Maybe it is the heat, but Lady has had 3 visits to us and 2 visits to the Mother Ship in the last 6 days. We KNOW when the ambulance goes out after her; the address is well known to us all. Even Ellen picks up on it. "Oh, no, they've gone out after x Elm St. again! Dr. Cripes already saw her once today!"
I quickly scanned the number of visits for the year. Between both ER's, outpatient labs and xrays, and a couple of outpatient procedures there were 67 hospital visits. By far the majority were for emergency care.
I know she likes Cripes, but he has had it with her.
"No way! She's goes straight to the Mother Ship when they call it in. One visit per doctor per day; any more is beyond the call of duty".
Interestingly, when she saw that Brian was on duty down at yonder Mother Ship she said, "What, him? I'm not seeing him". She really doesn't like Brian.
Two hours later she called. I can't prove it was her, but won't swear that is was not: "Hi, can you tell me who the doctor is today?"
Me: "Who's calling please?"
Caller: "Um....Mary"
Me: "Mary who?" I asked pleasantly. And politely, don't forget that I was polite.
Caller: "Mary......Smith. Why do you need to know that information?" Mary Smith is known to be Lady's cousin or some such.
Me: "Well, Mary, I'm sorry, but we just don't give out that information"
Caller: "That's ridiculous! How dare you refuse to tell me who the doctor is"
Me: (Very sweetly) "Yes, I know it is inconvenient, but it is a safety issue"
Caller: "Safety! What has that got to do with anything! Do you think someone might come down there and kick his ass?"
Me: "That is always a possibility, Mary"
Caller: "I've never heard of anything so ridiculous in my life! How am I supposed to know if I like the doctor who's on?
Me: "Well, Mary, that is problematic. However, in an emergency situation such as life threatening illness or injury, most people are OK with that. If you do not have an emergent problem, the alternative is to see your primary care provider"
Caller: "Well, it's an emergency if I say it is an emergency"
Me: "Yes ma'am, I would never presume to tell you not to come to the ER if yout feel your problem is so serious you cannot wait to see your doctor"
Caller: "Well, I don't like your tone, and I am going to complain to Patient Care Services tomorrow. I'm going to tell them that you were rude to me"
Me: "Yes ma'am, that is your prerogative. Why don't you give me your phone number so my boss can discuss my rude attitude with you personally. Mary Smith, correct?"
*click*
Bye, Lady. Have a nice night.
Sunday, July 24, 2011
Saturday, July 23, 2011
Our Witch Melted, Can We Have a New One? and other random stuff
That is actually a paraphrasing of a blog, LOVE the name. You could check it out. But it IS an appropriate sentiment for the 100+ degree heat here in the Northeast and the potential for problems. You know, like dehydration, heat stroke and other such heat related issues, many of which can be prevented from becoming a MEDICAL EMERGENCY by following a few common sense tactics: stay hydrated, keep cool and STAY THE HELL OUT OF THE HEAT, MORON!
I worked a princess day shift, my 10th shift in 9 days and I am done with it. I am sitting in my living room with an icy cold brew with both the air conditioner and fan on. In a sundress (which I would never wear outside in public unless I was, literally, on fire). Tina went out for 10 seconds and was ready to come in immediately, so not like her. Mr. EDNurseasauras and I will not be heading to the lake for the weekend as planned. We will take a day trip, but there is no airconditioning there and we just suffer too much without it. Wah, wah, wah.
"With record high temperatures, the heat is on!" (isn't that clever, I thought. Not!). "Medical personnel are on high alert!", intoned the 6 PM news reporter.
"I'm not", I informed Mr. EDN. "I'm on exceedingly LOW alert".
The local TV channel had a reporter at Fenway Park giving tips about how to stay cool while at the game. It is over 100 degrees Fahrenheit, the highest temperature in about 80 years.....they were using some sort of heat seeking, satellite directed, laser guided thermometer to take the temperature of the plastic seats in the bleachers. 118 degrees. WTF? The concrete steps? 148 degrees!! You could literally fry chicken on that thing, and you want people to sit out there? Madness!
Here's a tip for staying cool while watching the Red Sox: STAY HOME. Or go to a bar with this new-fangled thing called air conditioning. Yikes.
I was on the phone (on hold) when a well-dressed woman walked into the department carrying one of those Styrofoam beer coolers containing bottled water. It was our Director of Nursing. "I know there is no water fountain, and want you all to stay hydrated". Nice. How many of y'all's bosses toted in water? I was impressed.
I was even more impressed that since we had run out of enema bags she went across to the pharmacy and picked up a couple.
Just....no words for that. I sense a great new marketing campaign:
"Record high temperatures may cause dehydration and heat injury. But by far the most dangerous problem is....constipation. When you need an emergency enema, go directly to the Emergency Room. Your God-given right to a comfortable bowel movement should be your number one (not number two) reason to come to the ER when it is about as hot outside as the surface of Mercury. Because the heat is so much easier to tolerate when you can just take a good crap".
I worked a princess day shift, my 10th shift in 9 days and I am done with it. I am sitting in my living room with an icy cold brew with both the air conditioner and fan on. In a sundress (which I would never wear outside in public unless I was, literally, on fire). Tina went out for 10 seconds and was ready to come in immediately, so not like her. Mr. EDNurseasauras and I will not be heading to the lake for the weekend as planned. We will take a day trip, but there is no airconditioning there and we just suffer too much without it. Wah, wah, wah.
"With record high temperatures, the heat is on!" (isn't that clever, I thought. Not!). "Medical personnel are on high alert!", intoned the 6 PM news reporter.
"I'm not", I informed Mr. EDN. "I'm on exceedingly LOW alert".
The local TV channel had a reporter at Fenway Park giving tips about how to stay cool while at the game. It is over 100 degrees Fahrenheit, the highest temperature in about 80 years.....they were using some sort of heat seeking, satellite directed, laser guided thermometer to take the temperature of the plastic seats in the bleachers. 118 degrees. WTF? The concrete steps? 148 degrees!! You could literally fry chicken on that thing, and you want people to sit out there? Madness!
Here's a tip for staying cool while watching the Red Sox: STAY HOME. Or go to a bar with this new-fangled thing called air conditioning. Yikes.
I was on the phone (on hold) when a well-dressed woman walked into the department carrying one of those Styrofoam beer coolers containing bottled water. It was our Director of Nursing. "I know there is no water fountain, and want you all to stay hydrated". Nice. How many of y'all's bosses toted in water? I was impressed.
I was even more impressed that since we had run out of enema bags she went across to the pharmacy and picked up a couple.
Just....no words for that. I sense a great new marketing campaign:
"Record high temperatures may cause dehydration and heat injury. But by far the most dangerous problem is....constipation. When you need an emergency enema, go directly to the Emergency Room. Your God-given right to a comfortable bowel movement should be your number one (not number two) reason to come to the ER when it is about as hot outside as the surface of Mercury. Because the heat is so much easier to tolerate when you can just take a good crap".
Friday, July 22, 2011
Eh?
Me: (after blowing a shit load of water into the ear of a young man with waxy buildup, 2nd stupidest reason on earth to go to the ER after "constipation"):
"CAN YOU HEAR ME NOW?"
"CAN YOU HEAR ME NOW?"
Thursday, July 21, 2011
Oh, the pain
Madness has a dual perspective on living with a family member with chronic headaches, and having to deal with those who show up regularly in the ER with same in order to get narcotics. I pretty sure every ER has them. We are told that people's pain is people's pain, and who are we to say they do or do not experience what they say they are? Give them what they want and they will go away and give us great customer service reviews.We are just supposed to treat it and move on.
We do. But it gets more and more difficult when it is clear that the habit is like feeding squirrels. Give them a prescription and kick them to the curb. The docs aren't here all the time and so it may be weeks or months before they see the patient again. We nurses are having to deal with the drama and bullshit, the manipulative behavior, and the enablers with bad manners. And feel like pushers to boot.
Stopping at ER has become just another part of the routine for some; drop off the dry cleaning, get a pedicure, make a deposit at the bank, pick up dog food, lunch with a friend, then stop at the ER for a quick dose of dilaudid. Oh wait, let me get that extra large iced coffee first, and my cell phone needs to be plugged in, what outlet can I use.
Our newest doc gives out few narcotics. Mac is all about being reasonable, and things like whacking your shin on the bathtub 10 minutes ago with no bruise and no swelling doesn't necessarily get you Percocet. Especially if there are multiple visits for pain-related complaints. He doesn't feed the drama, and like Gil, likes a nice, Zen sort of ER. LOVE him. He is a great addition to the ER family.
Now if I can just get Parvati to drink that particular Kool-Aid my life would be so much simpler, sigh.
We do. But it gets more and more difficult when it is clear that the habit is like feeding squirrels. Give them a prescription and kick them to the curb. The docs aren't here all the time and so it may be weeks or months before they see the patient again. We nurses are having to deal with the drama and bullshit, the manipulative behavior, and the enablers with bad manners. And feel like pushers to boot.
Stopping at ER has become just another part of the routine for some; drop off the dry cleaning, get a pedicure, make a deposit at the bank, pick up dog food, lunch with a friend, then stop at the ER for a quick dose of dilaudid. Oh wait, let me get that extra large iced coffee first, and my cell phone needs to be plugged in, what outlet can I use.
Our newest doc gives out few narcotics. Mac is all about being reasonable, and things like whacking your shin on the bathtub 10 minutes ago with no bruise and no swelling doesn't necessarily get you Percocet. Especially if there are multiple visits for pain-related complaints. He doesn't feed the drama, and like Gil, likes a nice, Zen sort of ER. LOVE him. He is a great addition to the ER family.
Now if I can just get Parvati to drink that particular Kool-Aid my life would be so much simpler, sigh.
Tuesday, July 19, 2011
Um...
I watched on the monitor while a young man in his early 20's walked across the parking lot. By the time he reached the door he was hunched over and moaning. Back pain.
10 minutes later, I watched another young man, also in his early 20's do the exact same thing. Back pain.
Neither had insurance.
Neither had ID.
Neither could remember their temporary local "new" address or phone number. They both gave a different a different permanent address, same town in another state.
No, they didn't know each other.
They said they were both roofers. One of them listed "seizure disorder" as a medical problem. The Talker sent them out with whateva pain meds and a work note.
"REALLY?? I said. REALLY??! Fraud and bullshit aside, a roofer with a SEIZURE DISORDER?? Seriously??!"
"Oh. I didn' t pick up on that".
WTF?
10 minutes later, I watched another young man, also in his early 20's do the exact same thing. Back pain.
Neither had insurance.
Neither had ID.
Neither could remember their temporary local "new" address or phone number. They both gave a different a different permanent address, same town in another state.
No, they didn't know each other.
They said they were both roofers. One of them listed "seizure disorder" as a medical problem. The Talker sent them out with whateva pain meds and a work note.
"REALLY?? I said. REALLY??! Fraud and bullshit aside, a roofer with a SEIZURE DISORDER?? Seriously??!"
"Oh. I didn' t pick up on that".
WTF?
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