I wonder...

Do we get so many gi bleeds around this time of year because the
colors are so festive? Bright red and dark green...lovely!

GuitarGirl RN's rules of the ER #3

Ringworm is never an emergency. Never. Ever. An. Emergency.

GuitarGirlRN's rules of the ER #2

There is just no reasoning with psychotics.

GuitarGirlRN's rules of the ER #1

If you are 30 years old and your mom has to sign you in for a "problem
in the private area," you need to consider getting some scissors. To
cut the umbilical cord with. Seriously.

Merry Christmas!

From ambulance triage...

I'm terrible.

So, I'm the handful of years I've been an ED nurse, I've had my share
of people complaining to management about me.

Once a woman complained to my manager that I was racist, because I
triaged three sick elderly men (78, with severe dyspnea; 80, with
chest pain; and 85, syncope with a head laceration and altered mental
status) before her mildly sick 12-year-old son. The funny thing about
it was that all of them were the same race.

Then there was the insane retired nurse who wrote a complaint that I
was mean to her...after she hit me several times as I was trying to
help her to a bed.

All of these I can understand, to a point. People are feeling sick and
worried, and they're not at their best, and are unable to see past
their own needs at that moment.

But the latest one took the cake. I was summoned into a meeting with
management to discuss a complaint they had received about me.

When listening to the patient's lungs in triage, I "pressed the
stethoscope into her chest too hard and in a forceful way" that made
the patient uncomfortable.

Great.

Dear Surgery Intern

I know you're all jazzed up and stuff to be let loose on your own! I
can practically see the drool at the corners of your mouth as you
contemplate putting in your very first chest tube! I can hear the
email you're writing in your head: "Dear Mom, today I was able to hone
my surgical skills while saving a life...my job is oh so rewarding!"
So don't look at me like I'm the enemy. Stop fingering that scalpel in
your pocket. (Oh gosh, I hope that's a scalpel!)

But dude, take a step BACK! Do not get mad at me because I won't
witness your consent. The person you want to stab with a chest tube is
not some big 20-year-old kid. It's a 70-year-old lady. She's pretty
healthy looking, even with a pneumothorax. But she doesn't speak
English very well and even I can understand that she's scared about
being in pain. She keeps asking, "Operation room we do it? I go a
little sleep?" You telling me she'll be fine with 5mg of morphine and
some local anesthesia at the site is not going to cut it.

Don't be mad at me for grabbing one of our ED attendings (who happens
to speak the same language as the object of your chest-tube lust).
Come on, he agrees with me: this old gal had no CLUE what was coming
down the pike! You do know you can't get informed consent using hand
gestures and some made-up foreign vocabulary! Ending every word with "-
ski" does not mean that you're speaking Russian, not even if your
patient is nodding and smiling politely.

Look: a little conscious sedation and we'll all get what we want, and
then you can stab away to your little heart's content. See? I knew
you'd come around.

Xoxo,

GGRN

Seriously

If you are well enough to fuck in your ED stretcher, you are well
enough to go home.