Mikki is gone. Goodbye to her as she heads off to greener work pastures. Just remember there are no utopias in nursing, anywhere. I am not sure that there can ever be a utopia in endoscopy where she headed. For me, it would be the tenth circle of hell to spend all eternity (or until the end of my nursing career, possibly one and the same) as a bum look-up nurse.
So, Southern Cathy has taken Mikki's day shift position, and I have a new partner imported from downtown: meet Kate. She is disgruntled with the lack of leadership and general fuckery at the Mother Ship and is happy to roost with us. Welcome, Kate!
She and I have similar backgrounds and experience and an eerily similar sense of humor; quite scary, actually. We laugh a lot. Bobo is doomed when we are both working, it is quite entertaining.
If our first ten minutes together on shift is any indication, this looks like the beginning of a beautiful friendship.
I had triaged two individuals named Steve back to back. Ellen is slow to register, so I went looking for their charts to bring them into a treatment room.
Me: "Hey, did Ellen bring those charts back? I want to bring those two patients in"
Kate: "Ellen took them; she's bringing in the Steve's"
Me: "Bringing in the Steve's?"
Then I sang:"Bringing in the Steve's,
We shall come rejoicing"
by now Kate had joined in,
"Bringing in the Steve's!"
Then we laughed like idiots.
Kate: "What is a sheave, anyway?"
Me: "I think it is the little plastic piece at the end of a shoelace".
Kate: "Of course! Shoe lace sheaves! Brilliant!"
Yep, Kate is gonna work out fine.
Monday, May 23, 2011
Saturday, May 21, 2011
National Shortage
You won't see this on any newscast. It is a secret known only at the highest levels of government.
There is a national shortage of mirrors.
There has to be. I mean, some of the stuff people are wearing when they leave the house...it HAS to be that there is just no access to a mirror to see how they look.
Really??!!
It is the only reasonable explanation. Unless people are in possession of magic mirrors in which they see only what they want to see.
Here are some helpful hints for the mirror deficient:
If it feels tight, it probably is. That doesn't mean that you have the figure to wear it.
It you bought it in the sleepwear section, get dressed in actual clothes before you leave the house.
If you cannot button your jeans, you need a bigger size; perhaps several sizes. Really.
If you are not pregnant and cannot see your feet, please refrain from wearing a tank top.
Bra. 'nuff said.
Short shorts: just....don't. Please.
If you have legs that look like potato stix (thanks to Sue for that characterization), leggings just really aren't the look for you
If you must walk near the railing on the upper level of the mall and are wearing a skirt, you should really consider wearing underwear.
If you are male and wearing a shirt that says "It's Not a Beer Gut, it's a Fuel Tank for a Sex Machine", you have no hope of a normal girlfriend in the near future.
There is a national shortage of mirrors.
There has to be. I mean, some of the stuff people are wearing when they leave the house...it HAS to be that there is just no access to a mirror to see how they look.
Really??!!
It is the only reasonable explanation. Unless people are in possession of magic mirrors in which they see only what they want to see.
Here are some helpful hints for the mirror deficient:
If it feels tight, it probably is. That doesn't mean that you have the figure to wear it.
It you bought it in the sleepwear section, get dressed in actual clothes before you leave the house.
If you cannot button your jeans, you need a bigger size; perhaps several sizes. Really.
If you are not pregnant and cannot see your feet, please refrain from wearing a tank top.
Bra. 'nuff said.
Short shorts: just....don't. Please.
If you have legs that look like potato stix (thanks to Sue for that characterization), leggings just really aren't the look for you
If you must walk near the railing on the upper level of the mall and are wearing a skirt, you should really consider wearing underwear.
If you are male and wearing a shirt that says "It's Not a Beer Gut, it's a Fuel Tank for a Sex Machine", you have no hope of a normal girlfriend in the near future.
Saturday, May 14, 2011
Dear Narcotic Seeker, an Open Letter...
I see you have had a number of visits for your Holy Trinity of Chronic Complaints (dental pain, back pain, migraine). I make no apology for placing you in the waiting room. Just so you know, the medical professionals upon whom you depend for your endless supply of prescriptions for Percocet are busy with actual emergencies today. Two happen to be busy trying very hard not to die, one before we can get a helicopter here to transport her to Big City Hospital.
Ellen, our secretary to whom you give the same information every time you come in, is busy trying to assist the professional staff by making phone calls and other duties since the nurses are up to their assholes in alligators. It is inappropriate for you to lie on the floor in the waiting room and moan for a blanket. Frankly, we just don't care what you do or how much you act like a total douche; however, you are a distraction for Ellen, and you are making the small children and your fellow douchetards in the waiting area uncomfortable.
If you sit in the chair like a grown-up and behave yourself, you might be seen by the doctor in the next two hours. You might get one Percocet if you are a good little narc-seeker; however, telling me "Kiss my ass!" is not going to endear you to anyone.
With Disgust,
EDNurseasauras
Ellen, our secretary to whom you give the same information every time you come in, is busy trying to assist the professional staff by making phone calls and other duties since the nurses are up to their assholes in alligators. It is inappropriate for you to lie on the floor in the waiting room and moan for a blanket. Frankly, we just don't care what you do or how much you act like a total douche; however, you are a distraction for Ellen, and you are making the small children and your fellow douchetards in the waiting area uncomfortable.
If you sit in the chair like a grown-up and behave yourself, you might be seen by the doctor in the next two hours. You might get one Percocet if you are a good little narc-seeker; however, telling me "Kiss my ass!" is not going to endear you to anyone.
With Disgust,
EDNurseasauras
Saturday, April 30, 2011
When Stupid is Not a Concealed Weapon
New Cathy and I worked last weekend and I think we might have seen about 10 patients total, which amounts to DEADLY slow shifts. Wednesday, Thursday same thing. I managed to read about half of "1984", which I can't remember having read in high school but know that I did; I picked out lighting for my new kitchen and did most of my schoolwork for the week. And was bored out of my gourd, having to resort to watching a rerun of a ridiculous singing version of Gray's Anatomy; we saw in total 5 patients in 8 hours. All that quiet we have more than made up for in my last few shifts; it has been pants crappingly busy with actual REALLY SICK people.
I like to work with the Talker, he doesn't hurry people, which is why they love him. He has no urgency to to boot them out the door no matter what the complaint. This goes equally for dental paineurs (they get antibiotics only if they have more than one visit for same), antibiotic-seeking mothers whose kids have had a temp of 99 degrees for 10 minutes, back pain (chronic), and not-magically-better boo boos and viral illness after 12 hours. Of course this can backfire when it is really busy. He largely ignores Bobo's mandate that all patients be seen within 20 minutes. Sometimes it is as much as an hour. Or more. It gets complicated because the Talker doesn't automatically get xrays or order labs simply because the patient expects it; it is definitely not "Have it Your Way" ER when he is on. If it will not affect how he will treat the complaint, he is all about not exposing patients to radiation or paying tons of money for lab work. Have a UTI? We dip it, he treats with antibiotics. The common sense approach rules.
There were about 7 patients sitting in the waiting room; Ellen was buzzing around, dealing with a lot of non-emergent whining "how long is the wait". This really bothers her because she hates to ask us when we are busy, and is just not hard-wired to be firm with the idiots. Generally she is stuck in the middle where she never wants to be.
At 9:30 PM I looked over the charts in the rack:
Cough x 1 week in an 8 year old. Not worse, just not better.
"Asthma attack" in a tween girl (drama, drama, drama). Not wheezing, not coughing, not short of breath, sats 100% on room, lungs clear. Take a number honey, and get off your fucking cell phone.
Vomiting x 2 in a 20 year old frequent flier female who has been seen 8 times for "menstrual cramps" and always gets vicodin. WTF. Does not look sick and is drinking an iced coffee
Laceration in an 18 year old male. Microscopic. Will not require stitches.
"Flu-like symptoms"; nausea, no vomiting, no fever, no cough, no other symptoms except "I don't feel good". History of fibromyalgia.
Dental pain, first visit for same; accompained by 23 year old boyfriend who has had innumerable visits for same
Dental pain, 10 visits between the us and the Mother Ship. Known to have altered a presctiption in the past.
Of the patients in rooms and getting workups, two were being admitted with all the bullshit that entailed. At least they would be gone by 11 PM. One is getting antibiotics for cellulitis and is ready to leave. One is awaiting disposition for a UTI. Two kids with earaches waiting to be seen. The Talker usually doesn't prescribe antibiotics for all earaches automatically.
He spent 20 minutes in a circular argument patiently explaining to a woman who was strongly advocting for her 24 year old daughter for antibiotics for yet another viral illness.
"But we had them last time"
"She is not better so she needs them"
"If she doesn't have antibiotics how is she going to get better"
"But she had them last time and got better"
"She is sick, so she needs antibiotics"
"Couldn't you just give her some samples"
"She needs antibiotics because she is sick and not getting better"
"We will just come back tomorrow and get them"
You can't win any of these arguments when people are stupid
It may be time to start looking around for a new job. At least in a regular ER, most of this time-wasting crap and parade of idiots would go to the fast-track. Where I never want to work.
Thursday, April 28, 2011
Blast from the Past
I was flipping through the channels just now and came across an episode of "Marcus Welby, MD". This show is a time capsule of stuff that happened in the 1970's when I went to school. Get a load of those caps and white uniforms! Of course, the nursing stereotypes were pretty extreme.
I can't say as though all of this was the norm because I trained at a pretty progressive teaching hospital. Well, marginally more progressive than most I guess. "Natural childbirth" was hip in 1975, and fathers were part of the birth team functioning as the labor coach. But, only if the couple was married; no "baby daddies" allowed at that time.
This episode took place in 1975 and featured Gena Rowlands as a 36 year old professional woman, busy, successful and having it all except a baby; she had been struggling with infertility for years. In real life she was probably 45 and looked it.
Upon declaring her about four weeks pregnant, the mother-to-be phones up the husband to tell him the ecstatic news. The proud papa rushes over to old Marc's office with champagne, whereupon ALL THE DOCTORS, NURSES, HUSBAND AND PREGNANT WOMAN COMMENCE TO DRINK. Yikes.
A group of pregnant women, Marcus Welby's nurse and a couple of nursing students take a tour of the "Maternity Ward". First they get a look at the labor room, where "a nurse will help you time your contractions for the first stage of labor". Guess L&D nurses didn't have much to do in those days, at least until it was time for delivery.
Next, the group of scared looking women, clad in white OR gowns and caps moves on to the delivery room "where you will be moved for your second phase of labor". Scary damn place. "This is the table where you'll bring your child into the world!" Nurse Lopez says brightly
"Where do we first get to see our baby, Miss Lopez?", asks a scared primip.
Nurse Lopez looks strained, takes a breath and says, "Well, maybe in here Susan...if you're awake in time. You may be just under a local anesthetic if there are no complications. Then, you'll hear your baby's very first cry right in here". Camera pans to incubator, OR green-covered equipment, stirrups and scary shit as the young mother looks terrified. "Something to look forward to, isn't it?", Nurse Lopez asks gently and unconvincingly. The group is ushered out, no doubt to view other medieval implements of torture.
The rest of the show is pretty crayzee, but I don't have time to see it. I'll DVR it for later.
I can't say as though all of this was the norm because I trained at a pretty progressive teaching hospital. Well, marginally more progressive than most I guess. "Natural childbirth" was hip in 1975, and fathers were part of the birth team functioning as the labor coach. But, only if the couple was married; no "baby daddies" allowed at that time.
This episode took place in 1975 and featured Gena Rowlands as a 36 year old professional woman, busy, successful and having it all except a baby; she had been struggling with infertility for years. In real life she was probably 45 and looked it.
Upon declaring her about four weeks pregnant, the mother-to-be phones up the husband to tell him the ecstatic news. The proud papa rushes over to old Marc's office with champagne, whereupon ALL THE DOCTORS, NURSES, HUSBAND AND PREGNANT WOMAN COMMENCE TO DRINK. Yikes.
A group of pregnant women, Marcus Welby's nurse and a couple of nursing students take a tour of the "Maternity Ward". First they get a look at the labor room, where "a nurse will help you time your contractions for the first stage of labor". Guess L&D nurses didn't have much to do in those days, at least until it was time for delivery.
Next, the group of scared looking women, clad in white OR gowns and caps moves on to the delivery room "where you will be moved for your second phase of labor". Scary damn place. "This is the table where you'll bring your child into the world!" Nurse Lopez says brightly
"Where do we first get to see our baby, Miss Lopez?", asks a scared primip.
Nurse Lopez looks strained, takes a breath and says, "Well, maybe in here Susan...if you're awake in time. You may be just under a local anesthetic if there are no complications. Then, you'll hear your baby's very first cry right in here". Camera pans to incubator, OR green-covered equipment, stirrups and scary shit as the young mother looks terrified. "Something to look forward to, isn't it?", Nurse Lopez asks gently and unconvincingly. The group is ushered out, no doubt to view other medieval implements of torture.
The rest of the show is pretty crayzee, but I don't have time to see it. I'll DVR it for later.
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