Bits

This week has been ridiculously beautiful outside. And I've been at work most of the time, so it's
a bit of a moot point. I did get to the river one day though and this is the result:






























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I have a good bit of my stuff together for traveling. I just need to wait a few more weeks until hospitals post their openings for summer.

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A bit'o'scene from late night ER amusement:

Patient: Well, I've got an IUD in place and sometimes when we have sex it hurts. Is that normal?
Doc: There is a cord that comes through your cervix so if he's hitting the cord it can cause spotting and occasional pain. It's more common if he's a bit larger.
Patient: Oh he doesn't have that problem. It must be something else.

Man, talk about under-bus-throwing.

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I'm really bad at editing picture layout on blogger.

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Fin.

Business ideas

One of our unit secretaries, who is older than dirt and came with the building, was in the midst of a discussion on ER abuse and how as a rule we lose money on almost every patient who comes through the doors. This secretary (whose initials appropriately are BS) has come up with the perfect business plan. "I know!" she says, "since my feet get so ashy in the winter, we can just scrape off the heel flakies and sell it as crack! We'd make a killing and all these asinine frequent flyers would be smoking my feet! It's the perfect solution..."

I think at least one person actually threw up a little.

I lied. I know one person did, because it was me.

Comparisons

Patient: "I mean it's like ten of one, half dozen of another. Right doc?"

If you say so...

In all fairness he did realize what he said, and thought it rather amusing - which meant he was fair game to laugh at!

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PS- this is how I know my blog has the winning combination of nursing and other fun stuff:


Thank God for blog trackers.

Lessons

There is so much BAMFery in this article, you guys. And it's a serious article from Forbes.

Management lessons to learn from Star Wars.

I think the sad thing is that this is completely relevant to the managerial environment at my job right now.

Not related to nursing, in any way

Let me just get on my high horse for a minute...How in the name of all that is good did Alan Rickman NOT get nominated for an Academy Award for the role of Snape?

I spent 6.5 books trying to figure out if Snape was the baddest literary character ever, or the most bad-assed. I lost sleep over it, for reals. And then Alan Rickman comes along and is like "BOOM. I'm the biggest BAMF ever so I'm awesome for this role, or whatever."

Let's be honest here: the first couple of Harry Potter movies were average, and then they got more amazing and then Half-Blood Prince came out and I was all whoa this is phenomenal! And then Deathly Hallows part II came along, wherein I sobbed like a small child because of the sheer epicness that is Snape - thanks to Rickman.

So I'm just saying, Academy. Whiskey tango foxtrot?

Really?!

I got reprimanded by the Big Boss Lady this morning. For wearing a gray long sleeved shirt under my scrub top instead of the approved white. I'm over it. Especially since you assholes are lucky I didn't pee my pants or pass out while in triage for 12 hours, considering we never cleared the waiting room, I didn't get to make a bathroom run ever, I didn't have a tech half the night (=getting my own VS, taking patients back, crowd control, triage, and enforcer) even though I'm officially not allowed to leave the triage window at all and I didn't get a chance to eat anything.

Oh wait. I did have four girl scout cookies for lunch. We're cool; my bad.

Late night

It's four in the morning, on an extra slow night at work. I walk by the nursing station, and notice a pair of finger splints lying innocently on the workstation.

Or were they so innocent?!



Mischief abounds, and hilarity ensues.

Responsibility

There are quite a few patients whom I don't like. They are obnoxious, rude, don't care what I have to suggest regarding their health, and are disinclined to heed anything I say unless it's immediately preceded by "...and this is a magic shot which will cure your pain/diarrhea/vomiting/dizziness/drowsiness/gout."

But, and this is a big but, they are still a patient of mine. I will bitch about them in private but I will take good care of them because IT IS MY JOB. When you, Dr. Frat Boy, sign up to see this patient you are implying that you too will take care of them. Because it's your job.

When you signed up to see that patient with dizziness, facial pain, and subjective fever, you formulated a diagnosis of sinusitis before you even went in the room. You documented in your chart that you went over discharge instructions, observed the patient walking without difficulty, and heard her say she felt all better now. Unfortunately, none of this was the case as you documented all this without ever having been in the room.

Don't get all pissy at me when I call you out on this, and kindly inform you that the patient is actually so dizzy she can't walk straight. I'll advocate for this patient and tell you I think she's actually got vertigo, and when you toss med-school questions at me and ridicule me when I can't tell you the exact pathophysiology I'll just ignore you and suggest you go see the patient. Damn right I'm going to stand in the room and make you get the patient out of bed so you can see for yourself how right I am, even if I can't tell you the names of the tests used to identify this diagnosis. I'll go get that valium and meclizine right now, thanks. And I'll do all this even though I still can't stand the patient, and the patient doesn't even know or care that I fought for her.

Because it's our job.


*willful abusers of the system are excluded from the whole "deserving of respect as a patient" bit.

Masonry

My friend the nurse: Dude. DUDE. This guy just dropped an enema deuce, that poo had to be in there since at least 1990. He legitimately just shit an actual brick.

Me: That is quite impressive.

My friend the nurse: And he kept shitting! It's like one brick wasn't enough. I dunno, maybe he wanted to build a patio or something.

Double meanings

Overheard in the ER: "Hey Mr. Johnson, we're going to put this tube into your johnson."

And I- I took the one less traveled by

Well folks, it's official. I'm gonna peace out from the East Coast of the US. Destination? I don't know!!

I decided to do travel nursing. It's been a long, slow process getting here, but I finally have reached a breaking point where I need to get the heck away from this small town for a bit. There is a pretty solid chance I'll end up back here, as I don't want to live hundreds of miles from my family, but for now I need to go forth and explore.

There are a whole list of places I'd like to see and experience. I want to go live in the mountains, I want to live on the West Coast. I'd like see the Pacific Northwest. I want to live in a big city and take the metro to work. I'd like to learn to navigate a city bus system. I want to walk out my front door and see a volcano or a glacier. I'd like to be anywhere but here, at the moment.

Thus far I think my travels will take me to Denver, Seattle, San Diego, Sedona (or maybe Vegas!), Asheville, Washington DC, and New England. I might make it to all of these places, or I might not. It's okay. I think the biggest step is that I've made a step at all.

The Road Not Taken

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

Then took the other, as just as fair,
And having perhaps the better claim
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,

And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.

I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
--Frost

I can't wait to get out and live some - even if down the road I look back on this experience and go, "why did I leave a good thing? What was I thinking?!" It will be scary, since I'll be traveling alone. I've never been to many of these places. This is out of my comfort zone. What if I don't do well as a travel nurse? What if people don't like me? What if I don't know as much as I hope I do? There are many questions, but I'm hoping this will still be a grand time. Besides...

To live would be an awfully big adventure. -Peter Pan (yeah that's right, it's from Hook. So shoot me.)

Humor

The absolute best thing about working ER is knowing that as foul and potty-mouthed and inappropriate as I can be, there is always another person willing to take a joke even farther.

I told a filthy Helen Keller joke tonight, and promptly blushed when a coworker told me one even crasser. And then we laughed, and picked our brains for even more dirty jokes.

I've had a doc make comments to me which would get him immediately fired from any other job...but because this is night shift in the ER and we're all raunchy people, I just came back with a comment to top his.

Jokes are made about people which I can't even repeat here for fear of being struck down by lightning. No patient is safe.

There is constant harassment between my two favorite techs and I...in front of patients. If there isn't a comment made about one being old, one being fat, and me being too young to work legally, then it isn't a good night. Most of the time, we can even rope the patients into doing the insulting as well.

Things like this make me love my job, in spite of all the bullshit politics, management idiocy, rude and entitled patients, shit-cleaning (literally), and lazy staff. Really, I love my job because I can laugh and because these people are my second family.

Pharm

So Etomidate is out, thanks to a nationwide shortage. We're out of Ativan IV, and we have critically low supplies of Versed and Valium IV. What could possibly go wrong in this scenario?

Let's hope no one seizes or needs RSI in the near future.

*update*

Oh yes, we're also out of Zofran IV and Compazine IV. Woooo.

Long night

It was a crazy night. At 07:59, I'm still trying to get out of there.

Cardiothoracic surgeon walks by and spots me, wearing the same harried look as 13.5 hours prior.

"Oh my God, you're still here? This must have been a bad night after I left," he says.

Yes, I agree. It was. "And by the way, I'm sorry about that cluster of a transfer Doc B dumped on you."

His reply? "Ah, it wasn't your fault. You can't help the fact that numb nuts over at Hospital B probably can't even tie his shoelaces without someone holding his hand, and he still probably gets it wrong. We must rise above our distress though, and carry on*."

*Dare I say it? Did I make a surgeon friend? This one is normally grouchy. Maybe I'm just not used to the grouch being directed elsewhere; this is quite a new position for me.

Interwebs fun

Ever wondered what I do when I can't sleep? Well let's take a peek inside my train of thought...

01:59 - Watching Craig Ferguson clips, because he's quite the cheeky Scotsman and he makes me giggle.

02:12 - Still watching Craig. Still funny, as is ESPNUK.



02:14-I watch a clip of Craig discussing his mild dislike of crabs.



Kristen Bell mentions giant spider crabs. No way their leg span is that large. I get curious and go to wikipedia.

02:15 - HOLY SHIT! These crabs are huge!! Oh god I hope I never ever run into one of these things, I'll need a change of pants. I can't even bear to look at the picture any more.

02:15:46 - Youtube. Spider crabs.