Wednesday, February 13, 2013

Valid Question

Phone advice requested from a night shift worker:  "I am confused about Dayquil and Nyquil.  If I work nights, which one should I take in the morning?"

Tuesday, February 12, 2013

Even a Blind Squirrel Will Find an Acorn Now and Then.

I occasionally speak of squirrels, of which I have two; they are small plastic creatures that sit on my desk and mock me.

When one of our regulars comes in for the usual tedious complaints requiring a narcotic script for the 20th time in the last two months, the squirrels dance. They recognize kindred spirits.  My personal mantra regarding squirrels: 

If you feed them, they will come 

My co-workers have, sadly, adopted my irreverent view of drug seeking complaints. Sometimes they will return from triaging and pick up one of the squirrels, or simply make chittering noises.  Sometimes I will be asked if I have such a thing as an acorn about.  Silly stuff.

it is not the first time that squirrels have been a running joke in my life.  "You should have bought a squirrel" has long been a favorite tag line among my skating ladies thanks to a long bus trip and the movie "Rat Race".  Google it, it's pretty funny. A few years later, Suzu the Squirrel, a pretty life-like but decidedly creepy hand puppet became a mascot for another group of skating ladies.  And, I have 1/2 pair of cute squirrel earrings given to me years ago as a Psecret Psycho gift.

More recently I was given a fun pair of socks from a co-worker:

Last year I devised the "Golden Squirrel Award":

Shocking that this one did not get stolen off the big fake tree in the lobby

Around Christmastime this past year, someone brought in a miniature Charlie Brown Christmas tree for our desk.  I loved it so much I immediately purchased one for my son and left it on the door of his apartment since it is the size of a phone booth and he would otherwise not have one.  As for the one on the desk I decreed that it should remain year round as a haven for my squirrels.  New Cathy, self-appointed Decorating Ninja, has dressed it up for Valentine's Day:

Ellen added the bird with the acorn cap because she actually thought it was a squirrel.

Ellen is usually stuck out front, but sees the squirrels, squirrel signs and things like this:

I blanked out my name and was too lazy to type in "EDnurseasauras"
and thinks that I have a passion for and/or collect squirrels.  Inevitably it is assumed that I am the Expert on All Things Squirrel, when in fact I am merely the one who pushes the snowball off the cliff.  A few weeks ago she sent me this text when she started hearing noises in her chimney:

Ellen did, in fact have a a squirrel removed by the critter control.  It didn't have a whole lot of fight left in it

Ellen pointed out that, coincidentally, January 21 is National Squirrel Appreciation Day.

My final squirrel note got my dog, Tina, into the act.  As a terrier, she is all about sniffing out squirrels and chipmunks. She is relentless, but it's winter and there just aren't any critters around just now. Imagine my surprise that on one of the coldest nights of the year, she brought home a dead frozen squirrel.  I made a nice "thunk" when she dropped it on the deck outside the back door.  Mr. EDnurseasauras apparently didn't chuck it far enough away because she retrieved the same cold, dead squirrel the following night.

"Good girl!"

Monday, February 11, 2013

Oh Look! EDNurseasuarus Has a Blinking Skeleton!

How do I turn that annoying thing off?  It never USED to blink, then one day, suddenly, I have have a blinking skeleton inside the body of my dinosaur.  If you know how to get it to quit I would appreciate the information.  Thanks!

Always a Nurse

Text exchange with Partner in Crime, who had the weekend off:

PIC: So here I am at the Mexican Restaurant and I can't even drink in peace.  One of the line cooks has a seizure and my sister volunteers my assistance.

Me: WTF?!  You go girl!  I hope they comp your tab

PIC:  Me too!  I have had two beers since then

Me:  "I don't often have seizures.....but when I do, I prefer Dos Equis"

PIC: Hahahahaha!

Saturday, February 9, 2013

Nor'easter Notes

Ever wonder who goes to the ER in the middle of "The Storm of the Century"?

1.  Plow-guy who cut his hand in a snow blower

2.  Man Cold

3.  15 year old not-sick girl with "sores in my mouth for two days since I drank out the glass of somebody at school who I found out had mono".  Mom didn't want to wait around for the mono test because "The steak house is closing in an hour and I don't want to have to cook".

4.  16 year old who had "bladder pain" for 10 minutes.  Because she was prostrate with pain and walked like the letter "C" between texting her friends and updating her Facebook status, she bought herself an abdominal pain workup.   When she asked if the IV would hurt, I said, "well, it's a needle, it's gonna pinch for a second".  Mom, on the other side of the bed grasping her daughter's hand and smoothing her hair assured her "it's just a tiny needle, they need to find out what's wrong with you", while the daughter moaned loudly, "I DON'T WANT AN IV!  I DON'T WANT AN IV!  TAKE ME HOME"  whereupon mom told her, "Well, we need to know what's going on in case you need surgery"...WTF??  Who said anything about surgery?  which made the kid ramp right up.  This 16 year old SHRIEKED when the IV was started and continued to sob about how awful it was for a long time,  completely forgetting about her horrible bladder pain.  I vaguely remember muttering something about putting on big girl panties and handed mom a couple of People magazines suggesting that perhaps she could read her daughter something to distract her as constantly calling attention to the issue clearly wasn't helping.  She was WAY over the top drama and mom was enabling.  

"Is she completely unstable?" I asked New Cathy, who merely rolled her eyes.  She eventually got Ativan and a completely negative workup.  She was our last patient of the night 3 hours before we closed.

The two of us, plus the doc, stayed overnight and worked the day shift.  The secretary called in snowbound but we had a contingency lined up for that.  We didn't count on Wednesday, that moron, staying over, sleeping in until 9:30 or so, hanging around and not cleaning 2 feet of snow off her car.  Did I mention she wasn't even working?

We never saw a soul until 11:30 AM because people wisely stayed off the road, all the ambulance calls went straight downtown as ACTUAL EMERGENCY patients, and the Lady on Elm St. had already already used up her Big White Taxi with the Flashy Lights Ticket the day before.

I was actually bored.

Friday, February 8, 2013

The Crayzee Whisperer

Picture, if you will, the crazy Area 51 mad scientist in the movie "Independence Day".  Ok, don't bother; I'll just show you.

This was the face that caused a bunch of ruckus, yelling and shouting and intimidating our new secretary.  Never mind that the guy was in his 70's, Gil did it; he called police to help the man regain control.     It was very busy so he cooled his heels until I came on shift about an hour later. Yeah, sure send in the one nurse in the department LEAST likely to de-escalate an irate human being.

He was a cellulitis recheck and IV antibiotic patient who apparently didn't really understand that retrning to the ER for a reevaluation doesn't mean the following: being seen immediately and ahead of sicker patients, or the visit taking less than 30 minutes (especially if there is not an existing IV).  Here life often moves at the speed of paperwork, which I had some trouble accessing since Mr. Doe had been previously seen downtown.  I rapidly straightened it out and went to talk with him having been elected the Christian to step into the arena with the lions.

I introduced myself and told him what I was going to do, whereupon he launched into an accounting of how he had the cops called on him and wanted to know who did it.  He was pretty sure it was the doctor whom he referred to as "that putz"

Me: "Oh, I'm not sure.  I just came in, I heard that you were a little upset though.  I apologize for the wait"

Mr Doe was understandably angry, but tried very hard not to direct it to me: "I understand that it's not your fault.  It's unbelievable really.  It's like one big Kafka novel".

Me: "You're having your own private metamorphosis?"  It's the only Kafka I have read.  Not a fan, really.  The idea of a giant insect gave me bad dreams.

Mr. Doe: "No, no, it's the surrealism.  We're at the whim of the bureaucrats, pushing paper, making rules and decrees..."

He continued in this vein for some time while I nodded and smiled and said "Oh, sure", and "that's very interesting".

Mr. Doe had lots of interesting things to say, most of which seemed to be rambling.  "We would be arrested in 13 nations for saying anything about the Holocaust", having a diverse opinion would cost him tenure, how he had written books.  Some of it had a ring of truth to it, some not so much.

He seemed to have forgotten his earlier ire and warmed up to me, and by the time he was finished I had him eating out of my hand.  I was the greatest thing since sliced bread and he was going to speak to my boss about getting me a raise.  He apologized for scaring people but still harbored some animosity toward Gil.

"Ok, that's cool. I'm here tomorrow after 3 PM, so when you come back for your recheck ask for me and I'll get you right back to a room, mmmkay?"

The following day he arrived on schedule and asked for me, "the best nurse who works here".  Jules was horrified when I asked, "So, where are you on the Grumpy meter today?".  She had not seen that he was actually wearing a bright green  tshirt with a picture of Grumpy with a meter to measure his grumpiness.  He smiled mischievously and asked if "the Putz" was working today.


Thursday, February 7, 2013

Always After Me Lucky Charms

Being ill simply doesn't fit in with most individuals' plans.  Nobody has the time or patience to let nature take its course.  Heaven forbid people inconvenience themselves long enough to contact their primary care provider or wait for an appointment when it is so much easier to go to the ER.   Even having seen their primary care, members of Instant Gratification Nation wait about 5 hours on average, then naturally it's off to the ER to obtain the pill that makes them Magically Better.  Guess what, we don't have one.

Of course one could always fall back on magic. In fact, I am considering adding Do You Believe in Magic? to mandatory screening questions I ask at triage along with Do you smoke, drink, use seat belts, have unprotected sex, use coffee, or in an abusive relationship.  That would save some time.  Discharge instructions could then include such choices as:

1. Adding a daily serving of  Lucky Charms, which are Magically Delicious.

2.  Make a visit to the Magic Kingdom.  Lots of magic there.

3.  Listen to the Beetles Magical Mystery Tour.

4.  Gotta have you some Magic Beans

Wednesday, February 6, 2013

On Watching Your Language

Gotta love The Pirate.

The Pirate lost his first psych patient who ran out the door shouting, "Fuck you!  I'm not staying in the fucking hospital!" After allegedly taking an overdose and adding another couple of cutting notches to her arm she "just wanted to be stitched up and go home".

The Pirate, who does proof-read his dictations, charted exactly those words.

I always used to chart the profanity patients used until I was told by some Clip Board nurse that I really should not be charting the actual profanity.  I should just write "patient used the F word" or some shit like that.

"I went to a seminar with a bunch of lawyers who said I should absolutely write what the patient said in quotes because it's about the last thing anyone wants read aloud in court".

Word.  My charts are gonna look a whole lot more interesting from now on.

Tuesday, February 5, 2013


Partner in Crime had already spiked a bag of Avelox when Parvati changed her mind...two more times.
Which is why we no longer take any more verbal orders from Parvati.

Anyhoo, we kept the bag of expensive IV antibiotic around hoping we would be able to use it for another patient, but alas, it was not to be.  

"Let's put it in the refrigerator and see what happens", I suggested.  "It says not to because it causes precipitation"

24 hours later this is what we got.  Looks like feathers to me (note my Magic 8 Ball and Sarcasm Ball in the background)


Monday, February 4, 2013

Reap This

Today I walked into a day-shift shit storm as they were transferring a successful (read: "alive") code enroute to higher level of care.  There were lots of people waiting, some of whom had been waiting quite a while.  There was a handful of nice respectful individuals who were aware that a life-death situation was occurring.  They were calmly and appropriately waiting their turns.

Then there was Angry Woman.  She had a cat scratch.  She had been waiting over an hour.  SHE WAS AT RISK FOR INFECTION and creating all kinds of ruckus to the point where my boss became involved as my co-workers labored to transfer the nearly expired patient.


Jane: "I made nice with her.  She is waiting for Parvati to see her.  And she wants her B12 shot, she usually gets that as an outpatient, she doesn't have an order for it soIcalledovertoeherprimarycareandI'mwaitingforafax", she finished rapidly, probably hoping I didn't hear it.

Me: "So, let me get this straight.  She has an emergent cat bite and came in for an emergent B12 shot for which she doesn't have an order and she has made a scene and threatened to leave if she doesn't get it in the next five minutes and you have placated her, is that correct?"

Jane: "Um, yes?"

Me: "OK, I lost interest in that 5 minutes ago.  I'm going to do EKG's and line and lab a syncope patient.  Have fun with the douchey Angry Woman".  I walked off to retrieve the IV bucket and EKG machine, but not before I asked Angry Woman to take her Loud Hallway Douchey Telephone Yelling Session With Her Primary Care Provider's Office out of my hallway and into a room.  Eventually she stalked out, but Jane had told Angry Woman that she would call when the order came in.

 I politely told Jane that if I was busy with ACTUAL EMERGENCY patients that I would not be calling the shrew.   It was not pertinent to emergency care.

About 20 minutes later Ellen brought me a fax referencing Angry Woman from her primary care that read: "Re: Vitamin B 12.  Angry Woman called from the ER and stated that she would leave if the order was not faxed in 5 minutes"


Me: "Um, that's not an order, Jane"

Jane: "Sure it is....isn't it?"

Me: "Jane.  No diagnosis, no dosage, no route.  Not signed.  Definitely not an order"

Jane: "Her primary care office said she was a mumblemumblemumble"

Me: "Excuse me?"

Jane: "They said she was a bitch difficult"

Me: "As ye sow, blah, blah blah"

Sometimes squeaky wheels just get the well-deserved shaft.

Sunday, February 3, 2013

Cat and Mouse, 2.1

Yes, this is a mouse.  Under the old computer in the kitchen at work.  Its presence was detected by our little weekend housekeeper.

"Missus!  Missus!  There's a mouse in the kitchen!"
Esma insists on calling me Missus even though I've repeatedly told her to call me by my first name; we don't stand on ceremony here.  Maybe she just can't be bothered to learn everybody's names.  Anyway, Missus it is.

I walked back to find the offending critter who, having evaded the numerous traps placed and forgotten months ago by the pest control people, was now emboldened to storm the kitchen.  I moved a box to see the little rodent perched under the monitor.

We stared at each other for a  moment.  Critter twitched his whiskers nonchalantly.  "Hmmm....Esma, watch him for a minute I'm going to get my phone".  It has become the most obvious thing to do in this electronic era.  Take a picture.

He posed quite contentedly for several minutes until I got bored and tried to poke him into the trash bucket with the mop handle, all the while Esma laughing and squealing, "Get it!  Get it!".

Off it ran into my boss's office on the loose once again.  I sent her the above picture with the following text of her adorable little guest.

It is still out there......somewhere.