Ooooh......Pretty!

Partner in Crime had already spiked a bag of Avelox when Parvati changed her mind...two more times.

Which is why we no longer take any more verbal orders from Parvati.

Anyhoo, we kept the bag of expensive IV antibiotic around hoping we would be able to use it for another patient, but alas, it was not to be.  

"Let's put it in the refrigerator and see what happens", I suggested.  "It says not to because it causes precipitation"

24 hours later this is what we got.  Looks like feathers to me (note my Magic 8 Ball and Sarcasm Ball in the background)

Questions?

Reap This

Today I walked into a day-shift shit storm as they were transferring a successful (read: "alive") code enroute to higher level of care.  There were lots of people waiting, some of whom had been waiting quite a while.  There was a handful of nice respectful individuals who were aware that a life-death situation was occurring.  They were calmly and appropriately waiting their turns.

Then there was Angry Woman.  She had a cat scratch.  She had been waiting over an hour.  SHE WAS AT RISK FOR INFECTION and creating all kinds of ruckus to the point where my boss became involved as my co-workers labored to transfer the nearly expired patient.

Yawn.

Jane: "I made nice with her.  She is waiting for Parvati to see her.  And she wants her B12 shot, she usually gets that as an outpatient, she doesn't have an order for it soIcalledovertoeherprimarycareandI'mwaitingforafax", she finished rapidly, probably hoping I didn't hear it.

Me: "So, let me get this straight.  She has an emergent cat bite and came in for an emergent B12 shot for which she doesn't have an order and she has made a scene and threatened to leave if she doesn't get it in the next five minutes and you have placated her, is that correct?"

Jane: "Um, yes?"

Me: "OK, I lost interest in that 5 minutes ago.  I'm going to do EKG's and line and lab a syncope patient.  Have fun with the douchey Angry Woman".  I walked off to retrieve the IV bucket and EKG machine, but not before I asked Angry Woman to take her Loud Hallway Douchey Telephone Yelling Session With Her Primary Care Provider's Office out of my hallway and into a room.  Eventually she stalked out, but Jane had told Angry Woman that she would call when the order came in.

 I politely told Jane that if I was busy with ACTUAL EMERGENCY patients that I would not be calling the shrew.   It was not pertinent to emergency care.

About 20 minutes later Ellen brought me a fax referencing Angry Woman from her primary care that read: "Re: Vitamin B 12.  Angry Woman called from the ER and stated that she would leave if the order was not faxed in 5 minutes"

Hahahahaha!

Me: "Um, that's not an order, Jane"

Jane: "Sure it is....isn't it?"

Me: "Jane.  No diagnosis, no dosage, no route.  Not signed.  Definitely not an order"

Jane: "Her primary care office said she was a mumblemumblemumble"

Me: "Excuse me?"

Jane: "They said she was a bitch difficult"

Me: "As ye sow, blah, blah blah"

Sometimes squeaky wheels just get the well-deserved shaft.

Cat and Mouse, 2.1

Yes, this is a mouse.  Under the old computer in the kitchen at work.  Its presence was detected by our little weekend housekeeper.

"Missus!  Missus!  There's a mouse in the kitchen!"
Esma insists on calling me Missus even though I've repeatedly told her to call me by my first name; we don't stand on ceremony here.  Maybe she just can't be bothered to learn everybody's names.  Anyway, Missus it is.

I walked back to find the offending critter who, having evaded the numerous traps placed and forgotten months ago by the pest control people, was now emboldened to storm the kitchen.  I moved a box to see the little rodent perched under the monitor.

We stared at each other for a  moment.  Critter twitched his whiskers nonchalantly.  "Hmmm....Esma, watch him for a minute I'm going to get my phone".  It has become the most obvious thing to do in this electronic era.  Take a picture.

He posed quite contentedly for several minutes until I got bored and tried to poke him into the trash bucket with the mop handle, all the while Esma laughing and squealing, "Get it!  Get it!".

Off it ran into my boss's office on the loose once again.  I sent her the above picture with the following text of her adorable little guest.

It is still out there......somewhere.

Shorts

Stinkiferous: describing lingering, sometimes noxious odor in a treatment room long after the individual(s) have departed.  Examples are hockey and football equipment and feet, soccer shin pads, and any patient who works at the local candle factory.

I have had enough of posters and sign up sheets for fund raisers.  FYI: I will not be doing any further collection of books, clothing, or winter camping gear that will then be distributed by the hospital for bragging rights for the wonderfulness of their humanitarian efforts.

Also,   I will not be running any charity 3K's or 5K's for any more causes unless it is for a definitive cure for stupid.

Gil: "It's going to be a six hammer night".  Reference: sometimes people need to be beaten with a hammer.  Please note that I am not talking about patients.

Wonderful World of Speech-to-Text Dictations in which Mac Does Not Proof-Read:

"The patient has recurrent tooth pain.  Her only problem be self once she has her teeth extracted.  However there does not appear to be readily feasible or likely to happen"

"UV strep test and flu tests were negatibe as likely to have the same upper respiratory infection however he is been sick now for about a week longer continue to uese the Zofran as necessary for nausea and robitussin with codeine 1 teaspoon every 6 hours as necessary for cough if in 5-7 days Asian R 20 better adn the cough persists started on Zithromaz as directed once daily follow up with your doctor in 7-19 days if not market lee better"

Asian R 20?  Market lee better?  7-19 days? WTF?

On Venting

Nurses know there is only so much of work you can bring home.  I recognize the signs in Mr. EDNurseasauras when he has had enough and doesn't want to listen anymore;  the glazed expression, the wandering eyes.  I can't blame him, but other than writing and spewing my frustrations, there just is no other outlet sometimes.  The crew I work with now are unlikely to want to get a drink after work, unfortunately.  I miss those days with my Utopia Hospital and Pseudocity Medical Center people.  There was always someone who didn't feel like going directly home, which led to beer call or 'rita rounds.  There were frequent opportunities to vent at one or another social occasion.  At Utopia Hospital an evening at one of my co-worker's homes turned into a venting session that some of my less experienced staff desperately needed following the ER death of a SIDS child.  We just don't have a ton of opportunity for socializing since we are a small shop.

I go in spurts with this blog thing as evidenced by the paucity of posts in November and December.  While  I may have a lot to say in general, some days I just don't even want to think about work let alone write about it.  It's been one of those spells where I am just not motivated.  Nobody at work knows I have a  blog, it would just be too awkward.  "I journal a lot" I offer blandly as I jot things down on a paper towel and stow it in my pocket.  I write a lot of stuff down because I have a pretty piss-poor memory when it comes to writing all these witty posts. I come home with a few scraps of paper or a post-it note or two which sit in a pile until the urge to write something is overwhelming. Sometimes it's a funny remark, sometimes it's just a "moment" that makes me laugh, think, or just shake my head.  Once in a while it develops into a full blown rant.

Some time around December of last year I began amassing an enormous pile of notes.  They piled up  on a table next to my chair for a few months while I sat uninspired, until I opened the adjacent window to let in a little springtime fresh air.  There went any semblance of organization.  I have yet to plow through them.  And the notes keep on coming.

On occasion, I pick one up and look at it.  Here is one that I can reach:

"The key to good care is poking holes in people"
This is a reference to a conversation Sherry and I had about people who actually require no care at all because there is either nothing wrong, or there is really nothing we can do for them.  In that case, people get downright pissed that we aren't really doing anything other than to reassure them that they are not dying....crazy is another whole story.  "Poking holes" means starting an IV and giving a liter of saline which amounts to the same as doing nothing when the alternative is doing.....nothing.  We do this a lot.

So that is one post-it note down and 4,000 to go.