We are Here for You!

My co-worker, Lisa, moonlights at other ER's. Today, she was at the Bear Went Over the Mountain Regional Hospital ER about 20 miles away. Many of our more mobile, but less intelligent, frequent med seeking individuals with the Holy Trinity* of narcotic-gettin' complaints will shop there. Unbeknownst to them, Cripes occasionally works there as well as Lisa and a few other nurses from the Mother Ship. That is three of the four hospitals in the immediate area; guess we have surveillance covered.


Lots of times the individuals will take one look at either Cripes or Lisa (or others) and skedaddle like a rat leaving a ship on fire; sometimes they will swear to God they have never been seen for this or any other problem. That is pretty stupid, but then these aren't the brightest bulbs in the box. Just add it to the list of Great Moments of WTF-ery.

Lisa just happened to mention that one of our more challenged narc-seekers came up with a particularly tasty little nugget during her triage interview at Bear Went Over the Mountain ER. He had been seen at my ER (by Lisa) over the weekend.

"Oh no, I couldn't have been seen over the weekend (where he received a 'script for Percocet) because THAT ER is always closed on Saturdays and Sundays".

Note that we are open 365 days per year.

Lisa just wanted to know if she was going to be paid for working the weekend if we were closed, and how that would affect her every-other-weekend committment.



*Holy Trinity = back pain, migraine, dental pain.

Stuff I Found Behind the Ice Machine

As pretty much everything in our ER is old, old, old, it should come as no surprise that our ice machine is a model about 30 years more elderly than this specimen. It works pretty well, though and we always have a steady and abundant supply of ice cubes (not that crushed crap). These are solid particles that weigh heavily in a plastic bag and conform nicely to those swollen body parts; not to mention providing refreshing iced coffee whenever we need it.

There are only two problems; it occasionally makes a helluva racket and takes up a ton of space. The first problem is easily rectified with a well-placed kick just below the grate; the second is not rectifiable. But since there is so much room behind and next to it, I made a couple of amazing discoveries when I dropped a sleeve of cups behind it; really, it was like a trip in a time machine.

Apparently nobody ever cleans in there.

I found a box of gloves; they were latex which we haven't had in a long time. A few of old souffle-type med cups. An ice pick. 17 cents in change. A dessicated cookie. A garter (ha! haha!) do you even know what that is? A bottle cap from RC Cola. A golf tee (WTF?) A couple of pens. Lots of dust. Several old washcloths and one slipper sock. An old, old, wooden ship (nah, just kidding).

Oh, and THAT's were the MAST trousers went! ERP, I have them if you need them! Haven't used them since the 1980's, or maybe the 70's.

The HVAC apparatus is also elderly. It provides heat in the summer and refreshing air conditioning in the dead of winter. It is essential to dress in layers.

The duct that lies directly above our heads in the nurses' station was rerouted while I was away last week so that it continuously blows either freezing cold air or cool to lukewarm air. All. The. Time. The HVAC monkeys, I swear, just mess with it. There was also a new digital thermostat in the waiting room that I'm pretty sure does absolutely nothing.

Mikki and Sherry tried taping cardboard over it. Unsuccessfully.

Lisa adhesive taped a folded towel over it. Unsuccessfully.

I took a staple gun to it and unloaded a full round onto the edges of the towel. Somewhat successfully. Then I found a bunch of screws and pounded them into the squishy ceiling. That looked GREAT. But it worked, that towel nice and tight.

Today I came in to find that the duct had been rerouted again, so no more breezes. I am afraid of what will happen this summer.

Reel it In

As reams of mandated, useless, and repetitive paperwork take more and more time away from patient care it becomes increasingly difficult to sit with patients and discuss their discharge plans. One of the best things about working in a smaller facility is that we generally have plenty of time to spend with patients doing the kind of teaching that is rapidly becoming a thing of the past. We do our best to provide detailed instructions and an opportunity to ask as many questions as needed.

Sometimes, though, it just doesn't matter because the public just lacks manners and common sense.

Me: (entering patient's room): I have your discharge instructions and I would like to go over them with you.

Patient: (speaking on cell phone) I have to go, the nurse is here with my discharge. What? No. How did that happen? (to me): Just a sec. (to cell phone): What are you talking about? No, I don't have any prescriptions yet......

Me: (Leaves the room and closes the door).

Patient: (10 minutes later, opens the door). I thought you were going to give my my papers, I've been waiting for 10 minutes.

Me: I was waiting for you to finish your phone call so that I could have your undivided attention (restrains an expletive as co-worker kicks me under the desk).

Smile!

I just love that we have video cameras that capture all the drama of what is happening around our ER. There are, in total, 11 separate views that include our 3 parking lots, entry way, and waiting room among others. Other than a bit of unfrosted glass to peer out of in our ambulance bay that is adjacent to the main parking area and a small window in triage, there is not a greater opportunity to observe incoming than what our cameras capture. I can sit comfortably at one of two chairs at the nurses desk, pull up the camera program on my computer and, with the mere push of a button, visualize up to eight separate views simultaneously. Most patients are unaware of this, so we frequently have some fun with it.

Occasionally I will see a severely debilitated, limping patient come in complaining of severe back pain. What a thrill to see (on camera) the very same patient miraculously straighten up and walk with a rapid and steady gait through the parking lot to a waiting vehicle with his magic prescription for narcotics. A Miracle!!!

Equally miraculous is the patient who arrived by ambulance with the knee injury; no fracture, but it could definitely be a ligamentous or cartilage injury. Good thing it felt so much better after application of knee immobilizer and careful crutch walking instructions that the patient was observed to have removed the brace and THROW IT AND THE CRUTCHES INTO THE BUSHES AND WALK NORMALLY!! I was so impressed with our physician's ability to heal with just a 'script for Tramadol!

We call the biggest bush "The Giving Tree" because we have found that sometimes the afflicted who have experienced a miracle healing will heave unto it their slings, wrist splints or ace bandages like those who are healed at Lourdes. HALLELUJAH!!!

Lots of times people who shouldn't be driving home because we have given them medication are caught in a lie observed getting into the driver's side of a car; we like to let them know that they are impaired, and since we have no way of alerting every driver on the road, they will not be allowed to drive. Or we call the police. Decide.

One night we had a couple of cars broken into with the theft of some items such as a GPS, backpack, and money (who leaves money in a car?). I was able to pull up video evidence for the police that resulted in the apprehension of some less than scrupulous individuals; and since one of the individuals was attending a meeting, SNAP! Gotcha piture purty lady, heh heh.

Mikki likes that we can see if the police are parked in our back parking lot (she is a 'fraidy cat) to ensure our safety as we walk out.

Ellen wants to be able to tell all of the patients without ID or insurance, "that's quite alright, simply look up into that corner while our camera captures your likeness for future reference".

Me? I just have my eyes glued to the screen to make sure that no cars pull in at 10:57 PM. Then I lock the door. Good night!

Groundhog Day

The only way the groundhog would have seen his shadow around here is if he started digging a week ago.

I can't find my car, let alone a groundhog hole.

But the good news is, he did not see his shadow, thus, spring is on the way.