Finally, a diagnosis

I, too, suffer from Bitchy Resting Face.



Not that I'm complaining. It's a solid benefit when working the ER amongst the drunks and creepers.

Many happy returns

She's back!

GuitarGirl RN. Go read and love, y'all.

Ew

This morning I was leaning against the desk waiting for a doc to finish dictating so I could ask a question. There happened to be a super gaudy-looking gold dangly earring sitting there, I guess lost from a patient or such. I offhandedly say to the doc something about that earring really complementing the color of his eyes, and without missing a beat he replies "oh that's my nipple ring. I took it out when the patients could hear it jangling around under these scrubs."

I should mention that this doc is like two years away from retirement and just about the most straight-laced guy around. 

Yeesh. That's a mental image no one needs. 

Cardiac

So the other day I had a nice gentleman in new onset Afib with a rate of around 140. He had a pretty extensive cardiac and pulmonary history, so was kinda nervous about everything we did. I explained to him all about Diltiazem and why we were giving it, and he was still a bit nervous but let me give him the med. His rate came down below 100, and later I got the order to ambulate him. He failed the road test pretty spectacularly, with a HR now up to 160. I bolused another dose of Diltiazem, which didn't do much, and the doc came in to talk over his options.

The doc mentioned that she had talked to the cardiologist, who wanted to cardiovert the patient. The patient was really anxious about it, and so even though we talked through all the pros and cons he still wanted some time to conference with his wife.

The doc, myself, and the scribe were hanging out in the nursing station to give the guy some time, when the scribe looks over at me. "Hey," he says, "did you know that you have a major contraindication to cardioversion?"

I replied, with a somewhat confused look, that I didn't know of anything. [This is where I interject that this scribe and I are good friends whose friendship is 90% based off of the most creative insults we can think of for each other.]

"It's contraindicated because you have no heart!" he cackled.

The doc almost fell off her chair laughing, and immediately rushed to go tell the other staff that I had been one-upped in good insults for the night.

I, however, had the last laugh. Later on in the shift, when the patient was about to go upstairs, he graciously thanked me for taking care of him and making him and his wife feel so informed and relaxed. His exact words to me, which he said in the presence of the scribe and doctor, and I'm not even bullshitting you, were these: Thank you for being so caring. It's so nice to have a nurse with such a good heart.

Bam! Who's one-upped now, Scribe?!

Potty mouthed

I really do appreciate quality toilet humor. Anonymous witty person, I applaud you. Keep up the good work.

[spotted while walking in the broken equipment hallway at Home Hospital]

Home

I had my first shift back at Home Hospital last night. Honestly? It's like I never left. I'm still a shit magnet, staffing still sucks, it's still crazy busy all night long, and I didn't eat or pee for 12 hours. Ah, to be home.

For real though. It was absolutely nuts last night. I was in triage for the first six hours, and had to navigate both a new triage process (it's awful) and a new EMR system (right now it's awful but I think it'll be okay eventually). I had kind of forgotten the extent of this patient population's ridiculousness, but was quickly reminded when I had a lady berate me in the middle of the lobby because she "broke" her leg and I wasn't helping fast enough.

Actually, the conversation went a little like this:
Lady: Bitch I need some help in herrrr! I broked mah leg!
Me: Okay, let's get you registered so I can help you.
Lady: No bitch! I need help now!
Me: You can let me help you by getting registered and coming to this triage room with me.
Lady: I ain't leaving dis spot until you fix my leg!
Me: Okay. You wait here until you decide you want to let us help you. I'm going to be over here assisting the rest of this triage line.

I'm leaving out the part where she peed in the wheelchair, apologized for peeing in the wheelchair, announced that she was "hella drunk" and then blamed me for not providing a wheelchair with a built-in bedpan. Twas a good time.

And then, after six hours of triage madness, I went back to the core and promptly received a Priority 1 pedestrian struck on the highway. Complete with +etoh, multiple ortho injuries, and propofol goodness. Ah yes, it's like I never left.

Together we can rule the hospital...

I'm on day 5 of hospital orientation at the little community ED I'm working prn at (in addition to prn at Home Hospital). It's brutal. Painful. Excruciating. Mind numbingly droll, even.

Today is six to eight hours of computer modules. Hell on earth, as its otherwise known. The only amusing thing so far, and thus the only part I'll actually recall later, is this screenshot:

One Star Wars slide is definitely not enough to salvage this day. But it's a start.

***
Update
A picture of Darth wasn't enough to salvage a day. But this was:

[#whatshouldwecallme]

When it's finally the weekend:

Don't mess with a guy on a buffalo

You're gonna have to punch that cougar in the face. Git outta here, kitty cat! Beat it!



God bless the internet.

I have no new interesting content for you.

Sometimes, I hear a new term for something ER-related that makes me laugh unreasonably hard. Like when I sat through a computer inservice for a new charting system we're going live with next week, and our patient was Painful Testy. With a c/c of Difficulty Urinating. It was so amusing because the inservice instructor kept repeating the term, again and again and again.

Or perhaps when he kept referring to the cocaine use test patient as "Sugar Boogers."

I'm sure that was a well-rehearsed joke designed to keep us somewhat interested in the class, but I still found it so amusing that I'm blogging about it.

I mean...I've been off work for a month. My content backlog is rather bare right now and this was the best I could come up with. Sorry guys. I start back at the ER this week, and new, somewhat interesting posts should follow. Stay strong, friends.