Not Baby Talk

I cared for a sweet three-year old.  We had this conversation while I wrapped up his boo boo.  He apparently thought that all nurses were present at his birth

Little Voice: "Nurse?"
Me: "Yes?"
Little Voice: "Were you there when I was borned?"
Me: "No, honey, that wasn't me"

A short time later: "Um...nurse?"
Me: "Yes?"
Little Voice: "Were you a nice nurse who helped my mommy when she was sick?"
Me: "No, sweetie, that was another nurse"
Little Voice: "You're a nice nurse.  You didn't give me any shots.  Do all nurses help people?"
Me: "As much as we can, baby"

Little Voice (after pausing to consider if I was trustworthy of his secret) "Do you know that my mommy went to heaven to be with the angels?"

Umm...gulp.  No, I really do have something in my eye.

Postal Notes

In my monstrously large ER consisting of about 10 nurses and where communication should not be an issue, the most common method is by post-it note.  These are numerous and routinely decorate the area around the nursing station.  Changes in policy, (management fu*kery), mistakes, ("wall of shame"), or reminders (endless little notes telling us"don't forget to do blah, blah, blah" ) would pile up to the point of ridiculousness....unless I removed them.  That is my mission in life.

Parvati always has requests for exotic pieces of equipment, expensive dressings, meds we would rarely use, or specific types of suture material.  She might say, "TELL JANE THAT SHE HAS TO ORDER 3-0 GECKO SUTURES ON A P-3 NEEDLE!  IT IS MADE FROM THE INTESTINES OF KOMODO DRAGONS AND IS COATED WITH BUTTERFLY SPITTLE!  IT COMES ON A NEEDLE MADE FROM DEHYDRATED AND GROUND WILD AUSTRALIAN DINGOES!  I MIGHT NEED TO USE IT AND WE DON'T HAVE ANY HERE!  I CAN'T POSSIBLY MAKE DO WITH ANYTHING ELSE! "

Parvati always speaks in caps.  Yes, she is shouting.  I treat most of these requests as I would for a kid who asks for a pony for her birthday; I yes her to death and throw it away.

Sometimes it is a legitimate request for equipment that we actually need that might be in low supply such as this:

"Dr G wants 4-5 knife handles, please"

And since we just can't help ourselves, written below:

I want an ice cream, no...make that a hot fudge sundae!

Step away from the Ginsu


I would like a bike.


Always pass a knife handle-first to avoid amputation.  This has been a very important Public Safety Announcement.

World peace, please domination


I want to buy this place after I win the lotto.  And I want a pony.

Who is writing the note is more important than what is written.  Or some sh*t.

PS, **** You

Lisa routinely begs me to leave her "love notes", humorous little observations about the absurdities of our job and/or irreverent comments about upper management (these are numerous).   I managed, after a crushingly busy evening shift in which I did not get to the rest room for 7 hours, eat dinner, or do anything other than fix other people's mistakes, to pen this:

Sorry it is such a mess.  We were here until after midnight charting.  I had a fight with Mac because he was being pissy.  It was his fault for working a 16 hour shift and not being able to figure out how to electronically order stat meds so he just left it for me.  What a shit-show.  Cathy and I are both quitting.  I'm not answering my phone so don't bother call.  Have a nice day. 


EDNurseasauras

Harmony for All

The evening shift has its own vibe. At 3 PM I can walk into absolute chaos with staff spinning in their own individual orbits:  nurses, secretaries, X-ray techs, lab techs, and let's not forget docs.  I hate walking into chaos, people wound as tight as rubber bands.  I like calm.  No panic until it's time to panic.  Breathe in, breathe out.

My first official act is to GET THE DAY SHIFT OUT.  Currently, my colleagues are great people whose only fault is the mistaken notion that they cannot leave for the day with a single task undone. Often it has been such a busy day that after a full shift of fu*kery, there is not a single other thing you can do except leave.  Quietly.  And pour yourself a glass of wine when you get home.

I'm not really complaining.  Every nurse who has walked this planet has, at some point,  wanted to strangle with their own stethoscopes nurses who are so lazy that they waltz out the door in the middle of a shit storm, waiting with their coats on, purse on the shoulder, and car keys in hand.  Being on the  report-receiving end of a train-wreck with a shit ton of unfinished business just doesn't make anybody's day.  Report not given to the floor nurse, charts not filled out, pain meds 2 hours overdue, no labs drawn, antibiotics not started and patients not updated for hours.  Crazy busy happens, but when the nurse is chatting with EMT's and hasn't taken one of 10 people in the waiting room in two hours or is online shopping, that is unforgivable.  Shame on you.  That goes double for nurses who sit back reading the paper while directing the ER tech to do all the work.

Like I said, calm.  Let's just all be one in the moment.  Breathe in.  Breathe out.  Ommmmmmmmm............

This....or That

Allow me to assist you in navigating the murky waters of the emergency department.  We will bend over backwards to give you the best possible care.  Truthfully, though, you need to be mindful that the best care may not be exactly what you want or what your friends think you should have; you may not necessarily have it Your Way just because you ask for it or demand it.  Know that we are reasonable people and put on happy, smiley faces but don't do well when people are unreasonable or taking advantage.  Rudeness doesn't help either, and we spend an inordinate amount of time squirrel wrangling.  Or haggling.

What the patient wants:  narcotics
What the patient expects: to call and ask to speak to Dr. No-narcs, thus ascertaining whether or not he should come in or wait for another day.  Better yet, ask to speak to Dr. Santa Claus to ask a question, or ask to speak to any doctor for advice.
What actually occurs:  No name shall pass my ruby red lips.  I stonewall, hedge, hinder, thwart, oppose, hamper, block, resist, oppose or impede any efforts on the patient's behalf to get the information.  Over my cold, dead body.  I'm really good at rebuffs, too.

What the patient wants: weekend off
What the patient expects: that we will write a work excuse for an injury that occurred two weeks ago and wasn't even worthy of 1/2 day off then.
What actually occurs:  come in for an exam.  It's been two weeks, at most you will get a note giving the day of your visit.

What the patient wants: an ER visit that takes 10 minutes because she has to pick up her kids
What the patient expects: that her oh-so-minor complaint such as poison ivy deserves top priority and to be attended to ahead of chest pain, abdominal pain and head injuries because it "only takes a few seconds" to examine, treat, and write her a prescription.
What actually occurs:  I waste 10 minutes of my life that I will never get back triaging and then explaining that her ass will be in the waiting room about an hour, so she leaves in a huff without being seen.

What the patient wants: whatever Dr. Google, Dr. Oz, or Dr. As Seen on TV prescribes
What the patient expects: magic cure
What actually occurs:  the mindless fuck doodles informed health care consumer argues with the ER doc for 10 minutes of his/her life that he/she will never get back about how antibiotics DO work for viruses every time.

What the patient wants:  improving his odds of early demise from worsening obesity, diabetes, COPD and heart disease after a lifetime of non-compliance
What the patient expects: that there is a magic bullet that will extend his dismal life expectancy
What actually occurs:  There is not a whole hell of a lot we can fix in one ER visit.

What the patient wants: me to drop everything and call the pharmacy right away with your prescription for foot fungus
What the patient expects: to pick up it up in under 5 minutes so she won't be inconvenienced
What actually happens: you have been a rude pain in my ass from the moment you hit the door, so I phone in your prescription at 5:05 PM, leaving it on the recorded line.  The pharmacist picks those messages up every hour on the hour.  Buh-bye.