HP. BAMF. November. !!!

I am...this is...bamf...omfg...sweet mother...this will be EPIC.



Good God I don't even know how to express my excitement for this. I seriously just watched it like 15 times.

Mind games

So I've often wondered if working in the ER is going to screw me up in some sad way. Like maybe I'll be so crusty that I'm no longer compassionate, or I'll become so immune to broken dead people that others will think I'm cold-hearted. Perhaps I'll deal with drug seekers so many times that someone will ask me for a tylenol and I'll internally wonder if they're going to ask for dilaudid next.

There is so much blood, death, sadness and emotional trauma that there is no way I won't be screwed up somehow.

Well, tonight I discovered that yes, I am screwed up. The ER has forever changed me - there is no going back.

I recently pulled an insect out of someone's ear. While it was gross and gave me the heebie jeebies like whoa, I sort of put it out of my mind. Until tonight. When I was laying in bed, in my minimally air conditioned apartment because I'm a cheap bastard, I could hear a buzzing.

It might not even have been an insect. But then again, it might be. So instead of getting up like a normal person to open the door, or look for it, I panicked. "Oh sweet mother," I thought, "this insect is going to buzz around my room and wait until I'm asleep and then crawl down my ear canal so far and I'm going to wake up and hear it and feel it and have to go the ER and be sedated because I'll be spazzing, and everyone will think I'm ridiculous and then I'll be forever scarred because there was a BUG in my ear and I won't be able to function at work and then I'll be fired and then what will I do?!"

And then, when it was 95 sweltering degrees outside...I pulled up the down comforter from the bottom of my bed and slept under the covers with my ears securely covered. The entire night. FML.

I am scarred for life from the ER. But hey, at least it's an earbug-free life.

***
And by "night," I mean 9am to 430pm, because that's my sleepytime, suckahs. It's also the hottest part of the day for normal people.

I'm in the MFN phome boof.

I need a Bambalance.

Yeah, well, I need a beer now.

Whew!

I survived my first night as a preceptor! Good lord, I had no idea what I was doing. But we survived, I think she learned something, and patient care flowed without a hitch.

Now we get a Monday night shift...we'll see how we do tonight!

Eight weeks to go...

PSA

Listen up, people. I have a public service announcement you all need to hear.

Do not, I repeat, do NOT jump off of things that are not ground level. Twelve feet may not seem like a lot, but trust me - your tibia and fibula will not agree. In fact, they will most likely exit your body trying to get away from you and your lack of common sense.


This has been a public service announcement. You may now return to your previously scheduled blog reading.

Image from Google. Man, I love google images!

Picture this

It's 0445. Dead quiet in the nursing station. We all got our asses kicked last night, so everyone is just sitting there, trying not to fall asleep.

Dr. F, a happy go lucky guy and generally all around good person, is sitting at the computer reviewing an abdominal/pelvic CT. All is calm.

Out of nowhere...Dr. F lets out the creepiest, loudest Mr. Evil laugh while scrolling through the CT. Back and forth, back and forth he scrolls, laughing maniacally.

We all look over in shock, and realize that on the CT, a little gas bubble in the bowels looks exactly like evil PacMan chomping after the hapless monsters. "Oh, the evil that lurks in her bowels!" said Dr. F.

Laughter ensued for many minutes.


I only wish I had my camera phone on me. It looked exactly like this. We called her PacMan for the rest of the night.

AAA = bad

I took care of my first ruptured AAA last night. Can I just say...HOLY SHIT that was scary.

More coherent posts will follow, but I just needed to get that off my chest so I can sleep today.

The Wound-Dresser, part deux

By the way, I'm totally stealing the idea of posting poems from Those Emergency Blues. Who is totally awesome.

Just saying.

The Wound-Dresser

...I onward go, I stop,
With hinged knees and steady hand to dress wounds,
I am firm with each one, the pangs are sharp yet unavoidable,
One turns to me with his appealing eyes - poor boy! I never knew you,
Yet I think I could not refuse this moment to die for you, if that would save you.

...Thus in silence in dreams' projections,
Returning, resuming, I thread my way through the hospitals;
The hurt and wounded I pacify with soothing hand,
I sit by the restless all dark night - some are so young;
Some suffer so much - I recall the experience sweet and sad...

Walt Whitman, Leaves of Grass

Let it out, buddy

BLEEEAAAAGGGHHHHHHHH BARFFFFFF HUUAAAGHHHHHH

I'm putting in the IV now so I can give you zofran, just let it out and try to hold your arm still for me, okay? Charge Nurse will hold the bucket for you.

BBBBLLLLAAAAGGHHHHH HHHUUUAAAGH SPLASH HEEEEGGGUUAA

I'm almost done, you're doing great. This medicine will help with your vomiting.

BBUUUGGGGGLLLAAHHH SPLASH SPLASH

Okay, I'm giving the zofran now.

HHHHUUAGGHH SPLASH...

KER-THUNK!!

***
Even though I felt so bad for the poor man vomiting out his entire body weight in bean soup, it was kinda hard not to laugh when his teeth hit the bucket at the speed of light. Especially when you make eye contact with the other nurse. Somehow, things are even funnier when others witness them and you can't laugh out loud.

Thoughts on Death

You see Dr. Wen in there? He's explaining to that family that something went wrong and that the patient died. He's gonna tell them what happened, he's gonna say he's sorry and then he's going back to work. Do you think anybody else in that room is going back to work today? That is why we distance ourselves, that is why we make jokes. We don't do it because it's fun, we do it so we can get by...and sometimes because it's fun. But mostly its the gettin' by thing. - Dr. Cox



Morbid humor abounds in the ER. Dr. Cox had it right; we laugh because we don't want to cry.

When the patient is a young person killed at the prime of his life by a come-out-of-nowhere accident, it's not funny. It's not funny to run a massive resuscitation on someone younger than myself. It's not funny to run out of room on the trauma documentation paper because there are just too many injuries to list. It's not funny to have to untwist the arm because it's broken in a dozen places. It's a little bit funny when in the midst of calling out the injuries to the RN documenting, the doctor calls out "and he's got a stubbed toe too."

Really, it's not funny when he dies. And it's definitely not funny when you have to explain to his family what happened tonight. But then we leave the room, and we all take digs at the primary RN - we'll call him D - because this is his second patient of the night, and he's killed them both. Or so we joke. Because in actuality, they were both dead from the start - we were just trying to hold off the inevitable.

A little bit later, a sweet lady comes in for chest pain. EKG is normal, troponin is up. She is moved to a trauma room because someone just has a feeling. We tell D he can't come into her room because we like her and don't want her to die. Everyone laughs, because that is funny. We're joking with sweet lady while we get her comfortable. When we roll her to change the sheets, she gives me a hug. "You all are just so wonderful," she says. We all smile and secretly hope for the best.

Sweet lady gets back from CT, and her heart rate goes from 110 to 85 to 60 to 40 to 30. She gets an atropine to bump her back up. Whew. Then D sticks his head into the room to see if we need help, and she codes. Not funny.

And then the soft spoken, very kind ER doc, in the midst of an Integrilin, amiodarone, epi and atropine and compressions and shock her 15 times kind of code, looks over at D and says, "D...get the f**k out of this room!"

We all giggle, because that's funny.

And then it's change of shift, and I'm heading home. Young trauma is in the morgue. Sweet lady's friend is crying in the consultation room. I walk down to tell the nurse who initially had sweet lady all about what happened. We laugh at the fact that D only had 3 patients tonight, and killed them all. We call him Grim Reaper D and tell him to take a vacation tonight.

But really, it's not funny.

Because three people died tonight, and there was nothing we could do to stop it.

I cry in the car on the way home.

And now I'm here, and I'll eat a bowl of cereal and go to bed, because I'm back to work tonight. And people will still be sick again today. Life goes on.