You know what's neat? While sitting in a Trauma M&M, the surgeon started talking about a case he recently published. Without going into details, it was a very rare scenario made even rarer by the method of treatment, and this surgeon was the first in the world to do it (or at least write about it). Within the first few minutes, I started to recognize the scenario.
And then I realized it was my patient! I'm the one that took care of this patient through the ER!
Granted, my name isn't anywhere on this patient. Rightfully so since I did about zero percent of the hard surgical work. But still...my ER patient. My interesting patient. My dude who is now part of medical literature.
What's up vicarious living, baby.
Friday, September 23, 2011
Wednesday, September 21, 2011
Humor
It was a slamming night, and one of the other nurses was real busy so I offered to discharge her chest pain patient after his second set of enzymes came back negative. A few minutes later the doc hands me the discharge papers and I go to get the guy out of here. I wish I had taken care of him the whole night, because he was a riot and his family was just as funny. I joked with them for a few minutes while taking out the IV and all that stuff then sent them on their way.
After getting back to take him out of the system, I noticed an extra bit of dc paperwork I had forgotten. I called the number listed on file and started telling him about the instructions for retesting of blood. "Sir, you'll need to come back to outpatient in 2 days, and have your kidney function tested since you take metformin and had a CT with contrast done today. In the meantime, please hold your metformin for 2 days."
His response? "But what if my hand gets cramped?"
Over my head completely until he started giggling.
After getting back to take him out of the system, I noticed an extra bit of dc paperwork I had forgotten. I called the number listed on file and started telling him about the instructions for retesting of blood. "Sir, you'll need to come back to outpatient in 2 days, and have your kidney function tested since you take metformin and had a CT with contrast done today. In the meantime, please hold your metformin for 2 days."
His response? "But what if my hand gets cramped?"
Over my head completely until he started giggling.
Saturday, September 17, 2011
Priorities, seriously
So I got called into the Boss Man's office this morning, because the floor wrote me up and he wanted to address the issue.
At this point, my feet hurt, I haven't peed yet tonight, I didn't get to eat anything, I have blood on my scrub pants (which I just now noticed), I have poop on my scrub pants (which I just now saw but have been suspiciously smelling for the past two hours), I haven't finished charting on that last arterial bleeder that came in, and my coffee from 7pm is still sitting full on the counter next to my computer. It's been a rough night.
During the night, we moved a patient out of a trauma room and into one of the smaller rooms. The patient who was moved had some fairly big issues going on, but nothing that was going to kill her in the next 6 hours. The patient we cleared the room for, however, was very much going to die if we didn't act. He would probably have died in the next 25 minutes if we didn't get moving. So we got moving, did our ER thing, and eventually sent him off the OR. At the very same time, a cardiac arrest AND and an MVC came in - so our ER staff was split between three very critical patients. The patient who was moved next door was then quickly taken upstairs, as she had a bed assigned already and we needed the space in the ER.
I got written up because, in all the madness, I missed a skin tear on this patient. One skin tear, out of many. And actually, it wasn't my patient to begin with, so really I never did anything for this patient except wave goodbye as she was on the way up to the floor. Although I didn't even really wave goodbye, because I was slightly preoccupied with running the Level 1 Rapid infuser with mass quantities of blood products.
There really isn't a point to this story, except that I'm royally annoyed.
Dear floor nurse: I'm sorry I didn't dress a skin tear. I was busy. You know, actually doing something to save a life. Not that a skin tear isn't important...but...no, wait. It's not that important. Not in the grand scheme of the ER.
Fortunately, the nursing sup was in the ER the whole night, and backed me up regarding the madness. No thanks to Boss Man.
At this point, my feet hurt, I haven't peed yet tonight, I didn't get to eat anything, I have blood on my scrub pants (which I just now noticed), I have poop on my scrub pants (which I just now saw but have been suspiciously smelling for the past two hours), I haven't finished charting on that last arterial bleeder that came in, and my coffee from 7pm is still sitting full on the counter next to my computer. It's been a rough night.
During the night, we moved a patient out of a trauma room and into one of the smaller rooms. The patient who was moved had some fairly big issues going on, but nothing that was going to kill her in the next 6 hours. The patient we cleared the room for, however, was very much going to die if we didn't act. He would probably have died in the next 25 minutes if we didn't get moving. So we got moving, did our ER thing, and eventually sent him off the OR. At the very same time, a cardiac arrest AND and an MVC came in - so our ER staff was split between three very critical patients. The patient who was moved next door was then quickly taken upstairs, as she had a bed assigned already and we needed the space in the ER.
I got written up because, in all the madness, I missed a skin tear on this patient. One skin tear, out of many. And actually, it wasn't my patient to begin with, so really I never did anything for this patient except wave goodbye as she was on the way up to the floor. Although I didn't even really wave goodbye, because I was slightly preoccupied with running the Level 1 Rapid infuser with mass quantities of blood products.
There really isn't a point to this story, except that I'm royally annoyed.
Dear floor nurse: I'm sorry I didn't dress a skin tear. I was busy. You know, actually doing something to save a life. Not that a skin tear isn't important...but...no, wait. It's not that important. Not in the grand scheme of the ER.
Fortunately, the nursing sup was in the ER the whole night, and backed me up regarding the madness. No thanks to Boss Man.
Thursday, September 15, 2011
Sunday, September 11, 2011
Mishaps
I really am a shit magnet. Today was my first day at my new part time job, doing prn critical care transports. About half of the transports are for the really really sick people, like new intubated traumas, or the burn patients or pediatric stuff. But the other half is glorified babysitting of a patient who just happens to have a cardiac infusion running.
Like my dude today. He had a cardiac drip going, but was pain free, alert and oriented, ambulatory, totally independent, and funny as all get out. Needless to say, I did not anticipate any troubles for my first run. Which is dumb. As I am the aforementioned shit magnet, every single thing that could have gone wrong did.
I get to the office to meet the crew, and they had no idea they were supposed to be doing a run (dispatch's fault, not theirs.) We leave 30 minutes late. We get a flat tire on the way. Once at the hospital, our medpump decides to stop working halfway through programming the new drip in. The outgoing hospital forgot to sign paperwork. We had to borrow a pump from their hospital, which took 30 minutes as the nursing sup had to get involved and make us sign in blood that we will return it. The patient realized he forgot his cell phone in the bedside drawer as we were getting into the ambulance. His IV, which was patent on our arrival and patent upon leaving and patent halfway through the ride back decides to become no longer patent sometime between halfway home and arrival at new hospital. Nurse upstairs throws a hissy fit about said IV, even though time of un-patency was perhaps 10-15 minutes. I apologize (even though it wasn't my fault) and she is having none of it. I had planned on a 3 hour transport...It ended up being 7 hours.
Whew. Sometime, I wish I got the easy stuff. But then again, I guess I'd be bored if everything always went well for me.
At least the Skins won today. Hooray football season!!
Like my dude today. He had a cardiac drip going, but was pain free, alert and oriented, ambulatory, totally independent, and funny as all get out. Needless to say, I did not anticipate any troubles for my first run. Which is dumb. As I am the aforementioned shit magnet, every single thing that could have gone wrong did.
I get to the office to meet the crew, and they had no idea they were supposed to be doing a run (dispatch's fault, not theirs.) We leave 30 minutes late. We get a flat tire on the way. Once at the hospital, our medpump decides to stop working halfway through programming the new drip in. The outgoing hospital forgot to sign paperwork. We had to borrow a pump from their hospital, which took 30 minutes as the nursing sup had to get involved and make us sign in blood that we will return it. The patient realized he forgot his cell phone in the bedside drawer as we were getting into the ambulance. His IV, which was patent on our arrival and patent upon leaving and patent halfway through the ride back decides to become no longer patent sometime between halfway home and arrival at new hospital. Nurse upstairs throws a hissy fit about said IV, even though time of un-patency was perhaps 10-15 minutes. I apologize (even though it wasn't my fault) and she is having none of it. I had planned on a 3 hour transport...It ended up being 7 hours.
Whew. Sometime, I wish I got the easy stuff. But then again, I guess I'd be bored if everything always went well for me.
At least the Skins won today. Hooray football season!!
Thursday, September 8, 2011
Spelunking
Fun Young Doc: Hey Shrtstormtrooper! You're a big fan of hiking, right?
Me: Yeah, I do love it.
FYD: How about caving, have you ever done that?
Me: No I've never been caving. I'd like to sometime, though. What makes you wonder?
FYD: I'm so glad you asked! Come on, let's go butt caving in this patient and see how much poop we can get out of this FOS dude!
Suckered right into it. I couldn't even come up with an excuse.
Me: Yeah, I do love it.
FYD: How about caving, have you ever done that?
Me: No I've never been caving. I'd like to sometime, though. What makes you wonder?
FYD: I'm so glad you asked! Come on, let's go butt caving in this patient and see how much poop we can get out of this FOS dude!
Suckered right into it. I couldn't even come up with an excuse.
Monday, September 5, 2011
Badasses
Usually when someone meets me and they find out I'm an ER nurse, they're all like "man, that is so badass. You must see all kinds of crazy stuff!" And then they pester me for stories until I tell them the real gross one of the time the patient vomited charcoal all over my legs and it stained the skin beneath my scrubs and got into my socks, or the time I was hit in the neck with a trach loogie from across the room. That usually squelches the need for gross stories, and it makes me giggle to see them turn a little greenish.
But really, the ER that is portrayed on TV is a super high octane, go-go-go nothing but excitement all the time environment. In reality, it's not all that badass. For every freaky random lawn decoration leg impalement I take care of, we see a hundred toothaches. For every time someone goes into a v-tach arrest in the department and gets shocked back to the land of the living, I argue with fifty drug seekers. For every gunshot resuscitation, I give five enemas. For every EKG that prints out tombstones and sends the patient directly to the cath lab, I start IVs on thirty vague belly pain patients. For every statistic I just gave you, I made 100 percent of them up.
Eh, I digress.
Seriously though, the ER is a lot of fun. I do get to see crazy stuff and it's astounding how unbelievable some of the stories are. Just be prepared, all you people who meet ER nurses, that if you ask us to tell you a story...you might just end up hearing about that really exciting time we did something crazy like stick our finger up someones butt to insert a flexi-seal. Aka butt foley.
In summation, we're not always badass. But this guy is. He surgically removed his own appendix. While at a research base. In ANTARTICA. Read all about it, in the aptly named badassoftheweek.com.
***
Since we're speaking of badasses...I'm currently watching Return of the Jedi on TV. Boba Fett is introduced as the most badass guy ever in Empire Strikes Back. Even though he only has a couple of lines, it's generally understood that he is indeed a bad motherfucker. And then poof. ROTJ. He dies like a little bitch in a big giant sand monster pit. What a puss.
But really, the ER that is portrayed on TV is a super high octane, go-go-go nothing but excitement all the time environment. In reality, it's not all that badass. For every freaky random lawn decoration leg impalement I take care of, we see a hundred toothaches. For every time someone goes into a v-tach arrest in the department and gets shocked back to the land of the living, I argue with fifty drug seekers. For every gunshot resuscitation, I give five enemas. For every EKG that prints out tombstones and sends the patient directly to the cath lab, I start IVs on thirty vague belly pain patients. For every statistic I just gave you, I made 100 percent of them up.
Eh, I digress.
Seriously though, the ER is a lot of fun. I do get to see crazy stuff and it's astounding how unbelievable some of the stories are. Just be prepared, all you people who meet ER nurses, that if you ask us to tell you a story...you might just end up hearing about that really exciting time we did something crazy like stick our finger up someones butt to insert a flexi-seal. Aka butt foley.
In summation, we're not always badass. But this guy is. He surgically removed his own appendix. While at a research base. In ANTARTICA. Read all about it, in the aptly named badassoftheweek.com.
***
Since we're speaking of badasses...I'm currently watching Return of the Jedi on TV. Boba Fett is introduced as the most badass guy ever in Empire Strikes Back. Even though he only has a couple of lines, it's generally understood that he is indeed a bad motherfucker. And then poof. ROTJ. He dies like a little bitch in a big giant sand monster pit. What a puss.
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