Monday, December 10, 2012

Fast track....or not.

I was relieved to be assigned to fast track for a shift. I'm usually assigned the trauma rooms along with the other critical care areas, so it was a nice change of pace. The nurse who normally is assigned there protested a bit.

"I thought you hated working there."
"No, I never get assigned to fast track. I never said I hated it."
"I thought you only liked working with the critical patients."
"No, I always get assigned to work the critical rooms."

What I wanted to tell this nurse is that the charge nurse feels like she couldn't handle the critical patients and that's why she doesn't get assigned there. The charges have expressed that sentiment. There are a couple of nurses who fit that description and I think it does a disservice to them.

I happen to disagree with it. If you're going to be an ER nurse, then the nurse should be able to handle all types of patients - not just the weenie cases. Those that don't have the experience need to be assigned the typical critical care beds and have a strong nurse willing to help them. It makes the nurse stronger and the unit as a whole. But what do I know? I'm not a charge nurse. But if I was......

All of my patients were either on shot time, waiting for discharge or waiting to be sutured, so I had an open bed. I figured I'd help the triage nurse out because she had a bunch of doc office type patients in the lobby waiting to be triaged. I plucked out the longest waiting patient and brought her back to the available bed.

She was a wispy, bone thin woman. I started taking a good look at her while typing in the triage information in the COW (computer on wheels). Emaciated, scabs all over her face, bad teeth, long sleeve short on a warm day. I concluded she was a meth addict and possibly IV drug user. She had a wound that I originally thought would need sutures then discharge.

"I hate the hospital. I didn't want to come here."
"I understand. Let me see where you're hurt."

Shit. What I saw wasn't a fast track type of wound. She would need surgery. Great. That blows my whole 'bring you in, get you out' type of fast track flow.

She denied all of the drug use questions - of course. Patients always lie about it, but we're going to find out about it anyway. Why don't they just fess up in the beginning? It would make it easier for everyone involved.

So....fast forward to when I was told that the OR team was on their way NOW.
"Where's the dang chart? If you want her ready for surgery - I need it now."

When I finally get it in my hands, I roll my eyes. Couldn't the NP say anything to me about all the extra crap I have to do before calling the OR team? Nah, that would be too easy.
I went to the patient and started drawing some extra labs ordered and hanging her antibiotics.

"I'm really scared. I don't want to stay overnight. Can't they just let me go home afterwards?"

It was then that she confessed all of her drug use.
"I know."
"How do you know about that?"
I told her and she was blown away.
"Did you tell the surgeon who is in here talking to you?"
"No."
"Well, he needs to know. You'll have to stay in the hospital after the surgery and he needs to know how to take care of you. I'm not judging you, but if you go cold turkey on these drugs, you'll run into more medical problems while you're here. I need to tell him about it for your own sake."

She was whisked away by the OR nurse. As she left, she thanked me for being nice to her.
It made me think. Here was a person who didn't want to abuse the system to get her drugs, but really needed medical care because of a simple accident which grew into something worse because she was afraid of being morally judged by us.

Sometimes it's little scenarios like this that change one's thinking.

Thursday, November 22, 2012

Beauty Salon

When I worked in the ICU, I worked nights. Normally, it's as busy as days - emergencies come up, dementia patients become disoriented, critical patients mysteriously have perfect timing to start crashing.

This particular night, it was the "q" word. We learn never to speak it's name. The place wasn't full of patients.  I had 1 stable patient and the other was iffy. The iffy patient never had family visits. I went into her room to assess and spend some time with her. She had dementia, but tonight she seemed incredibly lucid.

I peeked in on my other patient, stable and sleeping. The other nurses were reading books and playing on the computer. It was a "q" night.
I went back into my patient's room and sat down to talk with her. It looked like she hasn't been bathed in a long time, she smelled bad and was completely disheveled. Personally, I can't stand that. Wherever she came from, they weren't doing a very good job of taking care of her. You can just tell by her hygiene.

I ran around getting all of my items to clean her up. I spent over an hour in her room washing her hair, doing mouth care (which I absolutely hate doing because it's one of my weaknesses - oral care. It can be disturbingly gross.), bathing, changing her gown and bedding. I had a nurse come in and check on me because I had been gone so long.

Once I was done, she looked good. She actually didn't look as sick as she was. We talked about her life and she told me some interesting stories about her past. I joked that she looked so good right now, we should go have a night on the town. She agreed and said when she felt better, she wants me to drive her to a place where she can sing again. I told her I'd be back on shift in 2 days and I would see what we could do about singing. She was happy and thanked me for a nice night. She fell fast asleep.

When I returned to the ICU two days later, I didn't see her. Her room had another patient in it. I asked the day nurse during handoff report where was Mrs. So and so?
"Oh, she died yesterday morning."
"Oh."
She died a few hours after our beauty salon night.
I was sad, but I felt comforted knowing that her last night on this earth was a good one. I was happy that we had that time together.

Tuesday, November 20, 2012

Defense

I already had a good rapport with a stable patient who had a previous stroke and experienced expressive aphasia as a deficit. (For the non medical people: it means the patient understands language, but cannot speak the words that he/she means to say.)

I popped my head into his room because I wanted to check on him quickly. I had some situations arise and I knew I would not be back for a while. I guess some other family members arrived while I was out of the room.
"Hi Mr. Soandso. Are you feeling any better after the medicine I gave you?"
He shook his head for yes.
I proceeded to tell him I would check on him later and that is he needed anything, all he had to was call. I was pretty much in a rush, so I started to head out the door.

The one family member there jumped up and stated, "He can't talk. He had a stroke."

"Yes, I already am aware of that. We've been communicating though." And I left the room, jotted some notes on his chart.

The woman approached me in the hallway. "What's your name?" I told her. "You were really defensive when I told you about how he couldn't talk. And you kept talking to him."

What I said: "Well, I'm sorry if you thought that. My intention was not to appear defensive."

What I wanted to say:

Ma'am, stop wasting my time right now with your petty hurt feelings. I don't have time for this. What you misconstrued as defensive was me trying to juggle 40 balls at one time - if I didn't even pop my head in there for a minute, he wouldn't have seen me for hours. Yes, I'm going to talk to him. I know he can't speak in complete sentences, but he understands. I talk to many patients that I don't know if they are mentally there - people in comas, post resuscitations, etc. It's called respect.

I just got done telling a mother that her child's symptom is cancer. She's in complete shock and is dealing with the horrible news by lashing out at her nurse. I don't enjoy it, but ya know something - she has an excuse.
In the other room, I have a patient that coded an hour ago and died. I have yet to talk to the family. I went into the room and saw that no one helped me out by cleaning up the body a bit. It was a very messy death. How can I let the spouse go in and see his loved one like that? I had to clean her up quite a bit and set up the room so her spouse can say goodbye.
As I running about for those patients, I had to check that the kid with a bleeding wound had enough gauze and pressure so his bleeding was controlled.

So, your delicate temperament is really, really low on my priority list.
Oh, and since you're giving me grief, I'm enforcing the one visitor policy rule - please head to the lobby.
<smile>





Saturday, October 20, 2012

Wednesday, October 17, 2012

Maybe I should have been a plumber.....

I'm all for chipping in, going above and beyond for the team, and working hard, but this was a little too much.  I arrived to work before 7 and eyed the patient board. We already had a full load of patients. Not a very good start to the day. My hospital recently decided, in all of its wisdom, that a normal load of nurses is not needed between the hours of 0700 and 1100. So, they have cut us back to a charge, triage and 2 other nurses to handle the entire department. Brilliant!

As I was getting my report from the night nurse, it didn't seem too bad. I had a new patient in one room - stable and pretty simple with regard to chief complaint. My trauma room had a post moderate sedation who should be discharged within an hour, maybe hour and a half. As I was getting the report, I heard the fire dispatcher on the radio send an ambulance to an unresponsive person. I start checking on my patients and doing the normal morning equipment checks.

10 minutes later, an ambulance comes in and fills my other room. After triaging this person, my charge comes to me and states that she will be using the other unassigned room for a code (the unresponsive person call).
Now, since we don't have enough nurses to cover the ER and run a code and watch my post sedation - we're in a pickle and have to get the trauma coordinator to leave her office and help.

Code comes in and its pretty much a done deal. As I was working that code, the triage nurse fills up all of my other rooms with not so stable patients. Next I discover that my charge has now assigned me the code. Although the patient is pretty much stable (dead), I still have to deal with paperwork, family, notifications, etc. Now I have 5 patients with all immediate needs. I wish I could have been there for the family members, but I couldn't. I had to delegate that to the pastor and administrators arrived to help. The post sedation patient was flippin' mad about not being able to go home yet, but the more she yelled - she had an airway and was coherent enough to understand her situation - she's stable. The other patient, threw some pillows at her and told her to elevate her limb and chucked the cast cutter in his room. Eyeballed the other patient and she looked like her bleeding was controlled a bit - not going to die in the next hour. Then I went to my new patient and started working on her - she could go down hill quicker than the other ones.

I'm whining, I know, but it's all a bit much when you can't actually do the job as well as you would like to do. In nursing school, they fill your head with all kinds of crap about therapeutic communication and nursing theories when in reality, you will never get to implement them because of all you have to do. You're set up to fail.

No one died, thank God (well, except the code, but that person was already dead). It's just there are many more days now that it just.....well, sucks.

Wednesday, October 3, 2012

100 and Counting...

I walked into my new patient's room while looking at her chart and prepared for the worst. She was a 100 year old lady with a chief complaint that I knew would warrant a hospital admission.
I was shocked when I walked into the room. The patient appeared to be in her late 60's. I looked down at her chart again to verify the age I thought I had read.

"Yes, I'm 100 years old dear. I don't think the people I spoke with earlier believed me."

Her daughter was bedside and I thought she was older than the patient. I started talking to the patient and began my assessment.
"When did you last eat?"
"I only had 2 cups of coffee this morning. I like my morning coffee."
"Me too, but I haven't had it yet."
"Oh sweetie, you really should get your coffee in the morning, it really perks me right up."

"What medications do you take?" I waited for pages of meds to list.
"Only 3....."  Really? Wow. I've had patients who were my age taking pages and pages of medications.

"When was the last time you were in the hospital?"
"Oh, not too long ago....in the late 1970s"
   "No Mom, it was in the 1980....I think 1988."
"Oh yes, that's right 1988. I can't believe I'm back here again."

My LOL (little old lady) was spunky, sharp as a tack and had a keen sense of humor that I took full advantage of.

As I was starting her IV, I asked her, "So, Mrs Soandso, would you tell me your secret to looking so young and being a vibrant 100 year old."
"Umm, I don't know."
"That's okay, don't tell me your secret then. You're keeping it to yourself. I see how you are."
She laughed and gently slapped my arm.

Then she asked, "Do you think the doctor is going to keep me here very long?"
"Well, I believe so. Your doctor wants you to be admitted to the hospital."
"Hmmm, what if I just jumped up and ran out of here?"
"If you're going to jump up and run out of here with all of these wires attached to you then let me know first. I want to get my cup of coffee and sit here and watch you do it."
"You want me to be your entertainment this morning? I'll oblige."
"Mrs. Soandso, you're already entertaining me!"

What a sweet, spunky lady. I have no doubt she'll live a lot longer than 100 years. It's so refreshing to have a patient like this. You have no idea.....

Friday, August 31, 2012

Paging Dr. Ass

A patient arrived by ambulance for some very minor injury, very minor. She was triaged at an ESI level 4.
I got her situated in the room and told her that her chart would go into the doctor's rack. She would be seen soon.

"How long is soon?"

"As soon as a doctor picks up the chart and comes into the room. I don't know what patients they are seeing right now, but you will be seen soon."

"You tell the doctor to get his ass in here now!! ASS HERE NOW!!"

"I'll relay your message..."

I told the doctors in their computer room what the patient had said. One of them took the chart, looked it over, and placed it back in the rack.
"I'll be in there later.....I just ate lunch and my ass will be ready to talk to her in about an hour."

Tuesday, August 28, 2012

Waaawa Waawa Wawaaaa....

I was assigned to triage the other day. In one of my previous few entries I've written - it sucks the ever loving life force from me and transforms me into a bitter shell of a person. Like I enter the triage area a plum and leave a prune, like a grape to a raisin, like a .....you get the idea.
After a few hours of it, all patients begin to sound like the adults on Charlie Brown/ Peanuts cartoons....Waaawaaa  wawaaawa   waaaawa.

I have 3 people at this point to triage and look out of the door to eyeball them. The one I was going to take next is laughing, playing with her phone and ignoring her children who were running around the waiting room.
So, I took someone else.

When I got to her, she walks in with her 2 rambunctious kids and her husband/boyfriend/babydaddy/whatever (H/B/BD/W). Both can't bother to look up from their phones. I start triaging her and she still won't stop texting or surfing or whatever the hell she was doing. I told her she would have to get off her phone during the triage time, cells phone are not allowed to be used during triage.

"Here, finish my e-mail to the DOCTOR'S OFFICE about how SICK I AM." and she hands her phone to H/B/BD/W. Then turns to me with a disgusted face and says, "WELL..."

H/B/BD/W who can't take his eyes off of his own cell phone mumbles something.
I ask him to repeat what he said because obviously it was directed at me.

"If you gonna be rude then we can go somewhere else. We don't have to go here."

"No, you don't. Our policy is no cell phone use in the triage area" <He's still not off the frickin' thing> "That is why I asked you to stop using it. Do you want me to continue or are you going to leave?"

I triaged her and sent them back to the lobby to wait since they had so much texting and e-mails to send.
She went right back on the damned thing and he never looked up once.
I secretly wished that they would trip over something while looking at their phones, so I could have had at least one laugh that day.




Monday, August 27, 2012

Testicles, Girlie, testicles!

I walk into the patient's room after seeing his chief complaint and had time to start the ball rolling before the ER doc came into to see him.
He was in the bed, crumped down with a scowl on his face. He was like the typical cantankerous old poops I've been dealing with lately.

"You gonna take my blood?"
"I'm going to start an IV and draw blood."
"Good luck with that. Are you any good? No one gets me on the first try. I have crappy veins."
I began to look at one arm, getting the lay of the land so to speak.

"I asked you are you any good? Haven't you found anything yet? Ahh, you're not going to get it."
"What's your hurry? I'm looking at your arms. Let me do my thing"
I asked him about his pain while looking.

"It starts here and goes down into this testicle. Girlie.......testicle. Testicle! Do you even know what a testicle is?"
"Ummm, no. I missed that day of nursing school. Is it like a tonsil?" I smiled at him and I saw a glimmer of a smirk back. His wife had a great sense of humor and laughed.
"You're going to totally not get this IV. Are you good at it?"
"I guess we'll see....they usually only let me clean the rooms, but the nurses said I can stick you with needles today."
I got the IV - no problem.
"Well, damn. I didn't think you were going to get it."
" No, you didn't"
"What? What did you say?"
"I said - In -Your- Face! Mr. Poopy Patient. In your face." I said this as I bundled him up like a little baby in a bunch of warm blankets. "There. Now you're almost cute."
"Get the hell outta here," he said with a smirk.
"Oh, I'll be watching you.....I'm watching you..."

I love my little cranky ole male patients. I'd like to smack them upside the head, but it's fun to try to turn them into smiling cranks.





Tuesday, May 29, 2012

Holiday Crud

I've been sick the past few days which has been inconvenient due to the holiday weekend. It started Saturday night and went into full bloom on Sunday. I had to work Sunday. As the day slowly ticked by, I felt worse by the minute. My charge nurse tried to get someone in to replace me, but no one would answer the phone.
I don't blame them, we have been consistently short handed and everyone has been working OT to the max.
So, with no other choice, I soldiered on, caring for people far less sicker than I was.

The ER doc, Dr CoolGuy thankfully was working and wrote me a script for Tamiflu. It sure felt like the flu. I waited for the end of the shift wondering if the hospital cared if I was possibly exposing my non sick patients and transforming them into future sick patients. <shrugs shoulders> Probably not.

Dr. CoolGuy and I have a taste for the same kind of soda - Diet Rite. He loves raspberry and I always have a hankering for white grape. He's able to find my kind around where he lives and I have no problem finding his around my grocery store. The first time I bought him a 12 pack of raspberry, he offered to pay me.

What?! No! "Quid pro quo douche bag!"  I said in my best imitation of Mr.Chow from The Hangover.

We have an understanding. I bring him his, next time he brings me mine. If he gives me a pity script, I pay with Diet Rite. I owe him a 12 pack for this one.

Now it's Tuesday and I'm still feeling like a big ball of crud. Better than before, but crappy all the same. The true diagnosis has presented itself, so I tried to make an appointment with my doctor this morning. I need some antibiotics and a medrol pack. Perhaps my doctor's office changed how they make appointments. Usually, I have to call the appointment clerk who is this young, bitchy girl - she's downright mean. She'll argue with you until you have to be just as mean to her and then she'll give you an appointment. This time no one answered. The patient has to leave a message and is told they will call back. Surprisingly, I got a call back about an hour later. The lady had a strong Indian accent. I think my doctor started using a call service for his appointments. She asked me why I wanted to see the doctor. After I told her, she was confused, "What?"
"I'm sick."
"All right, you can have an appointment at 3:15."
Is that what offices are doing now? Using call services? I'm wondering if mean girl will be there to take my copay or I'll just have to swipe my card at an automated self serve check in. Perhaps that's why some people use the ER as a doctor's office - it's so difficult to see their PCP.


Friday, May 25, 2012

House Calls by Dr. Finger

A patient comes into the ER with chest pain.
His wife is bedside and both had awesome personalities. I start the usual workup: assessment, IV, blood work, 12 lead, ASA, NTG. Racked the chart and waited for the doc to do his assessment and orders.

When I received the chart, I noticed something out of the ordinary - a guaiac. For the non medical readers, this is a test where stool is smeared on a card, chemicals are placed on the card to determine if there is occult/ hidden blood which means that there is bleeding somewhere in the gastrointestinal tract.

Perplexed, I asked the patient about it. He mentioned that he told the doctor he noticed a small amount of blood in his BMs recently. Okay. I informed him what I would have to do in order to get the sample and why I was doing it. I quickly got my sample.

"Hey doc!" He shouted out.

"No, I'm your nurse. Are you all right?"

His wife was next to him smiling. "When you stuck your finger in my ass, my chest pain stopped immediately! I feel so much better."

"I'm sure the medication I gave you started working."

"Nope. It didn't. It was your magical finger!!"

Later, after going over the discharge instructions, the patient's wife asked me if they could get my home phone number. Both of them were smiling as she said, "This way, if he has chest pain again, you could come over and stick your finger in his butt again and make it go away. He really hates coming to the hospital."

I looked at my magical finger, imagining all of the power it must possess.

Then I wondered how much I would charge for it to make house calls.....



Thursday, May 24, 2012

The Costs of Stupidity

Last week, my Dad was visiting from my home state. He stays about a week for his yearly visits. He normally makes his trip in July, when the weather is sweltering hot. The temperature is comfortable for this time of year, but the thermometer is gradually climbing which means turning on the A/C switch.

One morning, I walked out of my bedroom. "Does it seem warm in here to you Dad?"
The temperature control showed the air conditioning was running, but the thermostat reading did not confirm that it was doing any good. I started to investigate.

Circuit breakers - none tripped
Outside unit - running and clean, no debris around or in unit noted
Wiring - intact
Copper tubing - not stolen, no ice
Attic thingamajig - switch was on and running
Jumped up on the counter to feel the air vents - cool air, but hardly blowing

I called my hubby to tell him that I checked everything I knew to check and couldn't figure it out. I called the A/C people and a time was scheduled for the next day.

The next morning, this kid (20's) showed up and started doing the same checks I performed yesterday.....except for one.

"Did you change your filters?"
"Huh?"
"Your filters? When was the last time you changed them?"

I looked at my husband. "You changed them after the contractors put the hardwood floors in last week, right?"
"No. I thought you did."

Ugh.
I replaced all 3 filters in the house with the kid smirking a bit. He then went around and measured the airflow and temperature.
"It seems all right now. That'll be $____"

I wrote him a check and handed it to him, visibly peeved about the filters.
"Thank you ma'am. Next time you may want to check the filters before calling," he advised with that damned smirk.
I felt like telling him, 'well, yeah - no shit.'

My Dad sat there with a similar smirk on his face. "I don't want to hear it from you too, old man." I said jokingly. The smirk never left my Dad's face.

Perhaps this is a sign.
A sign from God warning me to think nicer thoughts when my patients do really, really stupid things.......

yeah, I didn't think so either.









Wednesday, May 23, 2012

From the Mouth of Babes...

I was a guest speaker at my kids' elementary school career day. I spoke to children in grades K-5th grade. It was an amusing experience. Some grades seemed to be fascinated by only one subject, asking questions that spurred more questions on only that one subject. The popular questions involved blood and guts, "gross stuff", strokes, and dead people.
My daughter returned from school proudly stating that all of the kids really liked my presentation except one fifth grader said "it sucked". My daughter was upset by this. I comforted her by saying, "Well, not everyone is going to enjoy it, that's okay." It didn't work. So, I said, "He's probably a turd who doesn't like anything." For some reason, she was satisfied with the boy being a turd. Mission accomplished.

Here are some of the endless questions asked by the kids:

"Do you know Jessica?"
"How many dead people have you seen?"
"Is it gross to see all of the blood and guts?"
"What is a stroke?"
"What is a mini stroke?"
"What happens when you have a stroke? Do you die?"
"Have you ever had a kid with a broken jaw? Because that was me."
"What happens when you get sick?"
"What happens when the ER is closed? Where do the people go?"
"Do you know David?"
"Have you ever had someone shot?"
"Did you stick your finger in the bullet hole?"
"What if someone pukes on you?"
"Do you take vacations?"
"What do you do with the dead people?"
"When someone has to go on the ventilator, how do you get his permission?" <this one was from a 4th grader>
"Have you ever seen bones sticking out of big cuts on people?"
"What is the weirdest thing you've seen?"
"I forgot my question, could you call on my again when I remember?"
"Can people leave the ER and then come back the same day?"
"Do you have to touch boogers? I can't deal with boogers."
"Have you ever had a patient named Ann?"
"Do people ever die in the ER?"
"How do you work around all gross people everyday?"
"Do people come in for spider bites?"
"I like bugs. I went to the ER for a spider bite. Do you remember me?"
"My mom works in the ER and she comes home and tells me about all the mean and stupid people. Do you know her?"

It was very enjoyable!


Thursday, May 3, 2012

Another Shift, Another Day...

I've been a naughty nurse and haven't posted in a long time. Actually, I have been busy with construction on the house, shuttling kids to and fro and my seemingly endless pursuit of more degrees. Also, I've been just plain ole uninspired to write anything.

I split a shift with another nurse so she could see her kid's baseball game. I thought it would be a nice, quick few hours until I found out she was assigned to triage. Triage, for me, literally sucks the life force and compassion from my body and leaves me a bitter shell screaming inside my mind...."Really? REALLY!!!?"

The amazingly trivial things people come to the ER for is mind blowing.

Once I arrived, I started the cattle call of patients to be triaged: a scraped knee, a cold, a panic attack....pretty much a sea of ESI level 4s that any doctor's office, urgent care clinic, or Mom kissing a boo boo can handle.

The most interesting and serious case was an insect bite.

"Do you take any medications on a daily basis?"

""Just my vitamins""  the patient was 77 yrs old.

"Do you smoke, drink alcohol, or take any illicit drugs?"

""Oh no, no....but I'm thinking perhaps we should all start.""

This brought a smile to my face and the patient turned out to be what I deem "a spunky chick". I enjoyed my short time with this patient and wished I could go back to the rooms and be her nurse. We'd have fun.

About 5 minutes prior to shift change, a registration clerk approached me as I was returning from bedding a patient.
"I tried to get someone from the back to look at this child."

"What's wrong with her?"

"She has a cut and the parents don't speak English."

Okay. I walked out to the registration desk and immediately became alert. The kid was limp, fixed gaze, covered in blood, deep laceration to the head, and with agonal respirations. "A cut" was an understatement of this kid's condition.

I'm wondering why ER registration clerks aren't required to take some basic first aid or perhaps a class on noticing when a person is in a life threatening situation. I'm not blaming the clerk, just wondering how long the family was standing there as I was bedding a patient. I'm sure if the clerk had emphasized the urgency to which this patient should have been seen, the other nurses would have dropped whatever they were doing and re-prioritized. Because they certainly did when I grabbed the kid, yelled for a trauma code and started working the patient in a trauma room.

I'm still praying for that kid - I hope she lived with neurological function intact.
However, after taking a look at the CT with the Docs, I don't think there's much of a chance....

Friday, February 17, 2012

A Day in the ER

A day in the ER:

Patient arrives via ambulance, ESI level 2

Pt:    Can I get a blanket? And some coffee? Maybe something to eat too, I haven't eaten all day.
RN: You can't eat or drink anything until the Doctor sees you. I'll get you a blanket after I do a few <hundred> things to get you in the process of seeing the Doc.
Pt:     What are you damn nurses good for if you can't bring me food?
<Yes, I'm not good for anything, I'm just a ER waitress.>


PT's family member: Blah, blah, blah.....this is such a long wait time, we're tired of waiting, blah blah.
RN:  I'm sorry for the wait, but the ER has had an incredible surge in patients at this time. The Doctor will be with you as soon as he can. Can I get you something to drink?
PT's family member: Yes, I want a cup of coffee. Where can I get it?
RN: We have it in a locked room, I can quickly get one for you.
PT's family member: I need a medium cup.  I need you to froth the cream before adding the coffee, then...
RN: We have creamer packets, how many do you want and I'll -
PT's family member:  IF YOU JUST PUT THE F*****G CREAMER IN THE COFFEE FIRST LIKE I SAID THEN YOU WON'T MAKE A MISTAKE. DO IT LIKE I SAID AND GET ME THE COFFEE!
RN: You can get your coffee in the cafeteria, it's down that hall.

PT: Are you my doctor?
RN: No, I'm your nurse. Woul-
PT: Well, you look like a doctor. You sound like a doctor.
RN: I am your nurse. So Mr. Soandso, would y-
PT: But I think you're a smart girl, I'm going to tell your boss to promote you to doctor.
RN: Thank you, but it doesn't work that way. I'm a nurse. So, I need you to-
PT: If you're smart then you shouldn't stay a nurse - that would be a waste......
<sigh>

Patient in the room ESI level 3:
RN: Hi, I'm your nurse and -
PT: Can I get a warm blanket and something to drink? How long do I have to be here?

Patient in room ESI level 4:
RN: Hi Mr. So and so, I'm -
PT: You're my nurse? Go get me a drink and a blanket.

Patient in room arrives via ambulance:
RN: Let's get you into a gown first, so we can-
PT: Are you a lesbian? Are trying to look at my tits?
<What? no blanket and drink?>

While on the phone trying to transfer a patient back to the resident's facility, a crying woman comes in informing me that my patient pulled everything out and eloped. The facility on the phone is telling me that it is my job to find a ride home for the patient, the charge nurse tells me I have a new chest pain in my room and nothing has been done - I better get in there to meet the protocol times and the security guard asks me to watch my dementia patient because she keeps leaving her room.

I couldn't find my happy place during this shift. It made me regret not going to law school..

Friday, February 3, 2012

Flashback

I've had a stressful past 2 weeks which I don't feel like talking about right now, so I think I'll reminisce a little.

I heard about the recent new hires at the department where I once worked and discovered that their interview process is a shadow of what I had to go through to get the same job.

To get a position as an officer at this Department of Public Safety, a potential candidate had to do the following:

>Fill out a 30 page packet which took a long time to fill out. Information had to include the past 20 years of history (which at the time meant going back to grade school information).

>Once called to start the process (it took 9 months - I actually forgot about the application), a candidate had to go take a written exam consisting of general knowledge, math, critical thinking and mechanical aptitude. The exam took approximately 5 hours to take.

>If you passed, a phone call confirmed it and invited you to take the next eliminator - the physical fitness test. It was a long "workout" which was timed combining both firefighting and police requirements.
    ~I forgot how long the time requirements were, but the test was exhausting and performed without rest
       breaks.
             Ready, get set, GO! Pick up a hotel pack (weight = approximately 70 lbs), run up 3 flights of stairs,
             drop the pack. Run to the edge of the building and pull up 2 sections of hose (approx. 40lbs) by a
              rope 3 stories. Pick up hose, lift over railing, touch the floor, and the lift over the railing again and
              lower to ground in a controlled manner. Run back to the hotel pack, and run down 3 flights of
              stairs with it.

            Run to the other side of the building, climb a ladder 3 stories, touch the top and back to the ground.
            Run back around to the other side, chop a piece of wood with an axe.
            Run inside the building where there is a hose rack with 10 sections of 2 1/2" hose on the top section.
            Take each section down, stack neatly and then return them back to their original place.
          
            Run outside the tower to an area where you have to run 50 ft with various boxes and weights, then
            drag a charged 2 1/2" hose the 50 ft. Drag a 180 lb manikin.
            Now you ran to the police obstacle course area. Jump/climb over various heights of chain link
            fences, crawl through some tunnels, balance on beams and perform some sprints.
            Next, get into a patrol car - huh, I forgot what the hell I did in there - weird. Then you jump out
            and hold a training 9mm gun in firing position for 2 minutes. (This doesn't sound difficult, but after
            everything, you feel like a rubber band).
            Now you drop the gun and run half a mile.

That's the end of the physical fitness test.

>If you passed that, then you get a phone call for a medical physical and a written psychological test to see how much you hate your mother and such.
>If you pass that, then you have an appointment with a psychologist to see how much you hate your mother again.

>If you pass that, you have to wait for your background investigation to be completed. They had people visit my relatives, neighbors, friends from school - back to elementary school. Amazing.

>If you pass that, then you meet with your case investigator who asks you about everything they found out and to explain any bad thing you could have done in the past.

>If you pass that, then you are invited to have be interviewed. An interview consists of 6 senior officers of both the fire and police department. It is not a pleasant experience. They use every means possible to piss you off and play psychological games. One was "the good cop", one was the "bad cop", one asked the goofiest and strangest questions, another was the agitator.
    I was seated at a round table with all the interviewers looking at me. The started pleasantly, then one by one started asking questions. The strange guy kept asking about decapitations and described gruesome scenerios with questions. The "good cop" asked a couple of questions, was all smiles and listened to me intently. The "bad cop" asked questions with a scowl on his face, swirled around in his chair while I was talking to him, etc. I was surprised by his actions at the time. The agitator told me he saw some of my grades in college and thought I was stupid. He asked, "Are you f*cking stupid or plain lazy?" "I'm not hiring a dumbass." WHAT???!! 
Any answer to his question he called me "stupid" or "dumbass". He clearly was trying to piss me off. Situational questions, shoot/ don't shoot questions, personal questions..... The finale was the question, "Who here will vote for you being part of our "family" and who here will vote against you and why."

I walked in there looking professional in my suit and left sweaty and plainly shocked. I was lead to an office where I was offered the position.

I have never before had an "interview process" like that and probably never will again.

The officer candidates now have it easy. They no longer interview that way and I think it's a shame. It clearly eliminated those that would succumb to easy stress in the job. One guy, who actually made it to the interview part, exploded and yelled at the interviewers and stormed out of the building. I don't know what they called him. LOL.


           
           

Tuesday, January 24, 2012

5 Minutes

This was my first 5 minutes with a patient who was brought in via EMS:

"I want a drink"
"I need a blanket"
"I need someone to take my shoes off"
"Take me take my pants off"
"How old are you?
"How long have you been a nurse?"
"Why are you asking me all these questions?"
"Go get my husband"
"Where's my blanket?"
"Move me up in bed, I'm uncomfortable"
"Yes, I'm allergic to all of those 15 medications"
"I started a new medicine - a pink pill. How should I know what it is..aren't YOU a nurse?"
"Can't I have some crackers before you put all these stickers on my chest."
"I have to go to the bathroom"
"Take off my socks, my feet are swollen"
"Why aren't you doing anything I'm telling you to do?"
"I'm going to have a panic attack."
"I'm having chest pain."
"I want to be a DNR."
"Where are the ambulance drivers?"
"What's your name again?"
"I don't want an IV"
"Do you know what you're doing?"
"Are you my doctor?"
"I want a blanket, a warm one."
"Don't you already have me in the computer?"
"Don't touch that arm, I can't have anything touching there."
"Are you coming back? I need things done."

I wanted to either stab myself in the ear with my pen or duct tape her mouth shut.
Why, O, why did I volunteer to pick up that shift?


Saturday, January 21, 2012

Freakin' Sink, but Lovin' the Dremel

I've been having some problems with my sink lately, specifically my faucet. A couple of weeks ago we found out that the side sprayer didn't work. So, I picked up a new one and replaced it with the help of hubby. After a few uses, it leaked. We discovered a rip in the hose. Back to Lowes, bought a new hose. We couldn't replace the hose because the set up under the sink was strange.
Today, my brother who once was in the construction business, took a look at it. He said that it was jerry-rigged. Really? Then he discovered that the faucet itself was leaking because the plumber never screwed in the stem properly and the base continually filled with water which rusted underneath and above the counter top. Unbelievable. I never really noticed anything until recently. Oh, and my house is only 5 years old.
So presently, as I type this, I have no faucet at all - my brother had to cut it, which lead to all of these aforementioned discoveries. I despise contractors. I don't trust them.

However, I do love my Dremel! I actually forgot I had it until today. It's such a versatile tool. I need to buy some more attachments for it. I thought of some projects that I've been meaning to do and this is the perfect tool for them.

<<My Father-in-Law bought me the Dremel for Christmas one year. I think it's the same year I asked my hubby for a chainsaw for my birthday. We lived on a few acres at the time and I wanted to do some work around the place. Now I live on a golf course, not much use for a chainsaw without the neighbors complaining about me chopping up their little trees or cute front door benches.>>


It cut through the faucet nicely. The inner part is suppose to be free afterward and easily popped though the granite. Did it happen that way? Of course not! The inner part is corroded beyond belief just like the undermount. This is the reason why my kitchen looks like the entrance to hell sans kitchen faucet.
Hopefully, it'll all be fixed tomorrow.
Hopefully.....




Friday, January 20, 2012

Blogging is new to me. I have a lot to learn with regard to the layouts and "special boxes" (as I call them). I've seen some terrific blogs with additions that I'd like to develop, but I guess that'll come with time.

Hubby and I went to the bookstore yesterday and found some nice gems. We were verbally sparring most of the day like siblings who are annoyed with each other. I don't know why - I guess it was the mood of the day.
He was walking to the check out counter loaded down with a bunch of books,
"You could hold some of these books for me"
I teased him and said, "What....are you a girl?"
He promptly turned around with eyebrows raised and tossed my future purchase down the aisle with a flick of his wrist - "Piss off!" And he continued to walk on.
I could not stop laughing. I thought it was the funniest thing in the world at the time. I guess you had to be there.

I started going to a chiropractor recently for lower back pain which work naturally exacerbates. I've been feeling like an old lady for a while now. I'm truly amazed by how great I feel. No more lower back pain, no more ocular migraines, and both of my legs are now even (I've worn a lift in orthotics since high school). The difference was small, so it wasn't like I was walking around like a peg legged pirate, but I knew.
I'm a big fan....actually a HUGE fan of my chiropractor. I think everyone needs a little back cracking in their lives.