Friday, October 30, 2009

Today's Last Patient of the Night

From time to time I will try to keep you amused with stories about our final patient before we close. Last night we had the young man whose chief complaint was:

"I went to the bathroom and there was a bug"



The young man stated that he got really drunk and had a one night stand. He was so drunk, he said, that he couldn't even remember when it happened. Having casual, unprotected sex while intoxicated gave him a nice souvenir of the occasion. Even if he couldn't remember it. Or the woman. In fact, it gave him several hundred souvenirs.



He was in his 20's, and he was: With. His. Mother. She sat right there in triage and kept saying disgustedly "I can't believe you got drunk and caught critters"



Really. All things considered, I can't believe he actually had sex.



I never want to examine these type of complaints too carefully because the little buggers can jump; I leave that to our highly paid board certified emergency physicians. Besides, I would have had to put on my glasses and really PEER intently at his crotch. Frankly, I don't get paid enough to do that.



He went on his merry way with his prescription for Kwell with Mom still berating him. I felt kind of bad for him cause he was a little clueless. Still can't believe he had sex.

Thursday, October 29, 2009

The Games Have Begun


Hey! Anybody still there?

Summer was gone in a flash; why is that? It seems like just yesterday I took a day trip to the lake with Tina, enjoying a nice warm day, some kayaking and a cold beer or two. Ahh, the good old days.










I found this photo in my camera; David, are you noticing?
My brother and I used to have a
competition to see who could get the best sunset photo. Even though he is a better photographer than I am, this is clearly a contender. I would have liked to get up to the lake one more time for some leaf peeping, but it didn't happen. Too bad. I did get up there last year in October with two friends from nursing school. The temp went down to the mid-30's at night; we had not heat and no water, but we had a great time and some nice views.






Fall always makes me feel like taking a big, deep breath and square my shoulders in preparation for the onslaught of the winter edition of the Sick and the Stupid. Mostly because the sick stay home while the stupid go to the ER. Somehow doesn't seem right,now, does it? This winter flu season is already off to a rip-roaring start and promises even more New! and Improved! Sicker and More Stupid! individuals crusading to the ER in search of the Holy Grail.............instant gratification!


Now, we are staring down the barrel of winter; the kayak is in the barn and I barely come up for air since I am ALWAYS studying. Micro blows, thanks for asking.

We have had lots and lots and lots of individuals present with flu-like symptoms, it is a cornucopia of influenza We have given up mining for flu and just treat them for it anyway, but in most cases there is nothing to really go mining anyhow. Cough, no fever. Fever and vomiting, no cough. Sore throat. Many are simply diagnosed with viral illness, better kept at home with
Tylenol, rest and fluids. Somehow, though, these folks who drag themselves to the ER because they are so sick hear the word "virus" and take it as an open invitation to go to work. Or to send their kids to school so they can go to work.
Please, people. If you are coughing relentlessly you may as well stay home; your co-workers don't appreciate your attendance. Seriously. Nor do other parents appreciate having your ill children in school. Giving them Tylenol, sticking them on the bus and boogeying off to your oh-so-important job is not only so awful for your kids it makes you look like a complete jerk; kids ALWAYS rat you out to either the teacher or the school nurse that mommy gave them Tylenol for their temperature. Always. Having been a school nurse and knowing this trick I always asked the kids; usually they knew how high their fever is when they left home. I made it a point to convey this information to the parents when I called them.


Yeah, I know. Everybody is talking about the flu, or blogging about it. Or talking about blogging about it. Let me tell you, it is only going to get worse before it gets better. I will try really hard not to roll my eyes relentlessly because my mom told me they would stick that way.

People are panicked about the H1N1. "Last year", I complained to Dr. Cindy Lou, "this was just the flu. This year it is the Four Horsemen of the Apocalypse. And we haven't even started to see a lot of REALLY sick people. The doctor's offices are dumping all their patients here, and I'm sure it is going on all over. What's going to happen when we all get sick?".





And we will, we will. Some of our patient population is, to put it mildly, a bit challenged with the social graces. In other words, coughs and sneezes are not covered, but left to fly freely throughout the atmosphere; I have seen someone place USED KLEENEX on the registration desk; hand sanitizer? what is that? And the kids? don't get me started.


One of our unit secretaries Melissa, is pregnant with twins; around 22 weeks. When patients come in to our ER, she is one of the first to greet them. In other words, she is flu fodder. Being pregnant, she is, along with children, one of the high risk populations. She is nervous because her OB does not yet have the H1N1 to distribute until this week.


"Melissa, don't even talk to them unless they are wearing a mask!", I told her. "Just back up and point to the triage area, yell to one of us (nurses) and we'll take care of it. No sense putting yourself in the line of fire unnecessarily"

That is when I had the bright idea to create The Altar.





A little table containing a few face masks...............no, not this one.











more like this.






I added a big bottle of hand sanitizer and a sign that read:

IF YOU HAVE

COUGH, FEVER

OR

FLU-LIKE ILLNESS

PLEASE WEAR A MASK

TO PREVENT THE

SPREAD OF INFECTION


The "thank you" got cut off of my document. My boss thought that it was great that I was showing some initiative for "projects" (calm down, it won't happen again until after I finish with this synchro season, graduate from school and go to Alaska....in other words, don't hold your breath). Melissa was thrilled, and very relieved. And for the most part, people are pretty good about taking the masks. Of course some need to be educated about: the need to wear the mask over the nose AND mouth; that they are ineffective in the pocket or on the head when worn as a hat; and for Pete's sake, please leave some for the contagious people who are coming in after you, just because it's in a little basket doesn't mean it's appropriate for you to take a handful. Yikes.

Oh crap, I just remembered today was my brother Bob's birthday. HAPPY BIRTHDAY, BOB!