaults and bodily fluids and alien looking newborns and the importance of precip trays in the ER and how it's imperative to do checks on the test strips to make sure they're not expired because JCHAO.

It's just so weird to me that I can have a full conversation with a total stranger about vaginal juices and still keep a straight face while thinking about what I want for lunch, but someone farts and I'm immediately a fifteen year old boy who can't stop giggling.

Nursing is weird.

Friday, November 13, 2015

Empathy

I'm a pretty crusty bastard. After seven years in nursing, I've seen a lot and unfortunately been jaded by a lot. Many things which made me cry years ago are now brushed off with a sigh and the resignation of knowing that whatever it was will most definitely happen again sometime. I make terrible jokes, I go out for happy hour (or beer breakfast, depending on the shift) and immediately have a beer with friends, and I don't answer truthfully when people ask me what the worst thing I've ever seen was. Moral of the story, I'm hardened and I know it.

But deep down, I still feel all the feels. Like, all of them. To the point that they bubble over uncontrollably when the right moment arises.

Case in point: my recent new hospital played a corporate values video during one of the orientation days, and it was fairly sad but not heartwrenching or waterworks-inducing. That said, classy and wistful piano music against a backdrop of one-line summaries of the internal thoughts and struggles of both patients and staff is apparently the only cue I need to become a blubbering mess. Seriously. Multiple tissues and trying to hide it from the rest of the orientation people.

And then I watched Inside Out last night and good lord the waterworks. Ugly crying from start to finish. It was brutal.

I guess it's a good thing though...I DO still have a heart!

Friday, November 6, 2015

Words

"I've got so many taxis in my mouth. They all hurt. Can I get a cab ticket home since y'all giving me lortab?"

If you have access to that many taxis then surely you don't need a cab voucher.

*spoiler alert: he got a cab voucher because why the hell not.

I've always been perplexed as to why people let dental conditions get so far out of hand. While I completely understand that dental care is ridiculously expensive, basic preventative care is not. Barring poor genetics, a toothbrush and some colgate goes a long way. I went for almost six years without seeing a dentist, and because I brush twice (sometimes three times) a day I had no cavities. I also had no taxis. Plus I've known plenty of people who go decades without seeing a dentist but still take care of themselves and have no issues.

And before you get on me, internet, it's the people who freely admit that they haven't brushed their teeth in years who confuse me. I'm not talking about those who brush and just can't afford dental care or inherited shitty DNA from their folks. That's another post entirely, in which I could devote a lot of words to shaming health insurance for not including dental visits.

Thursday, October 29, 2015

Difference of opinion

It's interesting how varied the attitude towards nurses is. I had two interactions today with complete strangers who couldn't have had more differing thoughts on my job. After finding out that I was an ER nurse, the first guy today thanked me for going into such a difficult profession and putting everything I had into it. He had so much appreciation for us because he's been in the hospital before, and sees what we do. We ended our conversation with a heartfelt thank you on both sides.

The second lady found out I was a nurse and only commented "wow. You probably went into that job because you only work three days a week. It's the laziest of jobs."

Wow, indeed.


Friday, October 16, 2015

Re-employment!

Today is the end of my 4 week long lifting restriction, and to celebrate the occasion, I got a new job! I just took a new travel assignment in a gigantic ER in central Texas which should be a real good time. I'm looking forward to working in a busy ER again so I will have plenty of ridiculous stories to share, starting in November.

In the meantime, enjoy this story from ye olde days at Home Hospital:

I swear I was on candid camera this last shift. Except it wasn't funny, it was infuriating. And no one yelled "you're on candid camera!" at the end. Also the guy smelled weird. Like bacon. Which usually smells great, but not when it's coming from a person.

Anyway, I could do nothing right. He's a cardiac work up, so I tried to put the leads on and he wouldn't let me. But he let the nurse next to me put them on.

He felt mildly short of breath. I tried to put the O2 cannula on and he refused. But he let the doctor put one on his face.

I asked the dude if the nitro had resolved his chest pain. He told me yes. But five minutes later the doc asks if the nitro resolved his pain, and he goes, "uh no, and I don't know why the nurse didn't tell you that I still hurt."

The doc then offers morphine which the patient accepts. I remember that the patient had listed morphine as an allergy, so I tell the doc to hold the order while I ask the patient again. But the guy says, "well yeah I told you that but I'm not really allergic to it."

To top it all off, I'm in the room getting everything together for admission to the cardiac floor and overhearing the patients' conversation with a family member. Included was the phrase, "this nurse has been the worst. She hasn't listened to anything I've said the whole time here! I'm never coming back to this hospital."

Le sigh. I can't win.



Friday, October 9, 2015

Unemployment!

Sorry I haven't been posting recently. I've been on a ten day road trip, because oh yeah - I got fired from my job.

No, that's an exaggeration. I didn't really get fired. I did have my contract terminated early as I conveniently had a four week long lifting restriction imposed and four weeks left in my job...so yeah. HR decided that I wasn't able to "properly fulfill the duties of an RN" with the restriction, so had to terminate. I get it, I really do. If a patient DFOs and I'm the only one around, I need to be able to do something that doesn't involve just standing there being useless. But still. I've never been fired from anything. Ever.

It's an awful feeling. While I know it wasn't anything personal and was done very tactfully, I still cried after the call from the nice HR lady telling me that unfortunately I wasn't allowed to come back to work and they're very sorry to let me go as they've heard good things about me. I think the worst part about the whole thing was that I couldn't even cry comfortably as it hurt too much.

Silver lining though. My fiance flew up to Oregon and helped (read: did all the work) pack my apartment and then we road tripped to a ton of beautiful places, camped in national parks, and leisurely made our way back home. It was awesome, and the best possible way this could have ended.

Here's some pictures to prove that it was beautiful. Because seriously. Nature ermahgerd.












Wednesday, September 23, 2015

Hospital manners

I find one of the most amusing things about my decidedly non-amusing recent hospital stay was the speed with which I slipped into the role of shameless patient.

I was an inpatient for exactly 24 hours. In those 24 hours, I did the following:

1. Left the bathroom door open to pee because the IV pole wouldn't fit with me, not even caring that the room door was also open (no direct line of sight - I'm not THAT shameless).

2. I excitedly hit the callbell so I could inform my nurse that I farted! I usually enjoy farting, but the level of glee in my voice was something typically only reserved for the insincere apologies I offer after dutch-ovening my fiance.

3. Ordered a balanced meal from the cafeteria, consisting of two orders of tomato soup, one chicken broth, one cup of hot tea, one cup of iced tea, a smoothie, and an order of chocolate pudding. I sure did house the entire tray without a second thought. Or first chewing.

4. Walked a lot. On one of my multiple pre-fart laps around the nursing station, I had to sneeze but hurt too bad to not splint, so the arm not holding onto the IV pole went to my abdomen. The back of my gown? Left to its own devices. I think I had it tied shut enough, but I can't be sure and I didn't care enough to check.

5. Took full advantage of the fashionable attire available to me. I was admitted after working a 12 hour shift and didn't get to go home prior to checking in, so I was faced with either wearing dirty underwear all weekend or getting new ones. Since the gift shop doesn't include an aerie store, I got to wear the mesh briefs that are so prevalent in the mother/baby unit. They're super comfortable, for the record.

So, yeah. I guess I can laugh all I want about the ridiculous things that patients do, but give me three minutes in the hospital and I'll damn sure check each one off my own list.

Sunday, September 20, 2015

Weekend Plans

Let me set the scene - it's such a beautiful weekend here in Oregon. I had plans with friends to go on a wonderful hike today and then go to a new brewery for some delicious beer. I worked Wednesday-Friday night, and planned on having a great couple of days in the sun.

But then, an unexpected adventure began.

I woke up Friday in the middle of the day with some vague belly pain. It almost felt like hunger pains, which since I didn't have breakfast after work didn't really sound that weird. I got up and had a banana, and it didn't help at all. I went back to sleep, not restfully, but figured I had one day left of work so I'd just stick it out and go.

Halfway through my shift, I felt terrible. I had this awful periumbilical pain which was just constant, I didn't feel hungry at all, and then the occasional wave of nausea would hit. Pepcid and tylenol didn't help, and I continued to feel worse. Towards the end of the shift, it hurt to get up or sit down in my chair to chart. I couldn't stand up straight and constantly hunched towards the right. I went and talked to the overnight doc because I knew deep down what it was but didn't want to believe it. After hearing all my symptoms he just gave me a look and told me to go check in as a patient.

Side note, I bet most ER nurses can back me up on this - we rarely check in as patients in our own hospitals, and must essentially be on death's door step to do so. It's the whole "no foleys between friends" rule, I guess. But I digress.

I continued to stick it out the rest of the shift, miserably. When the day shift came on, I handed off my patients to my replacement but before I could do anything else the charge nurse and night doc corralled me to ask what I was going to do. Then they pulled the day shift doc over, and told him my story. "Oh yeah," he said, "you've definitely got appendicitis. I walked around like you are right now for a whole shift and then mine ruptured."

Long story short, he did a quick exam and I had all the classic textbook signs for an appy. I agreed to check in, my WBCs were 14K, and he didn't even bother with a CT before calling the surgeon. I ended up in the OR by 10:00, and this is what they found:


So yeah. I totally had appendicits. And it sucked. You know what else sucked? Being a patient. This was my first time ever going to the ER, first time getting surgery, and first hospital admission. All while being across the country from my family and my fiance. There will be another post about how strange it was to be on the other side of the bed rails, but in the meantime I will say that my coworkers were absolutely fabulous. From offering me places to stay, to visiting me in the hospital room, to bringing me pajamas so I wasn't bareassed in a thin gown all night, they were fantastic.

To end this story, I just want to say how awesome norco is. I hurt right now, but nowhere near my pain from yesterday. Thanks, narcotics! I won't be thanking you when I'm constipated for the next three days, but we'll cross that bridge when we come to it. Also, I'm totally blaming any grammatical or flow errors in this post on the fact that I'm taking pain meds.

TL;DR - I went to work Friday and didn't go home after my shift. Instead I worked 12 hours feeling like shit because I had appendicits, then I went to the OR and said good riddance to my useless vestigal organ. Then I spent the night in the hospital feeling super dopey in my stupid socks and wheelie IV pole, and now I'm back home with awesome pain meds writing terribly edited blog posts. Huzzah!

Tuesday, September 15, 2015

Addendum

Le sigh. I try and write something to express the rage inside me, and yet again GomerBlog has done it way better. Satire always wins.

Littman to Produce Separate Doctor and Nurse Stethoscopes.

"We always thought nurses actually used [them] to assess their patients so we just sold the same stethoscopes to all providers. Now that we recognize that most nurses just use a stethoscope for 'the look...' game changer!"