Second chances

It's humbling to see someone who, by all rights, shouldn't be alive right now. It's humbling to see someone be in the process of death and then be brought out of it. It's humbling to see a husband who is dying get a chance to live and see his wife again.

I've been orienting in Trauma since the past week or so, and I've seen some interesting but not too wild stuff. Critical but not fatal has been the name of the game, which makes for nice learning opportunities but few oh-s**t moments. I've dealt with a few MVCs, codes in progress, some chest pain workups, an electrocution, but no patients who went from alive to in danger of dying in the next 8 seconds without intervention.

Enter Chest Pain Sweaty Man. He came in by ambulance, and when he rolled through the doors we all did a double take. The Rosetta EKG sent in by EMS was clean, but we've been taught to treat the patient and not the machines. Chest Pain Sweaty Man looked like utter crap. He was talking fine, but had that weird gray color to him and was in danger of dehydrating solely through sweat. As EMS was sliding him from their stretcher to ours, a nurse was getting report. Chest Pain Sweaty Man took that moment to pass Go and collect his V fib and unconsciousness.

My preceptor grabbed the crash cart while I snagged the defibrillator, and we ran to the room. I charted, pads were placed, and we shocked Chest Pain Sweaty Dying At This Moment Man. I have seen plenty of unsuccessful codes, and I have seen the ones where a rhythm comes back but the person doesn't, but I have never seen a person get shocked and just...wake up.

Chest Pain Sweaty Alive Again Man opened his eyes, looks at us, and goes "oww, that hurt!" We all stared at him for a second, then snapped into action again. EKG showed tombstones that I could see from across the room. From V fib to cath lab was 12 minutes. It was impressive. Last I heard, Chest Pain Sweaty Man is back to being Husband and Father Man.
I have been blessed in almost all aspects of my life, from the mundane to the big. But Chest Pain Sweaty Man? Being given a second chance at life is the ultimate blessing. I can't help but be humbled every time I think of him. He should be dead right now. But because we were able to get to him quickly and work efficiently, he will wake up tomorrow and spend time with his wife and family.

It's been two months since I started in this career, and Chest Pain Sweaty Man drove home why I'm in it. Thanks, CPSM.

***
Crass-Pollination had a very similar incident happen at her hospital. I don't think, when I was deciding to go into nursing, that I was expecting this stuff to happen all that often. Sadly, it does.

The Seasons, they are a-changin

I have to wonder if perhaps I am being punished for something. You see, I love warm weather. Weather below 50 degrees makes me cranky.

For the past three days here, it's been extremely warm. Like flip flops and tee shirts kind of warm. Incidentally, I had to work all three days. While the walk from the ambo entrance doors to my car was nice, it just wasn't the same as having that day free to sunbake outside.

Today I'm off, and it's below 50. Not exactly flip flop weather.

I just checked the weather for tomorrow, and it's going to be 70. As for me? I'll be at work. All day.

Sad.

I guess this is the real world, where classes don't break for lunch and no one cares if you have cabin fever. I sorta miss college!

Watchmen verdict

Who watches the Watchmen? I did, and let me say: It is awesome.

I loved the graphic novel and how complex it was. It took me two reads through it to catch the major plot points and foreshadowing, and I guarantee that I'll find new things every time I pick it up from now on. I was apprehensive about how much of the dense, intricate, and sheer awesomeness of the novel would actually make it into the movie - after all, this isn't a novel that you can just cut parts out of and paste onscreen.

I just got home from the movie though, and the director hit it perfectly. The story flowed well, the actors nailed it, the visuals were amazing, and the dense and intricate story was pared down to a very concise chunk of good movie. While the soundtrack could have been better and I could have done with less of Billy Crudup's naked blue wanker, this movie was excellent.

So much was packed into this movie, but it never felt rushed or crammed in. Everything had a purpose for being on screen, and everything flowed with the overall narrative. I'm amazed at how much they had to leave out, but I'm even more amazed at what made it in. It just worked.

I always love the source novels better than their movies, simply because no detail is too small for the written page. This isn't an exception, but I think it came pretty dang close to being equally as good. I can't wait for the DVD!

Did it go Poof?

No matter how many times I've seen this, I laugh hysterically every time.



May be unsuitable for minors...oh what the heck, watch it anyway! It's not just for jackasses!

Attention all shoppers

So the whole East Coast is getting slammed with winter storms right now. Big surprise, considering it's wintertime. Our area is calling for a few inches of sleet and snow, and you'd think it's the end of the world or something.

I just popped over to Wal-mart for some coffee creamer and lunch supplies, and encountered a horde of shoppers frantically running around with a crazed look in their eyes. I know it's the East Coast and we don't get a ton of snow, but come on people, seriously. It's a few inches of snow. God forbid you don't have enough eggs to last you three days - do you really need six dozen of them? And there were people with like 7 gallons of milk, a dozen loaves of bread and 6 packs of toilet paper in their cart. Unless the coming winter storm is going to cause you to eat and shit yourself into oblivion, I don't understand why it's necessary to get enough supplies for a nuclear holocaust. Calm the heck down, people. It's going to be two days of weather just annoying enough to make you have to start your car 15 minutes early. Suck it up.

Oh, and please use some common sense if you have to drive. 50 mph on a snowy road is not okay. Drive slow, be careful, and don't be a tard.

Agh, I should have known not to go to Wal-mart at a time like this. All it does is aggravate me. And on that note, good night! I'll be up way early, to de-ice my car and go to work - the real world kind of sucks!

Pure awesomeness

Who watches the Watchmen? I do!

I am SO EXCITED for this movie to come out. I even bought my ticket today, so I don't have to worry about them selling out. Like, I'm so excited. I can barely contain myself! I'm going to the midnight opening, and I haven't been this pumped about a movie since Star Wars came out. Although, Revenge of the Sith sucked a big one, so I'm hoping my enthusiasm doesn't produce the same results this time.

Eee I'm excited!

Past medical history

A dialogue of absurdity. Enjoy.

Shrtstormtrooper: Are you allergic to any medications that you know of, or had any bad reactions to anything?
Patient: No, I don't have any drug allergies, and I haven't had any bad reactions.
Shrtstormtrooper: Do you have any medical problems, like asthma or diabetes or heart problems?
Patient: Nope, no health problems. I have a list of my meds though if you want that.
Shrtstormtrooper: Sure, let me take a look...okay, I see you were on Lisinopril, why did the doctor take you off it?
Patient: Oh, it's because my face swelled up real bad, the doc said it was angio-something and he didn't want me taking it anymore.
Shrtstormtrooper: .......I see. So you have high blood pressure and had a serious reaction to your medication. Please make sure you tell your health care providers that, it's really important for us to know. You're also on plavix and aspirin, why do you take those?
Patient: Oh, I had, what do you call it, atrium fibrillation. Oh yeah, I had a heart attack 4 years ago too. I even had stents put in!
Shrtstormtrooper: You take glipizide too, you must have diabetes.
Patient: But I don't take insulin, so it's not like bad diabetes.
Shrtstormtrooper: Right. That's quite the health history. Is there anything else I need to know about?
Patient: No, I'm pretty healthy right now.
Shrtstormtrooper: Mkay, thanks. I'm going to go spend three hours putting your history in, I'll be back.

Eh. Healthy as a sick horse, I guess.

Babysitting

So it's a well known fact that I'm not a big fan of children. They don't like me, I don't like them; it's a mutual thing. Usually when I walk into a room containing a child, said child takes one look at me and starts to cry. That held true all throughout today. Overall, I just try to steer clear of kids and any situation which puts me in charge of kids. That said...

I had a little 14 month old patient, and no one in the ER could get an IV in this poor kid. I call peds up and ask if I can bring him over so they can try too. When we get over there, the two peds nurses turn to me and say, "okay, if you can just man the desk and answer the phones and help anyone who needs it, we'll go stick this kid." In my head I'm thinking crapcrapcrapcrapholycrapthisisbadverybad. Out loud I inform them that I'm still on orientation, and maybe it's not a good idea for me to run the peds ship for an undetermined amount of time.

The nurses assure me it's okay, and saunter off to a locked room with my patient. And there I am...by myself...at a very large nursing station that is devoid of any other professional. The phones are ringing. Parents have questions. Doctors walk through and ask me things. Visitors ring in from the hallway. I start to sweat.

Yes people, I manned the peds desk by myself for 25 minutes today. I'm not sure if that's even legal, given my lack of peds expertise. At any rate, nothing catastrophic happened, I managed to successfully answer each phone call, and avoided looking like a tool to the doctors. Whew. I hope I am never ever ever in that situation again. It's a wonder the kids couldn't smell my fear from their rooms.

Man, kids and I don't mix well.

Conservation of Energy - it's the law!

Remember that time I said I wanted to try to run a half-marathon? Well, the date is getting closer. And I haven't been running. I've thought about it a lot, though. In fact, if thinking about running was just as effective as actually running I'd be ready for the Olympics right now.

There are a lot of things that have conspired to keep me from making it off the couch and into my running shoes. First, I got my work schedule for March and I have to work the day of the race. I'd lie to you and say that I was really bummed when I found out, but I'd prefer to keep my pants from going up in flames. Second, the Fabo hurt her foot and probably isn't up for a half marathon. You can best believe that I won't be running for hours by myself. Running isn't fun as it is; running alone is even less fun. Third, I'm way too cheap to join a 24 hour gym. I went to the school gym for a while, but since the semester started back up it's been overrun by freshman girls who are more interested in wearing tiny shorts and straightening their hair before coming in so they can look good for that omg hott boy from their gen ed history class. There are some actual good athletic girls in there too, but I feel a little schlubby next to them - it's sort of embarrassing when you're huffing after only a mile or two on the elliptical and they've been running for 17 hours already without breaking a sweat.

The biggest reason I haven't been running, though, is the weather. I'm a warm weather girl - when it drops below 65 I start to get cranky. So this whole 24 degrees outside thing isn't really my cup of tea. I'm also a very economical person. Why buy cold-weather running gear when you can just stay inside where you're already paying for heat? You may think I'm lazy, but I feel I'm just conserving body heat in these hard economical times.

Overall, I think I'm getting the best of every end of the deal here - I stay warm, my bank account stays happy, I eat cheetos, and I don't have to fight off freshman for an elliptical machine. When the weather warms up and the threat of bikinis can't be ignored anymore, I'll get my butt into shape. Until then, I'll stay warm - and maybe a little chunky.

Operation Stay Smart

Yo Mama's so fat, Ben Kenobi said "That's no moon...that's your mother!"

I think yo mama jokes are probably one of the most highbrow forms of humor out there. If you're a fifth grader. But even so, a good yo mama joke requires skill, wit, and a certain level of intelligence.

segue into relevant story...

I recently read a book called The Know-It-All, and it was very funny. The level of funny was about par with a well-executed yo mama joke, in fact. But what ties this tidbit into my overall story is this: AJ Jacobs, the writer, decides he wants to read the entire Encyclopaedia Britannica from a-ak to zywiec. Why? I'll let AJ explain.

"I used to be smart. Back in high school and college, I was actually considered somewhat cerebral. I brought D. H. Lawrence novels on vacations, earnestly debated the fundamentals of Marxism, peppered my conversation with words like "albeit." I knew my stuff. Then, in the years since graduating college, I began a long, slow slide into dumbness. At age thirty-five, I've become embarrassingly ignorant. If things continue at their current rate, by my fortieth birthday, I'll be spending my days watching Wheel of Fortune and drooling into a bucket."

AJ also talks about how the most important thing he can remember from college is that a burrito left on the floor for five days is still edible, but only if you chew really hard. He laments his loss of knowledge, and wonders how he can possibly become smart again. It's a good read; I highly recommend it. But I digress.

Everyone knows the old adage of "use it or lose it," and this definitely applies to me. I haven't cracked a nursing text book in two months, and sometimes I find myself unable to think of an anatomical part or drug side effect or the proper name for a butt-foley (to this day, I can't think of the correct name for that last one. I'm not all that concerned though because butt-foley has to be way more fun to say.) Will all of my nursing knowledge slowly slip away? Of course I'm learning more and more practical things since I've started working, and I am slowly becoming well-versed in relevant important meds and information, but the little obscure details from nursing school will surely filter out. There's only so much room in the brain, after all.

This is kind of alarming. I paid a lot of money for my education and textbooks, and I don't want to see that information ooze away. Of course I'll keep myself well-knowledgeable about the very important things and those which I see everyday, but it's going to be sort of sad to say goodbye to the minutae from school. Our professors harped over a lot of little teeny things, and I feel rather saddened at their imminent passing.

I suppose the only way to prevent my own slide into dumbness is to keep reading like it's my job. I don't really want to have homework ever again, but it's important to keep up-to-date on what is happening in the world of nursing. I just joined ENA and will be getting their journal and newsletters, which I think is a nice little baby step into keeping myself current. And as much as I hate to do it, I have decided that I'll crack open my textbooks every now and then and read up on a topic that I've gotten fuzzy on. My mission: avoid dumbness.

After all, it wouldn't do to have your nurse drooling into a bucket while taking care of you, would it?

Wedgies and work

Today was a good day!

I'm getting the hang of procedures and standard protocols in the hospital, and I managed to hold my own in Trauma today. Granted, I had no trauma patients...but I did do a ton of cardiac workups and admitted people and generally didn't cause any harm. Hooray for learning things!

Also, this article caught my eye while I was perusing the evening news. And it's GLORIOUS.

Woman wields wedgie to subdue subject

It just makes me smile inside. Who doesn't love a good atomic wedgie?

Life lessons

I have learned two very important lessons this weekend:

1. I, under no circumstance, ever want to be a charge nurse. I mean, that job blows. What do you do when you have four ambos coming in, a diabetic coma patient that just rolled into triage, a respiratory distress in a wheelchair in the hallway, and an electrocution...all at one time....when you only possess a precious few trauma rooms? I tell the charge nurse and return to my station. She tells herself she is going to go crazy.

2. Triage sucks anus. A lot of anus. People just keep coming and coming and coming and after the 85th abdominal pain with vomiting or sore throat with cough, you just don't give a crap. Until you're elbow deep dealing with said hallway wheelchair respiratory distress patient and there are 38 other people who need to be triaged and you don't have a room and someone somehow finds you in the hall and politely informs you that their mother is in a diabetic coma in the back of a big ass Explorer in the freezing parking lot. Then you have to care, but you sort of don't want to.

I hate triage. I don't want to be a charge nurse. That is all.

Magnet-Ball Vitals

Crass Pollination recently posted on a volunteer that was in her ER, and how terrified the volunteer was to go in and speak to an actual patient. That got me thinking about my very first day of nursing clinical. I'd like to say that I went in and conquered, knew what to do with those patients, and won the everlasting praise of my instructor. Alas, that's not how it really went.

If you've ever watched a little league soccer game, you know what I'm talking about. It's jokingly called "magnet ball" because all the little kids just chase after the soccer ball and whoever happens to be closest kicks it in no general direction, and everyone takes off again behind it. That's kind of how we were, except the ball was our instructor and instead of kicking her we bathed patients.



Instead of being in the hospital right away, our clinicals started out at a local nursing home. Our instructor has us keep journals of our whole semester, and I'd like to share with you the spoils of my first day. Enjoy!

I started with vitals on Mr. W. When I was standing in the hallway, a nurse walked by and asked me to get his vitals so I really had no chance to put it off any longer. I went in and explained what I was about to do, but had some trouble. Thanks for helping me out with his BP. I think I just sort of got overwhelmed and couldn't think straight.

After the vitals were done, I got to give him a partial bath. Again, thanks for helping with getting Mr. W undressed. I didn't want to hurt him and didn't quite know how to do it otherwise.

I then went to the other hall and found the rest of our clinical group. I helped J bathe her patient. It was so different from the previous two patients. The nurse wasn't there, there were three other patients in the room too, and there was that feel of first-time student nurse panic. One patient kept yelling, one was completely silent, and one kept talking about nipples. It was very overwhelming.

Blah blah blah, moral of the story is: Be nice to nursing students! We don't know how to do anything, and talking to patients is scary. It didn't stop being scary until about 8 weeks into the semester.

Whew. I'm glad those days are in the past. I now don't hesitate to strip a patient naked, it only takes me 90 seconds to get vitals, and I've heard far worse than innocent nipple talk. And oh yeah, I've got a brand new RN after my name. Yes sir, I've come a long way. Huzzah!

Balls of Steel

While watching the Superbowl halftime show, I was amazed to see the Boss take a crotch shot from a camera and keep on rocking. In fact, rather than get hurt, he probably took out that cameraman's eye with his junk. I mean he is the Boss. And that means his junk is pretty boss too.

Anyway, I caught this little clip from the Daily Show and it made me smile all over again. Because usually it's the ball-smashee who crawls away from an encounter. This time, however, the Boss took a smashing and inflicted more damage than previously thought possible - on the smasher.

The Daily Show With Jon StewartM - Th 11p / 10c

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Long day

I don't like watching people die.

It's fun to work on traumas, especially the ones where blood and meds and gloves and cardiac pads are flying every which way; it's not fun to end the code and realize you're looking at a middle age woman who arrested while her husband drove her to the hospital. It's fun to work a massive resuscitation where a chest is decompressed and a femur is sticking out of the skin like nobody's business; it's not fun to end the code and realize you're lookng at a 25 year old kid who lost a motorcycle vs. car battle while her fiance drove the car behind her. And saw it all happen.

Egad. I just don't like death. It was a hard day. But I am still loving this job.

On a brighter note, wft? Surgeons remove kidney through vagina. You know you want to read it...

****
MDOD also posted on the vaginal removal of kidneys. I might have posted it first, but they posted it funnier.

"Removing one's internal organs through one's vagina may not appeal to you. The doctor who removed a donor kidney "trans-beaverly" thinks differently."

Yes sir, you win.