Meanwhile, back at the Bait Shoppe:
Most of the ER docs will just tell patients to take mag citrate and get on a regimen of Miralax, but Gil ordered an enema.
"There is a special place in Hell for ER docs who order enemas", I said darkly. Worse, it's not even an ER anymore.
I really didn't put much effort into it to be honest.
But after her special treat, Enema Woman gushed about how wonderful Gil was, what great care he gave, how much she appreciated such a warm and feeling humanitarian, and how she would pray for his long and healthy continued existence.
Later I told Gil in detail just how much Enema Woman enjoyed her visit and and expounded on the wonderfulness that was Gil as he beamed in happy warm fuzziness.
Until I told him that I had given Enema Woman his home phone number so that she could personally contact him, as well as his address so that he could enjoy annual Christmas cards and gifts for years to come.
I get even.
Saturday, May 6, 2017
Wednesday, May 3, 2017
Bad patch
A bad day, or two, or a few you can cope with. Shrug it off. Find some distraction with family and friends.
But recently the bad days at work had been ongoing for weeks with no relief. Bad shifts, bad outcomes, bad people, bad, bad, bad. There was no additional help for the increased volume. Exhausted and frustrated, nurse call-outs were at a record high and we were all getting 3-4 requests a day to come in on a day off or a vacation.
With the relentless strain at work, I also had a lot on my plate at home. Just after the holidays we put our house on the market, downsizing into our dream home condo in less than 2 months. If you've ever sold a home, I don't have to tell you how nerve wracking that is…we had a LOT of showings before getting an offer less than 2 weeks on the market. It certainly seemed much longer. My husband took on the lion's share of responsibility, running around with the dog during showings, coordinating inspections and repairs. He went well above and beyond his fair share and coping with the idiotic demands from the Buyer's Agent from Hell (please, rot there. You know what you did). The final straw was the one thing I had been looking forward to. I had booked a weeks' vacation 7 months prior, before we had any thought of moving whatsoever. Instead it was another source of anxiety with the mechanics of moving house a couple of days after we returned home. I was overwhelmed. Every day brought a new problem to be dealt with at home, and I was brining my work home with me. I didn't complain much, but felt angry and sad and withdrawn.
After a particularly horrific night, staying two hours after the end of my shift with a critical and dying patient, I didn't sleep well. I was up early the following morning, mechanically let my dog out, set out her food, made coffee. I was in another world with my still-racing thoughts when I realized that she didn't come back right away as is her habit. I saw her out in the marshy area behind our house, circling, wagging her tail, darting about. She had found something...or something had found her. "Please let it not be a skunk" I mumbled as I set off through the brush in pajama pants and rain boots to retrieve her.
What had captured her interest was a deer. She was lying in some brush behind a log, sitting up in plain sight. She looked at me, back at my dog, then at me. "Well, she is either hurt or protecting a young one" I thought. I ordered the dog home.
About an hour later I went out to see if the deer was still there. It was. This time it attempted to get away and tried to jump over the log, but was stuck half way across it. I could see it had an injured leg and knew I had to contact someone to take care of it.
I started with a call to local police, who suggested I notify Fish and Game. This was no easy feat on a weekend. About 1/2 dozen calls later I managed to find a number for dispatch.
The warden who returned my call said he would be there in about an hour.
In a little while I went back out to check on the deer. She had settled back into a spot near the log. Unspooked, she gazed at me steadily. I felt very sad as I stood quietly watching her from 20 feet away. We were both helpless. She, injured and in pain, me unable to help. "I'm sorry," I whispered. "It will be over soon".
When the warden arrived I led him to marshy area. The deer was still, lying in the brush, alert, wary. She did not try to run. "I'm going to have to put her down, she's got a broken leg at least and is not in good shape. I'll have to shoot her"
"I know, it's what I expected. It's for the best"
I didn't want to, but felt a responsibility to stay where I was. I was not ordered away. The warden walked back into the brush; he withdrew his handgun and fired two shots. It was over.
I got a good look at her injuries as he dragged her to his truck. Not one, but two broken legs, clearly not new injuries. She had suffered a long time. "There are people in need who can use the meat", he said, glancing at me and seeing my eyes were shiny with unshed tears. "She won't go to waste".
"That's good", I choked out. I thanked him and stumbled back through the brush as the deer was loaded into the truck.
When I returned to the house, I buried my face in the coats in the hall closet and sobbed. Sobbed out all the emotion I had been suppressing for weeks.
My husband didn't understand. It was not about the deer. Not really. I felt like I owed it to that deer to be with her when she died. I do it for people all the time.
I just don't always cry for them.
But recently the bad days at work had been ongoing for weeks with no relief. Bad shifts, bad outcomes, bad people, bad, bad, bad. There was no additional help for the increased volume. Exhausted and frustrated, nurse call-outs were at a record high and we were all getting 3-4 requests a day to come in on a day off or a vacation.
With the relentless strain at work, I also had a lot on my plate at home. Just after the holidays we put our house on the market, downsizing into our dream home condo in less than 2 months. If you've ever sold a home, I don't have to tell you how nerve wracking that is…we had a LOT of showings before getting an offer less than 2 weeks on the market. It certainly seemed much longer. My husband took on the lion's share of responsibility, running around with the dog during showings, coordinating inspections and repairs. He went well above and beyond his fair share and coping with the idiotic demands from the Buyer's Agent from Hell (please, rot there. You know what you did). The final straw was the one thing I had been looking forward to. I had booked a weeks' vacation 7 months prior, before we had any thought of moving whatsoever. Instead it was another source of anxiety with the mechanics of moving house a couple of days after we returned home. I was overwhelmed. Every day brought a new problem to be dealt with at home, and I was brining my work home with me. I didn't complain much, but felt angry and sad and withdrawn.
After a particularly horrific night, staying two hours after the end of my shift with a critical and dying patient, I didn't sleep well. I was up early the following morning, mechanically let my dog out, set out her food, made coffee. I was in another world with my still-racing thoughts when I realized that she didn't come back right away as is her habit. I saw her out in the marshy area behind our house, circling, wagging her tail, darting about. She had found something...or something had found her. "Please let it not be a skunk" I mumbled as I set off through the brush in pajama pants and rain boots to retrieve her.
What had captured her interest was a deer. She was lying in some brush behind a log, sitting up in plain sight. She looked at me, back at my dog, then at me. "Well, she is either hurt or protecting a young one" I thought. I ordered the dog home.
About an hour later I went out to see if the deer was still there. It was. This time it attempted to get away and tried to jump over the log, but was stuck half way across it. I could see it had an injured leg and knew I had to contact someone to take care of it.
I started with a call to local police, who suggested I notify Fish and Game. This was no easy feat on a weekend. About 1/2 dozen calls later I managed to find a number for dispatch.
The warden who returned my call said he would be there in about an hour.
In a little while I went back out to check on the deer. She had settled back into a spot near the log. Unspooked, she gazed at me steadily. I felt very sad as I stood quietly watching her from 20 feet away. We were both helpless. She, injured and in pain, me unable to help. "I'm sorry," I whispered. "It will be over soon".
When the warden arrived I led him to marshy area. The deer was still, lying in the brush, alert, wary. She did not try to run. "I'm going to have to put her down, she's got a broken leg at least and is not in good shape. I'll have to shoot her"
"I know, it's what I expected. It's for the best"
I didn't want to, but felt a responsibility to stay where I was. I was not ordered away. The warden walked back into the brush; he withdrew his handgun and fired two shots. It was over.
I got a good look at her injuries as he dragged her to his truck. Not one, but two broken legs, clearly not new injuries. She had suffered a long time. "There are people in need who can use the meat", he said, glancing at me and seeing my eyes were shiny with unshed tears. "She won't go to waste".
"That's good", I choked out. I thanked him and stumbled back through the brush as the deer was loaded into the truck.
When I returned to the house, I buried my face in the coats in the hall closet and sobbed. Sobbed out all the emotion I had been suppressing for weeks.
My husband didn't understand. It was not about the deer. Not really. I felt like I owed it to that deer to be with her when she died. I do it for people all the time.
I just don't always cry for them.
Monday, April 10, 2017
Odd-year blues
I'll be winding down this nursing thing in a few years. I am looking forward to retirement but have a long way to go. In the meantime, I still have to do all of my certifications in order to work in the ER. Some are every two years, some every four. There are also classes to attend in order to maintain my biannual license renewal. Add to that the annual hospital competencies, and that is a lot of stuff to repeat, same shit different….year. Nothing much changes, yet another tick mark in the administrative Big Book of Checklists.
I just took the 2 day TNCC for about the 6th time, renewable every 4 years. It will be the last time I have to take it before I retire.
Always stressful, I approached this recert with a true "I don't give a shit" attitude, and it served me well as I was relatively stress-free. It helped that I knew two of the course instructors quite well, and I was taking the course with a lot of first timers as well as a few PACU, OR and ICU nurses who were unfamiliar with a lot of the ER stuff. Plus the kids from my own department had been ER nurses for less than 2 years. They were a lot of fun and even insisted I join them for a drink after class.
This time around I was pulled for the clinical testing on day two by one of my fav people. One on one with the instructor, you get a scenario, then have to go through the appropriate steps in the proper order. Of course in an actual trauma, all these steps are accomplished simultaneously by a number of people, but it is the thought process that is important here.
She gave me the easiest scenario, since I got the pregnant trauma victim as I always do in the practice session and did it effortlessly. The savvy instructor can tell nerves from lack of knowledge. As I rattled off all of the major testing points as my instructor cut off any in depth explanations (to prove I knew what I was doing), she impatiently waved me ahead to the next point with a "yep, you got it, next?", and was out of there in under four minutes.
Since this is an odd year, I have yet to do PALS (or ENPC if I can find something before August), ACLS, and of course, BLS. My other job back at the Bait Shoppe only requires that I have BLS because, you know, we can always just do CPR in an urgent care while we wait for EMS. SMH.
I just took the 2 day TNCC for about the 6th time, renewable every 4 years. It will be the last time I have to take it before I retire.
Always stressful, I approached this recert with a true "I don't give a shit" attitude, and it served me well as I was relatively stress-free. It helped that I knew two of the course instructors quite well, and I was taking the course with a lot of first timers as well as a few PACU, OR and ICU nurses who were unfamiliar with a lot of the ER stuff. Plus the kids from my own department had been ER nurses for less than 2 years. They were a lot of fun and even insisted I join them for a drink after class.
This time around I was pulled for the clinical testing on day two by one of my fav people. One on one with the instructor, you get a scenario, then have to go through the appropriate steps in the proper order. Of course in an actual trauma, all these steps are accomplished simultaneously by a number of people, but it is the thought process that is important here.
She gave me the easiest scenario, since I got the pregnant trauma victim as I always do in the practice session and did it effortlessly. The savvy instructor can tell nerves from lack of knowledge. As I rattled off all of the major testing points as my instructor cut off any in depth explanations (to prove I knew what I was doing), she impatiently waved me ahead to the next point with a "yep, you got it, next?", and was out of there in under four minutes.
Since this is an odd year, I have yet to do PALS (or ENPC if I can find something before August), ACLS, and of course, BLS. My other job back at the Bait Shoppe only requires that I have BLS because, you know, we can always just do CPR in an urgent care while we wait for EMS. SMH.
Sunday, April 9, 2017
Name game, volume 1
Some time ago I posted a list of stupidly spellled names. Since then I have been collecting them and sharing them with a couple of friends. I don't see these friends much, but the magic of technology allows us to keep a running dialogue. We shake our heads.
I get that people want their children to have names that are special and unique. But some of these take it to heights of stupidity, I mean, seriously? These are names that are going to be asked the spelling for life. LIFE.
If I do 10 at a time every week, I have enough to last months. Or until I forget about it or get bored. Likely the first one. So, without any further ado, this week's list:
Deserey, and Dessert. Both pronounce Desiree
Sydni
Karizma
Jammie. Pronounced Jay Me
Xoey
Taylier. Pronounced Tyler
Haleigh
Francheskha
Emelee
Alyjx. Extra stupid. I called "Ajax", assuming the "l" was silent
OK, more to follow
I get that people want their children to have names that are special and unique. But some of these take it to heights of stupidity, I mean, seriously? These are names that are going to be asked the spelling for life. LIFE.
If I do 10 at a time every week, I have enough to last months. Or until I forget about it or get bored. Likely the first one. So, without any further ado, this week's list:
Deserey, and Dessert. Both pronounce Desiree
Sydni
Karizma
Jammie. Pronounced Jay Me
Xoey
Taylier. Pronounced Tyler
Haleigh
Francheskha
Emelee
Alyjx. Extra stupid. I called "Ajax", assuming the "l" was silent
OK, more to follow
Sunday, March 12, 2017
Magic is for real
I have always believed the ER is not the place for brand new nurses to try out their wings. Too stressful. Way too much to learn. Sets them up for failure. Better to have some med-sug experience under their belt before jumping in the frying pain with both feet AND their hair on fire.
All of the new grad nurses who have started out in my ER are on their 2nd or 3rd health-care related career. Some have been paramedics who have gone on to nursing school. Some are EMT's, or paramedics, LNA's, and a handful of unit coordinators who have done that job while in school. These here are the Sacred Cows with varying levels of knowledge, hands-on training of some kind, skills not necessarily achieved in nursing school. The "have to hires", their orientation is very, very long, and includes months of training wheels. It's really an extra six months of nursing education, as they are nurtured, supported, mentored, watched, encouraged, allowed to take baby steps until they are fully mobile, upright, standing-on-their-own-two-feet nurses. They are not merely loosely supervised and used as additional staff. Some do well, some do well eventually.
Every once in a blue moon, though, there comes one new nurse so rare, so extraordinary you wonder if they have been reincarnated from a previous nursing existence. The total package, equally comfortable with the providers, nurse colleagues, and patients. Confident. Makes good decisions and, most importantly, asks great questions. Takes great care of patients.
It has been about 16 years since I recognized a brand new nurse with such excellence. She was an EMT, then paramedic, to RN. Got her BSN, MSN and is now working on her PhD in nursing. She was a great nurse right out of the box.
Now, in my department, I have met such a Unicorn. Marvel at the beauty.
All of the new grad nurses who have started out in my ER are on their 2nd or 3rd health-care related career. Some have been paramedics who have gone on to nursing school. Some are EMT's, or paramedics, LNA's, and a handful of unit coordinators who have done that job while in school. These here are the Sacred Cows with varying levels of knowledge, hands-on training of some kind, skills not necessarily achieved in nursing school. The "have to hires", their orientation is very, very long, and includes months of training wheels. It's really an extra six months of nursing education, as they are nurtured, supported, mentored, watched, encouraged, allowed to take baby steps until they are fully mobile, upright, standing-on-their-own-two-feet nurses. They are not merely loosely supervised and used as additional staff. Some do well, some do well eventually.
Every once in a blue moon, though, there comes one new nurse so rare, so extraordinary you wonder if they have been reincarnated from a previous nursing existence. The total package, equally comfortable with the providers, nurse colleagues, and patients. Confident. Makes good decisions and, most importantly, asks great questions. Takes great care of patients.
It has been about 16 years since I recognized a brand new nurse with such excellence. She was an EMT, then paramedic, to RN. Got her BSN, MSN and is now working on her PhD in nursing. She was a great nurse right out of the box.
Now, in my department, I have met such a Unicorn. Marvel at the beauty.
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