I'm sitting here watching coverage of the Boston Marathon on TV while avoiding schoolwork and Tina-walking. Pretty crayzee stuff, that. These are super human beings. I have friends who have worked in the medical tent at the conclusion of the race, but have never done it. It might be fun to do sometime, though.
Years ago when I worked at an ER close to Boston, we would occasionally get a Boston runner hours after the elite runners had finished. These runners were not world class, but had run their race in 4, or 5 hours and had muscle cramping or dehydration. It was fun to hear about the start in Hopkinton.
About 8 days ago we had a gentleman who had fallen in his yard and opened up a nasty gash on his knee. He was training for Boston.
The Talker and he bonded over a mutual love of running while he stitched the wound. As I bandaged it with my usual somewhat bulky first dressing, the patient wondered how he was going to run with it next day; with 8 days to go before the marathon, the distance running was done and now he was doing shorter training runs.
Me: I imagine that you would be putting a big band-aid over it if you are running tomorrow, hmm?
The patient laughed and admitted that was his plan. That's ok, it's his first marathon; it is a big deal for New Englanders because the weather is such a factor in training. We had a most miserable winter in New Hampshire, so I can imagine the adverse conditions that he faced. He was not going to let a little laceration stop him.
We wished him luck and, as always, invited him back for (free) suture removal in 10 days. I've been looking for him, but since he is not an elite runner I will not be seeing him on TV. I hope he does well.
Monday, April 18, 2011
Thursday, April 7, 2011
Goodbye, Mikki
Well, Mikki quit; she's moving on to be a bum-look-up-nurse in Endoscopy full time for a little bit of money but no nights, weekends or holidays. I would rather work at Chile's, frankly, but it is a good move for her. Naturally the vultures are fighting over her day shift hours. They can have them; I hate working days, given that SIC is about to become even more unmanageable. Jane has taken on some added responsibility and will be helping out at the hospital's version of VNA (visiting nurses) to get their dismal leadership situation in hand. Yeah, good luck with that. Jane hates confrontation. Me and the other cool kids have vowed to quit en masse if SIC is given any responsibility that even whispers at a management role.
So, we on the evening shift will be acquiring a new player. The rumor is that it will be someone from the Mother Ship. Is it me? I lost one co-worker who died, my work husband quit, now this. Perhaps I should buff up my resume.
Both Cathys, Sherry, Mikki and I went out to lunch to wish Mikki bon voyage and good luck with her new job; Kerry and Lisa were both working. We did invite SIC but she chose not to come.
I will miss Mikki. But it does put me first in line for getting July 4th off.
So, we on the evening shift will be acquiring a new player. The rumor is that it will be someone from the Mother Ship. Is it me? I lost one co-worker who died, my work husband quit, now this. Perhaps I should buff up my resume.
Both Cathys, Sherry, Mikki and I went out to lunch to wish Mikki bon voyage and good luck with her new job; Kerry and Lisa were both working. We did invite SIC but she chose not to come.
I will miss Mikki. But it does put me first in line for getting July 4th off.
Wednesday, April 6, 2011
Some Things Can't be Unseen
Kerry called me on my cell the other day while I was driving and caught me in a weak moment; could I PLEASE work 4 hours on Saturday morning so she could go to her son's playoff game, pretty please, please, puh-leeeeeeeeeeeeeeeeeze???! Sigh. OK. At least I got to work with Lisa who is funny as hell; we are a bad combination attitude-wise but usually manage to have more than a few laughs. What I didn't count on having to work with Parvati, who is painful to work with and who just feeds into people's drama unnecessarily. "WHAT? YOU HAVE VOMITED ONCE AND BEEN SICK FOR 15 MINUTES? YOU NEED IV FLUIDS AND LAB WORK TO MAKE SURE YOU ARE NOT DEHYDRATED!!". Um, no. You really don't. What you need is a prescription for common sense. With Parvati, everyone is treated as if they really ARE as sick as they think they are.
Like Whiny Cough Lady ("I have really bad roll-y veins.....do you have to put the IV there?....IV's don't ever hurt me that much..... can I have another straw?.....I don't liiiiiiiiiiike being siiiiiiiiiiiicccccccccccck......Don't you think I am the sickest and most pathetic creature on the planet who had bronchitis everrrrrrrrr??!!). Bleecch. She really didn't need to tie up my last remaining bed for two hours; didn't need any of that. What I needed was a bed for a teenager with a broken ankle. We are an ER, not a hotel.
Then there was Migraine Lady #1, 298 who was apparently put out that her 10/10 headache was not treated immediately with Dilaudid. She walked out prior to the completion of her care without a word to anyone, although she got IV fluids, Toradol and Compazine. I did all the things I was supposed to; offered her crackers and juice, took her vital signs, dimmed the lights, got her a toasty warm blanket or three, and reassessed her pain after I had medicated her. Too bad she left, because Parvati had just written an order for her to have her much desired narcotics. She scarpered when I was busy with an overdose, but unfortunately with the IV still in her arm. Her Skanky Neighborhood phone number was.....disconnected, surprise, surprise. Oh, no work number because she is unemployed. Ah, no insurance so you and I will take the hit on this.
But it is bad when people leave with IV's in their arm; liability.
So I called dispatch to see if they could send a police officer or animal control officer to politely ask her to return; we really don't want IV drug users running around unsupervised with expertly and hygienically placed venous access. Not that she was, but still.
Me: 'Hi, this is EDNurseasauras at the ER. One of our patients left with an IV in, her phone number is disconnected and I was hoping you could send an officer to her house to encourage her to return for its removal"
Dispatch: "Sure, no problem. What's her name and address?" I gave him the particulars; he said he would get back to me. We heard the call go out on the scanner. A short time later, the dispatcher called me back:
Dispatch: "I guess she hasn't made it home yet; what was she wearing?"
Me: "Is this a recorded line?"
Dispatch: "No, it's not".
Me: "OK, good. She was wearing a horrendous neon pink jogging suit, the likes of which should never be seen in public, never mind being displayed on a woman that size"
Dispatch: (muffled laughter), "OK, um. Ok. Hold on.. (more muffled laughter). Is it pink on top and bottom?"
Me: "Yes, except for the parts where the material doesn't cover the tattoos on her muffin top"
Dispatch: (strangled noise, muffled snorting), "Um, OK, sure. I'll send and officer to see if he can spot her on foot".
Me: "Shouldn't be too hard to miss".
She never showed up, another big surprise.
Jane calls all the patients who leave before they are discharged; most of the time it's because the wait is too long, or they have to pick up their kids, or they see who the doctor is and realize they will probably not be getting any Vicodin this visit. Migraine Lady said "we were mean to her and didn't care about her pain". Translation for the uninitiated: "I didn't get any @%^&!ing narcotics!"
Jane: "Oh, it's too bad you left before getting the Dilaudid that Dr. Parvati prescribed for you; the ER was very busy at that time with a critically ill patient that, unfortunatley tied up the nurses; sorry for the inconvenience. Hope you feel better, have a nice day".
Translation: @%^&! off.
Like Whiny Cough Lady ("I have really bad roll-y veins.....do you have to put the IV there?....IV's don't ever hurt me that much..... can I have another straw?.....I don't liiiiiiiiiiike being siiiiiiiiiiiicccccccccccck......Don't you think I am the sickest and most pathetic creature on the planet who had bronchitis everrrrrrrrr??!!). Bleecch. She really didn't need to tie up my last remaining bed for two hours; didn't need any of that. What I needed was a bed for a teenager with a broken ankle. We are an ER, not a hotel.
Then there was Migraine Lady #1, 298 who was apparently put out that her 10/10 headache was not treated immediately with Dilaudid. She walked out prior to the completion of her care without a word to anyone, although she got IV fluids, Toradol and Compazine. I did all the things I was supposed to; offered her crackers and juice, took her vital signs, dimmed the lights, got her a toasty warm blanket or three, and reassessed her pain after I had medicated her. Too bad she left, because Parvati had just written an order for her to have her much desired narcotics. She scarpered when I was busy with an overdose, but unfortunately with the IV still in her arm. Her Skanky Neighborhood phone number was.....disconnected, surprise, surprise. Oh, no work number because she is unemployed. Ah, no insurance so you and I will take the hit on this.
But it is bad when people leave with IV's in their arm; liability.
So I called dispatch to see if they could send a police officer or animal control officer to politely ask her to return; we really don't want IV drug users running around unsupervised with expertly and hygienically placed venous access. Not that she was, but still.
Me: 'Hi, this is EDNurseasauras at the ER. One of our patients left with an IV in, her phone number is disconnected and I was hoping you could send an officer to her house to encourage her to return for its removal"
Dispatch: "Sure, no problem. What's her name and address?" I gave him the particulars; he said he would get back to me. We heard the call go out on the scanner. A short time later, the dispatcher called me back:
Dispatch: "I guess she hasn't made it home yet; what was she wearing?"
Me: "Is this a recorded line?"
Dispatch: "No, it's not".
Me: "OK, good. She was wearing a horrendous neon pink jogging suit, the likes of which should never be seen in public, never mind being displayed on a woman that size"
Dispatch: (muffled laughter), "OK, um. Ok. Hold on.. (more muffled laughter). Is it pink on top and bottom?"
Me: "Yes, except for the parts where the material doesn't cover the tattoos on her muffin top"
Dispatch: (strangled noise, muffled snorting), "Um, OK, sure. I'll send and officer to see if he can spot her on foot".
Me: "Shouldn't be too hard to miss".
She never showed up, another big surprise.
Jane calls all the patients who leave before they are discharged; most of the time it's because the wait is too long, or they have to pick up their kids, or they see who the doctor is and realize they will probably not be getting any Vicodin this visit. Migraine Lady said "we were mean to her and didn't care about her pain". Translation for the uninitiated: "I didn't get any @%^&!ing narcotics!"
Jane: "Oh, it's too bad you left before getting the Dilaudid that Dr. Parvati prescribed for you; the ER was very busy at that time with a critically ill patient that, unfortunatley tied up the nurses; sorry for the inconvenience. Hope you feel better, have a nice day".
Translation: @%^&! off.
Thursday, March 24, 2011
Slipper-y Slope
I just don't tolerate being yelled at, especially on the phone.
Some old guy who had left the department with his wife about 10 minutes before I got there called, all agitated.
"I AM AT THE END OF MY ROPE! YOU PEOPLE CALLED ME AND TOLD ME MY WIFE LEFT HER SLIPPERS AND I COULD PICK THEM UP AT THE FRONT DESK! SHE HAD THEM WHEN SHE LEFT THERE IN THE AMBULANCE; NOW NOBODY KNOWS ANYTHING ABOUT IT! I NEED TO TALK TO LISA, SHE TOOK CARE OF MY WIFE TODAY! ARE YOU LISTENING? I CAN'T LOOK FOR SLIPPERS AND TAKE CARE OF MY WIFE TOO; IS THE DOCTOR THERE, I NEED TO TALK TO HIM!"
In the middle of his rant, I calmly but firmly said, "Sir I need you to stop yelling at me and calm down; I can't help you if you continue to raise your voice because I will be terminating this conversation; do you hear me sir? I need you to lower your voice right now and tell me that you understand"
The Talker rarely hears me use my Command Voice; he raised an eyebrow.
Meanwhile, the agitated old may continues to scream through my Noise Abatement Procedure.
Big sigh. "OK. I'm not yelling. My wife lost her slippers between there and the Mother Ship. I got a call from someone telling me I could pick them up at the front desk. I don't know which front desk, if it's at the hospital, or there, or at the ambulance. Can you find out"
"Sure, give my your phone number and I will try to find out. I can tell you that the slippers are not here (because I put the phone down and looked in the dirty utility room while you were busy trying to blow an aneurysm). I will call you soon"
I took down his number and called the ER at the Mother Ship.
I spoke to Katelyn, who went through the motions and was not very helpful, but she didn't have the slippers either. She said she would look out for them, though.
30 minutes later, I got a phone call from the Missus of Agitated Husband. She very calmly told me the same story. I explained that they were not in my department, nor were they located in the ER downtown. I gave her Katelyn's name and number though, because payback is a bitch.
ANOTHER 30 minutes later, Agitated Husband came to the ER and started yelling at Ellen. As always, trying to protect Ellen, I jumped up and ran around to the front desk; Julie was already on it. She takes no shit from anyone, but does it in a nice way. She told him to sit in the waiting room while she investigated, but he insisted on sitting at her desk.
Now I am all about helping people out, but come on; slippers? What is it with these slippers? What could possibly cause such angst? What the hell, are they the original Ruby Slippers? Diamond encrusted? Made of cats? Mink? Sheesh, take a chill.
By now I was bored with the whole ridiculous scenario so I took $10 out of my wallet, prepared to give it to the guy to buy the wife a new pair of blue fuzzy slippers to replace the old, worn out, filthy, stinky, cat hair laden, piss sodden slippers.
Julie, meanwhile, discovers an important piece of information that both the patient and Agitated Husband neglected to tell me; that the patient was admitted to the hospital as an inpatient FOUR DAYS AGO; her slippers are at the front desk on the 4th floor.
"Oh", says Agitated Husband, now mollified. "I'm not driving down there today".
Some old guy who had left the department with his wife about 10 minutes before I got there called, all agitated.
"I AM AT THE END OF MY ROPE! YOU PEOPLE CALLED ME AND TOLD ME MY WIFE LEFT HER SLIPPERS AND I COULD PICK THEM UP AT THE FRONT DESK! SHE HAD THEM WHEN SHE LEFT THERE IN THE AMBULANCE; NOW NOBODY KNOWS ANYTHING ABOUT IT! I NEED TO TALK TO LISA, SHE TOOK CARE OF MY WIFE TODAY! ARE YOU LISTENING? I CAN'T LOOK FOR SLIPPERS AND TAKE CARE OF MY WIFE TOO; IS THE DOCTOR THERE, I NEED TO TALK TO HIM!"
In the middle of his rant, I calmly but firmly said, "Sir I need you to stop yelling at me and calm down; I can't help you if you continue to raise your voice because I will be terminating this conversation; do you hear me sir? I need you to lower your voice right now and tell me that you understand"
The Talker rarely hears me use my Command Voice; he raised an eyebrow.
Meanwhile, the agitated old may continues to scream through my Noise Abatement Procedure.
Big sigh. "OK. I'm not yelling. My wife lost her slippers between there and the Mother Ship. I got a call from someone telling me I could pick them up at the front desk. I don't know which front desk, if it's at the hospital, or there, or at the ambulance. Can you find out"
"Sure, give my your phone number and I will try to find out. I can tell you that the slippers are not here (because I put the phone down and looked in the dirty utility room while you were busy trying to blow an aneurysm). I will call you soon"
I took down his number and called the ER at the Mother Ship.
I spoke to Katelyn, who went through the motions and was not very helpful, but she didn't have the slippers either. She said she would look out for them, though.
30 minutes later, I got a phone call from the Missus of Agitated Husband. She very calmly told me the same story. I explained that they were not in my department, nor were they located in the ER downtown. I gave her Katelyn's name and number though, because payback is a bitch.
ANOTHER 30 minutes later, Agitated Husband came to the ER and started yelling at Ellen. As always, trying to protect Ellen, I jumped up and ran around to the front desk; Julie was already on it. She takes no shit from anyone, but does it in a nice way. She told him to sit in the waiting room while she investigated, but he insisted on sitting at her desk.
Now I am all about helping people out, but come on; slippers? What is it with these slippers? What could possibly cause such angst? What the hell, are they the original Ruby Slippers? Diamond encrusted? Made of cats? Mink? Sheesh, take a chill.
By now I was bored with the whole ridiculous scenario so I took $10 out of my wallet, prepared to give it to the guy to buy the wife a new pair of blue fuzzy slippers to replace the old, worn out, filthy, stinky, cat hair laden, piss sodden slippers.
Julie, meanwhile, discovers an important piece of information that both the patient and Agitated Husband neglected to tell me; that the patient was admitted to the hospital as an inpatient FOUR DAYS AGO; her slippers are at the front desk on the 4th floor.
"Oh", says Agitated Husband, now mollified. "I'm not driving down there today".
Wednesday, March 23, 2011
The Bitch Box...Take a Number
For some reason, our CEO of less than a year thought it was a good idea to have a suggestion board on the hospital intranet web page. It is pretty entertaining; it is actually more of a bitch board. I am not sure what the educational level is of most of the individuals who post, but let's just say the spelling and grammar are not a priority. Neither is respectful, well thought out posting. Mostly it is about whining. I read it every day because eventually, the Clipboard Peeps are going to get tired of disrespectful and frivolous whining and pull the plug. For example:
"During the day the macaroni and cheese is $3.00 for a large scoop and $1.50 for a small scoop. The other evening I only wanted a little, so I took a small scoop. I was charged $3.00. When I pointed out to the cashier that the sign said it was less for a small scoop, she said it was $3.00 no matter how much you took! This is unfair; it should be a consistent price for both lunch and dinner!"
The food services manager replied that it was all a misunderstanding (yeah, a $1.50 misunderstanding in the cashier's pocket), that the evening cashier had been spoken to and that if the individual would present herself to the cafeteria she would get a refund and a free meal voucher. Score! One of the easier problems to solve.
Someone (and I have my suspicions) from our own ER wrote the following:
"I wish that someone would reconsider installing WiFI in our department. We have both outpatients and ER patients, many of whom are here for hours and hours with nothing to do but read a bunch of old National Geographics and watch a dinky old TV. This is unacceptable and crappy customer service. Since we are required to have closed captioning, the TV is so old that the captioning takes up half the screen. Besides that the TV is on an old rickety table that is a danger to young unruly kidz (actual spelling)and you can only see the TV anyway if you are right in front of it"
The response came from one of the undersecretary Suits in Charge of Stupid Shit:
"We appreciate that your facility is something of a unique entity. While we have not budgeted for the installation of WiFi for this fiscal year, you will be getting a new, larger, wall mounted television in the near future". I call that...not exactly compromise, but we do get something. I hope that the Mother Ship day shift won't be missing ESPN on their cafeteria TV much.
Here's another:
"What is the policy on charge pay? It seems that some of the managers give it out, and some don't. If a manager is on during the day and up to her butt (actually written) in paper work or in meetings with no real understanding of what is going on with the floor, she is not actually managing, now is she? The person who is dealing with the day to day, admissions, and generally overseeing of the floor should be compensated for taking on the added responsibility"
Of course the Head Cheese, that is, the Big Stinky Cheese, wanted name, rank and serial number of the complainant. No resolution that I can see, since most of the managers (who haven't been fired) have been looking for ways to cut, cut, cut. Let's cheat nurses out of charge pay, good idea. Excellent leadership.
This was another nugget of awesomeness:
"How many calories are in the large chocolate chip cookies sold in the lobby coffee shop?"
Seriously?
And because nobody has the balls to say they don't like it, this little gem:
" What is the policy on co-workers peddling their own or their children's or grandchildren's fundaisers? I should not be subjigated to the constant baerage (actual spelling on both) of cookies, candles, wrapping paper or lottery tickets when I come to work".
Douchie complainer was referred to current policy, chapter and verse. And advised to grow a pair and just say no.
One individual, having obviously submitted several complaints on the same issue, the new health insurance provider for the company, was not satisfied with the response:
"Why can't you ever give a straight answer insted (actual spelling) of dancing around the issue? It is extremely frustrating!"
Yeah, we feel your pain.
"Last year there was a new policy that clinical managers would be working two clinical shifts per month; in the last 7 months Floor X has not seen Manager X slinging bedpans, giving meds, or doing any actual nursing tasks that are directly related to patient care. In fact, I have never seen our manager actually touch a patient. How do you respond to this" (Name of manager and floor removed by administrator)
Big Stinky Cheese: "All floor managers have been directed to take an active and participatory clinical role two shifts per month; we feel it is an important leadership activity. We have reinforced with all clinical managers that this is a priority".
In response, I would just like to say:
1. Go Greyhound! Don't know if it is just this manager, but I doubt it.
2. "Activity"??!! WTF.
More later.
"During the day the macaroni and cheese is $3.00 for a large scoop and $1.50 for a small scoop. The other evening I only wanted a little, so I took a small scoop. I was charged $3.00. When I pointed out to the cashier that the sign said it was less for a small scoop, she said it was $3.00 no matter how much you took! This is unfair; it should be a consistent price for both lunch and dinner!"
The food services manager replied that it was all a misunderstanding (yeah, a $1.50 misunderstanding in the cashier's pocket), that the evening cashier had been spoken to and that if the individual would present herself to the cafeteria she would get a refund and a free meal voucher. Score! One of the easier problems to solve.
Someone (and I have my suspicions) from our own ER wrote the following:
"I wish that someone would reconsider installing WiFI in our department. We have both outpatients and ER patients, many of whom are here for hours and hours with nothing to do but read a bunch of old National Geographics and watch a dinky old TV. This is unacceptable and crappy customer service. Since we are required to have closed captioning, the TV is so old that the captioning takes up half the screen. Besides that the TV is on an old rickety table that is a danger to young unruly kidz (actual spelling)and you can only see the TV anyway if you are right in front of it"
The response came from one of the undersecretary Suits in Charge of Stupid Shit:
"We appreciate that your facility is something of a unique entity. While we have not budgeted for the installation of WiFi for this fiscal year, you will be getting a new, larger, wall mounted television in the near future". I call that...not exactly compromise, but we do get something. I hope that the Mother Ship day shift won't be missing ESPN on their cafeteria TV much.
Here's another:
"What is the policy on charge pay? It seems that some of the managers give it out, and some don't. If a manager is on during the day and up to her butt (actually written) in paper work or in meetings with no real understanding of what is going on with the floor, she is not actually managing, now is she? The person who is dealing with the day to day, admissions, and generally overseeing of the floor should be compensated for taking on the added responsibility"
Of course the Head Cheese, that is, the Big Stinky Cheese, wanted name, rank and serial number of the complainant. No resolution that I can see, since most of the managers (who haven't been fired) have been looking for ways to cut, cut, cut. Let's cheat nurses out of charge pay, good idea. Excellent leadership.
This was another nugget of awesomeness:
"How many calories are in the large chocolate chip cookies sold in the lobby coffee shop?"
Seriously?
And because nobody has the balls to say they don't like it, this little gem:
" What is the policy on co-workers peddling their own or their children's or grandchildren's fundaisers? I should not be subjigated to the constant baerage (actual spelling on both) of cookies, candles, wrapping paper or lottery tickets when I come to work".
Douchie complainer was referred to current policy, chapter and verse. And advised to grow a pair and just say no.
One individual, having obviously submitted several complaints on the same issue, the new health insurance provider for the company, was not satisfied with the response:
"Why can't you ever give a straight answer insted (actual spelling) of dancing around the issue? It is extremely frustrating!"
Yeah, we feel your pain.
"Last year there was a new policy that clinical managers would be working two clinical shifts per month; in the last 7 months Floor X has not seen Manager X slinging bedpans, giving meds, or doing any actual nursing tasks that are directly related to patient care. In fact, I have never seen our manager actually touch a patient. How do you respond to this" (Name of manager and floor removed by administrator)
Big Stinky Cheese: "All floor managers have been directed to take an active and participatory clinical role two shifts per month; we feel it is an important leadership activity. We have reinforced with all clinical managers that this is a priority".
In response, I would just like to say:
1. Go Greyhound! Don't know if it is just this manager, but I doubt it.
2. "Activity"??!! WTF.
More later.
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