This Christmas...

Five days, kidney stone, septic shock, levophed and vasopressin, cipro and vancomycin and meropenem, failed vent weaning trials, new onset afib with RVR, unsuccessful cardioversion x2, amiodarone, and my grandmother has spent Christmas in the ICU.

Well, shit.

Hospitals are so much easier when you have no attachment to the patient.

Blogging will be sparse until things improve.

Upgrade trauma code

We recently had an patient who came in after an MVC. She was hurt pretty bad, but nothing that was life threatening. We were holding her in the ER while waiting for an inpatient bed, and everyone kept walking by the room and giggling.

Why giggling?

Because in the persons car, safely placed in a carrier, was her very vocal kitty.

A very vocal kitty who, because it was cold outside and because family was still hours away, was now the proud occupant of a kitty carrier in the corner of the trauma room. Just picture the scene: grumpy trauma surgeon called into work in the wee hours of the morning, bleary eyed and annoyed at being dragged out of bed on a sub-zero night. ER staff, bright and perky and giggling hysterically every seven seconds. Trauma surgeon, placing a traction pin while the cat is yowling in the corner...non-stop...for a solid half hour.

It was beyond fantastic.

The owner ended up being okay, and was transferred upstairs. Family came to visit, and we promptly discharged the cat back to its family.

The best part, however, is that because the carrier was restrained, the kitty met the qualifications to not be trauma coded...

Proof that seatbelts do work!

The five stages of grief

In nursing school, we spend like four days on learning the stages of grief. I think we should have just watched this instead:



It certainly would have allowed for many more important things...like cultural issues! Wait, no, we spent two weeks on that one too...

Patient vocab

Me: Is this just a pacemaker, or is it a defibrillator as well?
Patient: Wait, what?
Me: Does this thing make sure your heart beats every time, or does it shock you too if needed?
Patient: Oh, yeah, it's defibulated me a couple of times just this month!

Defibulator: That little device which shocks you at a later time if you lie about its purpose...

Full moon

Good grief. Tonight was the night from hell. For reals.

I only discharged like three patients the whole night because everyone was either 1) really sick, or 2) high drama and sobbing in their rooms until they got admitted for "acute pain."

I have never wanted to slam my head onto the desk so many times in one night.

I have never wanted to strangle so many patients with their call bells and IV tubing before.

I have never understood better how accurate the full moon superstition is.

I am most definitely going to sleep well tonight...and go nowhere near the ER.

Real life

I am 24 years old. I have gone through grades K-12, gotten my BA in 4 years and BSN in 18 months. I have been out of college for exactly one year now. I have been working as an RN in the local ER for slightly less than one year. And I am just now discovering how different the real world is from school.

For all of my previous years in school, when the holiday season rolls around the universities shut down and you get to spend that time with your families. Even working part time jobs during those breaks still allows for sufficient quality family time. I have now discovered that the real world is slightly different.

I work this Christmas. When many others are rushing downstairs to open presents, I'll be finishing a graveyard shift. When families are heading off to the candlelight church services, I'll be arriving at the ER with a giant cup of coffee. When my friends hang out around their trees with a cup of hot chocolate, I'll hang out around the accudose with my now half-empty giant cup of coffee.

So what will this workday end up like? Will it reflect the wishful Christmas spirit, where good things happen and miracles occur and people pull through and everyone is happy? Or will it be like any other day in the ER, where people cry and lives are disrupted and I have to hide tears while being strong for others? Or will it be a combination of both, where people hear the worst news of their lives but somehow find that extra strength to get through it?

I'm really not sure what to expect, but I hope it isn't too bad. I want to be optimistic but as I've already learned, real life isn't always generous. At any rate, I'll find out next week. And as this is only my first of many working holidays, I'm sure I'll find out again and again and again over the years.

Aunt Clara had for years labored under the delusion that I was not only perpetually 4 years old, but also a girl

Listen, I'm sort of a Grinch when it comes to Christmas. I love love love the fact that we are celebrating the birth of Christ and get to give because we love to, but I'm not a big fan of celebrating Christmas for like three straight months. I strongly dislike Christmas songs except for the occasional carol. I get sick of red white and green by about December 3rd. I think that Verizon Santa and reindeer commercial is silly. I suck at writing cards and I never seem to work up the energy to buy gifts.

Basically my heart is two sizes too small.

But you know what? I love A Christmas Story with all my heart. Sweet mother that movie is amazing, and redeems the entire overblown debacle of "the holiday season."

I might even sing a little Christmas carol to go along with this...

Tiger's Christmas card photo

My Dad is great for many reasons, one being that he sends me emails like this:



All I'm sayin is...had Tiger cheated on me, I wouldn't be holding that club anymore because it would be embedded so far in his nether regions it would be invisible.

Enabling

"I have cramps and I have endometriosis really bad. I get percocets for the pain. My pain is a 10/10 right now."

I see. So what did you take for your pain today?

"I took a tylenol yesterday, but they don't never work."

Apparently that bag of cheez-its you're plowing through at 0300 isn't helping either. Face, meet palm. I should also mention that she was wearing skinny jeans and 5 inch heels, texting the entire time, and sucking down a pepsi like it was the last one on Earth. Oh, and had visited the ER six times in three months for cramps...that math just doesn't add up.

Without hesitation, the PA wrote her a prescription for to-go 5 percocet, plus a script for 14 more. For. Cramping. I called the PA up and told him I wasn't giving it. He could if he wanted, but I wasn't doing it. After soundly berating my decision, he ended up giving her the discharge stuff and doing the teaching himself.

Whatever. At least when she comes in at the age of 35, cracked out and addicted to all sorts of painkillers and whatnot, my conscience will be clear.

Blogging is a lifesaver.

So I'm a new nurse. I often feel overwhelmed, wonder what the heck I'm doing here, and wonder if I'll ever be smart enough to be a good nurse. I get sick of the stupid people, and often want to tell people it's their own stupidity that has made them sick. I want to really tell it to the drug seekers. I want to stay home some days. I want to go home some days in the middle of the shift. Some days I think to myself, "I'm never coming back."

But then I go home and blog about it, and it's all better. And I owe it to Nurse K!

I started reading her blog way back in the dregs of nursing school, got inspired to start my own blog, and when I read this post I thought, "well played, shrtstormtrooper. Well played."

Experienced nurse to new trainee: "Just to warn you, this job will beat you down. You'll be tired, you'll not want to come some days, you'll question if you're really cut out for this, SOBs and drug seekers may even make you spiral into a depression that you can't explain. It's okay, I'm your preceptor, I'll help you through it."

I just wanted to say 'if the shit is getting you down, start a blog and never, ever tell anyone about it ever even if you're the 3rd most popular nursing blogger in the country.' ;-)

Maybe one day my blog will be just as popular. And no one at my job will ever ever know about it!

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Is it too soon to joke that GM is on the fritz?

CNBC: General Motors CEO Fredereick "Fritz" Henderson to resign