Assume The Position

Virginia was back. When I saw her walk back from Triage I grabbed my Diet Coke, threw my chart on the counter, and yelled to Lucy "I'm going to lunch!"

It was a good lunch.

When I returned, Lucy was waiting for me in the hallway with her hands on her hips and the glare of death in her eyes.

"You did that on purpose!" she exclaimed.

"Huh? Wha? You talkin' to me?" I stuttered.

"You know exactly what I'm talking about! You did that on purpose! You owe me big time Miss High and Mighty, Shit On Your Coworkers Charge Nurse!"

It was at this point I could no longer contain my laughter, or my Diet Coke. The latter of which came spurting out my nose.

"What happened?" I giggled.

Lucy proceeded to tell me about her fun time with Miss Virginia. Apparently, Miss Virginia's symptoms had returned. She had gone out again with Mr. Bad Man and had forgotten to bring along some protection. Not only did she have another wonderful case of a mucous producing STD, but she had developed a nasty patch of genital warts around her rectum.

She also had gained 80 pounds.

Assessing the area around the rectum is not easy to do when someone is laying on their back. If they happen to be obese, it's not even easy to do if they are laying on their side. Hence, we tend to place them on all fours - hands and knees.

Lucy had Miss Virginia assume the position.







Lucy leaned down and gently opened Miss Virginia's buttocks to assess the area. She was greeted with the longest, loudest, "juiciest" (exact quote) fart she ever had the pleasure to experience.

"My face was RIGHT THERE!" she exclaimed with a horrified look on her face. "I SAW the warts wave in wind as she expelled her air," she said as she waved her arms around above her head in a circular motion.

I started laughing until I was snorting.

"Oh sweet peas on a pod.....giggle.....snort.....Are you......giggle, laugh, snort......serious?"

"YES! And I just didn't know what to say to her," she replied.

Pardon you, might be a good place to start.

I've Been Tagged

I was tagged by My Own Woman to reveal 7 things about myself. I already gave you a list of 17 earth shattering revelations here, but what the heck? If I can't think of something, I'll just make it up. That will leave you wondering, won't it?

OK, here goes.

1. I went to Mexican tonight and had a peach Margarita.

2. I hate snow. The first day is OK - when it's still all white, powdery, and fluffy like a towel. Then day two hits and it's frozen solid and slick as snot, probably a little muddy from the activity of the cars/people/animals/dog crap/etc. Then you fall through as you walk across it and the icy edges slice your skin and knick your artery and you lay on the ground shivering and bleeding to death cause you can no longer walk. Yeah - don't you just loooooove snow?

3. I might be a little off my rocker.

4. I love old wooden boxes. Cigar boxes, storage boxes, decorative boxes. Any of them. As long as they are made out of wood.

5. I love scars. Loooooooooooooooove them. Adore them. Each one tells a story.

6. Stupid people annoy me. I mean seriously, who doesn't know that if your patient's blood pressure is 68/42 you MIGHT want to do something about it?

7. ER on NBC annoys me. But I can't stop watching it. It's my addiction. My heroin. My crack. My 12 year downward spiral into alcoholism. I watch it in secret. I watch it alone. Yes, my name is Julie and I am an ER addict.


Off to tag 7 other people. Hmmmm, I'm not sure I know 7 other people.

Syncopal Synopsis

Lucy's orientation did not start well. I thought for sure she was going to have to find another field to work in. Nursing just was not her cup of tea. Why, you ask? Well, since you inquired so nicely, I will tell you. I just love it when you ask nicely - so polite. Your parents raised you well. You know, I knew this kid one time who .............

Oh, whoops. Sorry. Got distracted there. I hate it when that happens. You start thinking of one story and then some little niblet of a memory starts waving from the sidelines and you follow it for a few moments and then all of a sudden you're at band camp.

Amazing how that happens.

So, anyway......................Lucy's first day was a comical montage of her hitting the floor. Yes, she passed out 3 times. You'd think she'd never done clinicals before. But oooooohhhhh noooooooo. She had. I don't know how she made it through nursing school. Come to think of it, there were some rumors of her paying off the instructors. Something about a big inheritance and her grandpa being the heir to some donut chain. Naw - couldn't be true. Not my little Lucy.

Our first incident began with a laceration. Not a large, gory, profusely bleeding laceration. Just a tiny, little, 4 inch cut from a steak knife. Our patient was sitting on the gurney when I removed his dish towel, observed an arterial spurt, and heard Lucy hit the floor. She took the mayo stand with her. All my sterile 4X4's were now scattered across the exam room floor. I looked at her briefly to make sure she was still breathing, then proceeded to wash out the patient's wound.

"Is she OK?" he asked.

"Yeah, she'll be fine. Don't worry about her," I said as I stepped over her sprawled out body. "Let me just get this irrigation tubing for washing out your wound."

"Um...........OK."

Her second incident came when Mr. Oldfart came in with an active GI bleed. Now granted, GI bleeds make me want to pass out just so I don't have to take care of them, but really - is the smell of rotting intestines mixed with blood really so bad?

HELL YES!

I would much rather smell a rotting dead body any day, than to have my nose anywhere near the tail end of a GI bleed. Lord almighty - the stench is enough to make you want to give yourself a "swirly" in the toilet just to wash out your nasal passages. At least this time she had the courtesy to make it out of the room before she hit the floor. She was weaving a bit on her way out, but I soon heard the other staff laughing and stepping over her so I knew all was well.

Poor little Lucy was absolutely mortified.

"I haven't eaten today. That must be why," she said.

Uh huh. Sure.

"I think my blood sugar may be low."

"Are you a diabetic?"

"No, but that must be why."

(insert eye roll here)

2 hours before the end of our shift, staffing called for an extra nurse in OR to receive for a C Section. I had experience in this area, so I decided I'd go and take Lucy with me to give her a break from the ER. I thought it would be a safe area. I thought seeing a baby would be a good thing.

Wrong.

We gowned up for the OR and took our places near the respiratory therapist who was standing next to the infant warmer. We visited for a few minutes and received a report from the circulator regarding the patient's history. Then the doctors began their incision. And Lucy looked.

Yes, she looked. I know what you're thinking. I thought it too. "No, Lucy! No! Don't look at the blood!"

She did.

And down she went.

Sigh.................

I told her maybe she shouldn't come back the next day. She did.

Last week I watched her step over her new orientee as they sat against the wall - pale faced, sweating, and vomiting into an emesis bag. I raised my eyebrows and glanced at Lucy.

"GI Bleed," she said.

Ah yes. Good times.

How To Tell If I've Had A Busy Day

There is a direct relationship between the number of pens in my hair and how busy I was during my shift.


I tend to "pocket" pens in my hair and forget they are there. It's a handy place to store them. You just take the chance of looking like peacock by the end of your shift if it's a busy one.

Oh - and I see I need another trip to my stylist for a fresh color.

AHA! My Evil Plan Is Working

Someone googled "why can't you shock asystole" and it gave them my blog as a link.

Mission accomplished (well, almost).

Maybe it was the producers from ER? What do think the chances of that are?

I know, I know. Highly unlikely. Since they'll probably continue to shock asystole for the duration of their run on TV. Sigh.....................

Overhead at the Payphone

So I was walking out of work the other night and overheard some guy on the payphone in the lobby.

"Listen Bitch. I need my pipe now. NOW DAMNIT! You have to reach through the cut in the seam of the seat and get it out of the stuffing."

I bet it wasn't Turkey he was stuffing. Or smoking.

Just sayin'....................

Working With the Bottom 1% of the Class

Dr. Dumbshit came in to work a weekend shift as a locum. It took me about 15 minutes to figure out Dr. Dumbshit was an accurate representation of his name.

I know that medicine is not an exact science. Being in the medical field gives me a behind the scenes perspective that the general public does not have. When most people complain about a doctor being an ass, a dumbshit, or a sanctimonious piece of crap - I usually just nod and smile, thinking the whole time, "Yeah, okay. Sure, that's your perception." But oh let me tell you - I would agree 110% with them on this one. I think that he may have opened up every medical journal and textbook in sight and said, "Ah...nah....they're not right. I'll do it the opposite way."

EMS brought us 2 victims from an SUV rollover. The 16 year old girl had been sleeping in the backseat and was partially ejected out the side window. Her upper body was in the rig, and her legs were trapped under it as it came to rest on it's side. Luckily, it landed in a ditch so there was a little "give" room under her legs. She still ended up with an obviously deformed left thigh.

Dr. Dumbshit and I prepared for her arrival in Trauma 2. I put the blue handled Xray pad on the stretcher in anticipation of getting her off the backboard ASAP, and still providing a somehwhat stable environment for transfers to CT scan, etc.

"Why are you doing that? Get that thing off of there!" Dr. Dumbshit yelled. Yes, yelled. Our very first interaction and my first thought was 'he has a lump of coal up his ass that may already be turning into a diamond.'

"Um......I'm preparing the stretcher for our trauma patient. This is standard for when we get them off the backboard."

"They better not be on a backboard. There's no reason for it," he replied.

HELLO? Seriously? This was an unrestrained backseat passenger in a rollover crash who was partially ejected. If they didn't require immobilization then I'd eat my cousin's dirty underwear.

"Trauma Standards of Care indicate they should be immobilized. And they will be, because our EMS crew is excellent in the care they provide."

Just as ended my sentence, Medic 1 rolled in with our IMMOBILIZED and splinted patient. God love 'em.

Dr. Dumbshit stomped his foot and yelled, "WHY IS THIS PATIENT IMMOBILIZED? NOW I HAVE TO SCAN THEM!"

Sweet shit on a stick. Seriously, this man was on the verge of a breakdown. The spittle was flying and the veins were bulging on his forehead. I pulled Lucy to the side and told her to go find Dr. Q quickly. Unfortunately, Dr. Q was busy with the patient's mother who was in the other room.

As our patient was screaming in pain, Dr. Dumbshit decided to start his trauma survey focusing on her leg. Yes, he skipped A, B, C, D, E, F, and G and went right to her leg. He started poking and prodding and attempted to take the spider straps off of her. Medic 1 and I both reached down and refastened the straps immediately.

"Dr. Dumbshit, do you think you might want to start with the primary assessment?"

Damn it all, he was messing up our flow. Trauma's are meant to be run in a very particular order. When you follow that order, things flow smoothly. You don't miss anything that needs addressed first, and you don't focus on something that does not matter at that particular moment.

"Nurse Crazy Pants, I can see that her leg is probably broken, so why don't I just start with that? Hmmmmmmmmm?"

"Well Dr. Dumbshit, maybe you might want to start with Airway, Breathing, and Circulation since I think she might have a pneumo. Her breath sounds are decreased on the left and she's having some difficulty breathing." Then I whispered under my breath "stupid idiot."

"WHAT DID YOU SAY?" he yelled.

"I said 'Sure, I'll get it'" handing Medic 1 a needle for a possible decompression.

"Oh, well, OK. Sure, let's do that. Yeah. Maybe we need a stat Xray too."

"Coming through!" Our blessed radiology tech shouted and pushed into the room with his portable machine.

"Yep, I already put the order through for that Dr. Dumbshit," I replied.

Luckily, the Xray revealed a minor pneumo. A little oxygen and she was good to go. We didn't have to intervene immediately with something more serious. Her IV lines were started by EMS in the field and fluids were infusing, so we didn't have to worry about that at the moment either. Her vitals were somewhat stable and we completed the rest of her trauma assessment. The splint was still on her leg and providing stabilization there. No increase in swelling noted, pulses palpable and strong. Cap refill brisk.

"OK, let's check her back." Dr. Dumbshit said as he threw off her straps faster than I could cross the room and started to roll her.

"STOP!" I yelled.

"Huh? What?" he said.

"Dr. Dumbshit, we need to do a log roll on her. Let me get 3 other people to help."

"Ah no, we can do it ourselves. She'll cooperate - won't ya Betty Lou?"

"No. You will not roll her without doing it right. Stop right now until I get additional staff." I pushed myself between him and the patient.

"All right, whatever Nurse Crazy Pants. Have it your way."

"Thank you," I replied. Stupid Idiot.

"What did you say?" Oops! did I say that part out loud?

"Um, I said um.... I'm stepping in it. You know - the blood on the floor."

"Harumph," he replied.

Dr. Dumbshit and I then had a professional disagreement about what to scan on her. He felt nothing. I felt maybe stem to stern related to her mechanism of injury. I won. Only because he got tired of me not backing down. But seriously, are we giving good trauma care here or are we just trying to protect the patient from unneeded radiation? Which takes precedence? I would think life saving interventions and the complete CT scan would help us there.

Upon her return from CT scan, Dr. Q made his way into the room. A brief update to him on the occurrences of the last 20 minutes enabled him to send Dr. Dumbshit to the fast track area of the ER while Dr. Q assumed care of the trauma patients.

Thank you blessed baby Jesus!

We ended up shipping the patient out to a larger facility to surgically repair her femur fracture. She did very well and after rehab was back to her normal self.

I never saw Dr. Dumbshit again.

Marriage Proposals

Bill comes in frequently to our ER. He likes his whiskey. He likes it a lot. What he doesn't like so much is getting a visit from our local law enforcement when he's above a .234. He doesn't like that at all.

Bill usually arrives with multiple cuts, abrasions, bruises, and occasionally a broken bone or two. He may even have some taser marks in his back. Bill is not so nice to the cops.

But he loooooooooves me. He never remembers me, but he certainly falls in love with me every time he comes to the ER.

"Will you marry meeeeeeeee?" he asks.

"Now Bill, you know I can't do that. What would all my other boyfriends say? They'd be so angry with you."

"Pleeeeeeeeeeeeeeeeeeeze?"

"No Bill."

"How come I've never seen you before? Are you new here?" he asks.

"Bill you see me every couple of months."

"I do?"

"Yup," I reply as I apply the B/P cuff and start cleaning up his cuts.

"Are you sure? I'm certain I've never seen you before. I'd remember those pretty eyes." He always reaches for my........um.......hands at about this time. I do a little 2 step with a samba flair to the side of stretcher and get out of his reach.

"Bill - keep your hands to yourself. I need to get you cleaned up."

"Okay. But will you marry me? Pretty please?"

This is about the time he vomits. Usually on my shoes. Eventually I'll get my timing down on that one too.

Searching Me Out

So I took the time to explore my stats on who is visiting my page and how they got here. Guess what I found?

Google Search Terms:

"my back hurts how do i get a dr to give me vicodin"

"head nurse porn"

"stories hogtied gay"


Doesn't that just say it all folks? I've got drug addicted, porn loving fans who like to get tied up. I LOVE IT!

For Meadow - When the Eagle Won

Bikers tend to love our county. Long, deserted highways stretch for miles and miles. Flat pavement, views of the entire county, wide open spaces - it must be appealing. The summer months bring us more bikers than you could imagine.

Which presents a problem.

Motorcycles and animals do not mix well.

Now I have multiple stories of big bad trauma cases involving motorcycles and deer, cows, or horses, but after the last sad blog entry it's time for some humor. And can I just say that a motorcycle and an eagle make for a hilarious story?

Veronica was on a solo ride across the state. She needed a break from her husband and incessantly whining kids, so she hopped on her Harley and took off. She called them 2 hours after leaving and said "Don't expect me home sooner than next week. Cook your own damn dinner." I liked Veronica immediately when she told me this.

It was a Wednesday afternoon when the EMS tones went out. "Medic 1, please respond to a motorcycle vs. animal crash on Hwy 116 at mile marker 148. Victim alert and responsive. Complains of facial cuts and neck pain."

"Here we go again," I thought. I checked the trauma bay, made sure everything was stocked. I called Lucy to be my second nurse. "But I'm on lunch," she replied.

Because it's so much more important to eat than take care of a patient.

I dragged Lucy's ass into the trauma bay and we waited for the arrival of Medic 1. A couple of minutes later State Trooper Smith walked through the ambulance bay shaking his head and laughing.

"What's up, Smith?" Lucy asked.

"You guys shoulda seen it. Oh my god." Laugh, snort, giggle. "Oh hell man. I was right behind her when it happened. I've never laughed so hard in my life."

"What? What happened??"

Trooper Smith proceeded to tell us the story. Apparently Miss Veronica was enjoying a nice leisurely drive through the country when an eagle decided he wanted a ride too. The eagle flew right in front of Veronica and slammed into her chest, which apparently was not exactly how it wanted to land.

"Oh man, shit was flying everywhere! Feathers, arms - oh hell." More laughter. By now Trooper Smith was crying.

Veronica didn't enjoy having the eagle on her chest so she started trying to pull it off with one hand, while slowing the bike and steering it into the ditch with the other. The eagle became mighty pissed that she would even (gasp) DARE to touch him, so he gave her a piece of his mind. Talons slashing, wings flapping - the fight was on.

Veronica dumped her bike in the ditch and rolled off with the eagle now attached to her head.

Laughing and snorting, Trooper Smith said, "She.....she......was.....giggle...heehee......she was trying to pull..........heehee.......the eagle off.......snort......and......he was clutched onto her........laugh, giggle........head.....and wouldn't let.....giggle......go." He was now bent over with his hands on his knees laughing uncontrollably. I thought we were going to have to give him a sedative.

Lucy and I were laughing along with Smith. It's hard not to when someone is bent over, crying and snorting with laughter. That's one damn funny sight. Especially when they are in a police uniform.

Just about then, EMS rolled up with the patient. As they brought her into the bay, she heard Trooper Smith's laughter.

"Oh great! You told them didn't you?" She shouted.

He was trying his best to compose himself, but every time he looked at her he burst out laughing again.

"Yeah, Yeah. Whatever. I'm sure it was fucking funny watching it happen. It wasn't so funny for me though," she said. Then she started to giggle. "OK, maybe it was."

Veronica filled me in on the rest of the story. She was screaming, and trying to rip the eagle off her head - not realizing she was actually holding the eagle in place as he was trying to fly away. This pissed the eagle off and he started scratching her and flapping his wings harder. Feathers were flying everywhere, the eagle was screeching, blood was flying from her face, and the trooper was yelling at her to let the damn eagle go.

"I finally let him go and he flew off." And this is when Trooper Smith started laughing at her. "He couldn't stop. He tried to pull it together and be professional, but he kept snorting and giggling."

"She had feathers.........stuck on her face," Trooper Smith piped up from the back of the room. More laughter.

The EMS crew had cleaned Veronica up for us. She had multiple cuts on her face, but none were too bad. A few would leave scars, but she was otherwise extremely lucky. Her neck pain turned out to be nothing.

She was more pissed off about the fact that she had to dump her bike in the ditch and it got scratched up. "I just bought that thing 6 months ago. Damn it!"

We gave her a few stitches, bandaged up what we could, and sent her back out with Trooper Smith to her bike.

"I'm not going home now. I have more riding to do."

Please Let Me Go

He lost his wife to cancer 4 months before, his precious Betty Sue to whom he had been married for 40 years. He began drinking the day of her funeral and hadn't stopped. One Sunday evening, he decided he had had enough and wanted to join Betty Sue. So he drove himself in front of a semi truck.

He was still alive.

He was still conscious.

The trauma team was ready, the flow went smooth. Our patient ended up with a left chest tube, lacerated spleen, a tear in his intestines, pelvic fracture, a femur fracture, bilateral forearm fractures, and a minor closed head injury. Before we intubated him for his emergent trip to OR1, he kept screaming "Let me die! Let me die!" He was sobbing and saying he wanted to be with Betty Sue.

His son arrived just before we were planning intubation. "Steve - tell them to let me die! I need to be with your mom. Please! Please!" His son was crying and shaking. "No Dad, I can't. I can't lose you too."

"Please Steve, please let me go," his dad replied.

"Damn it Dad! No! Stay with me! I need you here!" Steve yelled at him.

His Dad turned his head away from him and refused to speak again. He was crying the whole time. As our physician explained to the patient what we were going to do (intubate, OR, etc), he made no indication that he was listening. He just cried.

This man was 60 years old and had the potential of many more years of life. The stress of the situation could have been warping his view of what he wanted. The head injury could be doing it too. He wanted to die, but only to be with his deceased wife. What ethical road do we take here?

The gentleman ended up in ICU for 6 days. The entire time in ICU he was asking the nurses to let him go. Telling them he wanted to die. He had multiple consults with psych/mental health/social workers to no avail. He was still determined that he wanted to die. He refused to speak with his son or any other family members.

On day 7 he was transferred to the Surgical Trauma floor where he promptly coded 35 minutes after arrival. They worked on him for 40 minutes before they called time of death. Many of us have often wondered if he did something to assist his death since he was no longer under 1:1 observation. He was so determined to die.

This was one of the saddest cases I've been involved in. He had sunk so deep into his depression after the death of his wife that he couldn't even reach the edge of rational thought. How do you fight something like that? I think when someone has made a decision to commit suicide in a large manner (driving in front of a semi truck, shooting self in head, etc), there is no turning them back. He was intent on joining Betty Sue, and he eventually did.

Undiscovered Country

Mr. Ben Dover came in with complaints of a delicate nature. I settled him onto the stretcher in Triage and asked how I could help him today. "Well, Miss. I have a problem near my, um, near my.............rectum," he whispered. He was blushing redder than a desert sky at sunset.

"OK, Mr. Dover. What seems to be the problem?"

"Well, it's, um, it's draining some, um, weird stuff."

Weird stuff, huh? Weird like grape juice? Ketchup? What the hell could be weird that comes out of your body?

"Mr. Dover, can I take a look?"

GASP!

"NO YOU MAY NOT!"

"Well, we can't very well treat you if you won't let us see it."

He was mortified that I had even asked to look at his rectum. Mr. Dover was a 28 year old male who had never seen a physician before. I almost think he'd never seen a girl before.

After about 10 minutes of educating the patient on the reason I needed to see the wound and the professionalism with which I would observe it, he finally gave in. I gave him a sheet to cover with and asked him to roll onto his side after undressing from the waist down. Once he was positioned properly, I opened his buttocks and observed the wound.

Sweet Boil on a stove! He had a large wound next to his rectum that was draining very foul smelling pus. Thick yellow/green pus.

"Did you injure yourself here or did this appear on it's own?" I asked.

He didn't answer.

I repeated myself and he said, "I'd prefer to talk to the doctor."

Sure thing. I'm not sure I wanted to know the answer anyway. I notified Dr Q of the patient's arrival and chief complaint. Dr. Q went in to examine him. It turned out that the patient had squatted to take a dump while he was camping in the woods and stabbed himself on a stick. He was too mortified to seek help for it and let it fester for a week or so until he could no longer sit down. Dr. Q did a quick I&D, started him on antibiotics, and sent him on his way.

Another day in the life of the ER.

Mental Health

My bipolar schizophrenic frequent flyer is back. It's been 6 months of stability, so she quit taking her medications. Last week she started coming into the ER 5 or 6 times a day requesting to be seen for problems such as "I need my pill box filled," "I have a sore on my toe," "I need a shower," and "I need something to eat." She refuses mental health services and the system deems she is still competent to make her own decisions.

These types of patients are so hard to deal with. It is not their fault they behave like they do. They don't really have control over it. Yet I still get angry when she has interrupted my care on a much sicker patient for the 4th or 5th time to request something simple. The sad thing is that one day she will come in and truly be in a crisis and nobody will believe her.

She has learned not to come in when I am working now. I don't give her anything she wants. She gets her MSE and then I discharge her immediately. By the end of last week she started calling first and asking if I was working. If I was, she stayed away. I like that little arrangement.

Eventually one of her neighbors will call her daughter and she will come up and start making her take her medicine again. She'll stay on her meds for about 6 months and then we'll start all over.

Our state has cut many of the services for the mentally ill. This means more untreated patients clogging up the medical side of the system for mental health needs. It's a vicious cycle, and it is extremely frustrating to deal with on a daily basis in the ER. I don't have any answers for it, other than increase funding again. I hate politics - I usually don't get involved in political arguments or discussions at all. But this issue is really starting to irritate me. Another contributing factor to ER over crowding.

ER on NBC (and again)

Sigh..........................................


Hmmmmmmmmmmm.


Well, what can I say? This week's episode focused so much around personal storylines, there wasn't really a lot of medical intervention for me to rip apart.

Who didn't see the Congestive Heart Failure looming on the horizon with the baby the instant they mentioned fussy/crying with feedings? Of course it's easy sitting in the recliner at home evaluating what you know will happen related to dramatic license versus having a real patient in the ER that is exhibiting signs of "colic." Most infants would be sent home and told to follow up with their primary PCP, just like Pratt was trying to do. Very interesting.

I actually laughed out loud when Morris started doing "the bicycle" on the stretcher with his arms and legs to prove he didn't have a spinal injury. That was priceless. I haven't had a patient do that yet, but I'm still waiting. Now, ripping of the C-collar? Absolutely. Usually the patient is drunk, high, or both. "Collar? I don't need no stinking collar!"

Sam's little environmental engineer guy is a hottie!

That is all.

Face Up, Flat On My Back

We all have them. Embarrassing moments, that is. I try to remind myself of that every time I think of the following story. I try to tell myself that I am not the only nurse who has made a complete and total ass of herself in front of a patient. There are others.................right? Please tell me I"m right.

Mrs. Fever For 5 Days came into the ER on a Sunday night. She told me during triage that she had been feeling poorly for the last week - fever, cough, rash, body aches, etc. I escorted her back to the Gyne Room as it was the only room free, and laid her on the stretcher (for those of you that don't know, some stretchers have pegs on the end of them that you hook stirrups to so you can do a pelvic exam). Mistake number one.

Her husband came in with her and took a seat in the chair against the back wall of the exam room. I remember he was wearing a gray Tshirt with a black zip up jacket that had a deer embroidered on the front. Now every time I look at a Cabela's catalog I think of this damn story. I wonder if I could claim PTSD?

I turned and grabbed a clipboard off of the counter and walked over to the foot of the stretcher. While obtaining her medical history, I raised my foot and rested it on the end of the stretcher using my thigh as a table for the clipboard. Mistake number two. On this particular day I had chosen to wear a new set of scrubs. A set that was a wee bit big for me. Mistake number three.

Can I just say that when you get a new set of scrubs, hem them up before you wear them to work? Not a week later. Not a day later. BEFORE.

Can you picture what's coming yet? Uh-huh.

After getting all the information from her, I started to turn back towards the counter and take my foot off the stretcher. Remember those pegs on the end of the stretchers that I told you about earlier? Uh....yeah. As I turned, my foot went over the peg, but my scrub pants didn't. The hem was about 2 inches too long and hooked onto the edge of the peg. I felt it catch and hopped back around to face it on one leg, which in turn twisted the fabric around that little sucker. I started to lose my balance - and I was gonna go over hard.

I dropped the clipboard and started waving my arms around frantically, trying to catch my balance. "Oh, oh, oh , oh, oh,.....ahhhh," I said (or screamed - who knows). I did a little improvised samba with my ass trying to stay upright. I could see the patient trying to sit up on the stretcher and reach out to help me.

I finally lost the fight. I toppled like a tower and landed face up, flat on my back with my leg still up in the air - scrubs tangled on that damn peg on the stretcher. My head smacked the floor and I swear to all that is holy that I saw stars and chickens dancing above me. I groaned a little and mentally calculated my potential injuries.

The patient's husband came flying out of the chair as the patient finally got upright on the stretcher. "OH MY GOD! DO YOU NEED A NURSE?" she shouted.

Then I started to giggle.

And snort.

And laugh so damn hard that I almost peed my pants. Only then did they join in too.

Trying to untangled yourself from a stretcher while you are laughing so hard you are crying is no easy task. Your body is shaking so much that you can't get your fingers to work right. Then you just start tugging. Tugging as hard as you can, laughing, snorting, crying. It was not a pretty sight, let me tell you.

I tugged on my pants so hard that I ripped them up the leg's inner seam. They came off that damn peg, but the cooling breeze I was receiving up to my inner thigh was not nearly as refreshing as I thought it would be. This just made me laugh more.

Lucy came in to see what all the commotion was about, took one look at me, and spit the water she had been drinking across the floor. Oh yes, it was a shining moment in my nursing career.

My patient did thank me with a card a week later.

Dear Nurse Julie,

Thank you so much for making a miserable experience so much more enjoyable. I don't think I've ever laughed that hard when I was felt like dying. You truly made a crappy experience tolerable.

Signed,
Mrs. Fever For 5 Days

ER on NBC

You will all be happy to know that I missed Thursday night's episode. I have no scathing critique to offer the masses.

Damn it.

For Jodee

He walked in with 2 nails sticking through his left hand, holding a bag of chips. And he was laughing. "Duuuuuuuude!" he giggled. "Look what I did." Snort, giggle, laugh.

Interesting.

"Sir, please take a seat on the stretcher. Can you hand me the bag of chips?"

"Why? You got the munchies too? HeeHeeHee." He giggled like a little school girl. I couldn't help but laugh. "See? You DO have the munchies!" he said as I chuckled.

"Sir, hand over the chips. I need to see your hand."

"Oh sure. Just save 'em for me - I'm still hungry." He tossed them at me.

I set the chips on the counter and grabbed his hand. The nails were about a quarter of an inch apart, embedded directly through his hand. The head of the nails were on the top side of his hands. "What did you do?" I asked him.

More laughter. A few snorts. "Ah man - it was classic. Nail gun wars! Wheeeeee!"

Seriously? Yes. By this time I was laughing as much as him. He was high as a kite and seriously thought that having 2 nails stuck through his hand was the funniest thing he'd seen in 3 months, 2 weeks, and 17 days (exact quote).

One might wonder what happened 3 months, 2 weeks, and 17 days previous. I didn't even want to ask. Unfortunately I did (morbid curiosity kills me at times). That happened to be the moment he felt he could ride his dirtbike through a couple of trees that were about 30 inches apart. He didn't make it - but his bike did.

It was a very slow afternoon so I sat there and chatted with him while we waited for Xray. He told me he and his buddies had been getting high in his shop he was building, when one of them pulled a nail gun off the top of the compressor and started shooting at people. He abruptly stopped his story, looked at me sideways and said "You ain't gonna tell the cops are ya?" I assured him I wasn't going to release that information and got a high five from him. "You're cool as shit," he said.

Actually, shit is kinda warm so I don't know that it was truly a compliment.

He went on to tell me that everyone started running out of the shop except him. He grabbed another nail gun and started firing back. "Dude! I jumped and rolled over the stacked lumber and fired at him backwards. It was fucking amazing! Just like the movies." Unfortunately, he put his other hand up in front of him to block of the onslaught of nails coming at him. Those nails fell short, but he fired 2 beautiful ones right into the back of his hand. "That there's just funny," he snorted.

Why couldn't all my patients be this entertaining?

He started to tell me about all the other times he has injured himself. They all involved doing something with his buddies, and usually a substance or two. I asked him if he thought maybe not getting high every time would keep him a bit safer. "What good is life if you can't have fun?" he said. "Why would I want to sit on my ass doing nothing when I could be jumping my dirtbike (broken ankle), rolling my truck (broken arm), jumping off my roof (leg impaled on rebar), or wrestling with my friends (broken nose, broken finger)?" He kind of had a point.

Xray came and took him for his pictures. The only injury he had was to one tendon which would limit his mobility in his middle finger. That was the icing on the cake for him. He was laughing so hard he was crying. "You mean I won't be able to bend my birdie down? I'll always be flipping people off? That's fucking cool!"

Dr. Q tried to explain that it wasn't as nifty as the patient thought it was. Dr. Q has no sense of humor.

"Yeah, whatever man," the patient replied. "I gotta go tell my friends!" He jumped off the stretcher, slapped me on the back as he walked out of the room and said, "You rock Nurse Julie. I'm gonna tell all my friends to come see you."

As soon as I got the air back in my lungs I gasped, "Gee, thanks." I threw his bag of chips back at him and he caught them in his other hand and held them high above his head as he sauntered down the hall. "See ya Duuuuude!" he called.