Senior-Itis!

The third-year residents are going to be graduating soon. Since this class has been fast, and smart, and fun, and cool, I'm going to miss most of them. One, however, I'm not going to miss so much. He's a great doctor, and he cares about his patients, but he drives me completely crazy.

A vignette from our relationship:

Dr. Crazy: GuitarGirlRN, are you covering Area 1?
GGRN: (trying to stick a large needle into a sick old lady while she screams and fights; sweat is dripping off GGRN's nose) No. Area 2. [Area 1 is beds 3-11; I'm at bed 16]
Dr.C: Well, who is covering Area 1?
GGRN: (dodging a flying arm) I don't know--it's posted over there. (Dr. C stalks off)
Dr.C: (comes zooming back) You ARE covering this area! Bed 15, that's yours, right?
GGRN: Yes, but you asked me if I was covering Area 1!
Dr.C: (shaking head in patronizing way) Don't you know I call this area Area 1? Come ON, get WITH IT!

He was NOT being humorous. Apparently I'm not psychic enough for this job.

Happy memorial day

Mmmmm...there's nothing better than a hot dog grilled out on the ambulance ramp!

Public Service Announcement

There is no such thing as "a little" allergic to peanuts. You can't be "a little" allergic to peanuts and then eat a peanut butter cookie.

Also, just because the Epi Pen says "for home use" on it, that does not mean "leave it at home and don't bring it out into the world where the allergens are."

Thank goodness we live in a large urban area and not out in the boonies where it might take fifteen or twenty minutes to get to a hospital, so when your kid stops breathing he is only minutes away from help.

That is all.

P.S. the kid was ok after epinephrine, steroids and magnesium, and a bunch of nebulizers.

I Promise

To have some good posts up soon! I have a lot to write about--and not all of it is snarky, either.

Why do people think it's ok

to sit their butts on a stretcher I just wiped down and changed the sheets on? Look, if you're visiting a friend or relative, don't sit on the clean stretcher. Because how would you like it if you were feeling sick and got called into a room only to find someone else's butt prints on it? Ask for a chair! Or better yet, look around for one. Because I'm busy changing stretchers that people have sat on.

My Good Deed for the Day

Actually, for the year, I think.

One of our rather unpleasant frequent fliers was brought in because he was sleeping on the sidewalk outside his favorite bar. This man is a filthy, stinky, cursing, aggressive, piss-soaked, racist, evil bastard. He comes in two to three times a week, mostly for being passed out in public, and occasionally because he falls and needs something sutured up or x rayed.

When EMS wheeled him in we knew he had to be even more foul than ever--they were wearing full masks and plastic outfits. Not only was he full of piss, he was coated in shit in various stages of drying. He stunk to high heaven.

I was floating, and it wasn't terribly busy, and I have a cold. So I can't smell very well. I decided to clean him up--while he was too out of it to object.

I put him on a sheetless gurney, I suited up in double plastic gowns, shoe covers, triple gloves. I amassed supplies and wheeled him into our decon showers. And then I cut all his clothes off (including his MAGGOT ENCRUSTED VOMIT SOAKED SWEATER), removed his poop-covered shoes and decontaminated his disgusting claw-feet using ERnursey's stink-foot-in-a-bag technique, covered his naked body in soap and bicarb and hosed him down. I scrubbed all the crusty shit off of him as he lay there making drunk noises. (And for all you "drunks are people too" folks out there--the showers are indoors and the water was nice and warm.)

And you should have SEEN what came out of his belly button. It was like a freaking hockey puck or something. Seriously. I broke a little bar of soap in two and used it to dig the fossilized mung out of his navel. If I could have reached my phone, I would have taken a picture of it for you, but my phone was back at the nurse's station with my stethoscope and my bat utility belt.

Anyway, he was nice and clean and dry, and the patient relations people brought him some clothes from the clothes bin. AND shoes. And he actually didn't smell anymore.

But he sure did the next day when he came back covered in shit again. Sorry, my good deed for the year is done. Someone else can clean him up.

Nurses Week: Less Cheesecake, More Staff, Please

Yes, it's nice that the world wants to recognize that nurses do a lot of hard work. We do! And we deserve people to recognize it.

That said: I hate nurses week.

What is it about a free lunch that turns people into raving idiots? Seriously, if our ED staff educator comes up to me one more time and says, "There's food in the back, you should make a plate!" I'm going to flip out. I think she told me FOUR times yesterday. Yeah, I'm going to rush right the heck in there and pile a styrofoam plate high with greasy bad lasagne and fried chicken cutlets. That everyone has already picked over. It's like as soon as the containers are opened, the vultures descend--and most of them aren't even nurses: unit clerks, techs, and transporters are the ones to get there first. If I DO make my plate, I have to put my haul into the fridge for when I go on my lunch break around three pm. Ew, no thanks. Not to mention that the LAST place I want to be on my break is in our stinky, windowless lounge with the TV blaring and people comparing bunions. I need some FRESH AIR and an actual nutritious lunch, thank you very much.

And then we had a Viennese Hour in the cafeteria with raffles and snacks and cheesecake. People came back from that thing with plates PILED with three and four pieces of cheesecake. What, are you stocking up for winter? At the raffle, they were giving away iPods and digital cameras and gift baskets and stuff like that. I hate raffles. The single most annoying and cantankerous nurse on the ED won a digital camera and then spent the next hour going up to everyone, shrieking about how she won and showing them her booty and visibly gloating. The nicest, sweetest nurse in the ED won a huge, ugly Christmas ornament in the shape of a house that sits out and gathers dust. She sighed and said, "well, it's nice that I won, but how am I going to get this thing home?" It's like two feet tall.

The worst thing was that the docs on the floor had been given roses to hand out to the nurses. GACK. That skeeves me on SO MANY LEVELS I can't even get into it.

Again, it's nice to be recognized. But how much money did the hospital spend on this weeklong fiesta? And they just laid off FIVE new nurses from the floor and are not renewing our four great travel nurses who work mid- and night shift. And they're not allowing any overtime. So next month when we're all working ourselves to the bone because we're short staffed, who is going to remember a plate of crappy baked ziti or a stale roast beef sandwich or even an iPod? I guarantee that all the money they spent for catered lunches and dinners every day for a week for every unit and six million cheesecakes and electronics and other crap to raffle off would have paid at least one nurse's salary.

Happy Birthday

So today in the ER we had not one but TWO birth-type situations. As you may or may not know, us ED nurses do NOT like birth-type situations.

The first was a mom of three (now four) who delivered at home, assisted by EMS. Healthy mom, healthy baby, we triaged tem and rushed them right up to L&D so mom could deliver the placenta.

Not even an hour later, we were called out to the street--a young mom was stretched out in the back of a cab, screaming that she wanted to push. Then her water broke (poor cabbie). We got her on a stretcher and RACED upstairs to L&D, exhorting her to PANT LIKE A DOG AND DON'T PUSH!! The baby started crowning just as we rolled through the door of her room. Thank goodness the midwife was right there, as that was more adventure than I wanted.

Hic!

97%ALCOHOLIC

HEY NOW! I only scored this high because I was a bartender for a long time. (Same as being an ER nurse: deal with some nice people, some jerks, and a lot of drunks; run around like a lunatic when it's busy; work weird hours; and give them drugs--just a different kind.)

Once again, ER stands for EMERGENCY ROOM

Not free pregnancy test room.
I was standing at the front desk with the patient reps, shooting the breeze, and a young woman came up and started signing in.
Me: How can I help you?
Woman: Do you guys do free pregnancy tests?
Me: No. You can get them at any drugstore pretty inexpensively, or you can go to Planned Parenthood on Monday.
Woman: Oh. Well, I don't trust those tests. They're not accurate.
Me: We use the exact same test as the ones sold in the drugstore. Are you having any bleeding or abdominal pain right now?
Woman: No. What about a blood test?
Me: We only do those if you're having an emergency. Have you missed your period?
Woman: No.
Me: I'm confused; can you tell me a little bit about why you want a pregnancy test?
Woman: Well, I'm trying to get pregnant, and I might be pregnant, and I want to start prenatal care as soon as possible.
Me: You should probably see your OB/GYN for checkup and a pregnancy test, then, since we don't do prenatal care in the ER.
Woman: But I don't have an OB/GYN.
Me: Again, Planned Parenthood is a good resource. I can also give you our physician referral line number.
Woman: I really just want a pregnancy test.
Me: If you want to sign in to be seen by the doctor, you can. But I'm not going to give you a pregnancy test.
Woman: (sighs and stomps out)

I KNEW it!

Migraneurs ARE crazy.

M.D.O.D., MonkeyGirl, and Nurse K have been right all along.

According to a study in the journal Headache, migraine is commonly associated with a variety of psychiatric disorders, including depression, bipolar disorder, panic disorder, and social phobia.

See? SEE?!

Back to the Stone Age...

Or at the very least, the paper age. Our work computers are all down--have been for over twelve hours now, and will be for at least 24 to 48 more.

It's chaos, since this was not a planned outage, and many of the docs and nurses (including yours truly) have never used paper charting. We write our notes on paper but all of the flow charts we're required to use are on the computer and now we have to document on these arcane paper forms. The docs are lost when it comes to ordering things that we don't readily have in the ED.

And to top it all off, everything is running slow as molasses. The pneumatic tube system is overloaded, so it keeps shutting down, and we have to hand carry specimens to the lab. It takes forever to get results because the fax machines are taking up the slack and are busy all over the hospital. Two other area hospitals are on diversion, so we're getting slammed, and handwriting triages suck.

Wish me luck!