I have had people call 911 from the waiting room on many occasions, usually by disgruntled individuals with relatively non-urgent complaints who felt that their problem deserved attention ahead of minor complaints such as chest pain. Mostly by people who were not as sick as they thought they were. Some who thought, erroneously, that they would be magically whisked into the back door and immediately ensconsed in a comfy bed, or taken to another hospital. Never, ever have I had an 11 year old female do it for attention.
(Heard on police scanner): "Got a 911 hang up from XXX st., the ER. Came from a phone in the waiting room".
Me: "WTF"??
Sunday, May 13, 2012
Saturday, May 12, 2012
Lady, Lady, Lady
Lady is still up to her old tricks; frequent visits (mostly during the day), speed-dialing the patient services rep to complain about some imaginary slight, or for perhaps calling attention to her obesity, poor eating habits and lack of diabetic control cause-effect.
She had some abdominal surgery a while back, but at Ginormous University Hospital in another state. Naturally, because she is a poor healer she had some wound dehiscence. Said hole in her belly has been plugged up on a daily basis by the home care nurse.
The thing about home care is that the patient must, oddly, be at home to receive a service. Lady's home care nurse, understanding what a deep personal relationship we have with Lady, gave us a heads up that we might hear from her. She didn't happen to be home at the time of his visit and she would only be able to stop back at her house late in the afternoon. It depended on his other scheduled visits.
Of course she called to inquire if she should come right down for us to handle her emergent wet-dry dressing change. She didn't know about the call from the home care nurse.
Lady: "Yeah, I'm having some issues with my home care nurse. She's beginning to be a real pain in my ass. She said that just because I missed her visit by 7 minutes she couldn't come back because she had to go way out to Booneysville and it would take her out of her way. That is unacceptable, I was out buying groceries so I could have healthy food for my diabetes, and groceries don't buy themselves. Should I come in and have you change it?"
Me: "No, Lady, your home care nurse is the one you see every day who knows about your wound and how best to do the dressing. What exactly did she say? Maybe that she would TRY to come by and that she would call you?"
Lady: "Uh, um.....well, she's really beginning to bother me. She might be able to come back but she didn't say when"
Me: "It is the weekend, any issues you are having with her will have to be dealt with on Monday. In the meantime, she is your nurse. I suggest you wait until you hear from her. She did say she would try to get back to you, but to be fair, you were not home when you agreed to be there. That's not her fault, is it? And if she had to go to Booneysville waiting around for you when she didn't know when you would be there isn't fair to her or her other patients"
Lady: "Well, so you're saying I shouldn't come in?"
Me: "No, I said wait to hear from her. If she can't reschedule your visit, have her call ME"
Lady: "Oh. So she can tell you how to do the dressing"
Me : "Yes" (actually because I know she will not be calling me which means you will not come in by that big white taxi with the flashing red lights for a dressing change that doesn't need to be done)
Come Monday, two things happened; Lady fired the home care nurse, and the home care nurse stopped by to thank me.
She had some abdominal surgery a while back, but at Ginormous University Hospital in another state. Naturally, because she is a poor healer she had some wound dehiscence. Said hole in her belly has been plugged up on a daily basis by the home care nurse.
The thing about home care is that the patient must, oddly, be at home to receive a service. Lady's home care nurse, understanding what a deep personal relationship we have with Lady, gave us a heads up that we might hear from her. She didn't happen to be home at the time of his visit and she would only be able to stop back at her house late in the afternoon. It depended on his other scheduled visits.
Of course she called to inquire if she should come right down for us to handle her emergent wet-dry dressing change. She didn't know about the call from the home care nurse.
Lady: "Yeah, I'm having some issues with my home care nurse. She's beginning to be a real pain in my ass. She said that just because I missed her visit by 7 minutes she couldn't come back because she had to go way out to Booneysville and it would take her out of her way. That is unacceptable, I was out buying groceries so I could have healthy food for my diabetes, and groceries don't buy themselves. Should I come in and have you change it?"
Me: "No, Lady, your home care nurse is the one you see every day who knows about your wound and how best to do the dressing. What exactly did she say? Maybe that she would TRY to come by and that she would call you?"
Lady: "Uh, um.....well, she's really beginning to bother me. She might be able to come back but she didn't say when"
Me: "It is the weekend, any issues you are having with her will have to be dealt with on Monday. In the meantime, she is your nurse. I suggest you wait until you hear from her. She did say she would try to get back to you, but to be fair, you were not home when you agreed to be there. That's not her fault, is it? And if she had to go to Booneysville waiting around for you when she didn't know when you would be there isn't fair to her or her other patients"
Lady: "Well, so you're saying I shouldn't come in?"
Me: "No, I said wait to hear from her. If she can't reschedule your visit, have her call ME"
Lady: "Oh. So she can tell you how to do the dressing"
Me : "Yes" (actually because I know she will not be calling me which means you will not come in by that big white taxi with the flashing red lights for a dressing change that doesn't need to be done)
Come Monday, two things happened; Lady fired the home care nurse, and the home care nurse stopped by to thank me.
Friday, May 11, 2012
Nurses...Advocating. Leading. Caring.
This statement has apparently been adopted by the American Nurses Association, which I didn't know until I Googled it. I did this because I KNOW my hospital didn't come up with it on their own. It appeared as a caption on a list of "Nurses' Week Activities" in a previous post, with all of the crappy offerings letting nurses at this facility know just how valued we are. Massive eye roll here.
Not a fan of Nurses Week, never have been. It's a Healthcare Hallmark Holiday. Like Grandparents Day, or National Potato Chip Day, or any one of hundreds of silly recognition days.
Just out of curiosity I checked around the web to see what kind of floral or gift offerings exist specifically for Nurses Week. I came up with coffee mugs filled with Hershey Kisses, as well as snack baskets filled with M&M's, Kit Kats, Snickers, cookies and other bad stuff. These are apparently interchangeable as Teacher's Week gifts. A few contained "healthy" stuff like commercially prepared granola bars, cheddar cheese popcorn, etc. Yikes.
I get that food, candy, and coffee (hence the candy filled mugs) are the first things on the list when it comes to "treats" for nurses. But I envisioned that our twisted marketing department had their own perspective on "Nurse Feeding" and came up with this:
Keeping nurses full of fatty, high calorie and/or sugary foods will contribute to obesity and other health problems. The benefits, while minimal both short- and long- term for nurses, will be increased for the corporation patient satisfaction scores:
1. Long term health issues guarantees a steady stream of nurses as patients due to the increase in diabetes, obesity, cardiac disease. Revenues will be markedly increased.
2. Patients, with careful marketing, can be lead to view RNoUS (RN's of Unusual Size) as more empathetic, and thus perceived as more caring. Satisfaction scores will be increased exponentially.
I would be happy with a salad, thanks. And because I can never find anything I need to do my job, my constant running about insures that my activity level remains high. Hey! Maybe we could get some coupons for decent footwear...
Not a fan of Nurses Week, never have been. It's a Healthcare Hallmark Holiday. Like Grandparents Day, or National Potato Chip Day, or any one of hundreds of silly recognition days.
Just out of curiosity I checked around the web to see what kind of floral or gift offerings exist specifically for Nurses Week. I came up with coffee mugs filled with Hershey Kisses, as well as snack baskets filled with M&M's, Kit Kats, Snickers, cookies and other bad stuff. These are apparently interchangeable as Teacher's Week gifts. A few contained "healthy" stuff like commercially prepared granola bars, cheddar cheese popcorn, etc. Yikes.
I get that food, candy, and coffee (hence the candy filled mugs) are the first things on the list when it comes to "treats" for nurses. But I envisioned that our twisted marketing department had their own perspective on "Nurse Feeding" and came up with this:
Keeping nurses full of fatty, high calorie and/or sugary foods will contribute to obesity and other health problems. The benefits, while minimal both short- and long- term for nurses, will be increased for the corporation patient satisfaction scores:
1. Long term health issues guarantees a steady stream of nurses as patients due to the increase in diabetes, obesity, cardiac disease. Revenues will be markedly increased.
2. Patients, with careful marketing, can be lead to view RNoUS (RN's of Unusual Size) as more empathetic, and thus perceived as more caring. Satisfaction scores will be increased exponentially.
I would be happy with a salad, thanks. And because I can never find anything I need to do my job, my constant running about insures that my activity level remains high. Hey! Maybe we could get some coupons for decent footwear...
Tuesday, May 8, 2012
Nurses Week
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.
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.
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.
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