Yeah, This is How I Operate

If I have to mix medication drips I generally make a big mess.  Yes, we mix our own.  The pharmacy doesn't live here.  Cabinets open, drawers open, syringes and wrappers, papers, calculators.  Usually people know to stay out of  my way when I am mixing anything.

This is my kitchen.  I also make messes at home, so at least I am consistent. I am one of those cooks who, a)doesn't like it, b) isn't good at it and c) cooks all over the kitchen.  As evidenced by the sheer quantity of stuff laying about.

You must be wondering what extremely complicated and amazing dish I was creating to have made such a hash out of my kitchen, right?  Well, it was French toast.  For me.  See that little stack of jam over there?  I made that last week.  The kitchen was in WAY worse shape than this.

Roll Tape

Our new electronic medical record system has been in place for awhile, and although I have refused to wear my awesome, neat, super-rad, peachy cool SUPER USER! t-shirt, I continue to pick up a little something new everyday.

Today's conundrum entailed figuring out how the doc could get "buddy taping" written as an order for say, a broken toe.  Can't imagine why the hospital would even bother with this, but if they can charge $400 for the doc to write the order it should certainly cover the nurse applying a 12 cent piece of tape.  Go figure.

Cripes just gave up.  "I don't care if it's ordered, and I am not going to free-text it.  It's too much of a pain"

Well, I like a challenge as much as the next person so tried every combination I could think of: tape, splint, buddy tape, buddy splint.  Nope, none of those.  Nurse tape, finger tape, boo-boo tape, toe tape, duct tape, toe shoes.  Micropore splint.  Nope, none of those either.

Suddenly, I pulled "Anatomic Splint" out of my a**.

Bingo.  That will be $400, and it's not even that cool colorful duct tape like this:

I left a roll of zebra duct tape on Kate's locker.  After I disguised this squirrel in zebra camouflage:

Because some days are just a fun-filled zebra safari.  Hark!  Behind you!  Hoof beats!!

SHOULD Old Acquaintance Be Forgot?

Harry: What does this song mean?  My whole life, I don't know what this song means.  I mean, "should old acquaintance be forgot"?  Does that mean we should forget old acquaintances, or does it mean if we happened to forget them, we should remember them, which is not possible because we already forgot?

I recently reconnected with an old high school friend via social media.  We exchanged brief Hi, how are your, how have you been?.  I ventured a Want to get together for coffee and rehash old times since we live about 2 hours away from each other?  I got no response to that.  I was a feeling a little...miffed.

I guess having no contact with someone for 39 years puts a bit of perspective on the issue....what was the issue?  Something stupid, can't even remember.  Obviously it involved feeling hurt and betrayed on my part.  Maybe hers, too.  Carrie was my best friend in high school even though I always knew she was a little....odd.  Not bucket of pig blood and torch the prom odd.  Still, she came from a difficult family and was affected by life-long marination in her family's history-steeped greatness, local legend status, and exceedingly high expectations.

Carrie and I stopped getting together on school breaks and weekends as we first grew apart and then, separately, grew up.  Certainly not having any contact in nearly 40 years there is not so much a void but a monstrous, massive black hole.  High school was a blip on the radar, nothing more; looking back we essentially started drifting  away from each the day we graduated.  Oh, we wrote newsy letters back and forth our first year, she from college, me from my childhood home.  I worked for a year before I started nursing school, the best thing I could ever have done although at the time I felt like an isolated loser.  I chafed that I was missing out on all those college experiences that my peers were having and living away from home, but I am convinced it kept me from flunking out of school in the first week.

Over the years, I fleetingly wondered about Carrie.  She did not attend either of the class reunions I managed to go to; it seemed she had dropped off the face of the earth.  I know she is doing something she loves, discovered via her blog detailing her experiences as a teacher. She is positive and passionate.  Good for her.   I did not relate my blog experience simply because I prefer to keep my identity to a chosen few.  I can count on two puny fists people who know me although a former colleague once sent me an email linking this blog, thinking it sounded a lot like my sense of humor.

I can count on those same two puny fists the number I count as close friends, the  ones you could unhesitatingly call in the middle of the night; the friends who will show up, no questions asked, with either a bottle of tequila and a lime; or a shovel and bag of lime.  I have been fortunate to become closer to my nursing school friends and remain close to my skating ladies, all of whom have been an amazing part of my life and who know where a lot of bodies are buried*.  I did not go to high school with any of them.

I guess Carrie's disinterest disappointed because I expected the same type of instant reconnection with a high school friend that I have enjoyed in the past.  Wow, yes, dinner, drinks, a weekend away.  WOOT!  That got me thinking about how high school was the ultimate forgettable experience for a lot of  people.  Yep, that would be me.  Guess I will just let those sleeping dogs lie; 39 years is probably not enough beauty rest anyway.

Tequila, anyone?


*Disclaimer: metaphorically speaking.  No actual bodies were buried.

Is That an African or European Swallow?

We always get tons of calls looking for advice.  We are not a free advice service and are prohibited from giving any by our employers other than "if you think you need to be seen, come to the ER".   To be honest, these calls are largely an annoyance; we get 10-15 per shift.  They pull us away from caring for people who have already made the decision to be evaluated.  Don't you get annoyed when you have been waiting patiently in a store or business, only to have your turn for service trumped by a phone call?  The most important customer is the one right in front of you.

Sometimes the call is driven by fear or denial and instead of calling 911, people will call us.  Easy answer.  Hang up and call 911, or I will get the address and call dispatch for them if they are too hysterical. Most of the time though the are all about convenience or lack of common sense.  People get truly pissed off because we refuse to give them any practical information.  It is a liability.  I get that you don't want to talk to your PCP after hours, or it didn't occur to you to call your PCP in the morning before you went to the gym.  Perfectly understandable that although you have already called your PCP, you think it is stupid that you were advised to go to the ER and you just want to check and make sure.  Unfortunately most PCP's have the same bottom line in the decision tree that we do.  Go to the ER.

Some of secretaries are comfortable giving people the standard response: we don't give advice.  If the nurses are busy they can at least screen calls for us and give us a head's up before we pick up the receiver.  We take turns.  Sometimes the calls can be quite amusing, and we award them meaningless points.  Everything is made up and the points don't matter though.

I Rock, Paper, Scissored with Lisa and lost on an advice call.  We had been forewarned by Jules:

Mr. Outdoors: "Hi, I just have a question.  Yesterday I was out mowing my lawn, and I had my iPod on my belt, now today I feel kind of warm.  And I have a little bit of a headache (and 4 other symptoms like finger pain and grass stains).  Then I noticed that around where my iPod was touching my skin it seems a little red.  Is it because I was outside and it was hot?  Could it be a burn?  Should that happen?  Would it also cause the other symptoms?  How late are you open?  Should I come right down or should I wait until tomorrow to call my PCP?"

-15 points for asking more than just the one question you originally proposed

+5 points for mowing the lawn

+10 points for remembering you had a PCP

-20 points for having 3 or more symptoms

+50 points for me for knowing what....is the airspeed velocity of an unladen swallow.

Bonus points for finding out what was on his iPod

How to Class Up Your Delivery and Get VIP Service in the ER

Polite society has certainly gone the way of the hoop skirt.  Pardon my sainted bloomers, but the ability to express oneself in a reasonably polite and courteous manner, keep civil when one's opinion differs, or engage in respectful dissent is non-existent.  Many people unapologetically present their problems thus: "I have a pain in my ass" instead of "low back pain" without shame.  Descent into name calling and profanity to make their point is the new norm.  You can't reason with people, and it isn't just because they are dumber than a bag of hammers.  It is strictly ignorance because THEY THINK NOTHING IS WRONG WITH THE WAY THEY SPEAK.  Don't get me started on how they talk to their kids.

Hospitals have scripting and behavioral expectations for staff, why should we not hold patients to a higher standard?  How about a little accountability for unacceptable language, profanity, and inappropriate expressions?

I offer a guide for alternative language; scripting for patients if you will.

Instead of: "Why do you have to ask so many fu*king questions?
You might try: Forgive my impatience, my good woman.  Would you kindly assist me in understanding why you need to know what medicines I take and how it is relevant to any treatment I might receive for my chronic, debilitating, and narcotic-requiring back problem?  I would like to be an active participant in my care.

Instead of: "I have a mother-fu*king toothache, my pain is through the roof.  I can't afford no fu*ing dentist.  Just hook me up with pain pills, bitch"
You might try: "Alas, dear lady,  I am irretrievably guilty of neglecting my dental health and am suffering from yet another exacerbation of uncontrollable pain.   I can imagine that it seems inconceivable that I have allowed this situation to deteriorate to this degree. I regret that my current financial situation severely curtails my ability to offer adequate  monetary compensation to a dental professional as I would be unable to purchase cigarettes, liquor, or marijuana.  Would it be at all possible to provide me with some additional narcotic pain relievers?"

Instead of: "I am sicker than anybody in this shit hole and I shouldn't have to wait for a room"
You might try: Please excuse me if I seem short-tempered, but might I respectfully request that my condition be re-assessed?  I understand that my man-cold is not especially urgent, but I do believe this  illness seems to have escalated in the 10 minutes I have been asked to repose in the anteroom"

Instead of: Any expressions such as  "Coochy pain",  "Kicked in the scrote",  "My girlfriend/boyfriend gave me some nasty-ass infection in my pu**y/dick".
You might try: I regret that I have a matter of some....delicacy to discuss.  Please forgive me if I offend you with any unacceptable slang, but...oh, I blush to say it...I have an injury/possible disease in my nether regions.  

Instead of: "I fired my doctor because he/she is the world's biggest douche bag.  He blew me off when I asked for an increase in my pain meds because he thinks I am full of shit".
You might try: I am currently between primary care providers, thank you.  We have come to an amicable parting of ways and I find myself in an unaccustomed awkward position.  Might I beg your indulgence in providing me with just a few of my usual analgesics just to tide me over until I have engaged another primary care provider?


Instead of: "What the hell am I waiting for?"
You might try: Excuse me, I completely understand that you are very busy caring for people much sicker than I am.  When you have a moment, might I trouble you for an update?


Instead of: "You are all a bunch of bitches/ c*ck suckers," etc.
You might try: I would just like to thank you so much for the excellent care you have provided me today.  I would love to let your administrators know how great my visit has been"

Let's raise the bar a little, people.