Shorts

Stinkiferous: describing lingering, sometimes noxious odor in a treatment room long after the individual(s) have departed.  Examples are hockey and football equipment and feet, soccer shin pads, and any patient who works at the local candle factory.

I have had enough of posters and sign up sheets for fund raisers.  FYI: I will not be doing any further collection of books, clothing, or winter camping gear that will then be distributed by the hospital for bragging rights for the wonderfulness of their humanitarian efforts.

Also,   I will not be running any charity 3K's or 5K's for any more causes unless it is for a definitive cure for stupid.

Gil: "It's going to be a six hammer night".  Reference: sometimes people need to be beaten with a hammer.  Please note that I am not talking about patients.

Wonderful World of Speech-to-Text Dictations in which Mac Does Not Proof-Read:

"The patient has recurrent tooth pain.  Her only problem be self once she has her teeth extracted.  However there does not appear to be readily feasible or likely to happen"

"UV strep test and flu tests were negatibe as likely to have the same upper respiratory infection however he is been sick now for about a week longer continue to uese the Zofran as necessary for nausea and robitussin with codeine 1 teaspoon every 6 hours as necessary for cough if in 5-7 days Asian R 20 better adn the cough persists started on Zithromaz as directed once daily follow up with your doctor in 7-19 days if not market lee better"

Asian R 20?  Market lee better?  7-19 days? WTF?

On Venting

Nurses know there is only so much of work you can bring home.  I recognize the signs in Mr. EDNurseasauras when he has had enough and doesn't want to listen anymore;  the glazed expression, the wandering eyes.  I can't blame him, but other than writing and spewing my frustrations, there just is no other outlet sometimes.  The crew I work with now are unlikely to want to get a drink after work, unfortunately.  I miss those days with my Utopia Hospital and Pseudocity Medical Center people.  There was always someone who didn't feel like going directly home, which led to beer call or 'rita rounds.  There were frequent opportunities to vent at one or another social occasion.  At Utopia Hospital an evening at one of my co-worker's homes turned into a venting session that some of my less experienced staff desperately needed following the ER death of a SIDS child.  We just don't have a ton of opportunity for socializing since we are a small shop.

I go in spurts with this blog thing as evidenced by the paucity of posts in November and December.  While  I may have a lot to say in general, some days I just don't even want to think about work let alone write about it.  It's been one of those spells where I am just not motivated.  Nobody at work knows I have a  blog, it would just be too awkward.  "I journal a lot" I offer blandly as I jot things down on a paper towel and stow it in my pocket.  I write a lot of stuff down because I have a pretty piss-poor memory when it comes to writing all these witty posts. I come home with a few scraps of paper or a post-it note or two which sit in a pile until the urge to write something is overwhelming. Sometimes it's a funny remark, sometimes it's just a "moment" that makes me laugh, think, or just shake my head.  Once in a while it develops into a full blown rant.

Some time around December of last year I began amassing an enormous pile of notes.  They piled up  on a table next to my chair for a few months while I sat uninspired, until I opened the adjacent window to let in a little springtime fresh air.  There went any semblance of organization.  I have yet to plow through them.  And the notes keep on coming.

On occasion, I pick one up and look at it.  Here is one that I can reach:

"The key to good care is poking holes in people"
This is a reference to a conversation Sherry and I had about people who actually require no care at all because there is either nothing wrong, or there is really nothing we can do for them.  In that case, people get downright pissed that we aren't really doing anything other than to reassure them that they are not dying....crazy is another whole story.  "Poking holes" means starting an IV and giving a liter of saline which amounts to the same as doing nothing when the alternative is doing.....nothing.  We do this a lot.

So that is one post-it note down and 4,000 to go.

Pointy Things

The 10:30 patient turned out to be a woman who had "snagged" her upper arm on something at work 12 hours previously.  Her emergency was that she felt like she was going to hyperventilate because the area felt really tender and it felt like there was something under the skin.  I thought it was some kind of bullshit Wally world employee work injury issue, but as it turns out; it wasn't.  She had a 1/2 inch sliver of wood removed by The Pirate  (he wears a cool earring: "arrrgh").  I don't know how he found it, but he did.

The patient and her husband spent the next 10 minutes oohing and ahhing over the size, shape, color and clarity of the offending object, and speculating as to how it got there and stayed there without her actually being cognizant of that fact until 12 hours later.

Her name was kind of....odd.  Let's say it was along the lines of Lotta Vodka, or Rita Margarita.  
"Is that her real name?  Honestly?"  

Seriously.

Flu-mageddon

By this time last year we had been through so many boxes of masks we were reduced to using the leftover pedi masks with the teddy bears on them, but not a lot of actual flu.  Until Christmas Eve we had not seen a single positive flu swab when we had a 4 year old with pneumonia.  Flu positive and very sick.  Lots of:

"I have the flu"
"I might have the flu"
"I think I have the flu"
"I have been exposed to flu"
"I am sick, therefore I have the flu"
"Can I have a work in case I get the flu?"

None of these patients were sick enough to cease using their cell phones,  stop yelling at their unruly spawn, or had skipped a stop for coffee or a Happy Meal on the way in.  Their diagnoses?

Bronchitis
Cold
Cold
Mancold
Douchetard Mancold
Looking for a work note, duh.

All that changed two weeks ago when we tripled our usual number of patients, along with the rest of the US who are now experiencing overwhelming numbers of patients.  It is Flu-mageddon.  One particularly awful day was the kick-off event with the waiting room full of families wanting to be seen en masse for cough and cold along with our usual collection of Saturday afternoon back pain, dental pain and other narcotic seeking individuals.   Bobo, of course, blamed the nurses for not getting people out of the department quickly enough.  What a tool.  I delighted in sabotaging his door-to-doc times by triaging at the speed of sound, keeping every room filled, parking lab pending's in the hallway, and calling in another nurse along with keeping the entire day shift.  I'll show you passive aggressive; he was beside himself.   Lucky for him The Talker just showed up to bail him out.  I love the Talker, excellent team player.  Bobo take notice.  

There was an awful lot of "I don't feeeeeeeeeeeeeeeeeeeeel goooooooooooood!"  which made it tough to take care of the finger amputations, granny dumps, vomiting infants and the like who all needed a room at the same time.   

The Talker spent 20 minutes trying to explain (in English and at a grade 6 level of comprehension to a 22 year old man and his father who had signed in together with father-son Man Cold) that ANTIBIOTICS DO NOT CURE VIRUSES.  "Well", said the father indignantly, "why didn't they tell me that when I called to ask if you treat the flu?"

"People are absolutely incapable of taking responsibility for themselves", said the Talker shaking his head in disgust.  "I have been telling everyone to look on the CDC website,  I'm sure nobody has".  For  the Talker, that was an unprecedented and scathing commentary on the degradation of society as a whole.

Me: "Why should they, it's easier just to come here for nothing and have you explain it to them"

Here is the information, in case anyone cares, from the CDC website: (http://www.cdc.gov/flu/about/qa/coldflu.htm)

What are the symptoms of the flu versus the symptoms of a cold?

In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations. 

(from CDC website http://www.cdc.gov/flu/about/qa/coldflu.htm)

I'm thinking that the numbers might not be so overwhelming except whole families are checking in at the same time.  WTF?  This cannot be a phenomenon limited to our own small ER.  Usually it is a pair of adults and 2,3,4 kids all for the same thing: cough, runny nose.  NONE of these people are sick enough to go to the ER.  The kids have rarely even missed a day of school.  We have simply stopped doing flu swabs on most people and the pharmacies have run out of Tamiflu.  

One family was brought by the dad because his wife was at home sick.  The oldest kid was a teenager with cough for 2 weeks; the younger kid about 11 with cough for 1 week.  Dad "just didn't want to get the flu like everyone else".   Really?  All three immediately donned masks.  Thank you, coughers, for not exposing Ellen.

Our doc decided to flu swab the teenager along with a rapid strep test since he had won the prize for the longest symptoms.   "OK, bud, you're taking one for the team", I told him as I stuck the flu swab up his nose.  Both were negative.  They went home with cough medicine to share.  

Paranoid Dad: "How can I keep from getting sick?"

Me: "You've probably already been exposed, but good hand washing is always recommended"
Paranoid Dad: "Will I get it if I wear a mask?"
Me; "No telling.  Let me consult my Magic 8 Ball"

I really do have one.  "It is decidedly so"

Paranoid Dad: "Can I have a handful of masks to take home with me?"
Me: "No"

Go buy your own masks.
If we gave a "handful of masks" to everyone who wanted them, we would be out of masks in a day.  

In addition to the Magic 8 Ball,  I also have a Sarcastic Ball that Lisa gave me for Christmas:

 Not that I ever need much help to come up with a snappy retort.  Go here to play with the virtual one.

My next addition to the toy pile will be this:

Just like the "Easy" button!