Stuff I See on the Camera

MANY people have no idea, although the warning is clearly posted, that we have surveillance cameras which cover about a dozen views of the building both inside and out.  The real-time  display on our computer can be programmed with our favorite views; everyone has their own.  My own particular choices include the two front parking lot views which cover the ambulance bay and the walkway to our patient entrance, the waiting room, the inside entrance to the patient door and the outpatient registration area.  Once I saw a cat so big walk across the lot I though it was a fox.  I have seen a family of skunks walking across the back parking lot; this was a revelation, I did not know that skunks travel in packs.  Do skunks spray other skunks?  Do they, too, find the odor noxious?  Curious...

I love observing people and catching them n the act of doing something ridiculous.  I have spoken about people who leave with the Miracle Cure: the lame who walk without a limp, the bent-over who walk upright.  I submit for your amusement those who appear to misrepresent their maladies for whatever reason.  The most common is, of course, drug-seeking, followed by work avoidance/workman's comp claims, and attention seeking.

One young man and his female companion were observed walking across the parking lot.  They paused in front of the walkway to the front door patient entrance, crouched, and enjoyed a cigarette while remaining in that position.

Between the end of the cigarette and the walk in the front door, the young man developed a pronounced and painful-appearing limp.  He had been seen 3 days earlier for knee pain and his Percocet was gone.

He didn't get anymore because it was pointed out that we have hidden cameras.  He stormed out threatening to call his lawyer and crying bullshit.

Another gentleman was observed getting out of his car, leaning against it and having a 10 minute or so cell phone conversation.  He gesticulated, paced, and otherwise seemed to be in control of himself.

Then he walked in the door holding a bloody handkerchief to his eyebrow, moaning and groaning dramatically.  I asked what happened between the end of his phone conversation and his walk into the department to make him so miserable: had he been attacked by wild dogs perhaps?

"You have cameras?"
Um, yeah.

One couple stood right under the camera making out for the longest time; I really wanted to tell them to get a room.  When they finally came in, the woman was having 10/10 abdominal pain.  She wanted a work note.

One guy proceeded to wax his car while his girlfriend was being seen for a wrist injury.  When she left with a wrist splint, she took the wrist splint off and helped him finish his waxing.

I worked a day shift (shudder) and saw that a police car, lights a-flashing, was in the front lot.  The officer was applying handcuffs to the driver of a car that had pulled in ahead of him.  When backup arrived, the second officer advised us that the car would be there for awhile, and the animal control officer would arrive shortly to take custody of the detainee's dog.  Said dog was to remain in the car: Sit.  Stay.  It being a hot day, I was more worried about the dog, but animal control arrived promptly and he, too, was hauled off to jail. 

Early in the spring, one woman sunbathed on the hood of the car.  In a bathing suit top.  Do I REALLY need to tell you that it wasn't a pretty sight?  Hmmmm?

I watched a girl come in for a wheelchair because her boyfriend had "a really bad leg injury and couldn't walk".  He, like so many, was observed walking around the car in a perfectly normal manner, and take a carton of cigarettes and a gallon of windshield washer fluid out of the trunk.  I though he was going to drink it, but he popped the hood and casually poured it in BEFORE he sent the girlfriend in for the wheelchair.

Better than TV.

Just Shaking My Head

One of our frequent fliers with a host of chronic, pain related and narcotic-seeking complaints came by with her 30 year old son.  His complaint today was back pain, shoulder pain, leg pain, leg numbness, knee pain, neck pain (from no trauma that he could recall), and dental pain.  Really.  Sonny has apparently not been able to work since he was 18, had no insurance, no job, no doctor, and nobody to grease the wheels of government sponsored care due to his inability to work.  And that, my friends, is the real reason for his ER visit; per mom, "He needs to have this documented and fill out forms or whatever and get him serviced (her words, not mine). Somebody has to do something for him!"

With all of these chronic pain issues and his 10/10 pain, he is on no meds.  Takes no pain meds, not even ibuprofen or Tylenol.  I took a look at his old record to see if his past visits were as numerous as I suspected.  I was pretty shocked that he had NOT ONE ER visit since 2006 for a sore throat.

Well, well, well.  Interesting.

The Talker spent a good long time with Ma and Sonny.  They left with a prescription for Tramadol and the social worker's card.  What was the story?

As I suspected, Sonny couldn't seem to hold a job, although he has had plenty.  In fact he had worked today at the Happy Mart pumping gas.

"So what was that bit about not being able to work in 12 years?", I asked.

"Well, it's not that he hasn't been ABLE to work, but other issues have precluded his ability to WORK WELL", answered the Talker.

"Like what?"

"Oh, sleeping late and not getting to work on time because he was out late with his friends.  Just not feeling like working.  Not liking to work on weekends. Being hungover.  You know, all the usual issues the rest of us struggle with".

Um, yeah.

Arrrrrrrrrrgh

Billy was brought in by his mother with a really nasty laceration through his eyebrow and into the eyelid.  He had stepped on a water bottle, lost his balance and fell while on his deck, busting through the railing he broke en route to the backyard four feet below.  Amazingly, he had no loss of consciousness. Billy weighed 250 pounds at 5ft 4 inches.  That he did not break his neck is likely attributable to the 8 or 9 beers he had consumed during the course of the evening. His list of medical problems included high blood pressure, chronic back pain, more chronic pain issues.  Billy was 46 and lived at home. I would add alcoholism to his list, but that's just me.

I have absolutely no idea how Mrs. Billy's Mom got him to the ER on her own, but she deserves some serious props.  Hope she had a GREAT Mother's Day.

Billy moaned and groaned and moaned and groaned.  Then he groaned s'more.  To quote Dean Wormer, "fat, drunk and stupid is no way to go through life, son".  Nor is living with your mother at 46.

Billy's biggest concern, though, was how much of a scar his laceration would leave; Bobo said he would certainly have a scar. I advised Kate that she better grab this one before he was snapped up; quite a catch.

Billy: " yeah, how big a scar do you think?"

Bobo: "It's difficult to say"

Billy: "Well, how would it compare to these?"

Billy lifted his shirt and displayed some impressive scarring on his equally impressive gut.

Bobo did a double take.  "What are those from?"

Billy: "Well, I got shot here, stabbed...stabbed again...I ran with a pretty rough crowd when I was young"
Seems more like the crowd ran over him.

Bobo scrutinized the jigsaw puzzle on Billy's torso and indicated the scar on the left side of his chest: " Wow, looks like the gunshot there just missed your heart"

Billy: " Yep, I'm lucky to be alive.  So, how about that scar; I have to be looking good for the ladies"
Bobo: "Probably not that bad by comparison"

Um, yeah.  I am thinking he might just be able to pull off the pirate look when Billy nodded with approval.
"Yeah", he said, "the ladies will love that".

We sent him to the Mother Ship for a CT scan, which turned out just fine.  While there, he asked the unit secretary out.

Um, yeah.  See, I told you Kate, that kind of merchandise doesn't stay on the shelf long.

New Gal

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.

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.