All day long all I hear is:
"Arrrrrrrgghhh! EDnurseasauras help! My whole dictation is frozen! What should I do!"
"EDNurseasauras! How do I figure out how to add to an e-chart if I already closed it?"
"Damn! That's the 5th time I've entered this order! It just keeps getting kicked out! Now what?"
I can usually figure out and fix most computer charting errors, glitches, transfers, work-arounds and fu*k-ups. And it's not because I am a SOOOOOOper User.
Mac: "It's a good thing you're here or our fat would be in the fryer. How did you get so adept with all these computer issues?"
Me: "I click on every button and tab 'til I either run out, figure it out, or beat it into submission. I have absolutely no fear of pushing buttons which is why I would be a really bad choice have on a nuclear submarine"
Mac: "Yeah. Oops. There goes Argentina"
Me: "Exactly"
Monday, October 8, 2012
Friday, October 5, 2012
Maybe I Should Patent This...
Many of our chronic dental painters / narcotic entrepreneurs have horrible teeth, no doubt about it. While their "horrible pain and can't afford a dentist" will probably be treated without suspicion initially, the subsequent 6 or 7 visits a month for 10/10 pain smack of insincerity and scamming behavior. Most dental pain is treated with antibiotics and pain medication. The more visits, the less likely it is that percocet will be on the discharge menu. After a few of these visits, the savvy patient starts adding allergies; first ibuprofen, then tramadol. Then tylenol, which would then eliminate percocet as a choice. Clever seekers will say they have no trouble with the oxydocone, but that effectively shoots them in the foot since we never, ever give out plain oxy's in the ER.
When the patient is diagnosed with abcess, sometimes they get IV antibiotics. Mostly they leave with a script for penicillin and pain meds. Some doctors will write notations on the script numbering the penicillin "1 of 2". When only script #2 is presented at the pharmacy (the pain med) this prompts a call from the pharmacist asking what the 1st script was, because the patient can only afford one of them. Definitely needs antibiotics, they are told; maybe they should buy that instead of cigarettes. The patient usually just goes away, to try and play us another day.
Why not just combine the antibiotic AND the pain med? Percocillin! Everybody is happy!
When the patient is diagnosed with abcess, sometimes they get IV antibiotics. Mostly they leave with a script for penicillin and pain meds. Some doctors will write notations on the script numbering the penicillin "1 of 2". When only script #2 is presented at the pharmacy (the pain med) this prompts a call from the pharmacist asking what the 1st script was, because the patient can only afford one of them. Definitely needs antibiotics, they are told; maybe they should buy that instead of cigarettes. The patient usually just goes away, to try and play us another day.
Why not just combine the antibiotic AND the pain med? Percocillin! Everybody is happy!
Thursday, October 4, 2012
Cat and Mouse
Nobody has a sense of humor anymore, especially our IT people.
We are housed in an old building. There are mice from time to time, tiny little field mice. I haven't seen any in about 3 years, but one was spotted recently by a patient who got pretty upset about it and made all kinds of stupid demands, said she wasn't paying her bill, etc., etc., etc.
I got right on it. I sent an internal request for someone to investigate our mouse problem. Just for laughs, I sent it to IT. I figured it would be a nice change from dealing with forgotten email passwords and taking turns writing about how wonderful they are on the hospital attaboy board. I checked the box that said "mouse, wireless" and sent it on over.
Memo exchange follows:
TO: EDNurseasauras
From: IT
RE: Mouse Problem
IT is only responsible for hardware issues, computer programming malfunctions, Help Desk issues, and other system issues related to electronic charting, etc. Your mouse problem does not fall under IT responsibility. Please initialize request to facilities.
TO: IT
From: EDNursesasauras
RE: Mouse Problem
That's ok, I'm more of a do-it-yourselfer. In the absence of a mouse trouble-shooting tutorial, what kind of cheese would you recommend I initialize?
TO: EDNurseasauras
From: IT
RE: Really, it's not our problem but I suppose peanut butter might work.
TO: IT
From: EDNurseasauras
RE: It is now
If I catch the mouse, should I just disable it? Would there be any point in reinstalling?
TO: EDNurseasauras
From: IT
RE: Really???
Now you're messing with me, aren't you?
Do you even have a mouse problem?
Yep. Also I know the location of the beige marketing cart. And Jimmy Hoffa.
Eventually the facilities department set traps.
More on that later.
We are housed in an old building. There are mice from time to time, tiny little field mice. I haven't seen any in about 3 years, but one was spotted recently by a patient who got pretty upset about it and made all kinds of stupid demands, said she wasn't paying her bill, etc., etc., etc.
I got right on it. I sent an internal request for someone to investigate our mouse problem. Just for laughs, I sent it to IT. I figured it would be a nice change from dealing with forgotten email passwords and taking turns writing about how wonderful they are on the hospital attaboy board. I checked the box that said "mouse, wireless" and sent it on over.
Memo exchange follows:
TO: EDNurseasauras
From: IT
RE: Mouse Problem
IT is only responsible for hardware issues, computer programming malfunctions, Help Desk issues, and other system issues related to electronic charting, etc. Your mouse problem does not fall under IT responsibility. Please initialize request to facilities.
TO: IT
From: EDNursesasauras
RE: Mouse Problem
That's ok, I'm more of a do-it-yourselfer. In the absence of a mouse trouble-shooting tutorial, what kind of cheese would you recommend I initialize?
TO: EDNurseasauras
From: IT
RE: Really, it's not our problem but I suppose peanut butter might work.
TO: IT
From: EDNurseasauras
RE: It is now
If I catch the mouse, should I just disable it? Would there be any point in reinstalling?
TO: EDNurseasauras
From: IT
RE: Really???
Now you're messing with me, aren't you?
Do you even have a mouse problem?
Yep. Also I know the location of the beige marketing cart. And Jimmy Hoffa.
Eventually the facilities department set traps.
More on that later.
Wednesday, October 3, 2012
Today's Last Patient of the Night....
....was about 5 years old. He had a cough, the same cough he has had for about a week and for which he has already seen his primary care on two occasions. Nothing new about the cough and no new alarming symptoms he was just not Magically Better.
Partner in Crime brought in a child-sized gown for him to change into an mom immediately burst into tears. Not because she was fearful for her child's health or unable to pay the bill.
"Give him another gown!", she shrieked, "it has clowns on it! Take it off!"
Ohhhhkay. I'll take the red nose off, sheesh.
Partner in Crime noted that all the kids' gowns have clowns on them.
Partner in Crime brought in a child-sized gown for him to change into an mom immediately burst into tears. Not because she was fearful for her child's health or unable to pay the bill.
"Give him another gown!", she shrieked, "it has clowns on it! Take it off!"
Ohhhhkay. I'll take the red nose off, sheesh.
Partner in Crime noted that all the kids' gowns have clowns on them.
Thursday, September 27, 2012
Livin' the Dream
Often I find it necessary to take two deep breaths and force a cordial expression on my face even when I have just had a vacation. I am seeing way too many of the same faces again and again for absolutely silly reasons, merrily abusing the system. There are just too many taking the a free ride with their "hurray for me, f*ck you" attitudes. Yes they have a primary care; they just don't want to be inconvenienced.
One of the free-riders is the wife of a narcotic seeking douche bag who is now living with his mother. Or in jail or some sh*t. She has an alliterative, cutesy name so I will just call her Betty Buttz. Betty comes in to the ER regularly enough for me to know all her information and her kids by name for just stupid reasons at LEAST twice a week. She can be counted on to come in on Thursday or Friday with nebulous injury or pain and is seeking a work note, AKA "Get Out of Jail Free Card" for the weekend. She works maybe 8 hours per week at the most at a $1 store. If she has a medical issue such as sore throat, rash or dental pain (often) she can be counted on for two or three additional visits for changes in antibiotics and additional "Get Out of Jail Free Cards for Condition XX, Not Magically Better". She also regularly asks for refills for "stress and anxiety" medications. She doesn't ever get them, but that doesn't prevent Betty from asking.
Betty's birth control poster children are also seen frequently. They are easily the most klutzy, uncoordinated kids on the planet as mom's answer to every bump, bruise, ache and pain is to squeeze her fat free-care ass into her car and transport the kids to the ER. I think the school office is wall-papered with her kid's "Get Out of Gym Free" notices. These kids are obese and could use a little physical education. Last time one of the kids had a 3 or 4 day old knee boo-boo I refused to give out another pair of crutches because I know I have personally given out at least 2 sets to everyone in the family. Unless they are using them to hold up the walls of their double-wide, they can reuse a pair.
As if these bi-and tri-weekly visits didn't suck enough empathy out of me, Betty Buttz has started to accompany Crayzee Cutter Friend as a mouthpiece / advocate for her regular field trips to the ER for her self-inflicted suture-requiring transfer-to-tertiary-care-psych-eval. Crayzee Cutter Friend's medical history, multiple allergies and psych meds are also well known to me. Betty Buttz is always helpful during Crayzee Cutter Friend's visits by routinely updating her Facebook status and texting their numerous friends and family who also never accompany her to the ER.
Crayzee Cutter Friend predictably gets a ride by Big Taxi with the Flashy Lights (again) to a complimentary psych evaluation (again) so Betty is pretty much at loose ends for the rest of the night (again).
"Where are the kids today, Betty?" I asked conversationally, like I cared. Probably off playing in dumpsters and inhaling toxic fumes judging from their usual choice of activities.
"With their father".
"Isn't it nice you have an evening out?", I observed brightly.
Betty took the opportunity, as long as she was there, to get herself checked out in the ER (again).
One of the free-riders is the wife of a narcotic seeking douche bag who is now living with his mother. Or in jail or some sh*t. She has an alliterative, cutesy name so I will just call her Betty Buttz. Betty comes in to the ER regularly enough for me to know all her information and her kids by name for just stupid reasons at LEAST twice a week. She can be counted on to come in on Thursday or Friday with nebulous injury or pain and is seeking a work note, AKA "Get Out of Jail Free Card" for the weekend. She works maybe 8 hours per week at the most at a $1 store. If she has a medical issue such as sore throat, rash or dental pain (often) she can be counted on for two or three additional visits for changes in antibiotics and additional "Get Out of Jail Free Cards for Condition XX, Not Magically Better". She also regularly asks for refills for "stress and anxiety" medications. She doesn't ever get them, but that doesn't prevent Betty from asking.
Betty's birth control poster children are also seen frequently. They are easily the most klutzy, uncoordinated kids on the planet as mom's answer to every bump, bruise, ache and pain is to squeeze her fat free-care ass into her car and transport the kids to the ER. I think the school office is wall-papered with her kid's "Get Out of Gym Free" notices. These kids are obese and could use a little physical education. Last time one of the kids had a 3 or 4 day old knee boo-boo I refused to give out another pair of crutches because I know I have personally given out at least 2 sets to everyone in the family. Unless they are using them to hold up the walls of their double-wide, they can reuse a pair.
As if these bi-and tri-weekly visits didn't suck enough empathy out of me, Betty Buttz has started to accompany Crayzee Cutter Friend as a mouthpiece / advocate for her regular field trips to the ER for her self-inflicted suture-requiring transfer-to-tertiary-care-psych-eval. Crayzee Cutter Friend's medical history, multiple allergies and psych meds are also well known to me. Betty Buttz is always helpful during Crayzee Cutter Friend's visits by routinely updating her Facebook status and texting their numerous friends and family who also never accompany her to the ER.
Crayzee Cutter Friend predictably gets a ride by Big Taxi with the Flashy Lights (again) to a complimentary psych evaluation (again) so Betty is pretty much at loose ends for the rest of the night (again).
"Where are the kids today, Betty?" I asked conversationally, like I cared. Probably off playing in dumpsters and inhaling toxic fumes judging from their usual choice of activities.
"With their father".
"Isn't it nice you have an evening out?", I observed brightly.
Betty took the opportunity, as long as she was there, to get herself checked out in the ER (again).
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