Other ER nurses in the blogosphere, like ER Nursey and Girlvet, are complaining about their censuses being low and nurses being either laid off or forced to take vacation time.
I know why. BECAUSE ALL THEIR PATIENTS ARE AT MY HOSPITAL!!!
We are packed to the rafters most days, including weekends, which used to be slow. We're doubling up beds. We're holding up to 30 patients in the ED, waiting for beds upstairs. The ambulances do not stop coming in. We're signing protests of assignment forms every day--I mean, how is it possible that each area has one to two ICU patients and possibly two telemetry patients all waiting for (nonexistent) beds upstairs? And that's in addition to the SIX other patients they might have. We're working short most days. Night shift is begging people to come in so they at least get a dinner break. Six new nurses just started orienting, but they won't be on their own for another couple months or so. I've been precepting one woman, who thank goodness is an experienced nurse (just not experienced in the ED, or with the kind of patient load we have), so I can help other people out, but more often than not, I have to help her get out of the weeds when she gets behind. Transporters? HAH! And most of the patients are actually sick.
So all you RNs with nothing to do? COME ON OVER, I've got work for you!
Friday, October 24, 2008
Monday, October 20, 2008
Med Students
Okay, so I'm probably going to get a lot of crap for this, but I have to say this latest crop of med students is . . . kind of dumb. Or lazy. Or both.
Admittedly, I don't know that much about what's involved in med students' rotations through our ED, but I do know that they are there as part of their education, and maybe they should take a little interest in what's going on?
I understand that they are tired and stressed out and sometimes freaked out and miserable. Believe me, most of the residents are, too. But past students haven't acted quite as strange as this bunch.
They seem to spend a lot of time lurking around: near the doctors' station, in corners, in the trauma room staring at the cabinets. "Do you need to find something?" I always ask, thinking their resident sent them over to get supplies. "No..." comes the answer. "Okay, just ask if you need something."
One refused to do the infamous DRE (digital rectal exam) that most med students are sent to do--to get some stool to smear on a guiac card to see if there's blood in it. He presented me with the card and said, "Dr. So-and-So needs some stool on this." I told him to go ahead and get it, and he told me "I don't need to do that, since I'm going to be an anesthesiologist." Not if this behavior continues! Apparently, the resident he's with is very frustrated with him, because he doesn't want to do anything; she thinks it's a cultural thing and that he has a problem taking instructions from a woman. Great.
I'm just not used to the way these students are kind of dragging ass all over the place. Ask them to do something and they roll their eyes. I've overheard several presentations, and when they forget something and their supervising doctor asks them to go back and clarify it with the patient, it's as if you asked them to stick their whole arm up their own assholes.
One of them came up to me and said, "Dr. Blah Blah wants you to give 2 Percocets to the guy in the asthma chair area." Since there were like four men in that area, I asked, "What is the patient's name?" She responded, "Dr. didn't give me a name. She just said, 'Tell GuitarGirlRN to give the guy in the chairs 2 Percocets.' " I said, "Ok, but I need a name. Could you find out for me? Or point him out?" She sucked her teeth and said, "I don't know which one! I'm just telling you what Dr. said to me!" and walked away.
Even in interesting situations like a code, or a trauma notification, they're hanging back, lurking around doorways--not jumping in like previous classes. I understand being shy or unsure, but when people are asking you, "Hey, come on over here and do some chest compressions," or "Spike this bag of fluids," or "Come look at this x-ray, what do you see?" and you're looking around like "Who, me? Uh, my laundry is done, gotta go..." I just don't see it as a good thing.
If you're lost, I'll help you and tell you where to go. If you don't know what supplies you need to start an IV, I'll show you. Need gauze? Okeydoke. Need to find a urinal so you can get a specimen? Right over here. Even if I'm busy I'll help you or find someone who can. I'm not mean. I'm happy to show you how to put in a Foley or start an IV. But you need to shake a leg and show some interest--or just pretend! Fake it til you make it, med student!
Admittedly, I don't know that much about what's involved in med students' rotations through our ED, but I do know that they are there as part of their education, and maybe they should take a little interest in what's going on?
I understand that they are tired and stressed out and sometimes freaked out and miserable. Believe me, most of the residents are, too. But past students haven't acted quite as strange as this bunch.
They seem to spend a lot of time lurking around: near the doctors' station, in corners, in the trauma room staring at the cabinets. "Do you need to find something?" I always ask, thinking their resident sent them over to get supplies. "No..." comes the answer. "Okay, just ask if you need something."
One refused to do the infamous DRE (digital rectal exam) that most med students are sent to do--to get some stool to smear on a guiac card to see if there's blood in it. He presented me with the card and said, "Dr. So-and-So needs some stool on this." I told him to go ahead and get it, and he told me "I don't need to do that, since I'm going to be an anesthesiologist." Not if this behavior continues! Apparently, the resident he's with is very frustrated with him, because he doesn't want to do anything; she thinks it's a cultural thing and that he has a problem taking instructions from a woman. Great.
I'm just not used to the way these students are kind of dragging ass all over the place. Ask them to do something and they roll their eyes. I've overheard several presentations, and when they forget something and their supervising doctor asks them to go back and clarify it with the patient, it's as if you asked them to stick their whole arm up their own assholes.
One of them came up to me and said, "Dr. Blah Blah wants you to give 2 Percocets to the guy in the asthma chair area." Since there were like four men in that area, I asked, "What is the patient's name?" She responded, "Dr. didn't give me a name. She just said, 'Tell GuitarGirlRN to give the guy in the chairs 2 Percocets.' " I said, "Ok, but I need a name. Could you find out for me? Or point him out?" She sucked her teeth and said, "I don't know which one! I'm just telling you what Dr. said to me!" and walked away.
Even in interesting situations like a code, or a trauma notification, they're hanging back, lurking around doorways--not jumping in like previous classes. I understand being shy or unsure, but when people are asking you, "Hey, come on over here and do some chest compressions," or "Spike this bag of fluids," or "Come look at this x-ray, what do you see?" and you're looking around like "Who, me? Uh, my laundry is done, gotta go..." I just don't see it as a good thing.
If you're lost, I'll help you and tell you where to go. If you don't know what supplies you need to start an IV, I'll show you. Need gauze? Okeydoke. Need to find a urinal so you can get a specimen? Right over here. Even if I'm busy I'll help you or find someone who can. I'm not mean. I'm happy to show you how to put in a Foley or start an IV. But you need to shake a leg and show some interest--or just pretend! Fake it til you make it, med student!
Thirty-Six Cents
Monkeygirl has a post about finding Chinese food detritus found in an obese person's skin folds and it reminded me of one of my favorite stories from when I used to work on the floors, before I came to the ED.
We got a lady who was admitted because her many decubiti needed debriding. She had several of them, and was so fat, she was as wide as she was tall. I took all of her clothes off and prepared to dress and document all of her wounds.
Part of her abdomen and one of her breasts were greenish; I thought she had a fungus or something. I started wiping it off and followed it up to a skin fold, where I found . . . a quarter, a dime, and a penny--that was oxidizing and was turning her skin green. There were perfectly round sores underneath each coin. The smell was lovely too. Yum.
We got a lady who was admitted because her many decubiti needed debriding. She had several of them, and was so fat, she was as wide as she was tall. I took all of her clothes off and prepared to dress and document all of her wounds.
Part of her abdomen and one of her breasts were greenish; I thought she had a fungus or something. I started wiping it off and followed it up to a skin fold, where I found . . . a quarter, a dime, and a penny--that was oxidizing and was turning her skin green. There were perfectly round sores underneath each coin. The smell was lovely too. Yum.
Friday, October 17, 2008
Stayin' Alive
Wednesday, October 8, 2008
Drunks are *FUN!*
(Please note the *asterisks of sarcasm*)
The drunk who had been snoozing suddenly decided he had to pee, so he whipped out his wing-wang and started hosing down his chest, the bed, and the floor with torrents of piss. "Dude, WAIT! What are you DOING!" I yelled.
"I gotta piss!" he answered. Nice. The river of loin lemonade started to splatter and flow underneath the curtain, where it soiled the socks of his next-door-neighbor, a young woman having a sickle cell crisis.
Next, he got up and staggered to the bathroom...better late than never, I suppose. On his return, he decided that he would much rather get into bed with the young sickler woman than get back in his own bed. With much persuading, he staggered along to his own stretcher, and upon discovering that they were soaked with his own urine, yelled, "Nurse! My bed is wet! Change these sheets!"
One of the doctors was passing by and made him say "Please" to me. *Because you know, that "Please" made it a MUCH MORE FUN TASK FOR ME.*
As I was bundling up his *fragrant and lovely* soaked bedclothes, the following exchange took place:
Him: So, we gonna get together?
Me: What?
Him: You know, are we gonna BE TOGETHER?
Me: What!?
Him: You know. Fuckin'.
Me: I don't believe that will be happening today, sir, since I don't find men who piss their beds attractive.
Him: Fuck you, then.
Me: Yeah, not so much.
I went to fetch security to remove the gentleman, which they were only too happy to do, since on arriving at the man's bedside, they discovered that he had sparked up a spliff the size of a cigar and was happily toking away in the middle of the ED.
The drunk who had been snoozing suddenly decided he had to pee, so he whipped out his wing-wang and started hosing down his chest, the bed, and the floor with torrents of piss. "Dude, WAIT! What are you DOING!" I yelled.
"I gotta piss!" he answered. Nice. The river of loin lemonade started to splatter and flow underneath the curtain, where it soiled the socks of his next-door-neighbor, a young woman having a sickle cell crisis.
Next, he got up and staggered to the bathroom...better late than never, I suppose. On his return, he decided that he would much rather get into bed with the young sickler woman than get back in his own bed. With much persuading, he staggered along to his own stretcher, and upon discovering that they were soaked with his own urine, yelled, "Nurse! My bed is wet! Change these sheets!"
One of the doctors was passing by and made him say "Please" to me. *Because you know, that "Please" made it a MUCH MORE FUN TASK FOR ME.*
As I was bundling up his *fragrant and lovely* soaked bedclothes, the following exchange took place:
Him: So, we gonna get together?
Me: What?
Him: You know, are we gonna BE TOGETHER?
Me: What!?
Him: You know. Fuckin'.
Me: I don't believe that will be happening today, sir, since I don't find men who piss their beds attractive.
Him: Fuck you, then.
Me: Yeah, not so much.
I went to fetch security to remove the gentleman, which they were only too happy to do, since on arriving at the man's bedside, they discovered that he had sparked up a spliff the size of a cigar and was happily toking away in the middle of the ED.
Roomba Update
Not like most of you care, but I figured I'd share anyway:
I called customer service, and they told me that since my Roomba is past warranty, and since they don't have a repair service, they would offer me a deal: A new Roomba Sage, which is basically the same one I have, just a different color, or a brandy-new Roomba at a discounted price.
The Sage they offered me is a bare-bones model. It doesn't even come with a charger or battery, which was fine with me, since I'm just going to use the ones from my current dead Discovery. The cost for this option? $100. Also, since it's new, from them, I get a new warranty!
I would have loved to splurge on a discount on one of the new models, but the one that I want is around $260 or so, even with the reduced price.
Eh, whatever. I just want my Roomba back. The dog-hair tumbleweeds are piling up!
I called customer service, and they told me that since my Roomba is past warranty, and since they don't have a repair service, they would offer me a deal: A new Roomba Sage, which is basically the same one I have, just a different color, or a brandy-new Roomba at a discounted price.
The Sage they offered me is a bare-bones model. It doesn't even come with a charger or battery, which was fine with me, since I'm just going to use the ones from my current dead Discovery. The cost for this option? $100. Also, since it's new, from them, I get a new warranty!
I would have loved to splurge on a discount on one of the new models, but the one that I want is around $260 or so, even with the reduced price.
Eh, whatever. I just want my Roomba back. The dog-hair tumbleweeds are piling up!
Friday, October 3, 2008
Change of Shift etc
Change of shift is up! The "Autumn Harvest" edition is ready for your perusal. Go check it out!
In other news, I am in mourning. My Roomba's motor has burned out, apparently, which sucks. (Or doesn't...hee ha ho...hee...ha...ok, not funny, whatever...) I've had it for three years, and I love my little trilobite-looking friend. It sucked up all the dust bunnies and dog-hair tumbleweeds it could find and never complained as long as I lovingly cleaned it from time to time. And now it's dead. Well, it still moves around but the brushes don't turn, which means it doesn't suck up the hair properly. I ran all the diagnostics and it definitely is the motor, and as geeky as I am, I am not so technically inclined that I can replace the motor myself if I bought one on E-Bay. I emailed them, and they suggested doing all the things I already did. I emailed them back with all my information, and they still haven't gotten back to me...probably because the Roomba is long out of warranty. I'll have to call them and yell a little, I think--I mean, I know it's a robot and is extra special, but it wasn't cheap, and my grandma is still using the same Electrolux she got for her wedding 45 years ago. I'm willing to pay for a repair if it's not crazy astronomically expensive, since a new Roomba is like $300.
In other news, I am in mourning. My Roomba's motor has burned out, apparently, which sucks. (Or doesn't...hee ha ho...hee...ha...ok, not funny, whatever...) I've had it for three years, and I love my little trilobite-looking friend. It sucked up all the dust bunnies and dog-hair tumbleweeds it could find and never complained as long as I lovingly cleaned it from time to time. And now it's dead. Well, it still moves around but the brushes don't turn, which means it doesn't suck up the hair properly. I ran all the diagnostics and it definitely is the motor, and as geeky as I am, I am not so technically inclined that I can replace the motor myself if I bought one on E-Bay. I emailed them, and they suggested doing all the things I already did. I emailed them back with all my information, and they still haven't gotten back to me...probably because the Roomba is long out of warranty. I'll have to call them and yell a little, I think--I mean, I know it's a robot and is extra special, but it wasn't cheap, and my grandma is still using the same Electrolux she got for her wedding 45 years ago. I'm willing to pay for a repair if it's not crazy astronomically expensive, since a new Roomba is like $300.
Thursday, October 2, 2008
Uh...OK, crayzee....
Here is a comment I got yesterday on a previous post. It seems to have nothing to do with the post...but I found it interesting.
OK...Thanks for the info! Anyone else find this amusing?
In other news, it's my birthday! Today I'm celebrating by going to the dentist and then to our financial planner to find out if our tiny investment portfolio has crapped out. Two of my very favorite things. And then I have to write a paper. Fun.
Can anyone tell me why my sidebar is flashing on and off like a Christmas light?
My name is Craig Hannah and i would like to show you my personal experience with Ativan.
I have taken for 6 years. I am 37 years old. GREAT FOR INSOMNIA......Great for Manic stages of Bi-Polar..It's really is the only drug I can take without any side effects..I cannot even take asprin without feeling it..I have OCD and have severe sensitivity to meds, this one is great.
Side Effects :
None.....Miracle drug...onset of 20/30 minutes, peak of 1 to 3 hrs...it will erase your memory if u take it in large doses...made that mistake once..Been on and off of it since 2001. I don't get addictive to it. I only take .05 2 x a day for controlling High Blood Pressure, Anxiety and IBS..I sometimes can get away with breaking the 0.5mg down into 4 equal doses.
I hope this information will be useful to others,
Craig Hannah
OK...Thanks for the info! Anyone else find this amusing?
In other news, it's my birthday! Today I'm celebrating by going to the dentist and then to our financial planner to find out if our tiny investment portfolio has crapped out. Two of my very favorite things. And then I have to write a paper. Fun.
Can anyone tell me why my sidebar is flashing on and off like a Christmas light?
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