Watching this silly YouTube skit made me feel the strange sensation that we like to call "deja vu." I'm serious... I swear that I have had this same exact conversation, and with more than one patient, in my past. People kill me... they just kill me.
WATCH THIS
It's amazing how someone actually caught the hilarity of the entire situation in one computer generated skit... from what medication she was needing, to her list of allergies, to her asking for the "VIC" medication. I felt like I was at work all over again!
I would like to dedicate this to the patient I had the pleasure to deal with some time back. The patient who told us that she was at the hospital for her "pseudo-seizures." (No... I didn't ask if she knew what "pseudo" meant.) Then she complained to administration that the nurses caused her pseudo-seizures to worsen because they put ice in her water. ICE. That's what did her in... the ice. Not to mention that if you were truly having seizures, no nurse... not even a new grad, would give you something to drink OR that if you knew ice made your seizures worse... why the F*** did you drink the ice water?? She was one of those amazing and truly rare patients that could verbally communicate with us during seizure to tell us that she needed her IV shot of Ativan. So this video... it's for you lady... sorry we gave you ice.
Sunday, December 20, 2009
Saturday, December 19, 2009
Tips for putting up Christmas lights
Tip #1: If you recently had surgery on your back... which is a major procedure... I would NOT recommend climbing 10 feet up a ladder.
Tip #2: If you are going to climb up the ladder anyways... don't do it drunk. At night.
Tip #3: If you are over the age of... say 65... don't climb up a ladder. I'm not discounting anyone for their age here, I'm a firm believer that you are not old till you feel old, but seriously, you've worked hard for 65 years... just hire someone to do it. And in all honesty, if you are over 65 I imagine that you would have better things to do than spend the next month in the hospital and miss the holidays, all for some sparkly lights.
Tip #4: If you are over the age of 80 and you climb 15 feet up a ladder, then I think that you should be worked up for psychotic behavior. I also think that the person who allowed you to climb the ladder should have to be hospitalized too.
Tip #5: If you are going to climb a ladder to put up lights... consider the medications that you are on, and the risks involved. Like Coumadin, a serious blood thinner. If your doctor told you to be careful brushing your teeth because you have a risk of bleeding, I would think that falling off a ladder would be a risk to bleed (badly) too.
Tip #6: If you are going to put up Christmas lights, don't stand on your kitchen chair that you have balanced in the gravel yard. Because the gravel will win, your lights will not get put up, and your holiday photos will show two black eyes and a swollen nose. Makeup can't cover that up!
Tip #7: I think the kid down the street would like to make an extra 10-20 bucks, so pony up the money and hire the kid. Because 20 bucks is cheaper than a month in the hospital, it will hurt a whole lot less, and you will be home to enjoy the lights and not spending your holidays with me... at the hospital.
Tip #8: All of these tips are also applicable to taking DOWN the Christmas lights.
Tip #9: If you don't want to follow these suggestions, and you think it won't happen to you, please try to remember these few things when you are a patient... 1. It can and will happen to you, eventually. 2. You climbed the ladder, not me... so don't take it out of me. I'm here to help you and care for you, and I will, if you let me.
Tip #10: Have a happy and safe holiday season... and who cares if the lights get up or not!!
Tip #2: If you are going to climb up the ladder anyways... don't do it drunk. At night.
Tip #3: If you are over the age of... say 65... don't climb up a ladder. I'm not discounting anyone for their age here, I'm a firm believer that you are not old till you feel old, but seriously, you've worked hard for 65 years... just hire someone to do it. And in all honesty, if you are over 65 I imagine that you would have better things to do than spend the next month in the hospital and miss the holidays, all for some sparkly lights.
Tip #4: If you are over the age of 80 and you climb 15 feet up a ladder, then I think that you should be worked up for psychotic behavior. I also think that the person who allowed you to climb the ladder should have to be hospitalized too.
Tip #5: If you are going to climb a ladder to put up lights... consider the medications that you are on, and the risks involved. Like Coumadin, a serious blood thinner. If your doctor told you to be careful brushing your teeth because you have a risk of bleeding, I would think that falling off a ladder would be a risk to bleed (badly) too.
Tip #6: If you are going to put up Christmas lights, don't stand on your kitchen chair that you have balanced in the gravel yard. Because the gravel will win, your lights will not get put up, and your holiday photos will show two black eyes and a swollen nose. Makeup can't cover that up!
Tip #7: I think the kid down the street would like to make an extra 10-20 bucks, so pony up the money and hire the kid. Because 20 bucks is cheaper than a month in the hospital, it will hurt a whole lot less, and you will be home to enjoy the lights and not spending your holidays with me... at the hospital.
Tip #8: All of these tips are also applicable to taking DOWN the Christmas lights.
Tip #9: If you don't want to follow these suggestions, and you think it won't happen to you, please try to remember these few things when you are a patient... 1. It can and will happen to you, eventually. 2. You climbed the ladder, not me... so don't take it out of me. I'm here to help you and care for you, and I will, if you let me.
Tip #10: Have a happy and safe holiday season... and who cares if the lights get up or not!!
A new job... a new outlook
I know I have not posted any amazing stories in a while... but with good reason. At least I think it is a good reason =).
As I explained in my profile... I was becoming a slightly jaded nurse. Well, I took control of the situation and made a change. I was offered a new position and I jumped on it! So I've been busy with orientation to the new position and taking continuing education as all nurses should to continually improve their practice. So while I may not be AS jaded as I was feeling before... I've still found stupid people doing and saying stupid things.
So I'm back... and I've got stories!
As I explained in my profile... I was becoming a slightly jaded nurse. Well, I took control of the situation and made a change. I was offered a new position and I jumped on it! So I've been busy with orientation to the new position and taking continuing education as all nurses should to continually improve their practice. So while I may not be AS jaded as I was feeling before... I've still found stupid people doing and saying stupid things.
So I'm back... and I've got stories!
Thursday, November 5, 2009
TMI
We've all experienced the "Oh my God... that is too much information" moment. The TMI moment. You basically want to hit rewind... delete. Or wish for a sudden attack of amnesia. But since I couldn't do either, I will spread the wealth!
We admitted a patient last week after he was involved in an altercation and sustained a facial injury. Of course, the police showed up to take a statement and collect any information/ evidence that they needed. Due to the nature of the injury and the background information to the alteration, the police searched the patient. They found only 2 items on this patient... his ID and Axe body spray.
So the doctor, slightly jaded to these types of situations, asked the patient about the Axe body spray, "Do you huff this stuff?"
The patient (who does have gastritis mind you) responded, "No, I have sh*t-farts and I use it to cover up the odor."
WOW!!! TOO MUCH INFORMATION!!!! Rewind... rewind... rewind. Maybe a minor head injury with resulting amnesia?? HELP!
We admitted a patient last week after he was involved in an altercation and sustained a facial injury. Of course, the police showed up to take a statement and collect any information/ evidence that they needed. Due to the nature of the injury and the background information to the alteration, the police searched the patient. They found only 2 items on this patient... his ID and Axe body spray.
So the doctor, slightly jaded to these types of situations, asked the patient about the Axe body spray, "Do you huff this stuff?"
The patient (who does have gastritis mind you) responded, "No, I have sh*t-farts and I use it to cover up the odor."
WOW!!! TOO MUCH INFORMATION!!!! Rewind... rewind... rewind. Maybe a minor head injury with resulting amnesia?? HELP!
2am and bored??
I've never understood the patient that comes to the ED because of some "problem" at 2am and proceeds to tell us that the "problem" started 2 weeks ago.
You ask, "Is it getting worse? Is it different than it was when it STARTED 2 weeks ago?"
They answer, "No."
So really, 2am, in the ED, is the most convenient time for you to seek medical care? Are you so bored that you want to spice up your life with an expensive visit to your local ED? And when did the EMERGENCY part of 'Emergency Department' disappear? Because personally, I don't think that your non-worsening back pain that started 2 weeks ago constitutes an emergency... especially if you are walking around comfortably with a 2 year old on your hip and your cell phone to your ear.
So while it gives me and my colleagues job security... it still doesn't stop me from asking, WHY?
You ask, "Is it getting worse? Is it different than it was when it STARTED 2 weeks ago?"
They answer, "No."
So really, 2am, in the ED, is the most convenient time for you to seek medical care? Are you so bored that you want to spice up your life with an expensive visit to your local ED? And when did the EMERGENCY part of 'Emergency Department' disappear? Because personally, I don't think that your non-worsening back pain that started 2 weeks ago constitutes an emergency... especially if you are walking around comfortably with a 2 year old on your hip and your cell phone to your ear.
So while it gives me and my colleagues job security... it still doesn't stop me from asking, WHY?
Saturday, October 31, 2009
Ready... Set... DUCK
In my years as a nurse I've seen a lot of vomit. Not one of the perks of my job... but just a part of my job. I handle it with grace, as it generally doesn't really bother me. Not much really bothers a nurse, and if it does, you get over it real quick your first year.
But tonight... I saw something completely different.
I was helping a fellow nurse in her new patients room. He was in an accident after drinking and had broken a few bones. So here he was. He was not allowed to sit up in the bed at all, he had to lay flat in the bed (related to some of his injuries). We were cleaning him up and turning him from side to side. He is an alert and oriented patient. He knew where he was and he had the ability to verbalize with us his thoughts and feelings. However, he was not able to tell us when he decided to projectile vomit across the room. Now I have seen projectile vomiting... but this was amazing. It literally flew across the room, hit the wall with such force that it splattered all 4 walls and the ceiling. It was like a damn firework show! The lucky part of the situation was that the patient chose to turn towards his nurse... not to me. The unfortunate part of the situation was that it was rank old-alcohol-dinner vomit. UGH! So while I don't generally have issue with smell it surprised me when I started to dry heave and had to make my way out of the room. But the kicker of the WHOLE situation was that as I started to make my way to the closest phone to call for housekeeping... I noticed the other nurse in the room. This poor nurse was frozen in her tracks and completely covered in vomit. She had it in her hair... all over her scrubs... she was soaked (remember, we had no warning). I almost died.
As soon as I get out of the patients room I crack up hysterically... it's how I keep from just crying... but I can't even breath at this point. Luckily the other nurse followed me out of the room and laughed as well... think we were both in shock.
But don't worry, we got her new scrubs and a shower. The other nurse was a trooper last night... something tells me that I would have stripped down to my skivvies and gotten in my car and gone straight home to my shower OR I would have begged the ED to let me use the decon shower (and get a high pressure hose down!).
Ah... the Friday night before Halloween. How special. Mental note for next year...
But tonight... I saw something completely different.
I was helping a fellow nurse in her new patients room. He was in an accident after drinking and had broken a few bones. So here he was. He was not allowed to sit up in the bed at all, he had to lay flat in the bed (related to some of his injuries). We were cleaning him up and turning him from side to side. He is an alert and oriented patient. He knew where he was and he had the ability to verbalize with us his thoughts and feelings. However, he was not able to tell us when he decided to projectile vomit across the room. Now I have seen projectile vomiting... but this was amazing. It literally flew across the room, hit the wall with such force that it splattered all 4 walls and the ceiling. It was like a damn firework show! The lucky part of the situation was that the patient chose to turn towards his nurse... not to me. The unfortunate part of the situation was that it was rank old-alcohol-dinner vomit. UGH! So while I don't generally have issue with smell it surprised me when I started to dry heave and had to make my way out of the room. But the kicker of the WHOLE situation was that as I started to make my way to the closest phone to call for housekeeping... I noticed the other nurse in the room. This poor nurse was frozen in her tracks and completely covered in vomit. She had it in her hair... all over her scrubs... she was soaked (remember, we had no warning). I almost died.
As soon as I get out of the patients room I crack up hysterically... it's how I keep from just crying... but I can't even breath at this point. Luckily the other nurse followed me out of the room and laughed as well... think we were both in shock.
But don't worry, we got her new scrubs and a shower. The other nurse was a trooper last night... something tells me that I would have stripped down to my skivvies and gotten in my car and gone straight home to my shower OR I would have begged the ED to let me use the decon shower (and get a high pressure hose down!).
Ah... the Friday night before Halloween. How special. Mental note for next year...
The Crash Cart
So last night was by far one of the most hysterical nights of my life!!! By hysterical I mean, if I didn't start laughing (and stay laughing) I would have ended up in tears. And I hate to cry... for any reason... but especially out of frustration. At the end of my shift one of the tech's told me that I looked tired. Well.... YEAH, but thank you... I look like shit!
I will have many blog postings about last night... but I feel that I must start with the Crash Cart story... because it makes the least amount of sense to me. And it really was the starting point of my night. BTW, for my non-medical readers, the Crash Cart is the cart that they bring into the room when a patient has stopped being alive. It has the shock paddles (you know the medical shows, when they yell "clear") and all the other fun gadgets and drugs that we use to restart a life.
Well, this evening, on my ventures through my nursing unit I noticed that the crash cart was looking a little wonky... so I went to do my check on it and found that it had been opened and not put back together and locked. Which is unusual, but not altogether impossible, sometimes in a pinch we will break into the cart to find a piece of equipment that seems to be eluding us. But generally, we immediately return to the cart and replace the borrowed item with a new one and lock the cart back up. And to add to my dismay, someone had done me the favor of pulling all of the latex gloves OUT of the box and leaving them strewn all over the cart. Helpful... really. So I clean up the situation and put the cart back together. (For those of you who have had to do a cart check... tedious and time-sucking work).
So I walk up to some nurses on the unit and told them about what I found. To which one of the techs told me that he saw some group of ADULT visitors rifling through the cart.
Well... that changes my opinion of a few things... including how my friday night was going to go.
First... WHY the hell would you see something like this and not a) stop them or b) tell someone else so that they could stop them!!
Two... as a visitor, WTF do you want that could possibly be in a crash cart? And... if you were looking for drugs... the only ones that we really have will either stop your beating heart, start your non-beating heart, put you in a coma (which will stop your breathing), and other such non-entertaining medications. And to top it off, the drug section of the cart... which is the visible TOP of the cart, is still sealed and safe. So the visitors were rifling through the drawers for what??
Three... who has the balls to just break into a cart in a nursing unit with people milling around 24/ 7, looking for some unknown medical equipment. (But then again... they did it, witnessed, and got away with it.)
And Four... these visitors were adults. Adults!!! Aren't they supposed to know better?? Another fine example.
So... deep breath... WELCOME FRIDAY NIGHT.
I will have many blog postings about last night... but I feel that I must start with the Crash Cart story... because it makes the least amount of sense to me. And it really was the starting point of my night. BTW, for my non-medical readers, the Crash Cart is the cart that they bring into the room when a patient has stopped being alive. It has the shock paddles (you know the medical shows, when they yell "clear") and all the other fun gadgets and drugs that we use to restart a life.
Well, this evening, on my ventures through my nursing unit I noticed that the crash cart was looking a little wonky... so I went to do my check on it and found that it had been opened and not put back together and locked. Which is unusual, but not altogether impossible, sometimes in a pinch we will break into the cart to find a piece of equipment that seems to be eluding us. But generally, we immediately return to the cart and replace the borrowed item with a new one and lock the cart back up. And to add to my dismay, someone had done me the favor of pulling all of the latex gloves OUT of the box and leaving them strewn all over the cart. Helpful... really. So I clean up the situation and put the cart back together. (For those of you who have had to do a cart check... tedious and time-sucking work).
So I walk up to some nurses on the unit and told them about what I found. To which one of the techs told me that he saw some group of ADULT visitors rifling through the cart.
Well... that changes my opinion of a few things... including how my friday night was going to go.
First... WHY the hell would you see something like this and not a) stop them or b) tell someone else so that they could stop them!!
Two... as a visitor, WTF do you want that could possibly be in a crash cart? And... if you were looking for drugs... the only ones that we really have will either stop your beating heart, start your non-beating heart, put you in a coma (which will stop your breathing), and other such non-entertaining medications. And to top it off, the drug section of the cart... which is the visible TOP of the cart, is still sealed and safe. So the visitors were rifling through the drawers for what??
Three... who has the balls to just break into a cart in a nursing unit with people milling around 24/ 7, looking for some unknown medical equipment. (But then again... they did it, witnessed, and got away with it.)
And Four... these visitors were adults. Adults!!! Aren't they supposed to know better?? Another fine example.
So... deep breath... WELCOME FRIDAY NIGHT.
Monday, October 26, 2009
911... what is your emergency?
So when you call 911, they will always ask you "what is your EMERGENCY?"
I'd like to know how a 40-something patient explains that her 'emergency' is that she had a "cough that started yesterday and was bothering her" with a straight face.
She was alert and oriented, ambulatory, and without mental deficiencies. Although I'm prone to not believe the last characteristic to be true.
But she called 911... she was dead serious... she took the ambulance in... and she would not leave when they wanted to discharge her. She made the ED docs life such hell that they finally admitted her.
And as you guessed it... she did not have medical insurance AND her cough was creating her so much pain that she needed some narcotics as soon as possible. LIKE NOW!!!
I'd like to know how a 40-something patient explains that her 'emergency' is that she had a "cough that started yesterday and was bothering her" with a straight face.
She was alert and oriented, ambulatory, and without mental deficiencies. Although I'm prone to not believe the last characteristic to be true.
But she called 911... she was dead serious... she took the ambulance in... and she would not leave when they wanted to discharge her. She made the ED docs life such hell that they finally admitted her.
And as you guessed it... she did not have medical insurance AND her cough was creating her so much pain that she needed some narcotics as soon as possible. LIKE NOW!!!
Monday, October 19, 2009
Mesh panties
So the other day a patients family member came out to the nursing unit and asked if we had underwear for the patients.
The nurse informed this "wife" that we only had one-size-fits-all mesh panties for the female patients on their menstrual cycle (to hold the sanitary napkin in place... duh). Ick... I know. Sorry.
So the "wife" went away for a while. Later she showed up again requesting these mesh panties. Well... we already explained what they were so we handed them over without question. (Although we were all very curious!)
Later in the shift the nurse entered the MALE patients room and found the patient lounging around in these mesh panties.
EEEWWWWW! and Why??
The nurse informed this "wife" that we only had one-size-fits-all mesh panties for the female patients on their menstrual cycle (to hold the sanitary napkin in place... duh). Ick... I know. Sorry.
So the "wife" went away for a while. Later she showed up again requesting these mesh panties. Well... we already explained what they were so we handed them over without question. (Although we were all very curious!)
Later in the shift the nurse entered the MALE patients room and found the patient lounging around in these mesh panties.
EEEWWWWW! and Why??
Friday, October 16, 2009
Dressing change hell
So you are covered in abscess's. Where did these abscess's come from?? You are using heroin and meth... and apparently you think the best route is "skin popping."
NOT my issue.
But you want treatment for these abscess's... cause I'm sure the are causing you pain and issues. Fine... welcome to our hospital. The doctors admit you, they treat you with antibiotics, and they even take you to minor surgery and clean some of these abscess's out.
You are a guest in this fine hospital of ours. We are feeding you, we are boarding you, we are giving you medicine's finest antibiotics to rid you of these pests, we are giving you pain medicine for the discomfort you must feel after years of "skin popping" that you applied upon yourself, and we are changing your abscess's dressings so that you might heal. SO PLEASE DO NOT SCREAM BLOODY MURDER TO THE NURSE WHEN THEY ARE DOING THESE THINGS FOR YOU.
And... going AMA so that you can go get your "fix" so that you can "handle" your dressing changes will not be tolerated. We will NOT save your bed for 5 hours, so that when you return we can give you MORE drugs and then try to "treat" your condition.
Cause NOW... I DON'T GIVE A SHIT. If you want those "pesty" abscess's off... I'll just take your arms off completely. Try smoking your meth or shooting up your heroin without arms.
Take a picture, please... I'd like to see it.
NOT my issue.
But you want treatment for these abscess's... cause I'm sure the are causing you pain and issues. Fine... welcome to our hospital. The doctors admit you, they treat you with antibiotics, and they even take you to minor surgery and clean some of these abscess's out.
You are a guest in this fine hospital of ours. We are feeding you, we are boarding you, we are giving you medicine's finest antibiotics to rid you of these pests, we are giving you pain medicine for the discomfort you must feel after years of "skin popping" that you applied upon yourself, and we are changing your abscess's dressings so that you might heal. SO PLEASE DO NOT SCREAM BLOODY MURDER TO THE NURSE WHEN THEY ARE DOING THESE THINGS FOR YOU.
And... going AMA so that you can go get your "fix" so that you can "handle" your dressing changes will not be tolerated. We will NOT save your bed for 5 hours, so that when you return we can give you MORE drugs and then try to "treat" your condition.
Cause NOW... I DON'T GIVE A SHIT. If you want those "pesty" abscess's off... I'll just take your arms off completely. Try smoking your meth or shooting up your heroin without arms.
Take a picture, please... I'd like to see it.
Tattoo's and IV's
If there is one thing that I get a lot of experience in, it is starting IV lines. I often get called by nurses on my unit to start an IV, difficult or otherwise. Sometimes we are forced to put and IV in a foot... not our first choice, but if their veins are shot in their arms... we go for the feet. I've done it all.
I actually like putting IV lines in, but I don't just put them in for fun. I really only try if I think I have a good chance at getting the line in.
But a few pet peeves about putting lines into patients...
One... please don't tell me where to put the IV. I will a) think you are an IV drug user, if you know where to put it. and b) I will NOT put the IV where you "like" it best, I will PUT it were my nursing judgment tells me the best place is.
Two... if you are covered in tattoo's, don't tell me you are afraid of needles. Because I won't understand. And yes, I've gotten a tattoo or two. So don't play that card. I won't get it and I really won't try to... suck it up.
Three... If you have a tattoo, don't explain to me that a certain IV line might RUIN your tattoo. Because when we can't get a line in you to give you your Dilaudid and Ativan... guess you got to choose... the IV or the tattoo. Cause you can't have both.
And FOUR... the most obnoxious one on the list. I really don't want to start the IV between your tattoo'd ladies nipple and the snake tongue. So while I like starting IV's, this still seems a little over the line for me.
*In my head... tourniquet, check; gloves, check; IV setup, check; needle, check; alcohol, check; landmark... OMG... nipple and tongue.*
F this.
I actually like putting IV lines in, but I don't just put them in for fun. I really only try if I think I have a good chance at getting the line in.
But a few pet peeves about putting lines into patients...
One... please don't tell me where to put the IV. I will a) think you are an IV drug user, if you know where to put it. and b) I will NOT put the IV where you "like" it best, I will PUT it were my nursing judgment tells me the best place is.
Two... if you are covered in tattoo's, don't tell me you are afraid of needles. Because I won't understand. And yes, I've gotten a tattoo or two. So don't play that card. I won't get it and I really won't try to... suck it up.
Three... If you have a tattoo, don't explain to me that a certain IV line might RUIN your tattoo. Because when we can't get a line in you to give you your Dilaudid and Ativan... guess you got to choose... the IV or the tattoo. Cause you can't have both.
And FOUR... the most obnoxious one on the list. I really don't want to start the IV between your tattoo'd ladies nipple and the snake tongue. So while I like starting IV's, this still seems a little over the line for me.
*In my head... tourniquet, check; gloves, check; IV setup, check; needle, check; alcohol, check; landmark... OMG... nipple and tongue.*
F this.
Thursday, October 15, 2009
Many unknown
We admitted an elderly patient last night with a left hip fracture.
Many issues came to light with this particular admit...
First... the patient had been walking around on this fractured hip for over a week. The patient claims that they saw their naturopathic physician after a fall last week. The doc told them that all they needed to do was rest and take Tylenol if absolutely necessary. As you can see, the patient turned back to western medicine and brought themselves to the hospital when the pain was just too much to take.
Second... to get the patients pain under control we had to use Morphine, Valium, and Dilaudid. How the heck did the patient get by at home??
Third... my favorite, the allergy list. One form said "many unknown." WTF does that mean?? Another form said "almost all medications." I think the naturopathic physician filled the patients head with some really good ideas. Honestly... if you tell us you are allergic to almost all medications... guess we can't give them to you. Unless you, as the patient, cannot tell me when you had a certain medication and what your reaction to it was... guess we are going to test the medication out. You just took three narcs... trial and error??
**This is not meant to sway any opinions regarding naturopathic medicice or slander naturopathic medicine in any way. It is just a story. As a healthcare provider I respect all people and their practice and/ or beliefs. It is simply unfortunate that this patient lived in pain for over a week.**
Many issues came to light with this particular admit...
First... the patient had been walking around on this fractured hip for over a week. The patient claims that they saw their naturopathic physician after a fall last week. The doc told them that all they needed to do was rest and take Tylenol if absolutely necessary. As you can see, the patient turned back to western medicine and brought themselves to the hospital when the pain was just too much to take.
Second... to get the patients pain under control we had to use Morphine, Valium, and Dilaudid. How the heck did the patient get by at home??
Third... my favorite, the allergy list. One form said "many unknown." WTF does that mean?? Another form said "almost all medications." I think the naturopathic physician filled the patients head with some really good ideas. Honestly... if you tell us you are allergic to almost all medications... guess we can't give them to you. Unless you, as the patient, cannot tell me when you had a certain medication and what your reaction to it was... guess we are going to test the medication out. You just took three narcs... trial and error??
**This is not meant to sway any opinions regarding naturopathic medicice or slander naturopathic medicine in any way. It is just a story. As a healthcare provider I respect all people and their practice and/ or beliefs. It is simply unfortunate that this patient lived in pain for over a week.**
Friday, October 9, 2009
Riddle me this...
Your medical history includes hypertension (high blood pressure) and a brain aneurysm. You deny using recreational drugs, alcohol, or tobacco. You don't have a history of pain, acute or chronic.
So tell me... why do you have METHADONE listed as one of your home medications??
So tell me... why do you have METHADONE listed as one of your home medications??
Thursday, October 8, 2009
A what??
We admitted a patient who was severely assaulted. Someone really took out some anger on this poor patient.
So what was the patient assaulted with?? A hanger, a shoe, and a peanut butter jar.
WTF? For one, I didn't think a hanger could be so dangerous. Two, a peanut butter jar? Really? And three, why do we know this?? Or care?
People never cease to amaze me.
So what was the patient assaulted with?? A hanger, a shoe, and a peanut butter jar.
WTF? For one, I didn't think a hanger could be so dangerous. Two, a peanut butter jar? Really? And three, why do we know this?? Or care?
People never cease to amaze me.
If you have to ask...
If you have to ask your nurse if it is "too gross" to eat your midnight snack while you are sitting on the bedside commode trying to get nature to move...
THEN YES, IT IS.
And as the nurse, the best response... "well, just don't touch your butt." Cause apparently we feel that if you want to eat while trying to have a BM, then the chances of you doing something of this nature is within the realm of possibilities!
THEN YES, IT IS.
And as the nurse, the best response... "well, just don't touch your butt." Cause apparently we feel that if you want to eat while trying to have a BM, then the chances of you doing something of this nature is within the realm of possibilities!
Tuesday, October 6, 2009
Follow-up to femur-boy
So as a follow up to the pain-medication-refusing-femur-fracture patient that wanted to leave AMA with their leg in two pieces.
He finally admitted to the fact that he did not see the vehicle hurdling at him point blank because he was (drum-roll please)... smoking meth while crossing the street.
Am I surprised?? Not really...
Now I know why he didn't want any pain medication.
He finally admitted to the fact that he did not see the vehicle hurdling at him point blank because he was (drum-roll please)... smoking meth while crossing the street.
Am I surprised?? Not really...
Now I know why he didn't want any pain medication.
A lesson on cleaning your gun
Here is a lesson for you... but a few things first:
1. I don't own a gun.
2. I've never shot a gun.
3. I've never cleaned a gun.
4. I AM A NURSE.
So here is 'Gun Cleaning 101'
1. If you own a gun, know how it works.
2. If you've shot a gun, you should know how amazingly powerful they are.
3. If you are going to clean a gun, you should know how to clean it properly.
4. MAKE SURE THERE ARE NO BULLETS IN THE GUN WHEN YOU CLEAN IT.
And probably more important than that...
If the gun doesn't fire properly when you pull the trigger, do not, I REPEAT DO NOT, look down the barrel of it to find the cause of the miss-fire. (This goes for pellet guns and BB guns too!) Actually... for that matter, NEVER look down the barrel of a gun... for any reason.
I know.
1. I don't own a gun.
2. I've never shot a gun.
3. I've never cleaned a gun.
4. I AM A NURSE.
So here is 'Gun Cleaning 101'
1. If you own a gun, know how it works.
2. If you've shot a gun, you should know how amazingly powerful they are.
3. If you are going to clean a gun, you should know how to clean it properly.
4. MAKE SURE THERE ARE NO BULLETS IN THE GUN WHEN YOU CLEAN IT.
And probably more important than that...
If the gun doesn't fire properly when you pull the trigger, do not, I REPEAT DO NOT, look down the barrel of it to find the cause of the miss-fire. (This goes for pellet guns and BB guns too!) Actually... for that matter, NEVER look down the barrel of a gun... for any reason.
I know.
Roller-coaster
Sometimes I wish that doctors communicated with each other a little more when a patient is in the hospital... because generally the mess they leave in their wake is a nightmare for the nurses to clean up.
One doctor entered this patients room today and informed him of the 'good news'. The good news was that the "brain lesion" that was found on the initial CT done in the ED was not a tumor and was not a stroke. I agree that is good news.
The patient was elated with this news. The patient and their spouse were both in pleasant moods, the patient was smiling (for the first time since admission). Things were looking up for them. Can you blame them??
Then the next doctor enters the room. The patient was positive for lymphoma. So the patient just took a wild diagnosis rollercoaster. And now an emotional rollercoaster.
WTF do you do as the nurse now?? How can we compete with this?
One doctor entered this patients room today and informed him of the 'good news'. The good news was that the "brain lesion" that was found on the initial CT done in the ED was not a tumor and was not a stroke. I agree that is good news.
The patient was elated with this news. The patient and their spouse were both in pleasant moods, the patient was smiling (for the first time since admission). Things were looking up for them. Can you blame them??
Then the next doctor enters the room. The patient was positive for lymphoma. So the patient just took a wild diagnosis rollercoaster. And now an emotional rollercoaster.
WTF do you do as the nurse now?? How can we compete with this?
Thanks, I know...
So speaking of patients going 'against medical advice' (AMA) it brings back a recent interaction I had with another loser patient.
When a patient decides that they no longer want our care (or our free food and warm bed) and the doctors have not medically cleared the patient from the hospital, the only option for the patient is to leave the hospital AMA. I am not a prison guard, if you want to leave I'm not going to stop you (unless you are psychologically unsafe to yourself or others). Chances are that if you are so unhappy that you want to leave the hospital you are probably going to make my life just as unhappy, or worse. So go... but let me tell you a few things. You don't have to listen... just look at me, and when I ask if you understand, just say yes.
So this loser patient was in the hospital for a few days making all our lives hell. Apparently we couldn't fix him up fast enough (after he got his face broken for being an a**hole while he was drunk) for him to get discharged. I know, I know... my miracle worker was off that week. So I entered the patients room to cover a few legal points of leaving AMA. First, I go over the risks of leaving AMA... which always includes "up to and including death." That rarely gets the patients to bat an eye. Second, I make sure the patient is aware of the fact that their medical insurance 'may OR may not' cover their hospitalization, I tell the patient that they may be held financially responsible for their entire hospitalization. Some patients decide to stay when they hear this... who doesn't know how expensive that can be!!
Well, the impatient loser that was ready to leave AMA heard this last part about the insurance and promptly told me... "I don't have insurance any ways, so it looks like you are going to have to pay for my hospitalization whether I stay or not."
Thanks, I know... my tax dollars at work. Now get...
When a patient decides that they no longer want our care (or our free food and warm bed) and the doctors have not medically cleared the patient from the hospital, the only option for the patient is to leave the hospital AMA. I am not a prison guard, if you want to leave I'm not going to stop you (unless you are psychologically unsafe to yourself or others). Chances are that if you are so unhappy that you want to leave the hospital you are probably going to make my life just as unhappy, or worse. So go... but let me tell you a few things. You don't have to listen... just look at me, and when I ask if you understand, just say yes.
So this loser patient was in the hospital for a few days making all our lives hell. Apparently we couldn't fix him up fast enough (after he got his face broken for being an a**hole while he was drunk) for him to get discharged. I know, I know... my miracle worker was off that week. So I entered the patients room to cover a few legal points of leaving AMA. First, I go over the risks of leaving AMA... which always includes "up to and including death." That rarely gets the patients to bat an eye. Second, I make sure the patient is aware of the fact that their medical insurance 'may OR may not' cover their hospitalization, I tell the patient that they may be held financially responsible for their entire hospitalization. Some patients decide to stay when they hear this... who doesn't know how expensive that can be!!
Well, the impatient loser that was ready to leave AMA heard this last part about the insurance and promptly told me... "I don't have insurance any ways, so it looks like you are going to have to pay for my hospitalization whether I stay or not."
Thanks, I know... my tax dollars at work. Now get...
Sunday, October 4, 2009
Do you know what a femur is??
So the other night at work we admitted a trauma patient that was hit by a car. He was crossing the street against a light and got hit by a car traveling approximately 30 mph.
The patient looked like you would expect him to look. Blood, bruises, swollen facial features, dirt... the whole nine yards! The patient's main injury was a femur fracture. You know... the long bone in your thigh. It's connected to the hip bone and the knee bone (a la the children's song). The thing about this bone... it is an essential part of your skeleton and you need it to stand up under your own power.
This brainiac of a patient was ready to leave AMA (Against Medical Advice). This patient was trying his best to climb out of bed, he refused all pain medication (wtf?), and he was going to leave the hospital (for reasons unknown).
Besides being a complete moron, I was in awe at this patients ability to move as much as he did without pain medications (I have a good feeling he had his own brand of meds on board). His freakin' femur bone was in 2 pieces!!!
The patient looked like you would expect him to look. Blood, bruises, swollen facial features, dirt... the whole nine yards! The patient's main injury was a femur fracture. You know... the long bone in your thigh. It's connected to the hip bone and the knee bone (a la the children's song). The thing about this bone... it is an essential part of your skeleton and you need it to stand up under your own power.
This brainiac of a patient was ready to leave AMA (Against Medical Advice). This patient was trying his best to climb out of bed, he refused all pain medication (wtf?), and he was going to leave the hospital (for reasons unknown).
Besides being a complete moron, I was in awe at this patients ability to move as much as he did without pain medications (I have a good feeling he had his own brand of meds on board). His freakin' femur bone was in 2 pieces!!!
Friday, October 2, 2009
D-B-D
Douche-Bag Deluxe
Don't be one.
Honestly... I really hope that in the hospital that I work at that I'm not seeing a statistically fair cross-cut (or sampling if you prefer) of the society that I live in.
Because that would just be sad.
Don't be one.
Honestly... I really hope that in the hospital that I work at that I'm not seeing a statistically fair cross-cut (or sampling if you prefer) of the society that I live in.
Because that would just be sad.
Tuesday, September 29, 2009
The last laugh
I love when I get the chance to have the last laugh... and I owe it all to an aware Pharmacist at Local Pharmacy.
My night shift started off with a patient and her husband who were very upset, to say the least, that the patient was not discharged from the hospital. The discharge was being held up waiting for a doctor to come up and assess the patient to make sure she was safe and ready to be discharged. I mean... the patient was post brain surgery. But that was not of the concern of the patient or the patient's husband.
Long story short... the patient was yelling (although she claimed that we gave her the worst headache of her life), the husband was yelling. In fact the husband was literally in my face screaming, spitting, and turning red. Security was called. It was great... it's what I get up in the morning for (read with sneering sarcasm).
The patient is demanding her IV Dilaudid because her oral Percocet was not working. But she wanted to go home immediately. I'm still not sure where she thought she was going to get IV Dilaudid at home from... but I can make a good guess.
Finally we get the patient discharged, scripts in hand. Goodbye and good riddance.
About 3 hours later we get a call from the Local Pharmacy who wants to verify some scripts that we had discharged a patient with earlier in the day. Surprise... it was the very same patient who made my life so fun just a few hours earlier. The pharmacist was concerned that the narcotic prescription had been altered.
First... you treat the very nurses, who cared for your sorry ass after you just had your BRAIN cut into, like pond scum. Second... your husband comes close to what could be considered assault on a human being, aside from the fact that assault on a health care worker is a felony. Third... you threaten a law suit to anyone who dared look in your direction. And lastly... you ALTER your narcotic prescription??? And then you try to pass it off?? And now you want ME to verify the script... ME? (Do you remember what you said to me? Do you remember what you called me? Do you remember that your husband covered me in his saliva? You are lucky that I'd rather make sure your got your meds than risk you coming back to the hospital!)
Prescription did indeed appear altered.
So now you have NO pain medication. You likely got the cops called on you if you treated the pharmacist the same way you treated me. AND... I got the last laugh!
My night shift started off with a patient and her husband who were very upset, to say the least, that the patient was not discharged from the hospital. The discharge was being held up waiting for a doctor to come up and assess the patient to make sure she was safe and ready to be discharged. I mean... the patient was post brain surgery. But that was not of the concern of the patient or the patient's husband.
Long story short... the patient was yelling (although she claimed that we gave her the worst headache of her life), the husband was yelling. In fact the husband was literally in my face screaming, spitting, and turning red. Security was called. It was great... it's what I get up in the morning for (read with sneering sarcasm).
The patient is demanding her IV Dilaudid because her oral Percocet was not working. But she wanted to go home immediately. I'm still not sure where she thought she was going to get IV Dilaudid at home from... but I can make a good guess.
Finally we get the patient discharged, scripts in hand. Goodbye and good riddance.
About 3 hours later we get a call from the Local Pharmacy who wants to verify some scripts that we had discharged a patient with earlier in the day. Surprise... it was the very same patient who made my life so fun just a few hours earlier. The pharmacist was concerned that the narcotic prescription had been altered.
First... you treat the very nurses, who cared for your sorry ass after you just had your BRAIN cut into, like pond scum. Second... your husband comes close to what could be considered assault on a human being, aside from the fact that assault on a health care worker is a felony. Third... you threaten a law suit to anyone who dared look in your direction. And lastly... you ALTER your narcotic prescription??? And then you try to pass it off?? And now you want ME to verify the script... ME? (Do you remember what you said to me? Do you remember what you called me? Do you remember that your husband covered me in his saliva? You are lucky that I'd rather make sure your got your meds than risk you coming back to the hospital!)
Prescription did indeed appear altered.
So now you have NO pain medication. You likely got the cops called on you if you treated the pharmacist the same way you treated me. AND... I got the last laugh!
Uhhh... ya think??
So over the weekend I saw a patient that was admitted to the hospital because she had stabbed herself in her side with a pocket knife. The pocket knife was probably no longer than 2 to 3 inches, but regardless... it is a knife and it doesn't belong in any part of your body.
I decided to get a little more background on the patient, so I read the EMS report... which is ALWAYS a fun sport. The patient, herself, called 911 for help. Not a bad idea if you just stuck a knife in your side... but I want to know WHY she did such a thing. When the EMTs arrived on the scene they found the patient in the shower, wet, naked, and holding a towel over her stab wound to control the bleeding. WTF?? She called 911 and then got in the shower? She told the EMS crew that she wanted to make sure she was clean when they got there. Hmmm... I'm starting to see a pattern of bright ideas forming. So then the EMS crew loads her up into the ambulance to bring her straight to where I work... damn it.
So along the way to the hospital, which I'm sure included passing by other hospitals (lucky bastards), they ask the patient some background information and the question of all times... WHY? The patients pertinent background information includes that she has been doing meth for 2 days. Ahhh... clue number 1. It also included that she had drank 2 cases of beer and a fifth of vodka. Clue number 2... but I STILL don't understand why. So the EMS crew finally ask her if she was trying to commit suicide. The patient said "No, I would say it was just poor judgment."
UHHH... YA THINK? DO YOU REALLY THINK?? STABBING YOURSELF IN THE SIDE IS JUST POOR JUDGMENT??
I decided to get a little more background on the patient, so I read the EMS report... which is ALWAYS a fun sport. The patient, herself, called 911 for help. Not a bad idea if you just stuck a knife in your side... but I want to know WHY she did such a thing. When the EMTs arrived on the scene they found the patient in the shower, wet, naked, and holding a towel over her stab wound to control the bleeding. WTF?? She called 911 and then got in the shower? She told the EMS crew that she wanted to make sure she was clean when they got there. Hmmm... I'm starting to see a pattern of bright ideas forming. So then the EMS crew loads her up into the ambulance to bring her straight to where I work... damn it.
So along the way to the hospital, which I'm sure included passing by other hospitals (lucky bastards), they ask the patient some background information and the question of all times... WHY? The patients pertinent background information includes that she has been doing meth for 2 days. Ahhh... clue number 1. It also included that she had drank 2 cases of beer and a fifth of vodka. Clue number 2... but I STILL don't understand why. So the EMS crew finally ask her if she was trying to commit suicide. The patient said "No, I would say it was just poor judgment."
UHHH... YA THINK? DO YOU REALLY THINK?? STABBING YOURSELF IN THE SIDE IS JUST POOR JUDGMENT??
Friday, September 25, 2009
A little lotion...
This is an old story from my days of nursing school... and one of my more embarrassing.
I was doing my rotation through couplet care... mom and baby area. Nothing I have ANY interest in whatsoever. I'm happy for them... it's great... blah, blah, blah. I like the blood and guts.
Of course, by this point in time I had no introduction to 'incontinence cream.' Also known as barrier cream, baza cream, ect. It's basically a very thick waterproof cream that we use to create a barrier between a patients skin and the bed that they will eventually wet. Wet bedding against skin is a recipe for disaster. So while we check and change beds often, it is still best to protect the patients skin from the moisture all together.
So here I was, this silly little nursing school student in her white pants and university scrub top, wandering around in couplet care looking for an IV to start or something/ anything to make the shift a little more productive for me. (As bottle feeding an infant really didn't interest me!) I washed my hands for the 954,736 time that day and my skin felt like it was about to peel off so I decided to look for some lotion to soothe the sandpaper that my hands were. I found this white tube of cream. Looked like lotion. It said Johnson & Johnson on it... so I squeeze out a large pile of this cream into my hand. I'm excited that I found this thick cream... I'm thinking it will take care of my hands for sure.
So I start rubbing the lotion all over my hands... WTF. My hands are WHITE and WATER-PROOF. I run to the sink and attempt unsuccessfully wash this stuff off before anyone catches me. This is NOT what I had in mind when I was looking for something productive to do! It took forever to get most of the damn cream off... I went home that afternoon with white still under my fingernails (I was trying to literally scratch the stuff off my hands under the scalding hot water), white around my cuticles, and white in the deep grooves of my hands.
I started carrying around a small tube of lotion in my scrubs.
I was doing my rotation through couplet care... mom and baby area. Nothing I have ANY interest in whatsoever. I'm happy for them... it's great... blah, blah, blah. I like the blood and guts.
Of course, by this point in time I had no introduction to 'incontinence cream.' Also known as barrier cream, baza cream, ect. It's basically a very thick waterproof cream that we use to create a barrier between a patients skin and the bed that they will eventually wet. Wet bedding against skin is a recipe for disaster. So while we check and change beds often, it is still best to protect the patients skin from the moisture all together.
So here I was, this silly little nursing school student in her white pants and university scrub top, wandering around in couplet care looking for an IV to start or something/ anything to make the shift a little more productive for me. (As bottle feeding an infant really didn't interest me!) I washed my hands for the 954,736 time that day and my skin felt like it was about to peel off so I decided to look for some lotion to soothe the sandpaper that my hands were. I found this white tube of cream. Looked like lotion. It said Johnson & Johnson on it... so I squeeze out a large pile of this cream into my hand. I'm excited that I found this thick cream... I'm thinking it will take care of my hands for sure.
So I start rubbing the lotion all over my hands... WTF. My hands are WHITE and WATER-PROOF. I run to the sink and attempt unsuccessfully wash this stuff off before anyone catches me. This is NOT what I had in mind when I was looking for something productive to do! It took forever to get most of the damn cream off... I went home that afternoon with white still under my fingernails (I was trying to literally scratch the stuff off my hands under the scalding hot water), white around my cuticles, and white in the deep grooves of my hands.
I started carrying around a small tube of lotion in my scrubs.
I work in a zoo
I've decided that I work in a zoo.
In the dead of night, when all the day-shift workers are at home in bed dreaming about how all the night-shift workers are sitting around watching their patients sleep, the nursing unit takes on the feel of a zoo.
The little old confused ladies are screeching nonsensical words or calling out a name repetitively. The confused old men are yelling obscenities. The unfortunate patient that we had to restrain to the bed is writhing around in the bed and trying to chew his way out. The patient off his psych meds is jumping up and down on his bed. Some patient is smoking in the bathroom. IV pumps are beeping. Cardiac monitors are alarming. Bed alarms are blaring. Phones are ringing. A family member wants us to order them dinner. The alert patient is yelling because it's so noisy and it sounds like someone is having a party. And somewhere there is a patient taking off his hospital gown, removing his IV, and taking down his surgical dressing. (I've even seen a patient chew off his splint!)
The nurses are running around like they are in the midst of a prison riot.
I just feel like I'm in a zoo. I'm just waiting for the day when I have to tell a patient that they shouldn't be swinging from the ceiling.
In the dead of night, when all the day-shift workers are at home in bed dreaming about how all the night-shift workers are sitting around watching their patients sleep, the nursing unit takes on the feel of a zoo.
The little old confused ladies are screeching nonsensical words or calling out a name repetitively. The confused old men are yelling obscenities. The unfortunate patient that we had to restrain to the bed is writhing around in the bed and trying to chew his way out. The patient off his psych meds is jumping up and down on his bed. Some patient is smoking in the bathroom. IV pumps are beeping. Cardiac monitors are alarming. Bed alarms are blaring. Phones are ringing. A family member wants us to order them dinner. The alert patient is yelling because it's so noisy and it sounds like someone is having a party. And somewhere there is a patient taking off his hospital gown, removing his IV, and taking down his surgical dressing. (I've even seen a patient chew off his splint!)
The nurses are running around like they are in the midst of a prison riot.
I just feel like I'm in a zoo. I'm just waiting for the day when I have to tell a patient that they shouldn't be swinging from the ceiling.
Thursday, September 24, 2009
No medical history? At all?
Don't tell me you do not have any medical history if you follow that sentence with your list of allergies. People don't find out that they are allergic to Depakote, Haldol, Geodon, and Lithium by just sheer luck.
And when you were born no one handed you a list of Morphine, Tylenol, Toradol, and Fentanyl as your allergies and recommend that you just request Dilaudid or Demerol when you need pain medication either.
Either that or I must have lost my list... damn it.
And when you were born no one handed you a list of Morphine, Tylenol, Toradol, and Fentanyl as your allergies and recommend that you just request Dilaudid or Demerol when you need pain medication either.
Either that or I must have lost my list... damn it.
Must be bored...
I see this often and have yet been able to figure it out.
A patient will come into the hospital with a valid complaint. They do not appear to be looking for drugs (i.e. pain medication), cause lord knows we get that all the time. So we admit this patient with the valid complaint and begin the workup and consultations to specialists. Different studies are ordered and different medications are started. But here is what gets me... the patient refuses to go to the study/ exam (say an MRI). The patient refuses to take the medication. The patient refuses to have their blood drawn. The patient yells at the nurse whenever they enter the room or try to take a blood pressure. The patient complains endlessly about their original complaint.
Why do you come to the hospital at all if you don't want our care???
Guess what... you don't have to go to your study, take your medication, have your blood drawn, or have a nurse come into your room IF YOU STAY AT HOME.
Complain to your damn cat... they will take care of you the way you plan on letting us take care of you.
A patient will come into the hospital with a valid complaint. They do not appear to be looking for drugs (i.e. pain medication), cause lord knows we get that all the time. So we admit this patient with the valid complaint and begin the workup and consultations to specialists. Different studies are ordered and different medications are started. But here is what gets me... the patient refuses to go to the study/ exam (say an MRI). The patient refuses to take the medication. The patient refuses to have their blood drawn. The patient yells at the nurse whenever they enter the room or try to take a blood pressure. The patient complains endlessly about their original complaint.
Why do you come to the hospital at all if you don't want our care???
Guess what... you don't have to go to your study, take your medication, have your blood drawn, or have a nurse come into your room IF YOU STAY AT HOME.
Complain to your damn cat... they will take care of you the way you plan on letting us take care of you.
When do you call it quits...
We got a male patient in his 70's today that came in covered in what looked like scratches... lots of them. Some deeper than others, many had drawn blood at some point. He was COVERED... head to toe in them. Nicks, cuts, scratches, bruises... he even had what appeared to be rug burn to his butt.
The patient is awake and with the program so we wonder what could be going on here, is it abuse or neglect? So we question the patient, who is extremely hard of hearing mind you, and he tells us his story (and the rest of the hospital with his volume level).
Him and his wife got in a fight yesterday and apparently it was an all out brawl. And I mean a serious, rolling on the floor, scratching, kicking, punching, dragging across the floor kind of fight. In your 70's? With all his injuries you'd have to wonder about the stamina in these two pistols.
Well, wife (also in her 70's) looked much the same. And the police were indeed called to the house during the "event." I don't think I want tickets to that event... I'll pass. But I do want that kind of energy when I get to their age. Who wouldn't like to be able to kick someone else's butt and live to tell the story (without a broken hip) at that age??
But seriously... when do you just call it quits.
The patient is awake and with the program so we wonder what could be going on here, is it abuse or neglect? So we question the patient, who is extremely hard of hearing mind you, and he tells us his story (and the rest of the hospital with his volume level).
Him and his wife got in a fight yesterday and apparently it was an all out brawl. And I mean a serious, rolling on the floor, scratching, kicking, punching, dragging across the floor kind of fight. In your 70's? With all his injuries you'd have to wonder about the stamina in these two pistols.
Well, wife (also in her 70's) looked much the same. And the police were indeed called to the house during the "event." I don't think I want tickets to that event... I'll pass. But I do want that kind of energy when I get to their age. Who wouldn't like to be able to kick someone else's butt and live to tell the story (without a broken hip) at that age??
But seriously... when do you just call it quits.
Wednesday, September 23, 2009
Go back to work
This story takes place in an occupational health office of a LARGE corporation. My goal when I work in the occupation health offices is to keep employees at work and productive, this way they didn't have to send employees home all the time or have time missed related to appointments outside the office.
In this office I generally took patients/ employee's in for a number of different things, such as spot checking their blood pressure related to them taking BP medications regularly or checking a temperature or blood sugar, ect. This office also provided phlebotomy (blood draws) for patients who brought in a doctors order, and we sent the blood out to the lab for them... although strangely some people wanted to take the blood with them. Yeah... no, we'll send it out thank you. We also did a lot of patient consultations, basically doing patient education on anything they had questions about, from their new medication they started to breast feeding their new baby at home.
We also saw the mundane... "I don't feel good and think I should go home but my boss wants me to see the nurse." So here is the thing, I am NOT a school nurse, but some of these (adult) employees sure made me feel like one. Employee 1 says "I have a sore throat." I say "here are some throat drops, drink lots of water... now get back to work." Employee 2 says "I burned my finger curling my hair." I say "leave it open to air and keep it clean and dry, go back to work." Employee 3 says "I think I have a fever." I check a temperature and say "no you don't... go back to work." Employee 4 says "My stomach hurts." I say "here is some pepto bismol... now please return to work." (I was being nice that day). Employee 5 says "I'm tired and want to go home." I say... "I can't make that decision for you... go back to work and talk to YOUR boss."
Yes... they pay me to do this!!!
So you can imagine my excitement when a young employee enters the office with the sclera of both eyes beet red and complaining "my eyes... what's wrong with my eyes." Long story short, I spend over 30 minutes with this patient doing my assessment and asking questions. I asked LOTS of questions. I even asked if he had been lifting weights or coughing a lot lately, anything that would cause him to strain... I would think this would clue him in to tell me his story. But he let me go on and on for over a half hour. So finally at a loss, I pick up the phone to call the companies physician for a recommendation (something I tried to avoid if I could). While I was on hold the employee says to me, "could this happen if I was up all morning throwing up." Uh... YEAH... hence me asking you all those questions about recent activities and history. So I ask, "why were you throwing up all morning?" Employee responds, "it was my 21st birthday yesterday. I don't feel well. Can I go home?" My response, "go back to work."
Next time I see this, I'll just ask them if they are hungover. Then I'll tell them to go back to work.
In this office I generally took patients/ employee's in for a number of different things, such as spot checking their blood pressure related to them taking BP medications regularly or checking a temperature or blood sugar, ect. This office also provided phlebotomy (blood draws) for patients who brought in a doctors order, and we sent the blood out to the lab for them... although strangely some people wanted to take the blood with them. Yeah... no, we'll send it out thank you. We also did a lot of patient consultations, basically doing patient education on anything they had questions about, from their new medication they started to breast feeding their new baby at home.
We also saw the mundane... "I don't feel good and think I should go home but my boss wants me to see the nurse." So here is the thing, I am NOT a school nurse, but some of these (adult) employees sure made me feel like one. Employee 1 says "I have a sore throat." I say "here are some throat drops, drink lots of water... now get back to work." Employee 2 says "I burned my finger curling my hair." I say "leave it open to air and keep it clean and dry, go back to work." Employee 3 says "I think I have a fever." I check a temperature and say "no you don't... go back to work." Employee 4 says "My stomach hurts." I say "here is some pepto bismol... now please return to work." (I was being nice that day). Employee 5 says "I'm tired and want to go home." I say... "I can't make that decision for you... go back to work and talk to YOUR boss."
Yes... they pay me to do this!!!
So you can imagine my excitement when a young employee enters the office with the sclera of both eyes beet red and complaining "my eyes... what's wrong with my eyes." Long story short, I spend over 30 minutes with this patient doing my assessment and asking questions. I asked LOTS of questions. I even asked if he had been lifting weights or coughing a lot lately, anything that would cause him to strain... I would think this would clue him in to tell me his story. But he let me go on and on for over a half hour. So finally at a loss, I pick up the phone to call the companies physician for a recommendation (something I tried to avoid if I could). While I was on hold the employee says to me, "could this happen if I was up all morning throwing up." Uh... YEAH... hence me asking you all those questions about recent activities and history. So I ask, "why were you throwing up all morning?" Employee responds, "it was my 21st birthday yesterday. I don't feel well. Can I go home?" My response, "go back to work."
Next time I see this, I'll just ask them if they are hungover. Then I'll tell them to go back to work.
Cold Calorics
A little background on the 'Cold Calorics Reflex Test.' It is a simple neurological test that is done on the comatose patient to test brain stem activity. I stress that it is to be done on a comatose patient, and NOT on the awake and alert patient.
The test consists of irrigating the patients ear canal with cold water (sometimes ice water... but I think this to be a bit extreme). In the patient with an intact brain stem (a good thing), the patients eyes will turn toward the ear that you put the water into and then you will see horizontal nystagmus (rapid horizontal shaking) towards the opposite ear.
If the patient is awake and alert, as I'm sure you can see, they would be quite uncomfortable (ummm... you think), and most likely they will become dizzy and nauseous. I would probably even bet heavily on the fact that you will be cleaning vomit off your shoes shortly after you assault an awake patient with this test.
So here is the best part... I had an ear ache one afternoon and thought it would be wise to rinse/ irrigate my ear canal out. What the heck... we do this in the hospital all the time. Of course, in the hospital we bring the water up to body temperature prior to the irrigation. Well THAT lovely little piece of information escaped my memory while I prepared to irrigate my own ear. So the water I used was not 'cold' but it was NOT body temperature.
My brain stem is intact, my eyes moved the way that they were supposed to, I got dizzy... good news I suppose, although I was already pretty sure my brain stem was fine (I'm thinking my IQ is questionable at this point). Bad news? I had to clean vomit off my shoes, but after I laid down to avoid passing out.
Oh special... guess I'll go back to sticking Q-tips in my ears!
The test consists of irrigating the patients ear canal with cold water (sometimes ice water... but I think this to be a bit extreme). In the patient with an intact brain stem (a good thing), the patients eyes will turn toward the ear that you put the water into and then you will see horizontal nystagmus (rapid horizontal shaking) towards the opposite ear.
If the patient is awake and alert, as I'm sure you can see, they would be quite uncomfortable (ummm... you think), and most likely they will become dizzy and nauseous. I would probably even bet heavily on the fact that you will be cleaning vomit off your shoes shortly after you assault an awake patient with this test.
So here is the best part... I had an ear ache one afternoon and thought it would be wise to rinse/ irrigate my ear canal out. What the heck... we do this in the hospital all the time. Of course, in the hospital we bring the water up to body temperature prior to the irrigation. Well THAT lovely little piece of information escaped my memory while I prepared to irrigate my own ear. So the water I used was not 'cold' but it was NOT body temperature.
My brain stem is intact, my eyes moved the way that they were supposed to, I got dizzy... good news I suppose, although I was already pretty sure my brain stem was fine (I'm thinking my IQ is questionable at this point). Bad news? I had to clean vomit off my shoes, but after I laid down to avoid passing out.
Oh special... guess I'll go back to sticking Q-tips in my ears!
Tuesday, September 22, 2009
Pre-shift meditation
I do not mean to offend anyone with this, it is just a joke. I found it in a Day-by-Day Calender for Nurses... I'm sure I got it as a white elephant gift at a work Christmas Party!
Dear Lord,
I pray for the wisdom to understand my challenging patients;
Love to forgive them, and the patience for their moods.
Because, Lord, if I were to ask for strength, I would beat them to death.
Dear Lord,
I pray for the wisdom to understand my challenging patients;
Love to forgive them, and the patience for their moods.
Because, Lord, if I were to ask for strength, I would beat them to death.
Sunday, September 20, 2009
I don't really know where to begin.
READ THIS... and don't forget to read the comments, all of them!!!
I have heard, seen, witnessed some really stupid people doing or saying some really stupid things. This for sure takes the prize. There are so many many many things wrong with this that I'm not even going to begin listing them. I started reading the post and the comments and was highly entertained. I ended reading the comments just really ticked off and wishing that I could find this Patty chick in the trailer park she must have crawled out of and give her a (very large) piece of my mind. This woman basically slithered out of the trailer park just long enough to go to Walgreen's and attempt to get her fix. After not only exposing her lack of self control to the local law enforcement, she places a post on Ripoff Report.com to broadcast her stupidity and clear lack of education for all the world to see. And to top it off she comments back often with more ignorant statements.
So this very kind of thing is exactly what this blog is all about... WHEN I THOUGHT I HAD HEARD IT ALL... Patty, in Apache Junction, Arizona, just upped the ante.
I have heard, seen, witnessed some really stupid people doing or saying some really stupid things. This for sure takes the prize. There are so many many many things wrong with this that I'm not even going to begin listing them. I started reading the post and the comments and was highly entertained. I ended reading the comments just really ticked off and wishing that I could find this Patty chick in the trailer park she must have crawled out of and give her a (very large) piece of my mind. This woman basically slithered out of the trailer park just long enough to go to Walgreen's and attempt to get her fix. After not only exposing her lack of self control to the local law enforcement, she places a post on Ripoff Report.com to broadcast her stupidity and clear lack of education for all the world to see. And to top it off she comments back often with more ignorant statements.
So this very kind of thing is exactly what this blog is all about... WHEN I THOUGHT I HAD HEARD IT ALL... Patty, in Apache Junction, Arizona, just upped the ante.
And no...
I spent this beautiful Sunday with a couple of my friends catching some rays (say... sunburn and dermatologist appointment!) and discussing what we like to call our "bucket list." It's not necessarily the list of things that we would like to do before we 'kick the bucket', it's more along the lines of things we would like to accomplish before the end of the season. For example, we had a bucket list for the spring that included spring type of activities. A separate one for summer and so on. You get the point. So we are preparing the 'bucket list' for the last 3 months of the year... and it's funny how fast our time fills up... only accentuating how fast our lives are flying by.
Some how we got on the topic of going on a cruise. Both of them have been on several cruises and I have not been on one. So they are explaining to me what it's like to cruise and about the different activities. And here is the conversation to the best of my memory...
"All you have to decide each day is what side of the boat you want to sit on, if you are going to climb the rock wall... they even have ping pong tables. (slight pause) And no to the macarena."
I laughed so hard... sounds like the cruise has a lot to offer. What with ping pong tables and all. But note taken... should I actually get on a cruise ship one day I will say no to the macarena.
Some how we got on the topic of going on a cruise. Both of them have been on several cruises and I have not been on one. So they are explaining to me what it's like to cruise and about the different activities. And here is the conversation to the best of my memory...
"All you have to decide each day is what side of the boat you want to sit on, if you are going to climb the rock wall... they even have ping pong tables. (slight pause) And no to the macarena."
I laughed so hard... sounds like the cruise has a lot to offer. What with ping pong tables and all. But note taken... should I actually get on a cruise ship one day I will say no to the macarena.
Can I use the decon shower?
A little background for those of you not familiar with the "decon shower" in my title: I am referring to the decontamination shower that all Emergency Rooms are equiped with. It is basically a tiled room with large hoses that remind me of pressure washers. We would use such a room/ shower should a patient come in covered in a dangerous or flammable substance. Actually, there are many reasons why we might use such a shower... of which this is not about... so google it if you are interested.
There is not much worse than when you have been helping the nurse caring for a patient for a few days on end (remember that nursing is very "hands-on" with the patient), then you have a few days off that include sleeping in and lounging around the house, only to return to work and find that the patient that you helped the nurse with all last week is now in an isolation room because they have lice and fleas (and god knows what else).
First I cuss a little under my breath. Then I start itching all over. This is where the decon shower comes into play!! When I am done itching... which lasts the rest of my shift mind you... I go home, take a scalding hot shower, wash my hair till my scalp actually hurts, and sterilize everything I own. So much for sleep!
There is not much worse than when you have been helping the nurse caring for a patient for a few days on end (remember that nursing is very "hands-on" with the patient), then you have a few days off that include sleeping in and lounging around the house, only to return to work and find that the patient that you helped the nurse with all last week is now in an isolation room because they have lice and fleas (and god knows what else).
First I cuss a little under my breath. Then I start itching all over. This is where the decon shower comes into play!! When I am done itching... which lasts the rest of my shift mind you... I go home, take a scalding hot shower, wash my hair till my scalp actually hurts, and sterilize everything I own. So much for sleep!
Saturday, September 19, 2009
PAC-10 upset
#3 ranked USC just lost (in the final seconds) to the un-ranked Washington Huskies.
This is going to be a long season...
This is going to be a long season...
I know... I can relate...
At some point during almost every romantic comedy, the female lead suddenly trips and falls, stumbling helplessly over something ridiculous like a leaf, and then some Matthew McConaughey type either whips around the corner just in the nick of time to save her or is clumsily pulled down along with her. That event predictably leads to the magical moment of their first kiss. Please. I fall ALL the time. You know who comes and gets me? The bouncer.
— Chelsea Handler
Tell me you haven't been there... I dare you!!
— Chelsea Handler
Tell me you haven't been there... I dare you!!
I don't know my name... but I can read!
So this is not a recent story... but one worth telling (as per my friends).
Here is the background: I work with all different kinds of patients. From the young to the old... I kid you not... from 14 years old to 103 years old. (Those are my records to this date!). Caring for the spectrum of patients that I do... you see the differences in care that are required from one to the other. You also start to see a pattern in the different ages and sexes. For example... middle age men are the biggest babies about pain, regardless about the injury! But that is for another story. (And I'm SOOO not kidding... BABIES). Back to my story... I've discovered, in my non-scientific method, that old men and old women find 'confusion' in their own ways. They display their down slide into nightly confusion (sun-downing) in individual fashion. Old men generally undress and 'explore' themselves. Old women YELL out... what they yell is up to the individual.
So, to the story that my friends find worth a laugh. Generally, when a patient becomes 'confused' they can barely tell you their name. And if they do come up with their name, they usually assume that they are in their home and that there are some kids running around outside that they need to yell at. Usually they can't even tell you their name, and they have no idea what's going on... let alone read ANYTHING. So we had this >90 year old patient. This patient was clearly one of the smarter confused patients that we have ever had. In the middle of the night we suddenly hear "main menu" "main menu" "main menu" at a decible worthy of a football game. So what's caused it... the TV in the room has crashed and it's on the "Main Menu." Ok... so the patient doesn't know their name but they can read. A plus for sure. Shortly there after we hear "I'm thinking Arby's"... over and over again. Smart little confused patient... but I think Arby's is out of the question for you. At a loss we put the patient in a chair, in the hallway, at the nurses station. Suddenly... as the doctors are rounding on their patient... this patient yells out... at a decible level worthy of... say, standing in the engine of a lear jet at full throttle... "STROKE." So the staff runs to the patient... hello, we are in a primary stroke center.... "what do you mean? how are you feeling? what do you mean 'stroke'?" This patient looks at us and says "I'm feeling 'wildly' dizzy." Okay... lets get some vital signs and an assessment. Mid-blood pressure... "Help... help... help." Now I'm confused, I'm standing right in front of the patient talking to her. Then the patient points to the sign 0n the wall in front of her... "Stroke."
I lost 10 minutes of my life and about 2000 heartbeats. And now... I'm thinking Arbys.
Here is the background: I work with all different kinds of patients. From the young to the old... I kid you not... from 14 years old to 103 years old. (Those are my records to this date!). Caring for the spectrum of patients that I do... you see the differences in care that are required from one to the other. You also start to see a pattern in the different ages and sexes. For example... middle age men are the biggest babies about pain, regardless about the injury! But that is for another story. (And I'm SOOO not kidding... BABIES). Back to my story... I've discovered, in my non-scientific method, that old men and old women find 'confusion' in their own ways. They display their down slide into nightly confusion (sun-downing) in individual fashion. Old men generally undress and 'explore' themselves. Old women YELL out... what they yell is up to the individual.
So, to the story that my friends find worth a laugh. Generally, when a patient becomes 'confused' they can barely tell you their name. And if they do come up with their name, they usually assume that they are in their home and that there are some kids running around outside that they need to yell at. Usually they can't even tell you their name, and they have no idea what's going on... let alone read ANYTHING. So we had this >90 year old patient. This patient was clearly one of the smarter confused patients that we have ever had. In the middle of the night we suddenly hear "main menu" "main menu" "main menu" at a decible worthy of a football game. So what's caused it... the TV in the room has crashed and it's on the "Main Menu." Ok... so the patient doesn't know their name but they can read. A plus for sure. Shortly there after we hear "I'm thinking Arby's"... over and over again. Smart little confused patient... but I think Arby's is out of the question for you. At a loss we put the patient in a chair, in the hallway, at the nurses station. Suddenly... as the doctors are rounding on their patient... this patient yells out... at a decible level worthy of... say, standing in the engine of a lear jet at full throttle... "STROKE." So the staff runs to the patient... hello, we are in a primary stroke center.... "what do you mean? how are you feeling? what do you mean 'stroke'?" This patient looks at us and says "I'm feeling 'wildly' dizzy." Okay... lets get some vital signs and an assessment. Mid-blood pressure... "Help... help... help." Now I'm confused, I'm standing right in front of the patient talking to her. Then the patient points to the sign 0n the wall in front of her... "Stroke."
I lost 10 minutes of my life and about 2000 heartbeats. And now... I'm thinking Arbys.
Friday, September 18, 2009
Daytime TV
I've never been a big fan of television... a side effect of growing up in MY parents home. We always had a prescribed amount of time that my sibling and I could watch TV for... no more, ever! So I learned how to fill my time in other ways and it has stayed with me as I've grown into an adult. However... I often work the night shift in the hospital, leading to sleeping in the morning and then rolling out of bed to the couch around noon for some useless daytime TV. While I don't spend much time doing this... it's become a habit to watch a little TV while I work my way out of my stupor, brought on by my night shift working/ daytime sleeping schedule.
So I got up this afternoon around 11am and flipped the TV on and scanned the guide for something... anything to watch that does not involve Oprah, Dr. Phil, or Cops (I save Cops for the late night TV watching when I can't sleep!!). So I found a title that caught my eye... 'Wife Swap'. WTF... but I'll watch it, let the trainwreck begin.
So I just got up a little bit ago and I've already asked myself.... IS THIS FOR REAL? ARE THESE PEOPLE FOR REAL?
So I got up this afternoon around 11am and flipped the TV on and scanned the guide for something... anything to watch that does not involve Oprah, Dr. Phil, or Cops (I save Cops for the late night TV watching when I can't sleep!!). So I found a title that caught my eye... 'Wife Swap'. WTF... but I'll watch it, let the trainwreck begin.
So I just got up a little bit ago and I've already asked myself.... IS THIS FOR REAL? ARE THESE PEOPLE FOR REAL?
Thursday, September 17, 2009
You got it!
Nursing school may be many years behind me, but a few things have been branded into my brain for all times. One such lesson was that when you greet a patient or client, you introduce yourself by name and title and you request their preferred name from them. To clarify preferred, I generally know the patients name, but often people go by nicknames or shortened names and I want to know what the patient prefers that I call them. Easy enough. Depending on the situation and the patient themselves I sometime have my own secret nickname for them, but they generally do not match the patients preferred name. Until today. BINGO... a patient and their nurse is on the same page!! So while I can't express to you how much I wish that I was the particular nurse taking care of this particular patient... I will have to live (and tell) vicariously through a co-worker!! The patient is admitted to the unit for a diagnosis that lends him to slightly forgetful moments and occasional strange behavior. None-the-less, the nurse enters the patients room and goes through introductions, then she asks the patient 'Robert' (all names and specifics/ diagnosis have been altered, but the stories are true) "What do you like to be called... Robert, Rob, Bob...?" The patient, who has been acting appropriate since the beginning of the encounter looks the nurse square in the eye and politely tells her, and I quote, "you can call me 'assh***."
Okay then... you got it. And now we don't need to bother with the secret nickname!
Okay then... you got it. And now we don't need to bother with the secret nickname!
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