"What if he had quit when he didn't make the team? He would have never made Space Jam...and I love Space Jam."
"But what if there really were two paths? I wanna be on the one that leads to Awesome."
Kid President, you have my vote.
Wednesday, January 30, 2013
Monday, January 28, 2013
Every day, a losing battle
"Thermometer goes under your tongue for a moment with your lips closed around it" means keep the thermometer under your tongue for a moment with your lips closed. Not between your teeth, or with your mouth gaping open as if Hugh Jackman just walked by naked, or trying to make it touch every single taste bud in under 15 seconds, or under your tongue then beside it then above it, or attempting to put it under your tongue with your tongue outside your mouth, or making out with it like this is your first game of 7 minutes in heaven, or staring at me like you have no idea what your tongue is.
FFS, people.
FFS, people.
Wednesday, January 23, 2013
Ya done messed up
I'd say staffing is about 75% travelers at Travel Hospital #2, so it's understandable that we're viewed with caution at best and pure dislike at worst. It's tough trusting the care of most of the department to people you've only worked with a couple of times. I'm hoping my stock has risen slightly though, after I took care of a patient and made some solid decisions for her.
I had a lady who came in for typical vertigo - she'd had a few similar episodes years back which resolved quickly with po meclizine and a work note. When she came in this time though she was vomiting, pale as shit, and had that vertigo lean-to-the-side-like-you're-drunk hold on the bedrail. I hit her with meclizine, valium, zofran, and a liter of fluid which seemed to help her quite a bit. Her head CT was also negative. I came back in later and she was starting to feel really terrible again. I went to her doc, who also happens to be the ED director, and got some orders for another dose of meds. Again she felt better for about 20 minutes. The doc had gone in to reeval at that time, so seeing that she felt better he wrote her up for DC. When I got her up to see how she did, the vertigo came back full force and she couldn't even make it the ten feet to the bathroom without hugging the wall. I got her back in bed, and went back to the doc. He was actually really nice about everything, and agreed to call the hospitalist to admit for obs. The lady's ride home was kind of peeved that she had driven to the hospital to pick up the patient only to find out she wasn't needed anymore, but overall was fairly pleasant about it.
A couple of days later the doc came up to me and was like, "hey, remember that vertigo lady you couldn't discharge? She had an MRI in the morning, and guess what? Cerebellar infarct. Thanks for not making her go home."
He was already pretty nice to me, but I'm hoping he realizes I'm not totally incompetent and spreads the word among the docs so some of the others will quit being dicks.
***
On a side note, I really wanted to work the phrase "Ya done messed up" into this post, but I couldn't make it fit well. So I'll just show you the video it came from, and that should suffice.
Makes me laugh every time.
I had a lady who came in for typical vertigo - she'd had a few similar episodes years back which resolved quickly with po meclizine and a work note. When she came in this time though she was vomiting, pale as shit, and had that vertigo lean-to-the-side-like-you're-drunk hold on the bedrail. I hit her with meclizine, valium, zofran, and a liter of fluid which seemed to help her quite a bit. Her head CT was also negative. I came back in later and she was starting to feel really terrible again. I went to her doc, who also happens to be the ED director, and got some orders for another dose of meds. Again she felt better for about 20 minutes. The doc had gone in to reeval at that time, so seeing that she felt better he wrote her up for DC. When I got her up to see how she did, the vertigo came back full force and she couldn't even make it the ten feet to the bathroom without hugging the wall. I got her back in bed, and went back to the doc. He was actually really nice about everything, and agreed to call the hospitalist to admit for obs. The lady's ride home was kind of peeved that she had driven to the hospital to pick up the patient only to find out she wasn't needed anymore, but overall was fairly pleasant about it.
A couple of days later the doc came up to me and was like, "hey, remember that vertigo lady you couldn't discharge? She had an MRI in the morning, and guess what? Cerebellar infarct. Thanks for not making her go home."
He was already pretty nice to me, but I'm hoping he realizes I'm not totally incompetent and spreads the word among the docs so some of the others will quit being dicks.
***
On a side note, I really wanted to work the phrase "Ya done messed up" into this post, but I couldn't make it fit well. So I'll just show you the video it came from, and that should suffice.
Makes me laugh every time.
Tuesday, January 22, 2013
Number two
I have never understood what it is about the emergency room that automatically makes patients have to take the biggest poop of their life immediately after rolling through the doors. I'm not even kidding. The likelihood that they'll birth a food baby is exponentially higher if their chief complaint is syncope, afib with RVR, vertigo, or anything involving being strapped to a backboard.
The only patients who are excluded from this phenomenon are the ones who come in for not being able to poop, or for pooping too much. It's almost a guarantee that if the cc is diarrhea, they will stay dry the entire time. And if it's being backed up...I'm gonna hand you a bottle of mag citrate and hope you stay that way until getting home.
This morning I had a guy with syncope and chest pain who desperately needed to drop his kids off. He begged and begged to be allowed to walk down the hallway to the bathroom. I'm trying to explain to him why it's a bad idea, and he's just not down with the whole bedpan plan. "But come on, it's not that far! I'll only be a few minutes. I'll be fine!" he says. I finally got fed up and was like look, dude, I understand that it's pretty embarrassing to have to take a dump in the ER room with just a curtain between you and mortification. But just look at it this way: Elvis died while taking a shit. And that is how he will forever be remembered. Do you want to be that guy?
He used a bed pan.
The only patients who are excluded from this phenomenon are the ones who come in for not being able to poop, or for pooping too much. It's almost a guarantee that if the cc is diarrhea, they will stay dry the entire time. And if it's being backed up...I'm gonna hand you a bottle of mag citrate and hope you stay that way until getting home.
This morning I had a guy with syncope and chest pain who desperately needed to drop his kids off. He begged and begged to be allowed to walk down the hallway to the bathroom. I'm trying to explain to him why it's a bad idea, and he's just not down with the whole bedpan plan. "But come on, it's not that far! I'll only be a few minutes. I'll be fine!" he says. I finally got fed up and was like look, dude, I understand that it's pretty embarrassing to have to take a dump in the ER room with just a curtain between you and mortification. But just look at it this way: Elvis died while taking a shit. And that is how he will forever be remembered. Do you want to be that guy?
He used a bed pan.
Monday, January 21, 2013
Mogwai madness
So last night was pretty hellish. Like, every single one of my patients were crazy escape artists who ran me ragged or were sick as all get out or all of the above. For example: my little demented nursing home lady with altered mental status (new? chronic? who really knows...not the nursing home, that's for sure) who was very pleasantly confused. She would answer questions about medical history with, "oh no sweetie, I just like carrots," and reply to inquiries about her pain level with, "that's nice, a large hat." Because she had all the medical problems ever, her Hgb was 6.4 and Hct was 21 and urine looked like cottage cheese and lungs sounded awful. Hello, blood transfusion and foley and antibiotics, because she was also a full code and do everything per family. I get the catheter in, two IV lines placed, blood transfusion going, antibiotics infusing, pillows fluffed, sheets tucked in, curtain pulled open, and monitor wires neatly hidden. She smiles at me and closes her eyes for a little nap.
Not even six minutes later and I'm standing in the next room doing another workup, when the monitor alarm goes off. I head back into the room, and I swear to you it's like gremlins came in and tore the place apart and then disappeared back into the great beyond. The pillow was on the other side of the room. The monitor wires are dangling from the screen. The foley is laying next to her on the bed. Both IV lines have been pulled out and the blood is infusing onto the tile floor, the antibiotic into the blanket which is on the chair. It was fucking armageddon in there. And the craziest part? Lady looks like she hasn't moved one bit. She is still laying in the same position as when I left, eyes serenely closed. I am still flabbergasted how that whole disaster happened.
I also had a big burly psych patient attempt to escape. He almost made it because I'm like 5 foot 3, and he was Ray Lewis. He also probably almost made it because there aren't actually any real psych rooms in this ER and it's a pretty short distance from the rooms to the exit. I wish I'd had a haldol blowdart gun, because we (and by "we" I mean Sa-curity) pretty much had to then sit on him (literally) to IM med his ass until we could drag him back into bed.
And oh yeah, there was the lady who came in for "insomnia" and then complained to me that she didn't want to sleep on the stretcher because "those beds are uncomfortable." You know what would have been more comfortable? Your bed at home. And also, probably don't drink a red bull at 01:30. You make me wish call bells had never been invented.
All I'm saying is...I might have had two extra large glasses of sangria this morning when I got home. And made the most banging egg breakfast ever, because nothing says "de-stress" like heartburn.
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Nighty night, yall'z.
Not even six minutes later and I'm standing in the next room doing another workup, when the monitor alarm goes off. I head back into the room, and I swear to you it's like gremlins came in and tore the place apart and then disappeared back into the great beyond. The pillow was on the other side of the room. The monitor wires are dangling from the screen. The foley is laying next to her on the bed. Both IV lines have been pulled out and the blood is infusing onto the tile floor, the antibiotic into the blanket which is on the chair. It was fucking armageddon in there. And the craziest part? Lady looks like she hasn't moved one bit. She is still laying in the same position as when I left, eyes serenely closed. I am still flabbergasted how that whole disaster happened.
I also had a big burly psych patient attempt to escape. He almost made it because I'm like 5 foot 3, and he was Ray Lewis. He also probably almost made it because there aren't actually any real psych rooms in this ER and it's a pretty short distance from the rooms to the exit. I wish I'd had a haldol blowdart gun, because we (and by "we" I mean Sa-curity) pretty much had to then sit on him (literally) to IM med his ass until we could drag him back into bed.
And oh yeah, there was the lady who came in for "insomnia" and then complained to me that she didn't want to sleep on the stretcher because "those beds are uncomfortable." You know what would have been more comfortable? Your bed at home. And also, probably don't drink a red bull at 01:30. You make me wish call bells had never been invented.
All I'm saying is...I might have had two extra large glasses of sangria this morning when I got home. And made the most banging egg breakfast ever, because nothing says "de-stress" like heartburn.
.JPG)
Nighty night, yall'z.
Saturday, January 19, 2013
Update
I've been slacking on the whole "keep you updated on the travel nursing" thing, and for that I'm sorry. Sometimes things get in the way, like friends and whiskey and stuff. Re-read the previous sentence, by the way. Friends. That's right. I have them here!
The most recent post about the hospital was not exactly the kindest of reviews. At the time, I hated it. I wasn't making friends with the staff, it wasn't anything like the warm and welcoming environment I encountered at Travel Hospital #1, I strongly disliked one of the docs who seemed to have it out for me, and I sat at home on my couch for like five days straight because I was lonely. I don't know exactly when I turned the corner, but I realized recently that I actually like it there now.
The biggest change to my previous point of view is the rapidly improving outlook at the hospital. I made it a point to never turn down post-shift breakfast tacos, because I so desperately wanted to make friends. It worked because I've gone out with coworkers on days that don't involve the hospital, and though I'm not BFFs with anyone there I definitely don't dread going to work anymore. There are a couple of other travelers there who I really like and one girl in particular is super friendly and welcoming. I also figured out that the doc who seemed to hate me actually does, but he hates everyone equally. It's not aimed only in my direction, which made me feel much better. So I'm content at work.
I still miss the people from Travel Hospital #1, because I think they are some of the nicest people ever and I am in awe of how quickly I was accepted there. It's like I had known some of them for years, and I'll keep in touch with many of them for a long, long time. However, I had no friends outside of the hospital there. It was all work people, all the time - which I had absolutely no issue with, but when I came down here and didn't immediately click with coworkers I felt like a failure even though realistically I knew it would take time.
The other big thing that made me start liking Texas is the people I've met outside of work. I made friends with people whom I met on the way here, surprisingly, and even though it's a long-ass drive they're the ones I consider my favorites and have gotten closer to. I guess it's hard not to when I realized they won't judge my love of offensive humor, ermahgerd, youtube and alcohol. There are also people I've met through a friend of a friend from home, and it's really great to be able to say yes to invites out and also to have a common ground with them. I definitely don't sit at home feeling lonely; that's good for the the self-esteem.
So there you have it. I really like it here now, work doesn't suck anymore and I signed on for another three months. Hooray!
The most recent post about the hospital was not exactly the kindest of reviews. At the time, I hated it. I wasn't making friends with the staff, it wasn't anything like the warm and welcoming environment I encountered at Travel Hospital #1, I strongly disliked one of the docs who seemed to have it out for me, and I sat at home on my couch for like five days straight because I was lonely. I don't know exactly when I turned the corner, but I realized recently that I actually like it there now.
The biggest change to my previous point of view is the rapidly improving outlook at the hospital. I made it a point to never turn down post-shift breakfast tacos, because I so desperately wanted to make friends. It worked because I've gone out with coworkers on days that don't involve the hospital, and though I'm not BFFs with anyone there I definitely don't dread going to work anymore. There are a couple of other travelers there who I really like and one girl in particular is super friendly and welcoming. I also figured out that the doc who seemed to hate me actually does, but he hates everyone equally. It's not aimed only in my direction, which made me feel much better. So I'm content at work.
I still miss the people from Travel Hospital #1, because I think they are some of the nicest people ever and I am in awe of how quickly I was accepted there. It's like I had known some of them for years, and I'll keep in touch with many of them for a long, long time. However, I had no friends outside of the hospital there. It was all work people, all the time - which I had absolutely no issue with, but when I came down here and didn't immediately click with coworkers I felt like a failure even though realistically I knew it would take time.
The other big thing that made me start liking Texas is the people I've met outside of work. I made friends with people whom I met on the way here, surprisingly, and even though it's a long-ass drive they're the ones I consider my favorites and have gotten closer to. I guess it's hard not to when I realized they won't judge my love of offensive humor, ermahgerd, youtube and alcohol. There are also people I've met through a friend of a friend from home, and it's really great to be able to say yes to invites out and also to have a common ground with them. I definitely don't sit at home feeling lonely; that's good for the the self-esteem.
So there you have it. I really like it here now, work doesn't suck anymore and I signed on for another three months. Hooray!
Friday, January 18, 2013
Triagedy
I get to work last night, and it's slamming busy. We're getting our
assignments for the shift, and Charge looks at me and is like
"Shrtstormtrooper, you're in triage for the night with Other Travel RN who has been there for 7 months." Okay, cool. No sweat. I mean, I've been there for almost three months. I probably know enough to not kill anyone accidentally. The thing that blows my mind is how I got ZERO minutes of orientation before they were like Go Forth, Traveler, and save lives.
The sad thing is that this isn't even really a vote of confidence in my nursing skillz. It's more like the department is so stretched for experienced staff that Charge found out I had signed on for another contract and put me out there the very next shift. Desperate times call for desperate measures, or something like that.
And oh by the way, I'm staying in Texas for another contract, in case you didn't pick up on that two sentences ago. Whooooo!
The sad thing is that this isn't even really a vote of confidence in my nursing skillz. It's more like the department is so stretched for experienced staff that Charge found out I had signed on for another contract and put me out there the very next shift. Desperate times call for desperate measures, or something like that.
And oh by the way, I'm staying in Texas for another contract, in case you didn't pick up on that two sentences ago. Whooooo!
Wednesday, January 16, 2013
My apologies, sir
So, I totally know I didn't really cause that patient to go into V-tach. But sometimes you just kinda feel like you did, ya know? Like this morning. He came in complaining of dizziness and a few episodes of syncope. I'm like okay, sure, cardiac monitor, EKG, let's get some labs and an IV placed just in case. 95% of the dizzy-syncope in an otherwise healthy dude just = you probably did too much yardwork and had too many beers this weekend and now you're kinda dry and stood up too fast. But I stuck the #18G IV in and sure enough, he goes "uh, I feel kinda weird" and I look up and the monitor and HOLY SHIT IT'S TORSADES I NEED SOME HELP IN HERE, hit the code button on the wall, people run in and two shocks later he's feeling somewhat better. Better, except for the feeling in his chest like he just got hit by a dump truck. My bad, yo.
So it happens. I can't feel too bad about that. Sure, he just happened to code right when that IV broke skin. But whatevs. I shake it off and move on.
A short while later, I'm getting ready to place a foley cath because he's already peed the bed once - which I can't fault him for, since he did literally get the piss shocked out of him courtesy of me - and I'm not keen to change the sheets again. I'm talking the guy through the procedure, and clean clean clean wipe wipe with the betadine scrubs...no sooner does that catheter tip pass into his urethra and he goes all googly eyed and I look at the monitor again and OH SHIT ITS VT AGAIN I NEED HELP PLEASE. I run on over to the defib monitor, and SHOOOMP he's clear with 200 J of serious business to the heart. More amiodarone, more EKGs, and more apologizing because it feels like someone punched him in the chest.
I know the IV and foley weren't the real cause of those Bad Things happening, but damn. I do feel kinda guilty this morning.
So it happens. I can't feel too bad about that. Sure, he just happened to code right when that IV broke skin. But whatevs. I shake it off and move on.
A short while later, I'm getting ready to place a foley cath because he's already peed the bed once - which I can't fault him for, since he did literally get the piss shocked out of him courtesy of me - and I'm not keen to change the sheets again. I'm talking the guy through the procedure, and clean clean clean wipe wipe with the betadine scrubs...no sooner does that catheter tip pass into his urethra and he goes all googly eyed and I look at the monitor again and OH SHIT ITS VT AGAIN I NEED HELP PLEASE. I run on over to the defib monitor, and SHOOOMP he's clear with 200 J of serious business to the heart. More amiodarone, more EKGs, and more apologizing because it feels like someone punched him in the chest.
I know the IV and foley weren't the real cause of those Bad Things happening, but damn. I do feel kinda guilty this morning.
Friday, January 4, 2013
Breakfast
I know dementia sucks and all that, but sometimes I can't help but laugh. Like this morning. I'm trying to spoon feed this old dude his morning meds in some applesauce (because the 28 bed ER had 22 admission holds which meant I was floor nurse extraordinaire) and he is just not having it.
It's hard to explain to someone who is 100% demented why it's a good idea to take his meds. I had resorted to wheedling, cajoling, pleading, and making airplane noises. If it works for a two year old, why not gramps...right? No. Unsuccessful.
I finally asked again "but pop, aren't you hungry?" He looks at me and just goes "Nope. I've been full all night..." and dug his finger up his nose. I'm thinking NOOOOOO DON'T DO IT! and then he gets a hold of the biggest, greenest, crunchiest booger I've ever seen and proceeds to house that entire thing.
Good thing he won't remember me hysterically laughing at him.
Dementia sucks...but man sometimes it can be funny.
photo: Shel Silverstein, Warning
It's hard to explain to someone who is 100% demented why it's a good idea to take his meds. I had resorted to wheedling, cajoling, pleading, and making airplane noises. If it works for a two year old, why not gramps...right? No. Unsuccessful.
I finally asked again "but pop, aren't you hungry?" He looks at me and just goes "Nope. I've been full all night..." and dug his finger up his nose. I'm thinking NOOOOOO DON'T DO IT! and then he gets a hold of the biggest, greenest, crunchiest booger I've ever seen and proceeds to house that entire thing.
Good thing he won't remember me hysterically laughing at him.
Dementia sucks...but man sometimes it can be funny.
Thursday, January 3, 2013
I can haz crazy cat-lady status
Oh hai, insomnia. Usually when I can't sleep, I blog really interesting and insightful posts about things like the state of society, why nursing is awesome/scary/educational/awful, and how much I've grown as a nurse in a few short years.
Tonight, not so much. Blog performance anxiety, maybe. I guess you could call this my dry spell of blogging. It's not you, it's me, and all that. Seriously. I started like six different posts and all of them just sucked. So what to do?
Well guys, when in doubt...lolcats.
Two is enough. Right?
NO!
OH GOD I CAN'T STOP.
I'm done now guys. Seriously.
I can't help it. It's a sickness.
Must...stop...laughing...Ah, it's a lost cause. I'll be single forever because I can't stop giggling hysterically at these.
Tonight, not so much. Blog performance anxiety, maybe. I guess you could call this my dry spell of blogging. It's not you, it's me, and all that. Seriously. I started like six different posts and all of them just sucked. So what to do?
Well guys, when in doubt...lolcats.
Two is enough. Right?
NO!
OH GOD I CAN'T STOP.
I'm done now guys. Seriously.
I can't help it. It's a sickness.
"Happy cat's dream was a cheezburger....but he'd probably be pleased with this too."
Must...stop...laughing...Ah, it's a lost cause. I'll be single forever because I can't stop giggling hysterically at these.
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