School Nurse Fun

One of my colleagues was forced to treat, in the ER, a patient who was going to the OR for an appendectomy. The problem? Head lice. 3 days later, she was still scratching and obsessively asking us to check her head.


Having spent a number of years "moonlighting" as a school nurse, I know a thing or two about head lice. Nothing would strike fear into the hearts of parents and teachers like a rumor of head lice. Now, I refused to do scheduled head checks on a school of 500+ Kindergarteners and 3-5th graders. Some school nurses did, but WTF, I was the boss and my principal was fine with it; I had a "no nits" policy which worked well. In 9 years, I had no epidemics. A few cases of course, but my system of finding out who the friends were and targeting their classrooms for headchecks worked like a charm. Most of the teachers asked me to check them as well although I never, ever found so much as a spec of dust that LOOKED like a nit. I did have some fun with one or two of my teacher friends over the years by sharply and audibly drawing a breath and muttering "uh-oh". Psych!

My friend Rita the school secretary was a great one for practical jokes, as was I. We once took a picture of a popular grade 4 teacher and put in on a milk carton after he was late back to school with his class on a field trip. The kindergarteners did a fun little graduation program each year (it was always the same) that featured a song that goes "P-u-r-p-l-e, purple, purple" and sung to the tune "Camp Town Ladies". I had a giant blowup purple crayon that I marched back and forth so that only the teacher could see; cracked her up, especially the year I did it with a giant pair of sunglasses and a wizard hat. Being a school nurse would probably have been a better choice to finish up my nursing career, but I had to let it go; I loved the kids and teachers, but the parents were all nuts.

One year I decided to have some fun with the head lice letter I sent out:

Memo to: Parents

From: EDNurseasuaras, School Health Nurse


Subject: Critters


Prepare to be horrified.

OK, I won't beat around the bush: there are headlice in your child's class
Now that you've stopped screaming, you should know that there is no need to panic. Really.

Seriously. DON’T PANIC. It is a common occurrence. Head lice are very small critters that attach themselves to your child’s scalp. They bite the skin and suck blood. The bites are itchy; that is what tipped off your child’s teacher, the continuous scratching. By the way, Mrs. Jones won’t be in tomorrow; she will be taking a personal day.

Head lice lay eggs, which adhere to the hair shaft and are pearly gray in color; They may look like dandruff. If you can easily remove something that looks like dandruff, it is not head lice. If it has attached itself to the hairshaft and has no intention of moving on...yep, it's headlice.

Lice spread from person to person. Infestation may occur as a result shared hair brushes or hats; sometimes it's a love attraction. Also they jump really far.


Head lice will take over the next two days of your life if you are committed to eradicating them. Remember, cockroaches and head lice are all that will survive a nuclear holocaust, so unless you are prepared to use lethal force they will become a permanent fixture. Don't say I didn't warn you.

You will need to boil the brushes, put everything that won't melt into the dryer, vacuum anything too big to go into the dryer or put it in the garage with the stuffed animals for the next 30 days. I am not talking about your child. And we haven't even gotten to declaring chemical warfare on the critters. Hopefully yours won't have become immune to Rid yet. Be sure to spend about 4 hours combing your child's head with a fine tooth comb. I will be checkng your work, so be thorough. We want your child in school, but without his/her little friends.

If all of these methods fails there is always Raid... or shaving the head.
That’s all about headlice.
love,
Mrs. EDN

Randomness

Phone call tonight:

"Hi, I'd like to come down and get the equipment to draw my mother's blood. She has Alzheimers. I have the paper from the doctor saying what tests she needs so you could look at it and tell me which tubes I need".



um, no.



Phone call from a pharmacist 30 miles away:

"We just wanted to check and see if Dr. R. wrote over the Vicodin prescription. Also, the dosing was a little odd, it says to be taken three times a day".



nope. The doc didn't do it, the patient did. Overwrote "valium 5 mg" and changed it to vicodin 5/500. Local constabulary dispatched to perpetrators residence. NO SOUP FOR YOU.



2nd phone call from a pharmacist, this time local:

" Hey, just wanted to check and see if Dr. P. knew that (anonymous, for HIPPA reasons unless I made the whole thing up) just picked up a 'script for 30 Vicodin from Dr. N when he dropped off the one you wrote for him for 20 Vicodin."



hmmm. Nope, he didn't say he saw his doc today, must have slipped his mind. You can rip that one up and the patient and doc will have a little chat about the importance of being honest with your provider.



Woman complains of painful intercourse x weeks. Has no insurance so comes to the ER, where her care is virtually free courtesy of those of us who pay for her to have this privilege. Has an ultrasound, but doesn't want to wait around for it to be read by the radiologist. Husband certainly has time to ask for a script for narcotics though.

Pedi severe head trauma from last month doing well and headed to rehab.

Sign on closet of one of the nursing units:

Student Nurse Closet

in small handwritten letters just below above sign

"Occupancy 13 student nurses".

Told you it was random.

Home on the Range

We get an ambulance containing the 88 year old gentleman from a local Alzheimer's warehouse. He has had a bloody nose off and on for the last 2 hours; not hypertensive, and not on coumadin, and also not bleeding when he hit the door.

He had quite a pronounced Scottish burr. And was quite delightful.

He was wearing well worn jeans and a really nice pair of Nike shoes, and began quietly and continously singing "Home on the Range" in a lovely sweet (mostly) in tune tenor voice. Over and over and over.

I wanted him to sing "Loch Lomond", but the Brit paramedic reminded me that it is a song about death, so it probably wasn't such a good idea. I didn't mind, really. He was singing pretty quietly as I said and minding his own.


The doc stuck some adrenaline up his nose with a piece of cotton and went about his business, only to come back and find the cotton...gone. He gestured frantically; "I need you to babysit him, I don't know where the cotton is"

"Do you think he swallowed it, aspirated it, or pocketed it?" I asked unhelpfully.

"Dunno. Can you just squeeze his nose for 10 minutes?"

Sure.

Squeezing his nose for 10 minutes was no hardship for me, but it did keep him from singing "Home on the Range". He had switched to "Let Me Call You Sweetheart".

The gentleman calmly allowed me to squeeze. Every so often he would say (I thought), "I've been a carny all my life". As in carnival, perhaps.

Well. "So what kind of work did you do there?".

"Oh, cars, all sorts of engines".

What I realized was that he had been a mechanic all his life.

The doc comes back after 20 minutes or so, finishes up and my little man was ready for his ambulance ride back to the Alzheimers warehouse. I was sorry to see him go, although he did start to wander around a bit and was fascinated by the blanket warmer in his room.

Oh, and I found the missing piece of cotton on top of the thermostat.
"Home, home on the range....."

Calgon, Take Them Away

Overanxious parents bring in a 15 year. His hand was caught between the wood stove he was helping to move and the floor leaving him with a few deep abrasions and some swelling on one knuckle worthy of an xray, but it certainly not the "Really bad" injury as advertised. The father responded to my question about tetanus: "Mine is up to date".

Um, for the record I didn't ask. And I don't care, especially since you continue to refer to your son as "princess". One more admonishment for him to "man up" (he was) and I'll give you something to man up about. This was clearly not a very deep gene pool as I was to learn.


Mom returned from the bathroom and announced, "Hey, there's Calgon soap in the bathroom, isn't it supposed to take you away?"

Husband: "Why, isn't that an Italian sandwhich with cheese and sauce?"

Me: "No, that's a CALZONE" ("you moron", my thought bubble screamed)

Husband: "Well, I was in the same state, the both start with 'K', don't they?"

I had to leave the room.


After an xray (negative) I cleaned up the cuts, put on some antibiotic ointment, assured the mom that her son would be able to play baseball and sent them on their way. But not until the brain trust that was dad asked if he would get crutches.
"Um, for a hand injury?"

"No, I just wanted to have them around in case we needed them".

No.

F stop

Why do people find it necessary to punctuate their discomfort with "fuck" to make a point? I am not averse to dropping an occasional "F" bomb to make a point.....when it's appropriate. But it is seriously overused if you ask me.

Can I say "fuck" on this blog? Guess I'll find out.



Perhaps in the ER we should institute an "F Scale".



I see this as an adjunct to quantifying pain via the pain scale.


Let's say a patient is complaining of back pain. He might say something like "Ah, FUCK. My fucking back hurts so fucking much, I just want to fucking kill myself. FUCK!




So, the pain is 10/10, with an F scale of 5. And a +1 for suicidal ideation as a bonus.

Another way to guage the turkey factor is F per minute.

Fuck.FUCK!

Fuckfuckfuckfuckfuckfuckfuck!!!!!!!

This is just overkill. And insincere. I heard you the first 9 times you said it.


I used to work with a very funny doc. He was really an angry young man deep down, but pretty funny usually. In my opinion he had the best possible use of the F word. He frequently used used the expression: FYYFF.


Fuck You, You Fucking Fuck. Or more accurately:

Fuck YOU. You. Fucking. FUCK.
The last 3 words were sort of slow and enunciated, like 'You. dirty. rat".
Yep.


I really appreciate the f bombardiers who pause after a string of f's to ask me how my shift is going. Ah, trying to endear yourself to me are you? Won't work, I can see ya coming a mile away.


My boss hung up an article written by someone whose defense against busy or compassion-lacking nurses was to get "up close and personal" with them, to try to connect with them in some way as to increase the human factor. One of her tactics was to ask if the nurse had children, or comment "I love your clogs!". Seasoned and hard core nurses won't fall for this; it just signals them that there is an agenda. It did get me thinking though. Anyone of us would advocate strenuously for a loved one, it just happens that those of us who work in health care (especially the ER) are usually more direct.

Hey Doc, great clogs!

F-you.