Son of Misqoutes

A 2 year old was brought in with a crayon stuck in her nose.

Why?  "It was GREEN!"

It was easily removed with a Katz Extractor.  Man, I wish I invented that thing.

The following dictation was not proofread by the attending:

"The patient was stabilized in an Extractor which was inserted in the right nares and a small cranium was removed".

Crayon.  CRAYON.  CRAYON!!  I'm certain she is going to be needing that cranium sometime in the near future even if it is quite tiny.

This next one, courtesy of Dr. I Never Check My Dictations, details the very minor complaints of a young man who had been in an MVA.

"This young man suffered no loss of consciousness, but reports a headache which sex has resolved"

What?!  I had to point that one out once I stopped laughing, but not before I wrote it down.

FYI he meant "which SINCE has resolved".  

*snort*

Misquotes

The Talker takes the cake for the number of amusing misquoted dictations, he of the legendary "anal screw" dictation (ambulance crew).  He is a bit of a low talker which doesn't help.  Heck, I can't hear 3/4 of what he says.  I have never, ever heard him raise his voice about anything and he rarely gets excited.  That is to say a raised voice which would be in the normal human conversation range, and excitement....just couldn't picture it.

"Poni ice to affected area 20 minutes per hour".  Not the ice of regular sized horses, it must be poni ice.  Poni= apply


"You must quit soaking".  Dry out, you're all wet.  Soaking=smoking.  


"Watch for signs of injection"  Because they can sneak up on you.  Injection=infection

"History of My Grain Clinic"  It must have been somewhere in the Mid-West.  My Grain Clinic=migraine headache.

"...append ass us".  We will just stick it on the end of the butt.  appendicitis

By far the funniest thing I've seen or heard in awhile occurred while I was buying my new this past week, a story for another day since I am still on an adrenaline rush.  Be calm.  Breathe.  Drink more wine.

Anyway, a sales person who was not mine was dealing with an obviously disgruntled customer for whom English was not a native language and who was having some sort of difficulty with a series of repairs on a used car she had purchased.  I was too busy trying to get my calculator to work, but heard this much:

Sales guy: "So what's up, girl?"

Woman: "Yeah, I'm gonna have to talk to a lawyer or sump thin, these things are not being fixed".

Sales guy: "What's going on"

Woman: "You know, the blah blah is this, and the blah blah is that"

Sales guy: "What have the repair guys told you, and what do they propose to resolve the problem?"

Woman: "Yeah, it's a thing with the asshole, you know, I don't know anything about cars.  The asshole,  man, there's a problem with that"

Sale's guy (to his credit doesn't even blink): "I think you mean the axle"

I stuck my head in my purse to hide the laughter, but not before the sales guy winked at me.

Shark Tale

So, I'm sitting here watching the news, a follow up story from the other day in which a man on vacation was horribly bitten by a shark in front of his son while body surfing .  The man survived, and was alive and well enough to give commentary on how incredibly lucky he felt.  No, it didn't ruin his vacation because now he would have a story to tell.

A story to tell??  Um, I have a slightly different take.

I am too lazy to do the research or the statistics, but I would think that the odds of getting attacked by a shark for someone who casually swims in the ocean a few times per year are far fewer than someone who swims in shark infested waters all the time.  So on the bright side, this guy's chances of getting attacked by a shark a second time  IN HIS LIFETIME are slim.  To none.

Getting attacked by a shark and surviving is like getting struck by lightening.

But what about the odds of getting attacked by a shark and surviving, and SUBSEQUENTLY being struck by lightening???

This gives me a headache, think I will have another glass of wine.

No Medals for Poor Performance

Mr. Ednurseasauras called to inquire if I was able to watch any of the Olympic Opening Ceremony with doctor's and nurses jumping around and dancing with beds.  I had no idea what he was talking about until later.  "Nope.  I'm watching patients hit the fan".  This was not a literal statement, but I did have parents bring in a  baby whose head was struck by a  ceiling fan in motion as mom lifted him over her head.  No actual baby parts were injured.

A 19 year old female was observed exiting the car via Magic Cam and crossing the parking lot accompanied by a young male.  Said 19 year old then performed the oh-so-graceful-ever-so-gentle drop to the floor where she sat partially supported by the young male.  "She passed out!"

Yawn.  Wheelchair was deployed to lobby.  Young female is clearly not unconscious.  "Get up", I whispered loudly in her ear.  Young female complied and sat in the wheelchair.

Young female was apparently found "passed out" by her car in the driveway by Male companion.  She was nauseous yesterday.  Went to work today and didn't eat much, but managed to have a few sips of Budweiser for sustenance before taking a dive in the driveway.

Yawn, yawn.  Vital signs, EKG, labs, blood sugar all shockingly normal.  Not pregnant.  Run in a liter of saline.

She was pretty much ignored for the next hour since her arrival signaled the floodgates to open wide.  I was busy, busy.  Male companion had left the building also, becoming disinterested withYoung female's sub-standard dramatic acting skills.

Apparently Young female got bored because she wasn't getting enough attention, so she took out the generous 18g IV I had so graciously placed for her well being.   "I'm ready to leave", she said.

"Yeah, no. Sit.  Stay.  Good girl.  Be with you in a minute"

In the Possum Olympics, you have failed in the Qualifying Round and will not medal.

I love the Olympics, but I just can't watch the female weight lifting.  Those little tiny girls doing clean and jerk....I have to look away because I am expecting those weights to land on top of them and squash them like bugs.  Or that their arms will splinter like glass or their knees to pop out.

There isn't much I will try to lift these days as I have too many years of work ahead of me to risk injury.    For the most part,  I really don't have to lift much.  Most of the time it's drama like Young female.  It is fascinating that people can be compelled to RISE on command because I tell them I cannot support them: "You WILL hit the floor".   It is almost always women whose sense of self-preservation takes precedence over the need for attention.

The Lady Lies

Hard to believe that she is still alive, but the Lady on Elm is indeed alive and thriving.

And she still has the patient services representative on speed dial.

My boss plunked herself down at the desk and with eye's rolling detailed Lady's latest discourse of discontent, AKA complaint number 5,234.  There are two sides to this story but only one of them is the actual truth.

On one of those very busy nights in which all rooms were filled with mostly sick people, including two transfers and a death (with ER Wake^TM) Lady started with her usual phone fu*kery.  She will ask who is on, if we are busy, and to speak to a specific nurse.  The secretaries all recognize her voice if she calls as she assumes they will; they are good at deflecting her if we are busy.  Lady is the single exception to my previous post on advice calls  that result in "go directly to the ER."  Our advice to her for her non-emergent complaints are usually "call your doctor in the morning".  However, Lady has her own decision tree; in fact it is some kind of game to get us to give her permission to come to the ER.  I envision her decision tree on poster board, thumb tacked to her kitchen wall; every thought she has, every question if it remotely concerns her maladies, her meds, or any fleeting thought that might potentially, even remotely, require a medical opinion or common-sensical response encourages her to  pick up the phone and/ or "go directly to the ER".  She doesn't drive and her family members are all sick and tired of her evening visits to the ER and have generally made themselves unavailable to her after sunset.  That leaves only the Big White Taxi with the Flashy Lights.

After several phone calls in which she was ignored, Lady got restless waiting for responses to her silly questions, so she skipped right to the "go to the ER" section of her poster.  She was tucked into a room by herself.  I don't know if she is capable of intuiting that there are other patients who are sicker or require more care, or if she just doesn't give a crap; several times she called out to me.  I would run in and stick a pulse ox on her finger or bring a glass of water or just wash my hands and give her whatever update I had time for.  Not much we could do for her anyway.  After about 2 hours she was diagnosed with a strep throat, sent home by taxi that we had to voucher with 2 doses of antibiotics since the pharmacies are always closed when she comes in. We had to wait 45 minutes for the cab to come from another town as the local cab was also closed at that time of night.  So we paid for her care, paid for her cab, gave her free antibiotics, and the hospital ate the overtime for 2 nurses while we twiddled our thumbs.  Nice.

 A subsequent visit during her usual one-stop shopping for outpatient lab work, x-rays, and buying loaves of Wonder Bread the next day also included a "check in" at the ER.  This confirmed that yes, she had strep throat.  Keep taking those antibiotics.

Two weeks later, Lady came in again with sore throat.  Yep, you guessed it.  Strep.

So as to the actual complaint.   Lady claims that prior to ER visit number 3, nobody ever told her specifically that she had strep. During each of her two previous visits.  Even though it is clearly written on her discharge instructions.

Me: "REALLY.  Well, that is very interesting because I was the nurse for both visits and I VERY SPECIFICALLY recall almost word for word the conversation I had with her about strep.  We had a deeply religious experience as we waited for her hospital-supported taxi transportation home".

Jane: "I know.  She lies.  She embellishes.  And the patient services rep is her bitch."

Me: "Well you can expect some very specific notes for all of her ER visits from now on.  You know how much I like to type.   I enjoy being creative, and since now she has been exposed as a liar I can say whatever I want".

Jane: "Yes, your notes are hilarious.  Very creative and descriptive.  You should write a blog"

Meh.  I should just finish my book.