Monday, September 8, 2014

A Puzzle for You

License plate seen in a hospital parking lot:



Friday, September 5, 2014

Cat and Mouse, 2.3, or, I Hate Those Meeces to Pieces

If you have read any of my previous postings on  mice,  mice, and more mice, you may have gotten the impression that I don't mind them.  Seriously, I hate mice.  They are just so….rodent-y.  Filthy. Gag.  It is one thing to have them in the work place, but at home…..nope.  I was understandably VERY disturbed when I found mouse turd under my kitchen sink last week, having discovered that my packet of dishwasher gel packs was nibbled at the bottom.

"The dog got it",  Mr. Ednurseasauras told me.  "Two months ago".  As if it could ever be just a single mouse.

But, I bought it.  I don't do a lot of machine dish washing, probably only one load per week so it was possible that the packet had been nibbled months ago.  I put on two pairs of rubber gloves (which I threw out) and spent a morning clearing up and organizing the assorted cleaning clutter, vacuumed, bleached and decontaminated the entire area.  Then searched for further sign of the little f*ckers and cleaned every cabinet.  Having had enough mini drama for the day,  I washed my hair and puked.

There was no sign of additional rodents until yesterday when I FOUND MORE MOUSE TURD under the sink.

I have both a cat and a dog who have faithfully alerted me to the presence of mice in the past.  They have each caught a couple, and have even collaborated with mouse hunting/ slaying in the past.  The cat once left a mouse head on the kitchen floor to rebuke us for leaving her for the weekend, but the dog also impressive stats.  There was, however, no alert the time.

"You guys have failed", I berated them. Neither had the good grace to look ashamed.  The cat yawned, the dog licked herself.  Rude.

"We need to set traps", I announced to Himself.

Mr. Ednursesauras discussed the merits of various kinds of mouse-killing apparatus which we have collected and deployed, but never caught a thing.  We had some where they could wander in, but not out.  And some that are pads the rodent-y little feet stick to.  And of course the classic mouse trap-mouse traps, which are hazardous to human fingers.  Letting mice go is the same as leaving our borders unsecured, they just get back in.  Also, since our experience last spring with the beavers that resulted in the flooding of our property that we had just put on the market, I'm out for  invasive species annihilation.  My only rule is that I am not removing the carcass.  Nope.  Not looking at it.  NOT touching it.  Nope.

I do bees.  Hornets.  Yellow jackets.  I don't mind snakes.  I even had to clean up after a duck had gotten into our family lake house and died, and you can imagine the mess that made.  I have a lifetime of experience with body fluids,  both man and beast.  I think I am entitled to draw the line at dead mice.  Oh, and spiders.  I won't do spiders.

I baited the trap with a dab of almond butter and a small piece of 9-grain cracker believing that I would, a usual, not catch a thing.  I had the pest control service on speed dial and anticipated calling in the morning.

Two hours later I heard a rattling.  Shocking.

Dog: 0, Cat: 0, Human: 1.  Number of dead mice in the trap: 1

Mr. Ednurseasauras put on an old pair of work gloves and disposed of it.  I suggested he put in on our nosey neighbor's mailbox, but he wisely declined.

"Well.  That's that".

With the bait intact, the trap was returned to duty under the sink, Mr. Ednurseasuaras convinced that was the end of the problem.  Forty minutes later, I alerted him that there was a companion  dead mouse called to Final Accounting.

"What!?  How do you know that?  The dog hasn't moved".

I could hear it. Above the sound of the TV, my computer, and the air conditioner.   Call me crazy.

"Wow, you picked good bait", Mr. Ednurseasauras commented.

"Why, what did you use last time you tried this?", I asked.

"Provolone cheese".

NOW the dog was interested.

Today I cleaned under the sink, vacuumed, bleached, and disposed of another pair of Playtex Living Gloves.  Then washed my hair and puked again.

The dog has been at her post.

Tonight we hunt again…..
Stay tuned.

Thursday, September 4, 2014

Order Up

It still astounds me that the single most important need (aside from narcotics) for individuals in the ER is a meal tray.  I have come to hate the hours between 4:30 and 6:30 PM.  There is no room service available in the ER, unless the patient is a boarder (psych patients who have been there for days, usually).    People are like rabid dogs when it comes to food, "My mother hasn't had a thing to eat all day!!", like it's my fault that mother hasn't wanted to eat, been vomiting, or has been lying around too weak to eat for the weekend because you went away.

Here is a handy guide as to why food is not on my immediate list of important tasks:

1.  If you have come to the emergency room for abdominal pain, nausea, vomiting, or bleeding out the ass, we are not feeding you.

2.  If your blood pressure is 250/120, and I am trying to lower it by giving various medications, we are still not feeding you.

3.  If you come in with chest pain, we are not feeding you until you are seen by cardiology, which is after an EKG and many hours.  Don't ask.

4.  If you eagerly drink both quarts of the oral contrast (berry or vanilla flavored) for your abdominal CT and declare that it was delicious and hit the spot because you were so hungry, I am not feeding you anything else.

In case you are wondering what kinds of delicious treats and culinary magic we are able to whip up after the real kitchen closes, here is a short list of items we keep in our  ER"s "kitchen".

Apple juice, cranberry juice, orange juice, milk
Gingerale (regular and diet)
Graham crackers
Fruit cup
Peanut butter (individual servings)
Sandwiches (4 each: turkey, veggie, roast beef, ham and cheese)

At BWOM and the med center we had Lorna Doone's and Oreo's, which the nurses mostly ate.  And REAL Coca-Cola.  But not at Pseudocity.

Our refrigerator at Pseudocity is locked, by which I mean both the freezer and refrigerator.  Padlocked.  In order to unlock it, you must reach behind the fridge and find a magnet to unlock the cracker cabinet, then retrieve one of the keys to the padlocks for the fridge.  The ginger ale is under the counter.  It is unlocked.

It takes more concentrated effort to unlock food than narcotics, and takes twice as long.  On the off-shifts when the kitchen is closed, the real food goes quickly in spite of large signs that says "Do not give out sandwiches before 6:30 PM!!".   So does any motivation to make a meal out of crackers and peanut butter for the most part.

We don't have any soup or broth for grandma, or ovaltine or hot chocolate.  We don't even have tea.  And the coffee is just….horrific.

I am not going to feed your children.  The cafeteria is that way.  If it is closed, there are vending machines in the lobby with an array of delicious cereal, flash frozen hamburgers that just need microwaving, and candy.  And Mac's is down the street.

Wednesday, September 3, 2014

Reflection, Starting Over

I came across this post from a couple of years ago:

For years and years I worked at least two and often three jobs at the same time, but at at least one was always in the ER. I have had lots of different experiences.  I've worked in schools, as a camp nurse, in home care, employee health, a travel clinic, a same day surgery unit, pediatrics, telemetry, and med surg.  I have worked in large medical centers and community hospitals.  I been a staff nurse, charge nurse, supervisor, director.  I have done independent QA audits, worked for an agency. I have worked days, evenings, nights, weekends and holidays.  I have worked from within walking distance to my job or traveled over and hour.  I have worked with individuals who have become lifelong friends and others whose names I can't remember.  I have been both student and a teacher.  Sometimes I have felt unsure of myself and terrified, but have grown enough as a nurse to feel comfortable and competent, smart enough to know that I don't know everything.  I have done a lot, seen a lot, learned a lot.

I  have been restless and not altogether happy with my job lately.  For the last 3 years, it has been my only job.  It is close to home and I work with a small group of nice, accommodating people in a small ER.

I have been thinking that maybe it is too small.  I feel as though I am losing my skills as an ER nurse.  Few codes, trauma as rare as hen's teeth.  I am SO TIRED of the constant parade of drug seekers and the pressure to just make everyone happy, even if what they want isn't what they need.  Want antibiotics for a virus?  Sure!  An Xray for your three week old ankle injury that you insist must be broken?  No problem!  Dilaudid for your migraine of 10 minutes?  Absolutely!  Why do you need doctors with experience and expertise when you have WebMD?  All we ask in return is positive customer satisfaction scores.

I have never felt less valued as a professional nurse anywhere.  It's not my boss, she's great. It's the organization we work for.  Our director talks a good game, but there is no visible support for the activities of nursing.  There is a part-time research nurse, nobody really knows what she does and I have never seen her.  Committees?  The same dull people with the same dull ideas. 

I have a really crappy attitude and no real goals since finishing school.  For the first time in a long time I have no concrete plans to move on, move up, or move out.  Maybe it is because I am working only one job in a small town, I don't know.  I am in a real rut.  I have to work about 10 more years until I can retire and that pisses me off.  I can't see myself doing what I'm doing for another 10 years.

I keep telling myself I am lucky to have a job.

And then I didn't have a job two years later.  Serves me right for being too comfortable and complacent.    While I didn't exactly lose my skills, many of them were seriously misplaced and difficult to regain.

The funny thing is, if I hadn't been forced to find a new job (actually, three new jobs)  I would still be in the same rut.  But…it has not been a seamless transition.  I have had to learn, and re-learn, a lot.  I finally broke down and bought a couple of sets of new scrubs.  Yes they are black and grey, but color blocked and not cutesy.  OK, I drank the Kool-Aid of my fashion forward co-workers, but just a little sip.  Anyway, the unit teacher noticed my new and smaller sized duds and said I looked like I had lost a lot of weight and wanted to know how I was doing it.  "Oh, you know….stress and not eating", I joked.  But I really wasn't.  It isn't the people, it is the environment and my own need to do everything flawlessly.  Of course, that is near to impossible.

She had some helpful thoughts about not being too hard on myself.  "It takes about a year for a nurse to get completely comfortable in this busy environment, I think you're doing great".  I have a lot of trouble reporting off to the next nurse sometimes, especially if I don't feel like I've done everything.  I never want to be "that nurse" who walks off the floor in the middle of a shitstorm….can't do it.

But I get more comfortable every day.  And I still tell myself I'm lucky to have a job.