F stop

Why do people find it necessary to punctuate their discomfort with "fuck" to make a point? I am not averse to dropping an occasional "F" bomb to make a point.....when it's appropriate. But it is seriously overused if you ask me.

Can I say "fuck" on this blog? Guess I'll find out.



Perhaps in the ER we should institute an "F Scale".



I see this as an adjunct to quantifying pain via the pain scale.


Let's say a patient is complaining of back pain. He might say something like "Ah, FUCK. My fucking back hurts so fucking much, I just want to fucking kill myself. FUCK!




So, the pain is 10/10, with an F scale of 5. And a +1 for suicidal ideation as a bonus.

Another way to guage the turkey factor is F per minute.

Fuck.FUCK!

Fuckfuckfuckfuckfuckfuckfuck!!!!!!!

This is just overkill. And insincere. I heard you the first 9 times you said it.


I used to work with a very funny doc. He was really an angry young man deep down, but pretty funny usually. In my opinion he had the best possible use of the F word. He frequently used used the expression: FYYFF.


Fuck You, You Fucking Fuck. Or more accurately:

Fuck YOU. You. Fucking. FUCK.
The last 3 words were sort of slow and enunciated, like 'You. dirty. rat".
Yep.


I really appreciate the f bombardiers who pause after a string of f's to ask me how my shift is going. Ah, trying to endear yourself to me are you? Won't work, I can see ya coming a mile away.


My boss hung up an article written by someone whose defense against busy or compassion-lacking nurses was to get "up close and personal" with them, to try to connect with them in some way as to increase the human factor. One of her tactics was to ask if the nurse had children, or comment "I love your clogs!". Seasoned and hard core nurses won't fall for this; it just signals them that there is an agenda. It did get me thinking though. Anyone of us would advocate strenuously for a loved one, it just happens that those of us who work in health care (especially the ER) are usually more direct.

Hey Doc, great clogs!

F-you.

Some Vacation!

So I took a little time off. Well, a LOT of time off, can't believe it has been 3 months since I have neglected my blog. It totally amazes me that people still actually read my meandering scribblings. To those of you who have left comments, I apologize for never responding. Bad blogger that I am, I humbly beg forgiveness. I can assure you that I have not been idle.

As an aging BSN student I continue to plod along one course at a time. I can't say I actually enjoy it, but at least now I am over the hump and have more credits under my belt than the ones to come. I am CLEPping humanities next week so I can get credit for two electives, and plan to CLEP American government, college math, algebra, and chemistry. These latter three are not strong suits and will require tutoring probably. Although I did discover a web site, Aleks, which is sort of an online tutor for math and science. I have done a few math modules and have discovered that I'm not as math-illiterate as I have thought all these years. I found out that there are (gasp!) RULES for this stuff! Imagine that! I just never picked up on that in high school! Ha!



On the work front I have stopped doing the admission job. It was too stressful for a lot of reasons. Now, keep in mind that I have plenty of supervisory experience. I was a clinical leader in a very busy 35 bed ER, was a nurse coordinator for a bunch of school nurses, and I have been a charge nurse for most of my 32 years. Heck, my first job out of nursing school was a 3-11 charge nurse on a 40 bed rehab floor. Just me and my shiny new RN license, 1 LPN, and 4 LNA's. Talk about home alone! The point is I can handle pressure, but I digress; the admissions job was like fitting square pegs in round holes. Nobody wanted to take the admissions, the PACU needed to get people out, the ICU needed to get people out, the ER needed to get people out, Tele needed to transfer non-tele's off their unit, the floors were understaffed and overwhelmed, primary docs wanted patients directly admitted and it was pretty much a damned house of cards on most days because beds were scarce as hen's teeth.



So what have I been doing instead? I took a position at Scary Catholic Hospital where nobody yells at me. Yeah, I took a pay hit. Yeah, I have to work weekends and holidays. But it is a relatively stress-free existence. I will still work in the ER at Pseudocity, but I won't be doing much in the admissions line. I am rather liking my sanity.

Idiots in Paradise

I

AM

ON

VACATION!

Mr. EDNurseasauras and I are vacationing in Sedona. It is beautiful and alien, so not like the East; we are fascinated by the formations and history.

"I could live here", I commented to my husband.

"Yeah, right".

The people are friendly and helpful. That is the people who live here. The assholes are obviously the same everywhere, driving like idiots, cutting people off, and generally happy to be the oblivious center of their own universe.

Mr. EDN and I took a trolley tour on our first day. It was great, our driver pointed out many interesting sights and bits of history. There were several brief stops for photo opportunities and a 15 minute stop at the Chapel of the Holy Cross, built into the rocks. Regardless of any religious affiliation (or lack thereof) it is a pretty inspiring piece of architecture.

Our driver was clear that the trolley would be leaving in 15 minutes. My husband and I, as well as the rest of the group all managed to do our sight-seeing within this time restriction; two people were not.

We sat and waited. The driver did a head count. Counted again. Called the office to make sure that her numbers were correct. Asked passengers at the back of the bus if there had been another couple.

"Yep", I said. "There were. They are late. We were on time, as well as 90% of the group. Let's go".

The driver laughed uncertainly, not sure if I was kidding.

"No, really. We've voted them off the trolley for being tardy. Leave 'em"

"Yeah, she's right", remarked the man in the Red Sox cap at the back. Red Sox Nation is everywhere. "Leave them here to die. We shouldn't be punished for their tardiness"

Most of the passengers laughed and said "Yeah, let's go", and "C'mon, just go".

Pretty funny, actually. The boneheads showed up just as things were getting interesting, oblivious to the glares of my fellow disgruntled trolley-mates and unapologetic. Hey, thanks for coming.

La, la, la.

One night we went to a Chinese restaurant for some food to take back to our condo. There was a fountain adjacent to the restaurant, with a large bronze statue of Neptune. In the midst of this was a little pond with plants and flowers, and a large bronze chair.

As we emerged from the restaurand with our food, although it was poorly lit (no streetlights in Sedona), a man was getting up out of this chair. Another man, with a flowing grey hair and beard and wearing a bathrobe told him "You are in my chair". He had clearly just emerged from said pond. It is important to note that this little oasis was in the midst of group of shops and restaurants. My husband told me he had seen this gentleman earlier in the day walking along the main road. He was wearing the bathrobe at that time as well.

"I believe that man just bathed in that fountain", I observed.

"Let's go before they argue about the chair and it gets ugly", said my husband. The eccentric are everywhere too.

Mr. EDN and I went to the Grand Canyon, just one of the most beautiful and awe-inspiring sights we have ever seen. We had some fun taking pictures of ourselves and using the timer on my camera to get some shots of us both. Mr. EDN is an avid hiker (something I am not) and he got into it, spying the perfect outlook or rock for "the picture". One particularly challenging

shot involved climbing down a fairly steep slope and rock-hopping. For me, with not-so-great knees, it was a challenge.

"This could well be the last photo of me ever taken. Getting here is only the half-way point", I huffed as my loving husband assisted me to our perfect photo spot. "I wonder if the National Park Service will recover my body?"

"You are being dramatic. You did it, and you will get back no problem"

"Okay, fine. Remember, I trust you. And I will haunt you forever if this adventure goes south"

We did get our picture, and it is sensational if I do say so myself. Another brave soul (whose well-dressed wife had remained at the rim) climbed down to join us and was happy to trade photo-taking with us. My husband will talk to anyone, anywhere, and engaged this gentleman in conversation. Turns out we would have been neighbors in our former Massachusetts home as he lives not far from where we lived. Very small world indeed.

On our walking tour along the Grand Canyon rim the idiots continued to mass, their individual orbits colliding with others. One guy on a motorcycle rode along the pedestrian path. On the motorcycle. Where there were kids and elderly people off tour busses by the hundreds. Where's the NPS police when you need them? Speaking of tour busses, many of these people seemed unaware that there were other people trying to walk. On the right side of the path. Hello? This is America, please follow the rules of the road where we drive and walk on the right.

I asked my husband to shoot me if I ever expressed an interest in:

1. wearing a fanny pack

2. using a walker with wheels that could fit a dune buggy.

3. any kind of group bus tour to anywhere.

4. wearing a scarf in 100 degree heat. Sheesh.

We met some lovely people, such as the couple from Scotland who fostered crack babies and other poor substance abuse victims. The were fun people. I was happy to see that the wife's view of the idiocy of the world was much the same as my own. Then there was Barbara, a retired high school teacher who traveled on her own, comfortable with her choices and happy to meet people along the way. She wound up in our rail car because hers was crowded with families who let their unruly children run up and down the aisles, spoiling the experience for others. I love kids, but I just wish that their parents would take responsibility for them.

"Welcome to the adult car", I said. "I saw a sign somewhere that said unattended children will be given an espresso and a puppy. That's almost as good as the guy on the Disney train that said unruly children would be tied up, taken to Small World and made to sing until they are 15". We had a good laugh over that one, and the Scots couple, Barbara and my husband and I became fast friends for the duration of the trip.

Yet, even the idiots couldn't dampen our enthusiasm and we had a truly great time. All vacations must come to an end and I will shortly be back in the real world. Sigh.

This was a great vacation.

My New Baby

This is Tina, my new dog. She is a ton of fun, energetic, smart, LOVES to run and chase a ball or frisbee. She is the only reason I get up and walk a mile before I go to work in the morning, something I have just not been able to motivate myself to do.

She is a very sweet girl, 3 years old, part terrier and part beagle. I have had her for about 5 weeks, having adopted her from a family who no longer wanted her for reasons that are unimportant. Tina's picture was on the break room bulletin board for oh, about a month. One day I happend to ask if she had found a new home; nope, and by the way she would be making a visit to the ER that very afternoon. Long story short, to save her from being put to sleep, sap that I am, the dog comes home with me.

Now, I used to have the world's best border collie up until a few years ago when he had to be put down for illness. It just about killed Mr. EDNurseasauras, who vowed never to get another dog for the rest of his life. After a couple of years without one, I was ready. While he never said no, my husband always had good reasons why getting another dog was not a good idea. I never disagreed with him, but still , dog was on my agenda.


Fast forward to 5 weeks ago. I brought the dog home about 6:30 PM. Tina was skittish, fearful, mistrusting....of me. The cat she ignored. She had obviously been neglected and she smelled. I threw her into the tub and spent the next hour petting her and talking to her. She settled in.


Until my husband came home. Tina barked and barked at him as he came up the stairs onto the back deck with a large box. "Well", he observed, "you have a dog". "Yep", I replied, "You have a 37 inch TV. It appears we have a stalemate". I promised myself that I wouldn't fall in love with her, and if it didn't work out, I would try to find a good home for her. I hoped that my husband could manage to make friends with the dog and gain her trust. Believe me he loves animals and wouldn't harm a fly.

Tina continued to bark at my husband, and all males, for the next week. She barked at him if he left the room to get a snack. She barked at him if he got up in the middle of the night to get a drink of water. She barked at him when he got up in the morning. I was the one she ran to, hid behind and followed. She had decided she was my dog, although she liked my daughter a lot. All animals and babies love my daughter so it was not surprising.


"Two weeks", I said. "Let's give it two weeks. If she can't get used to you, well....I'm Gonna Miss You (I sang). Just kidding. We can't have a dog that doesn't trust you, I know that. Just be patient with her".


He was. He worked it and worked it. Coaxed her to come to him, but she was so heartbreakingly submissive I wanted to cry. She rarely made eye contact. After a week she stopped barking.


After three weeks she jumped up on the couch when he called so he could pet her.


Last week she got up with him in the morning and let him feed her instead of waiting for me.


Today she wagged her tail, danced, licked his face, and was excited to see him for the first time.


Hook, line and sinker. He's as in love with her as I am.

Violence in the ER

I know it happens in every ER; someone gets the shit kicked out of them by a patient or visitor who is unruly and abusive, usually under the influence of drugs or alcohol, or because the voices tell them to do it. Granted it is an unpleasant and inevitable aspect of the job, but it sucks to go to work and fear for your physical safety particularly if the security guards are elderly and not in the best shape. I thank the Psuedo City PD for their always prompt response to our 911 calls.

It's no different anywhere. At my last job at Utopia Med Center, we had a 3 room psych corner which I referred to as Area 51. Each room was equipped with 1. a bed, 2. a TV behind a plexiglass screen mounted out of reach near the ceiling, and 3. a closed circuit TV. It was nice and quiet, all three rooms located behind a sliding glass door that we rarely used. Each of the three individual rooms had a door with safety glass, and internal louvers for privay that could only be operated from the outside. The only design flaw that I could see was that it was a little out of the way for the stupendously drunk, but we did have a good crop of behavioral techs or security (strapping young lads all)to assist us when required.


The integrity of the plexiglass was tested on the very first night Area 51 was opened for business. One of the frequent psychotic flyers picked up a chair and heaved it at the TV...yep, plexiglass remained intact, but the chair broke in half creating a nice little weapon. Miss Thang was treated to four point restraints with a face shield since she was unable to curtail the spewing of spit in our general direction.


One night, another patient literally launched herself at the plexiglass window in the door and...you guessed it...blew it out completely. This thing must have weighed close to 40 pounds. The window struck one of my nurses on the back of the leg, causing a very deep and painful laceration and damage to her achilles tendon which put her out of work for 1o days.


I don't know if these things run in cycles, because here at Pseudo City Med Center there has been a proliferation of violent acts. One nurse was choked near to unconciousness by a crayzee. Another lashed out with a heavily booted foot at a pregnant nurse; fortunately his aim sucked. A couple of the chronic paineurs have become bored with the usual whining and become quite threatening; one actually went nose to nose with the security guard (an ex cop, bless him) and shoved him. This act just bought him a ticket to Psuedo City police station.


This increase in violence has spread to the inpatient units. Yesterday there was an overhead page for a code green, for employee distress up on one of the floors. One of the chronic insincere detox / suicidal regulars threatened a nurse and got up in her face. She was backed into a corner of the room; this is a paricularly tough cookie, so for her to push the panic button must have meant she was shaken to the core. When an employee distress code is called, the plan is for every able bodied male in the place to respond. Unfortunately, the only able bodied males who didn't respond was security. The individual was subdued and the nurse was safe, so it all worked out.

But.

There is a problem here. Clearly, security is used to responding to the ER, but not to the inpatient units. With more crayzees and violent individuals being admitted medically instead of to a forensic psych unit where they belong (and where there is adequate trained staff to deal with them SAFELY) the security staff is stretched pretty thin. Assuring the safety of the staff does not seem to be a priority for the the Bean counters; when an incident occurs, they are all about damage control, but it seems to be more of a case of following protocol than actually caring about what happens. Having a nurse choked nearly to unconciousness was not enough of an incentive to clamp down on violent offenders nor was the sign in the waiting room "Zero Tolerance Policy for Physical or Verbal Abuse of Hospital Personnel" much of a deterrent.

I would be happy with a Taser purchase for ER use PRN. With proper instruction, of course.