Today's Last Patient of the Night.....

....arrived at 10:30 PM. His complaint? "Vomiting Blood"

He and his two adolescent girlfriends giggled and texted and acted like idiots in general. I wouldn't dream of revealing his last name, but let's say if I had to pick a name out of a hat, it would rhyme with "Douche" (as in douche bag...which he was).

His triage note: "ate at Wendy's, then started vomiting blood. Pt. states he always vomits blood when he eats at Wendy's".

Yes, I know, I know. ...but why state the obvious here? You know me better than that, so I shall be withholding my comments; however, Meredith Grey has a few words to say on this issue. I will step aside to allow her perspective:

"Maybe we like the pain. Maybe we're wired that way. Because without it, I don't know; maybe we just wouldn't feel real. What's that saying? Why do I keep hitting myself with a hammer? Because it feels so good when I stop".

Thank you, Dr. Grey. I suppose your discharge instructions would include opening a nice big can of this:

Remember Essie?

From a few days ago? Well, my stroll down nursing Memory Lane jogged another nugget.

Essie got a new roommate at some point, who was ambulatory. And sneaky.

Bessie used to roam around at night. In those days we didn't have fancy patient alarms and monitors when patients went on the lam; we used a device called the the Posey Jacket, or Posey for short. This was a little mesh vest that zipped down the back and was tied to the bed; the patient had the ability to roll to either side, but it kept them from getting out of bed and into mischief (or going to ground and breaking a hip). It was, for all intents and purposes, a restraint device, although it sounds like a torture device, which I suppose it was since we aren't allowed to use it anymore. But it was never meant to be punitive, merely to keep the patient safe.
I have a point; I promise.

Posey's were difficult to get out of, but not impossible, in fact many of the elderly were quite adept at it. Bessie was what we referred to as a Houdini, master of the art of escape. One night all of the staff were involved in two simultaneous crisis situations, and Bessie's frequent bed check was missed. Sure enough she was on the loose.

But instead of raiding the pantry for sugar packets as she usually did, Bessie had another mission going; she had collected the dentures of every patient she could find and had placed them in a pillowcase. One dozen sets of dentures had been liberated from their Efferdent soup. To make matters worse, we were alerted to Bessie's larceny by the yelping from one of the male patients with whom Bessie was trying to get in bed.

THAT went over well. I don't really know how the day shift managed to reunite the teeth with their owners, but they did.

Mini Around Town, Part II

Milltown is just full of people this weekend. There is a Pumpkin fiesta on the town round with food and frolic; the economy can't be that awful since people and families are out in droves spending money. Just a ways out of town is a pumpkin launcher, hay rides and a corn maze. It's a beautiful fall weekend, just perfect for being out of doors. Mr. EDNurseasauras and I went out for breakfast, then tooled around for a couple of hours. Alas, I am working the entire weekend so I have a lot to squeeze in today.

As it is fall, we dog walkers must now share the woods with hunters. Of course I dress Tina and myself in the kind of day-glo orange color not found in nature at this time of year; still, I just don't feel safe on weekends frequenting areas in which hoards of individuals in full dress camo and toting weapons of mass destruction pile into pickup trucks and swarm over my usual hiking spots. That's OK, I just avoid the high-profile areas on weekends; not many hunters around during the week a-shootin' at Bambi and all his little friends.


Today I went to an old historic village site from colonial times that has been converted to public domain hiking. It is truly a beautiful area with miles of maintained trails, rolling hayfields, and wetlands. There was not a cloud in the sky as Tina and I made the rounds of all the rock walls where chipmunks hide.


Tina spotted a man coming up the path accompanied by a dark grey toy poodle. I recognized this as "Killer Poodle", owned by the property caretaker whom I've never met. "KillerPoodle" is a yappy little thing who resides at the caretakers cottage. He is infallibly found outside in the front yard, and barks and growls at anyone who passes by. Hence the name; I refer to him a "KP" for short. After our dogs had greeted each other in typical doggie fashion, Tina was off digging a hole on the other side of yet another rock wall. I made conversation with the caretaker dude about the usual New England topic of conversation (the weather) and asked him the usual questions about his canine friend.


"Well, he is about 8 years old. This in Niki II; Niki I is on the other side of the wall. He sort of came with the property, he was here before I was", said caretaker dude.


I was pretty sure I had only seen one KP on previous trips to the Village and looked over the wall to see if Tina had found any other little companions. As caretaker dude continued to speak, I realize that Niki I was, in fact BURIED on the other side of the wall. Typical old yankee humor. Niki I's grave was complete with a headstone with the obligate dates of existence. It was decorated with an engraved bone and pretty little pebbles; "Good Dog" was engraved on the bottom. Stay. Good boy.

KP ran off with his master, and Tina and I continued our search for chipmunks before I had to go to work.

Note: when we arrived home, the cat had caught a chipmunk. Tina prompty comandeered the catch. Sharing: good girls!

Today's Last Patient of the NIght....

.....was in his mid 30's, had a host of medical problems including stroke, alcoholism, diabetes and, since he was with his mummy, I am assuming he also had an impressive list of social deficiencies. It was 10:45 PM.

He needed a note because he missed his court-ordered community service.
The reason?

"I just didn't feel like going".

uh huh....

What Does That Mean, Anyway?

People often talk about how nurses are doing "God's work". Most days I disagree.

I do not believe it is "God's work" to take verbal abuse from a 39 year old with back pain (chronic) who plays football (every Sunday) and shows up the following Monday (every week) with excruciating pain. Why were we getting verbal shit? The physician, having looked up the patent's last five visits prescribed possible chiropractic treatment, ice and heat, ibuprofen and to moderate his activity; it was suggested that perhaps playing tackle football was not in the patent's best interest. Further, the patient was told that the physician was reasonably sure that none of the Patriots presented to the ER on Monday after a game looking for Vicodin. The patient was, of course, outraged and demanded the name of the physician's boss so he could complain; and, since he didn't get any treatment (except for some common sense advice) had no plans to pay for the visit. Oh, and he left his free-care application in the room.

I sure don't feel like it is "God's work" to look up the number of Medicaid for an able bodied 18 year old female who didn't have insurance but was too old for Healthy Kids and not in school. She had presented for a lump and bleeding "down there"; turns out it was a friction injury. Naturally she insisted on having her skanky boyfriend present for the inevitable pelvic exam. Why do these young girls go for these bozo's? Blecch.

For that matter, it surely cannot be "God's work" to put up with morons who twist a toe, ankle or elbow, or break a fingernail and high-tail it to the ER without first attempting ice, elevation or ibuprofen. If you are walking on it, using it to hold your cell phone to text message the world that you are in the ER, or slugging down a gallon of iced coffee from Dunkin's, it most likely NOT fractured. Especially if this is your 5th or 6th visit for a silly complaint this year. It is disheartening that there is so little common sense in the world.

You cannot convince me that it is "God's work" to document 30 (THIRTY!!) allergies for one patient, relatively few of them actual allergies; the only things that were missing from the list were "clouds" and "dirt".

On the flip side, there are some instances when I feel that, while perhaps not "God's work", I can glean, ever so slightly, a sense of satisfaction or accomplishment. To be honest, it is precisely those instances that keep me doin' what I do; in a sea of rude, unappreciative, nasty, stupid, violent, threatening patients and family members that strain my sanity and keep my eyes in a continuous roll, I am occasionally able to use my experience and skill to achieve something positive.

I kinda have a tendency to hold on to those moments like a lifeline on those days that I want to slap the ears off someone.

(This is my 100th post by the way, and I wanted to keep it as upbeat as possible!)