Just Doing my Job

My colleague Madness has a post up about the seasonal influx of patients with nausea, vomiting and diarrhea that are lining up in the ER.  She offers some (partially) tongue-in-cheek helpful hints for patients who aren't really sick enough to be in the ER.   Blame lack of common sense, blame a need for instant gratification or a magic bullet, blame lack of knowledge, but Madness is right on point:  patients with viral illness / vomiting, regardless of severity, do clog up the system.

However, one of her commenters took the pissy road.  He/she (anonymous, of course) snidely suggested that if ER's didn't want to be bothered with people who lacked the medical training to determine if they were sick enough to go to the ER, well then maybe hospitals should go on an information campaign to educate the public before they do something galactically stupid like go to the ER for frivolous reasons.

Excuse me.  Hahahahahahahahahah!  Haha!  HAAAAAAAAHAHAHAHAHAHAHAHA! (pauses to wipe tear from eye) HA!  HAHAHAHAHAHAHAHAHAHAH!!!!!!!!

That's rich.  Can you imagine any hospital endorsing that idea?  I can just see administrators foaming at the mouth on that one.  Public service announcements telling people NOT to go to the ER would be shooting themselves in the foot don't you think?

No, the responsibility for that task does not lie with hospitals, the ER, or ER nurses, at least not until people actually come in.  It would never work anyway, for several reasons:

1.  "I have been sick for 10 minutes" You  may be able to educate the stupid, but there is no cure for it.  Individuals who lack common sense are never going to be willing to do anything other than run straight to the ER at the first sign of a sniffle, so, vomiting?  Really?

2.  "My doctor told me to come" Many times patients do indeed do the right thing and phone their doctor for some advice about when they should worry. This is not unreasonable but they mostly talk to an office manager or triage nurse who then tells the patient go to the ER.  The office doesn't want vomiting people and there is a certain amount of liability telling people "it's a virus, you will get better".  This is enormously frustrating for people who, after enduring unnecessary labs, IV fluids, and hours of their lives are told, "it's a virus, you will get better".

3.  "Dr. Google told me to come".  People have access to all kinds of information online, watch way too much Dr. Oz,  and will often show up having already made their own diagnosis.  Information is not a bad thing, but when people come in with their treatment plan and choice of antibiotics already in place based on their research it can get ugly.  See, the problem is that we just don't see that much bubonic plague anymore.

4.  "YOU told me to come".  What I actually said was, "I cannot give any advice over the phone, if you feel like you need to be seen in the ER, we will see you".  For liability reasons,  I am obligated to end every single phone call to the ER for free advice in this manner.  Unless you are having crushing chest pain, then I might go off script and tell you if you were my family member I'd call an ambulance.  I understand that people want some guidance, but sorry, I'm just not allowed to give you any advice and every call ends up with the caller being frustrated and taking me away from the patient in front of me.

5.   "I am sick.  I'm never sick."People have their own individual perception of what constitutes an emergency.  Feeling crappy or scared, regardless of how minor a problem it seems to ER staff in the grand scheme of things is often a big deal to the patients.  People who are rarely ill can be frightened by vomiting.  As ER nurses we just don't get excited about some things, and remember, you may feel quite ill but you are probably not my sickest patient right now.  Perspective goes both ways.  It is important to note here, though, that being a drama queen about it does not endear you to my heart.  I can only reiterate Madness' wise words: "Man up".

6.  "I'm not dead yet".   Conversely, trying to educate people when and when not to go to the ER for their symptoms will not help someone who is insistent on going to work and spreading their germs around to others.  Some tough it out beyond their ability to cope.  These are very stoic people and people in New England who will simply stay away getting increasingly ill and dehydrated until it is late in the game.  Now not only are they really sick, but because they didn't lay low initially have infected dozens of others.  You can't change that mindset, it's useless to even attempt  doing so.

Please remember, people, we are speaking from a perspective of volume.  ER's are busy places, and are inundated with so many that don't really need to be there, as Madness pointed out.   Neither Madness nor I are referring to people who are genuinely ill, who are truly dehydrated and are physiologically unable to cope with their illness; the very young, the very old, the very compromised.  When people come into the ER and ask for change for the vending machine, well, maybe you can see why we are just a little frustrated at times.

Milestone

My Dad has been gone for 29 years.  On what would have been his 83rd birthday I realized that in the last year I passed a sad milestone; at age 57 I have lived more than half of my life without him.  As the oldest of five,  I was the last to hit this milestone.   

  

Dad only saw his two oldest get married.  Mine were the only two of his 12 grandchildren he ever met.  My ten nieces and nephews will only ever know Dad through our stories.

I've never been back to his gravesite in all these years.  It's not that I don't care, but I was never one for that kind of thing.  But I think about Dad a lot, especially when we are together as a family,  times he would have really enjoyed.  He had a great sense of humor and loved to laugh.  I wonder what books he would be reading now, what he would think about this presidential election;  what he would think about me as a person; if he ever would have forgiven me for those awful teen years.

Dad would have appreciated some of my ER tales having learned an awful lot as a medic in Korea.  He was a pharmacist who worked many years in a small neighborhood pharmacy back when it was called a "drug store" and he a "druggist".  He knew his patients well, and they loved him.  Everyone did.  He was the only genuine "people person" I have ever met.  I would love to know what he would have thought about the entitled a**holes, the chronic abusers of the system, the narcotic entrepreneurs that would now occupy his neighborhood if his little drug store wasn't now a real estate office.

I hope he would be proud of the adults his kids have become and the kinds of kids we have raised.  I know he would have loved to see those grandkids' school plays, learn to ride bikes, play sports, graduate, and become adults as much as he enjoyed those events as we kids grew up.

My brothers and I are lucky that our mom, at 80, is in good health and independent.  She has a more active social life than I do.  It wasn't easy for her though, having to go to work full time in her middle years just when the youngest of their children was ready to leave the house.  I know Mom misses him a lot.  She never got the chance for that "re-do" that I enjoy now, when the kids are on their own and it is just two people again.  The final sad milestone will be when, in a few months, my mom will have been without Dad longer than she was married to him.

Two of us have lived longer on this planet than Dad did although we don't talk about this, my brothers and I.  I'm sure we have all thought about it;  I was a little freaked the year I turned 54.   It's not that we don't talk about Dad, we do all the time.  We just don't talk about that particular hurdle.  We will never know exactly what caused Dad's sudden death, but I can assume that driving to work, turning off the car and simply ceasing to exist was not something that even remotely crossed his mind that day.  I can't speak for my brothers, but I try to mitigate the risk factors as much as I can.  We all live pretty active lifestyles perhaps keeping that fact in mind.  We were all athletes, and are in relatively good health although some of us might be carrying a few extra pounds.   But there are no guarantees in this life aside from the obvious, that no one gets out alive.

Which is why, I guess, we should enjoy every day above ground.  Happy birthday, Dad.

Pool Coup

Some months ago, Mr. Ednurseasauras an I joined a gym...excuse me, health club.  It is a pretty nice place, it has a good variety of stuff to do so there is no excuse for not going several times a week for classes, games, tennis, or whatever.  I enjoy several different exercise classes, pickleball and walleyball.  Unfortunately, I broke Mr. Ednurseasauras  on his first visit to walleyball; a torn calf muscle that took months to heal.  This is a man who hikes regularly, bikes, played hockey until he was 60, as healthy as  many 20 years younger, you get the picture.  It wasn't even an injury you could specifically blame on walleyball.  I mean, all he did was step forward on it so it could have happened anywhere; including the top of some mountain.  He was gracious about it but I blamed myself for badgering him into it as something we could do together.  Thus endeth any further campaigns on my part to ask him to do anything  but walk the dog.  He can go get hurt on his own time.   Which he does.   He is at present recovering and rehabbing from a patellar tendonitis.

On labor day weekend I had my own injury in an activity I have been doing since I was 10 years old; jumping out of a boat.  I had made a pretty bad job of docking the boat and leaped out to tie it, thus saving Mr. Ednurseasauras' knee; my own hyperextended in an explosion of pain.

 I spent the next several minutes dealing with both the pain and resulting near-syncope.  Mr. Ednurseasauras thought I was having a heart attack or stroke, which scared him very badly.  Long story short, I was fine, but the knee is still wobbly which has taken me out of court sports and exercise classes, and I didn't get to the gym for a month.  Tina doesn't get very long walks up rough terrain because I just don't trust that knee.

So, to do some kind of physical activity I started swimming in the lap pool, which seems to be just dandy for my knee.  I am presently doing 30 minutes of laps, then 30 minutes in the warmer pool vigorously treading water with just arms, or just legs and trying to get a workout out of both.

I lurked around one of the water aerobic classes for seniors to see if it was something I might like to try.  The first class seemed to consist of some ladies in their 70's floating on noodles with life belts and chatting.  Nope, didn't seem like it would be any kind of challenge.

The second class was lead by the same woman.  She had the participants raising their arms above their heads while kicking.  Still no challenge, and I had to leave the pool because one of the older gentlemen was straddling a pink noodle which extended out of the water in front of him so....I just couldn't look at that any longer.

Today the class seemed to be running over-time due to some earlier pool maintenance.  There was a small group of unruly home-schooled kids (the next class was advertised as being for home schoolers) anxious to get into the pool for lessons who were being disruptive.  They were sitting at the edge of the pool kicking and interrupting the flow of the class.  No parents in sight, surprise surprise.  One of the women, tired of kids fuc*ing with her chi yelled, "Hey!    You  have the rest of your life to get into the pool, most of us will be dead soon enough, so knock it off!"

Applause from the pool.  Silence from the crowd.

Important Announcement

Attention K Mart shoppers!

The will of the masses has prevailed!  ER gowns are now clown-free.

They are now covered with Pooh.

On a completely unrelated topic....what the hell is up with glow in the dark pull-ups???

That is all.

Please return to your regularly scheduled program.

Just One Click Away from Armageddon

All day long all I hear is:

"Arrrrrrrgghhh!  EDnurseasauras help!  My whole dictation is frozen! What should I do!"

"EDNurseasauras!  How do I figure out how to add to an e-chart if I already closed it?"

"Damn!  That's the 5th time I've entered this order!  It just keeps getting kicked out!  Now what?"


I can usually figure out and fix most computer charting errors, glitches, transfers, work-arounds and fu*k-ups. And it's not because I am a SOOOOOOper User.

Mac: "It's a good thing you're here or our fat would be in the fryer.  How did you get so adept with all these computer issues?"

Me: "I click on every button and tab 'til I either run out, figure it out,  or beat it into submission.  I have absolutely no fear of pushing buttons which is why I would be a really bad choice have on a nuclear submarine"

Mac: "Yeah.  Oops.  There goes Argentina"

Me: "Exactly"