Randomness

Phone call tonight:

"Hi, I'd like to come down and get the equipment to draw my mother's blood. She has Alzheimers. I have the paper from the doctor saying what tests she needs so you could look at it and tell me which tubes I need".



um, no.



Phone call from a pharmacist 30 miles away:

"We just wanted to check and see if Dr. R. wrote over the Vicodin prescription. Also, the dosing was a little odd, it says to be taken three times a day".



nope. The doc didn't do it, the patient did. Overwrote "valium 5 mg" and changed it to vicodin 5/500. Local constabulary dispatched to perpetrators residence. NO SOUP FOR YOU.



2nd phone call from a pharmacist, this time local:

" Hey, just wanted to check and see if Dr. P. knew that (anonymous, for HIPPA reasons unless I made the whole thing up) just picked up a 'script for 30 Vicodin from Dr. N when he dropped off the one you wrote for him for 20 Vicodin."



hmmm. Nope, he didn't say he saw his doc today, must have slipped his mind. You can rip that one up and the patient and doc will have a little chat about the importance of being honest with your provider.



Woman complains of painful intercourse x weeks. Has no insurance so comes to the ER, where her care is virtually free courtesy of those of us who pay for her to have this privilege. Has an ultrasound, but doesn't want to wait around for it to be read by the radiologist. Husband certainly has time to ask for a script for narcotics though.

Pedi severe head trauma from last month doing well and headed to rehab.

Sign on closet of one of the nursing units:

Student Nurse Closet

in small handwritten letters just below above sign

"Occupancy 13 student nurses".

Told you it was random.

Home on the Range

We get an ambulance containing the 88 year old gentleman from a local Alzheimer's warehouse. He has had a bloody nose off and on for the last 2 hours; not hypertensive, and not on coumadin, and also not bleeding when he hit the door.

He had quite a pronounced Scottish burr. And was quite delightful.

He was wearing well worn jeans and a really nice pair of Nike shoes, and began quietly and continously singing "Home on the Range" in a lovely sweet (mostly) in tune tenor voice. Over and over and over.

I wanted him to sing "Loch Lomond", but the Brit paramedic reminded me that it is a song about death, so it probably wasn't such a good idea. I didn't mind, really. He was singing pretty quietly as I said and minding his own.


The doc stuck some adrenaline up his nose with a piece of cotton and went about his business, only to come back and find the cotton...gone. He gestured frantically; "I need you to babysit him, I don't know where the cotton is"

"Do you think he swallowed it, aspirated it, or pocketed it?" I asked unhelpfully.

"Dunno. Can you just squeeze his nose for 10 minutes?"

Sure.

Squeezing his nose for 10 minutes was no hardship for me, but it did keep him from singing "Home on the Range". He had switched to "Let Me Call You Sweetheart".

The gentleman calmly allowed me to squeeze. Every so often he would say (I thought), "I've been a carny all my life". As in carnival, perhaps.

Well. "So what kind of work did you do there?".

"Oh, cars, all sorts of engines".

What I realized was that he had been a mechanic all his life.

The doc comes back after 20 minutes or so, finishes up and my little man was ready for his ambulance ride back to the Alzheimers warehouse. I was sorry to see him go, although he did start to wander around a bit and was fascinated by the blanket warmer in his room.

Oh, and I found the missing piece of cotton on top of the thermostat.
"Home, home on the range....."

Calgon, Take Them Away

Overanxious parents bring in a 15 year. His hand was caught between the wood stove he was helping to move and the floor leaving him with a few deep abrasions and some swelling on one knuckle worthy of an xray, but it certainly not the "Really bad" injury as advertised. The father responded to my question about tetanus: "Mine is up to date".

Um, for the record I didn't ask. And I don't care, especially since you continue to refer to your son as "princess". One more admonishment for him to "man up" (he was) and I'll give you something to man up about. This was clearly not a very deep gene pool as I was to learn.


Mom returned from the bathroom and announced, "Hey, there's Calgon soap in the bathroom, isn't it supposed to take you away?"

Husband: "Why, isn't that an Italian sandwhich with cheese and sauce?"

Me: "No, that's a CALZONE" ("you moron", my thought bubble screamed)

Husband: "Well, I was in the same state, the both start with 'K', don't they?"

I had to leave the room.


After an xray (negative) I cleaned up the cuts, put on some antibiotic ointment, assured the mom that her son would be able to play baseball and sent them on their way. But not until the brain trust that was dad asked if he would get crutches.
"Um, for a hand injury?"

"No, I just wanted to have them around in case we needed them".

No.

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.