Inque tuo sedisti, Sisyphe, saxo

Sometimes I feel so demoralized after taking care of countless victims of cruel or thoughtless actions, or dealing with the mass of entitled selfish people who demand everything yet work for nothing. I get to the point of irrational fury, because I care so much about being a nurse and helping people and fixing them that I am deeply offended at those who dare to chip away at my belief in the good of humanity.

On days that I feel like this I tend to think society is hopeless. I get angry at the manipulators and horrible people, and wonder if there is anything that can restore my non-jaded view of the world. I am down on myself and feel a lot like Sisyphus. Usually, I can talk myself back into a positive state of mind and remind my heart why I truly love nursing. Sometimes I get a much-needed nudge though.

I was just finishing up placing an IV in a sick little kid, who was stoically handling the procedure like a champ at only 5 years old. After praising him for being awesome, he gratefully accepted the popsicle offered to him for doing so well with the IV and then blurted out that he wants me to be his new best friend. I smiled and asked him why that was. "Because you made me feel better," he said, "and that's a nice thing to do."

And just like that, faith restored.

Quote of the day

Friend quote: You don't need breasts to have tits. Just ask Mark Wahlberg.

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And totally unrelated...I have Sportscenter on in the background. All of a sudden I hear Busta Rhymes & Mariah Carey's "I Know What You Want." I look up, perplexed as to why this is on Sportscenter and curious as to what it could possibly be advertising. The sport? BOWLING. Bowling. Awkward white dudes in weird shirts. And Busta. Whatever works, I guess.

A real emergency

So it was freakin' busy last night. Bambalance patients lined up waiting for a stretcher, long wait in the WR, tons of stuff to be done. I'm discharging a patient who had a rash on her arm. It's been there for two YEARS. You heard. Two years. She has been to (multiple) dermatologists. She's seen an allergist. She switched PMDs when her first couldn't tell her what was wrong. So when I discharge her with the instructions of "your bloodwork is normal, vitals are normal, and it's the same rash you've had for a while now. Here's some numbers for different specialists, you'll need to follow up with them," the patient gets pissed. At me. Personally.

She got that haughty look on her face and goes, "of course you don't know what's really wrong with me. You're just a nurse. Now go get the doctor, I want to speak with him about my diagnosis because obviously you don't know what you're talking about."

Oh, no. It's on, woman.

I kindly inform her that the doc has already spoken with her before discharge, and printed up his diagnosis on the papers, and that she has the same rash she's had for two years - so naturally she flips out and starts berating me, nurses in general, this emergency room, ERs in general, the ED doc, all ED docs everywhere, and the fact that we in the ER are too stupid to know why she has like 12 itchy bumps on her arm.

"Ma'am," I said, "unless those bumps instantly morph into Ebola, you're gonna be fine. This is the ER. We fix emergencies, not chronic skin rashes, and if you continue to yell at me security can escort you out. Here's your paperwork, have a nice day."

I can only wait in agonizing suspense until the day she signs in with Ebola virus. Sigh.

With gusto

You guys. Seriously. I was more giddy inside tonight at work than I've been in a loooong while. Usually, when the drama queens and man-babies show up in the ER with their nonexistent peripheral access sites (from lots of IV drug use) and their retch-moan-squirm routine (with VS more normal than mine) and lots of "vomicking," I have to hunt around foreeeever for an IV site. Takes me a couple of attempts and finally I get a 24G in their pinky and draw some pedi tubes of blood, which are inevitably hemolyzed.

But tonight. Oh, tonight I had an epiphany. I was standing in the room of one such patient, and internally bitching about the IV/labs/cultures x2 I had to draw off this epic man-baby. I looked at his arms, and then I happened to catch a glimpse of his big fat juicy EJ. No, I sadly thought, I'm not allowed to do EJs. Home Hospital didn't allow nurses to do them, even though my RN license says I can.

And then it hit me. I'm in TEXAS, MF'ERS! Ain't no rules against nurse initiated EJs at this hospital! I double checked with another nurse, and sho'nuff we're allowed to start them*.

I grabbed that 18G and threw the EJ in so fast it made my head spin. I had a set of cultures, full blood tubes, and a bamf IV line in like fourteen seconds. And it was so satisfying. I mean really...what is more enjoyable than telling your drama patient to hold still because you're about to shove a giant-ass needle into his neck? And the feeling of actually doing it? Glorious. Epic. Sublime.

The best part? I've never done one before but damn if I haven't watched a million ER docs place them and think "I could do that!" And apparently I can. But wait, I lied. The best part was actually when I went to the doc a while later for unrelated reasons, and he was like "man those labs were quick...where the hell did you find a line on him?" I'm all "oh, I just threw in an EJ. No biggie, son."

Boom. New skill. Acquired, suckahs.

*technically, one is required to have 3 supervised EJ starts before flying the nest. Oops. Good thing I'm a traveler and fall through those cracks!

Drugs

Ya know, when a patient comes in screaming WHEEEEEEE!!! I LOVE TO SHOOT UP WITH METH! METH LOVES ME! at the top of their lungs...it's a pretty tall order for that patient to sober up eight hours later and then try to convince me they have no idea how that meth got in their system. Just saying.

But valiant effort buddy. A+ for the attempt.

In no way related to nursing

Otherwise known as "Blog bits because I'm too lazy to actually put together a coherent and thoughtful post." So here goes!

I do love me some Chemistry Cat.

I mean come on. It's like science AND lolcats! Yes please.

***
I miss Billy Mays. He was a legit force to be reckoned with on the infomercial scene. Annoyed the hell out of me on a consistent basis, but I had to respect the sheer volume of his voice. No one else quite measures up to him. There was a moment of potential with the Sham-Wow guy, but then he had to go and beat up that stripper.

***
I've been getting over a cold recently, and incidentally there have been tons of commercials on TV for various cold medicines. However, when I see these I can only think of the newest cough and cold formula on the market today...and how effective it must be. I'd have been able to kick this colds' ass way sooner if I could get my hands on some of this.



***
I love nerdy things. I love parodies. I love late-night hours of watching YouTube. I love lip-synching. I believe this fits the bill.



***
Fin.

Newsworthy

These people are equipped to handle the responsibility of having long-range rockets (ostensibly for space access) capable of reaching orbit?!

North Korea finds secret Unicorn Lair.

From the article:

In an announcement Friday that seems better suited for a fairy tale, a North Korean state news agency reported that archaeologists recently reconfirmed the lair of a unicorn once ridden by an ancient Korean King.

Oh FFS, N. Korea.

Verdict

Verdict is in on Hospital #2: Fuck. This. Couch. And this ER...

I'm over it. The patient load isn't bad, the acuity isn't all that bad, the equipment is pretty nice, the patient ratio is sweet. But the staff? Not okay. For every single nice nurse, there are four who are total giant assholes.

As proof, I present my experience from tonight. I was on the exam side, which has lower acuity higher ratio. I had a full group, half of which were crazy drunk morons. I'm triaging a brand new patient and getting the nine thousand paperwork forms filled out. It's 22:53. All of a sudden, another nurse plunks her stuff down next to me and announces I'm moving over to the cardiac side. News to me, but whatevs. I finish the computer triage and start in on report. I'm not even halfway through report on the first patient when she interrupts me and asks "how come you haven't put in a line yet on this overdose?" Uh, well, it's because she's been here 7 minutes and I'm currently finishing her triage, and oh yeah she's a fake-OD-just-wants-more-ativan type patient. And since I was not aware I would be moving groups, I wasn't too chuffed about it. I finish report on the first patient and move on to report on the overdose. She interrupts me in that report and asks what the deal is on the third patient. I internally sigh and start in on report on this patient. No shit, she interrupts me again to ask for report on the last patient. Bitch please, if you had seventeen more seconds worth of patience in you, you'd have gotten full report on each one of them. I then get asked again why I haven't given the ordered fluid rate of NS 250 ml/hr on the second patient. Since the doc went in to see her while you were getting report from me, it's kinda hard for me to give you report and be in the room medicating at the same time. I haven't quite mastered that metaphysical maneuver yet.

Whatever. Maybe you're having a bad day. I can let that slide. So I sprint on over to cardiacs, where I take an absolute cluster of a group - one patient has been in the room for over an hour with med orders in and still no line. One patient has been up for discharge for 45 minutes. One is being triaged but still needs everything done. I go in and discharge the ready patient, and get report from the offgoing nurse. I then bounce into the first room and throw a line in and medicate the patient, and head into the next room to do a full workup. I'm elbow deep in gowning the patient, blood cultures, IV start, labs, istats, fluid boluses, neb treatments, and po meds (all by myself, mind you, no help from the ED tech) when I hear my name overheaded. It's the charge nurse. I call out that I'm in with the patient, and charge walks into the room. "There's an a-fib patient in the next room, she's been in there for 15 minutes and isn't triaged or on the monitor, with a HR of 160. What gives?!" she says.

I respond that I've just taken report and been in with two patients doing a ton of stuff, and that I wasn't aware of a new patient in my room. Now I'm in trouble because I've missed the five minute cutoff for EKGs. I look over at my computer, and taped to the monitor is a handwritten sign that reads NEW PATIENT IN ROOM 2. NEEDS TRIAGE. PS CARRY YOUR PHONE WITH YOU AND YOU'LL GET REPORT.

Oh no. Oh hell no. You know why I wasn't at the computer? Because I was doing shit. You know why I didn't have the phone on me? Because the nurse I got report from still had it. That is such a dick move, and the only person who actually suffers is the patient. Don't you dare pass that blame onto me. You're the triage nurse who didn't get a cardiac patient undressed, or put them on the monitor, or give report to the primary nurse. At least the charge nurse, who is a decent human being, saw that note and came out to rip you a new one.

And you know what? Karma's a bitch, yo, because you definitely got slapped by a drunk patient not even two hours later. I can't even care.

I'm going to finish my beer and go to bed. Forget this ER. I love this city but I'm over this work environment.