It is Nurses Week. Time to roll out a day by day schedule to honor the wonderful nurses:
Sundaes on Sunday, all shifts all units: note that our unit did not get them, being off-shift and off-site. Apparently none of the oh-so-important 9-5'ers considered us worthy of ice cream.
Appetizers in the Lobby: an Invitation-Only event singling out advanced practice nurses, nurses with professional certification, or nurses who have completed the clinical ladder "Jumping Through Hoops in Order to Get a 20 cent Raise If You Are At the Top of The Pay Scale" paperwork. Way to exclude 95% of the nurses, dear employer, as if our profession isn't divisive enough as it is.
Bagels: only for the home care people. Didn't say if cream cheese was included, or if it was BYO.
Nursing Grand Rounds: Always a boring affair, not worth the drive. Usually some doctor hijacks the meeting. No food either.
Mini Mall in the Lobby: Big whoop. I am assuming that since it is in the lobby, it is also open to the public. Wonderful opportunity to spend money on ourselves, during our scheduled breaks of course, if there is enough staff to take them. If so then there will be smoothies, candy offerings and soft pretzels. For purchase in the cafeteria. So much pampering. I can hardly stand it.
Midnight Breakfast: For the night shift, between 12 and 2 AM. In my experience and years of working nights, this is the busiest time. Except from 6-7, when it would be more convenient for the Suits who claim to be coming in to serve breakfast. Most likely the same Suits who said we would be getting Sundaes, so be sure to bring a snack, kids
Hourly Raffles and Free Giveaways: Most likely free swag from drug reps and cheap crap like key chains and water bottles with the company logo so we can be walking advertisements. Nice. It would be considered a sincere gesture if they raffled off a day off with pay, or a massage, or even a donation to a charity of our choice.
Finally, Bagels: from 6-8 AM on Saturday morning. I suspect they will be leftovers from home care several days previously. Frankly I would prefer Pop Tarts.
Bobo, our medical director and somewhat socially challenged on his best days has actually paid out of his own pocket for some nurses day gift (I think his wife is a nurse). In the past we have received lunch bags, t shirts, and coffee mugs. But slogans like "Nurses Call the Shots", "Love a Nurse PRN", "Nurses Rock" and other silliness goes right to the bottom of the charity bag for me. Let me say that I truly appreciate that he has taken the time and effort to do this. I really do. But I actually hate that more than the company logo.
At my nursing school graduation 35 years ago, one speaker exhorted us as newly minted nurses never to condone slogans that exploit us as men and women in health care, perpetuate stereotypes, and fail to present nurses as professionals. Big boobs, thigh highs and stilettos, giant syringes.....you know what I'm talking about. I have a few Emergency Nurses Association coffee mugs from a former boss that are tasteful, but other than that I say NO to silly slogans.
The only Nurses Week recognition I'm looking for is just a little sincere appreciation for the job I do from my employer. Sincerity is not one of their strong points, so hopefully my boss will come through with the ice cream.
Tuesday, May 8, 2012
Saturday, May 5, 2012
May 5 Hijinks
So this massive full moon on May 5 has certainly brought out some interesting specimens.
A 13 year old skater-chick came in who had fallen 4 hours previously. Her douche-tard father CALLED 911 to get the phone number of the ER to see if we were open. "Dad....that was really stupid. You could have just Googled the phone number from your phone". Couldn't have been his natural child as she had an abundance of native intelligence.
The usual Friday / Saturday night morphine-seeking migraine came in at her usual hour before closing.
Me: "Jeez, she's here every weekend. Doesn't she have something better to do on a Saturday night? Couldn't she just go to a movie if she's bored?"
Kate: "Why not just have a fu*king Margarita and call it a night?"
Me: "Cinco de Migraine is celebrated with morphine apparently".
Gil: "She's been overusing, I've seen her the last 4 out of 6 weekends"
Me: "That's only because you were off two of those weekends"
Gil: "Well, she can have her neurologist write a letter. She's shut off"
From the "Your Doctor Lied to You to Get You to Come to the ER" files:
Woman: "Yeah, I called my doctor and was told to come in to get my liver checked, hee hee"
Me: "Why?"
Woman: "I took a few too many Tylenol, and she said it might damage my liver, so I should have some blood drawn (snicker)"
She had taken 25 tablets of Tylenol, 500 mg each 26 hours previously. No, you don't get your blood checked and then get to go home, you are now at serious risk for liver failure and / or death. Guess what? Tylenol overdose is not funny. You get admitted to the ICU with a 1:1 suicide watch. I wish people would understand that just because you can buy something over the counter, or is "natural", or "organic" does NOT mean it is harmless. The antidote for Tylenol overdose is drinking a butt-load of liquid that smells like rotten eggs without puking, and pray that your liver makes it through. The medic that transferred my patient noted "she was really sad" on the way to her hospital bed. "Well, I was pretty clear that this was a very serious thing; when she came in she was all giggly and acting like it was no big deal".
I have seen this lady several times because she is also diabetic (on oral meds) and occasionally runs out of, fails to take or forgets to take, doesn't pick up her prescription, etc, etc then comes in with nausea and DKA, haha isn't that so silly of me. I think she really stepped in it this time.
A 52 year old man came in with toothache for 2 months and stated he had a "Dental Emergency".
Emergency? Nope. Dumber than a bag of hammers.
A 20-something female in excess of 300 pounds came in with nasal congestion. "Any medications?" I asked. "Only pre-natal vitamins", she replied. Oh. So you're pregnant, I...oh, never mind. WTF, Gil? You want me to find the fetal heart rate? Yeah, not my best skill in the best of circumstances I would rather put an IV in an infant, but the patient was understanding. Yes, I did find it. Eventually.
"Cholera" was the diagnosis for an individual who had come in with an ankle injury. Ooops. Slight coding error.
On the subject of "My Doctor Told Me....Go to the ER":
I just don't really care. Tell me the reason why you called your doctor, and give me the abridged version. I don't have time to listen to "Well, it all started in 1997, on a lovely spring day, I think it was a Wednesday". I will interrupt and ask pointed questions. I'm good at that.
A 13 year old skater-chick came in who had fallen 4 hours previously. Her douche-tard father CALLED 911 to get the phone number of the ER to see if we were open. "Dad....that was really stupid. You could have just Googled the phone number from your phone". Couldn't have been his natural child as she had an abundance of native intelligence.
The usual Friday / Saturday night morphine-seeking migraine came in at her usual hour before closing.
Me: "Jeez, she's here every weekend. Doesn't she have something better to do on a Saturday night? Couldn't she just go to a movie if she's bored?"
Kate: "Why not just have a fu*king Margarita and call it a night?"
Me: "Cinco de Migraine is celebrated with morphine apparently".
Gil: "She's been overusing, I've seen her the last 4 out of 6 weekends"
Me: "That's only because you were off two of those weekends"
Gil: "Well, she can have her neurologist write a letter. She's shut off"
From the "Your Doctor Lied to You to Get You to Come to the ER" files:
Woman: "Yeah, I called my doctor and was told to come in to get my liver checked, hee hee"
Me: "Why?"
Woman: "I took a few too many Tylenol, and she said it might damage my liver, so I should have some blood drawn (snicker)"
She had taken 25 tablets of Tylenol, 500 mg each 26 hours previously. No, you don't get your blood checked and then get to go home, you are now at serious risk for liver failure and / or death. Guess what? Tylenol overdose is not funny. You get admitted to the ICU with a 1:1 suicide watch. I wish people would understand that just because you can buy something over the counter, or is "natural", or "organic" does NOT mean it is harmless. The antidote for Tylenol overdose is drinking a butt-load of liquid that smells like rotten eggs without puking, and pray that your liver makes it through. The medic that transferred my patient noted "she was really sad" on the way to her hospital bed. "Well, I was pretty clear that this was a very serious thing; when she came in she was all giggly and acting like it was no big deal".
I have seen this lady several times because she is also diabetic (on oral meds) and occasionally runs out of, fails to take or forgets to take, doesn't pick up her prescription, etc, etc then comes in with nausea and DKA, haha isn't that so silly of me. I think she really stepped in it this time.
A 52 year old man came in with toothache for 2 months and stated he had a "Dental Emergency".
Emergency? Nope. Dumber than a bag of hammers.
A 20-something female in excess of 300 pounds came in with nasal congestion. "Any medications?" I asked. "Only pre-natal vitamins", she replied. Oh. So you're pregnant, I...oh, never mind. WTF, Gil? You want me to find the fetal heart rate? Yeah, not my best skill in the best of circumstances I would rather put an IV in an infant, but the patient was understanding. Yes, I did find it. Eventually.
"Cholera" was the diagnosis for an individual who had come in with an ankle injury. Ooops. Slight coding error.
On the subject of "My Doctor Told Me....Go to the ER":
I just don't really care. Tell me the reason why you called your doctor, and give me the abridged version. I don't have time to listen to "Well, it all started in 1997, on a lovely spring day, I think it was a Wednesday". I will interrupt and ask pointed questions. I'm good at that.
Monday, April 30, 2012
No Cure for This
Cripes: "What's wrong with this guy?"
Me: "Man-cold".
Cripes (singing falsetto to the tune Maneater) "Ohhh, here he comes, it's a Maaaaaaan Coooooold!"
Right. It can practically be diagnosed from the parking lot and seems to be a phenomenon that has bearers of the XY chromosome dragging themselves out of their death bed in the evening hours. It is universally accepted that the symptoms will have been present for.....a day. Maybe. Man-cold is emergent and debilitating. Females who accompany Man-cold to the ER are either disgusted with their companions, or complete morons who also drag 3 or 4 dirty unruly kids who also have Man-cold, the Disney edition.
Me: "Man-cold".
Cripes (singing falsetto to the tune Maneater) "Ohhh, here he comes, it's a Maaaaaaan Coooooold!"
Right. It can practically be diagnosed from the parking lot and seems to be a phenomenon that has bearers of the XY chromosome dragging themselves out of their death bed in the evening hours. It is universally accepted that the symptoms will have been present for.....a day. Maybe. Man-cold is emergent and debilitating. Females who accompany Man-cold to the ER are either disgusted with their companions, or complete morons who also drag 3 or 4 dirty unruly kids who also have Man-cold, the Disney edition.
Sunday, April 29, 2012
No Soup for You
I had spent what seemed like hours at the beck and call of an elderly couple. The wife was being treated for vague complaints; the husband was feisty, and was not happy to be in the ER. He followed me out of the room EVERY TIME to ask another question or to make another demand / request. There were several "one more thing to tell the doctor" and "I remembered something else". I had toileted, watered, warm blanketed, repositioned, explained the monitor, apologized for the tightness of the blood pressure cuff, and given them 3 vomit sacks (although she was not, in fact, vomiting). When he wasn't hounding me, the husband was on the phone loudly proclaiming to his friends / neighbors / family / distant cousins how much time had elapsed since they had entered the ER.
It was the middle of the afternoon although they had only been in the department for two hours. Another exhausting Q and A session concluded thus:
Husband (snippy): "So, are you going to be serving us dinner?"
Me (apologetically): "Oh, no; I'm sorry, we don't have any food service here, I'm sure I explained that"
Husband (more snippy than before): "I was really just wondering if we were going to be here long enough to require dinner"
Me (innocently): "Yes sir, I understand sarcasm".
It was the middle of the afternoon although they had only been in the department for two hours. Another exhausting Q and A session concluded thus:
Husband (snippy): "So, are you going to be serving us dinner?"
Me (apologetically): "Oh, no; I'm sorry, we don't have any food service here, I'm sure I explained that"
Husband (more snippy than before): "I was really just wondering if we were going to be here long enough to require dinner"
Me (innocently): "Yes sir, I understand sarcasm".
Saturday, April 28, 2012
Sure-Fire Ways to Annoy Me
1. Always ask if there have been any deaths lately, and if so, if there have been any dead bodies on the stretcher you now occupy.
2. Before you have even been examined, ask for 6 warm blankets, footies, a cab voucher home, the head of the bed elevated at precisely 45 degrees, Coca-cola (not that generic cola crap) with the straw bent and most, but not all, of the bubbles swished out.
3. Insist that when you Googled your insignificant ankle twist in the 20 minutes since you injured it that it appears to be at least a "Grade 2" sprain.
4. Ask me about my squirrel. Go on. I dare you.
5. By all means ask for your IV fluids, which you do not need, to be heated to 98.6 degrees so you "won't get brain freeze"
6. Continuously refer to yourself in the 3rd person.
7. Make a comment about how glad you are that you came in on a "quiet" night.
8. Tell me how bad your veins are when I come in to draw your blood, especially if they are fu*ing pipelines that could easily sustain the biggest IV in the box. If you really want to piss me off, tell me how "they" tried to get your IV last time and it took 9 tries and gave you a bruise the size of a sofa pillow.
9. Ask for sandwiches, cocoa, coloring books, and stickers for your filthy, unruly brood at 11 PM when you are here for your refill of Percocet.
10. Keep sending your little wild animals out to inquire about how much longer the wait will be.
11. Insist that "we" have your records
12. Also insist that I should call Dr. Q to get your medication list.
13. If you think that standing in the doorway of your room and glaring at me because you don't think you are getting enough attention for your dental pain is intimidating, you are mistaken. You are a colossal failure in that department
14. Sorry, I'm busy with an Actual Sick Person right now and coordinating things like ICU beds and ambulance transfers. Your door is staying closed because you are a distraction and the goings-on in other rooms is none of your business
15. Absolutely allow your sullen teen with the urgent ankle pain/headache/dry skin to be on the phone when I am triaging.
2. Before you have even been examined, ask for 6 warm blankets, footies, a cab voucher home, the head of the bed elevated at precisely 45 degrees, Coca-cola (not that generic cola crap) with the straw bent and most, but not all, of the bubbles swished out.
3. Insist that when you Googled your insignificant ankle twist in the 20 minutes since you injured it that it appears to be at least a "Grade 2" sprain.
4. Ask me about my squirrel. Go on. I dare you.
5. By all means ask for your IV fluids, which you do not need, to be heated to 98.6 degrees so you "won't get brain freeze"
6. Continuously refer to yourself in the 3rd person.
7. Make a comment about how glad you are that you came in on a "quiet" night.
8. Tell me how bad your veins are when I come in to draw your blood, especially if they are fu*ing pipelines that could easily sustain the biggest IV in the box. If you really want to piss me off, tell me how "they" tried to get your IV last time and it took 9 tries and gave you a bruise the size of a sofa pillow.
9. Ask for sandwiches, cocoa, coloring books, and stickers for your filthy, unruly brood at 11 PM when you are here for your refill of Percocet.
10. Keep sending your little wild animals out to inquire about how much longer the wait will be.
11. Insist that "we" have your records
12. Also insist that I should call Dr. Q to get your medication list.
13. If you think that standing in the doorway of your room and glaring at me because you don't think you are getting enough attention for your dental pain is intimidating, you are mistaken. You are a colossal failure in that department
14. Sorry, I'm busy with an Actual Sick Person right now and coordinating things like ICU beds and ambulance transfers. Your door is staying closed because you are a distraction and the goings-on in other rooms is none of your business
15. Absolutely allow your sullen teen with the urgent ankle pain/headache/dry skin to be on the phone when I am triaging.
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