Thursday, February 28, 2008

Everything's Coming Up Roses

Why does everyone feel the need to come to the ER to shit? And I'm not talking patients here. I'm talking other staff.

Apparently, people like to haul their butts all the way down to the ER to take a dump in our bathrooms. Lab personnel, Xray personnel, even the dang business office people! Do they think they can hide their stink in the ER? Do they think it will blend in with the other smells of the unit? OK, they're right there, but seriously people................shit on your own unit.

I'm almost at the point where I can identify coworkers by the smell of their poo.

Friday, February 22, 2008

Challenges of Obesity

I ate lunch with 2 of the EMS crew and one of our ER docs today. The conversation turned to alcohol levels, drug seekers, and morbidly obese patients - sometimes all in one.

Obesity is an epidemic in our country. We all know that. What some people don't realize is how much of a strain it puts on the medical professionals who have to treat them. The EMS crew were discussing a story about how difficult it was to get a 550 lb patient out of her house last week. They had to call the fire department for lifting help as they could not even move her. They talked about a 700+ lb lady we have in our community who they are just waiting to get a call on. They have a plan involving planks from the hardware store and tarps.

Now before I get any nasty comments, they were not making fun of her. They seriously had to plan for how they would be able to transport this patient to receive appropriate medical care at a hospital. The challenge is if they are able to get her to the hospital, what will we put her on? Our stretchers do not accomodate her weight, neither do our hospital beds.

Obesity leads to multiple medical problems, many of which you all already know so I won't repeat or lecture. How do we solve this? Can we? I don't think we can. But we must prepare for heavier and heavier patients as we see more of them every day. We must prepare not only for the physical demands of caring for them, but also the mental demands. We must figure out how to develop a plan of care for every other disease process that accompanies the obesity, and then we must plan how to complete the plan of care without interacting with treatments for the other diseases/conditions. It's a never ending cycle. One with a pretty scary ending.

Just the Pills Please Miss

I can't always remember what I've already posted on this blog and I'm too damn lazy to scroll back through everything I've written, so this may be a repeat story. I don't really know............or care.

Bob came in holding his right ribs complaining that he had fallen off the back of a truck 15 minutes prior. He stated his pain level was 10/10. I took him back to an exam room immediately and started my assessment. I had him undress and put a gown on. That's when I got a good view of his injured area.

I shook my head.

"Bob, what really happened?" I asked.

"Huh? What? I told you," he replied.

"Bob, I know you're not telling me the truth. What do you want?"

Bob hung his head and said "I just want some Vicodin."

"Well, you're not gonna get it. Anything else we can do for you?"

"Nah, I'll just go home."

Bob's injured area was a small abrasion approx 2 X 3 inches which was mostly scabbed over. He had picked portions of the scab off to make it bleed. He thought he could pass that off as an acute injury.

Not on this nurse.

I had 3 more interactions with Bob over the next 2 weeks. He finally got to the point where if he saw me as his ER nurse, he turned and walked out the door. Eventually he moved across the state. Wonder if I had anything to do with that or not?

My naughty habits

I love dirty jokes. The raunchier the better. Sexist, chauvinistic, pigheaded, dirty jokes make me laugh until I cry, and the ER is a terrific place to hear them. I get 'em from coworkers, doctors, and even the patients. I must have a sign on my head that says "naughty girl" or something. People feel free to have verbal diarrhea around me and I adore it.

I ain't right in the head.

I was introduced to the whole naughty joke genre by my grandmother when I was around 11 or 12. She told me a joke involving a mouse, a pussy, and a tattoo. I was hooked. I made her tell me all the ones she knew. I have a cool grandma like that. Aren't you jealous? Now she starts happy hour at noon and has an even larger repertoire. I love her.

If you are a patient in my ER, please bring a dirty joke along.

Sunday, February 17, 2008

Bring It On!

I made the mistake of opening my big fat mouth and being a smart ass to Dr. Q. Shocking, isn't it? I know. I found him slamming things down at the nurse's station, mumbling to himself about fighting with insurance companies and being disrespected by the patients.

"Hey Dr Q - you wanna take this outside?" I said with my fists held up in front of my chest.

He rips off his lab jacket, grabs my arm, and says "Hell yes! Let's go!"

"I NEED BACKUP!" I screamed as he pulled me out the double doors and into the grassy area beside the ambulance bay.

Fresh snow on the ground. 10 fresh inches of the white shit.

My comrades got there just as he lobbed the first snowball straight at my face. I ducked, and Lucy took it in the eyes.

The fight was on!

15 minutes later exhausted, dripping wet, and crying with laughter we all tromped back into the ER. The rest of our shift was a breeze, even though we had 2 trauma's, a code, and 10 or so drug seekers. It's easy to deal with stuff like that when you have a little stress relief snowball fight.

Drumroll Please..........

Cathy stood in the hallway with the adult diaper in her hand. She was telling her RN that something wasn't right with the patient's stool.

"Just smell it," she said. "It's not right."

"I'm not going to smell it!" Lucy replied. "What the hell?"

"I'm telling you - something's not right! Wait, let me......" Cathy brought the diaper up to her face and licked it.

"OH MY GOD!!!!!!!" We heard Lucy yell.

Laughter surrounded her as we all knew Cathy had put chocolate pudding on the diaper. Lucy about shit herself watching Cathy lick that diaper.

Medical people are a quirky lot. We have to relieve tension with laughter and joking or we would never survive our shift, let alone our career. I am lucky enough to work with people who enjoy a good joke, whether receiving or giving.

We have a Paramedic who is insanely in love with his rig. I'm talking on the verge of a psychological disorder. Ripe for the picking in other words, and boy did I do the picking.

I took a picture of his rig and made about 20 For Sale posters with his work extension on it. I hung them all over the hospital and got everyone to call him asking about buying his rig. All for the low, low price of $5,000.

His vehicle was worth well over $50,000.

Approximately one hour into the shift I see Paramedic Pete charging through the doors of the ER. For some reason I felt the need to run.


Poor sport.

"THAT'S NOT EVEN FUNNY JULIE! NOT ONE BIT FUNNY!" he yelled again. By this time his face was red, spittle was flying out of his mouth, and he was shaking his fist in the air.

Oh my.

I couldn't help it - I started laughing. He just looked so damn funny. That calmed him down a bit and he started snickering.

"Damn you, leave my car alone," he smiled as he walked away.

Five days later, I was drenched with a basin full of water as I was walking out of the trauma bay, stripping off my yellow gown. I stood there sputtering and trying to breathe through the 2 cups of water that I inhaled right as it hit.

I heard laughter all around me.

"I told you to leave my car alone," I heard Pete say through his laughter.

"I .....cough cough......think I ......sputter, cough, snort......need......cough......intubated," I gasped.

Dr Q walked by just at that time, slapped me on the back and said "Nah - if you can talk, you can breathe."

Too Drunk to F*@k

Apparently we had a new record in our ER on Friday night.


I know - I didn't believe it either. I thought the nurse was totally shitting me. An alcohol level of .631? "Whatever," I replied.

They ran the test 3 times just to be sure. They ran controls on the machine. It was correct.

I cannot even imagine living a life where you are still able to live and breathe at a .631. That means this man has built up a tolerance over the years to be able to be completely pickled and probably walks around at a .3 on a normal day. Scary, isn't it?

Then I stumbled upon this little gem surfing the net today. Holy crap. This is what our kids will face on the road as alcoholism becomes more rampant and people build a tolerance level that is insane.


Wednesday, February 13, 2008

Back Again?

I was a patient in my own ER last night, and can I just say right now that that ain't right. You should never have to be treated by those you work with. There is no need for your coworkers to know your STD history.

Just kidding.

I only hurt my back.

Nursing is notorious for back injuries. Why? Well, because. We clean your ass, move your ass, and lift your ass - which makes for some back breaking work. And apparently, it's not a good thing to lunge to the left to catch a patient who is falling. Not just any patient, but a mom who has just delivered a baby, has a weak leg from an epidural, and weighs about 250 lbs.

But seriously.............who's really going to let her fall? No nurse that I know of, yet that is what I was told to do next time. "Let the patient fall," they said.

Sure thing.

(Insert eye roll here. Add one huge sigh and a shaking of the head)

So Dr. Q saw me in the ER. He walked into the room, shook his head, and handed me a prescription for Vicodin. He loves me.

Diagnosis? Back pain with Radiculopathy. The worst part is the burning sensation in my hip and down my leg. He said it should go away with rest and steroids. He gave me the vicodin just because he knows he needs to keep me in a good mood. He knows me like that.

Friday, February 08, 2008

The Things We Talk About

I washed maggots out of a wound one day. Real, live, squiggling maggots. Apparently, Mr. Hygiene was performing his own wound cleansing via maggot therapy. Unfortunately, he wasn't doing it on purpose.

I was telling the story to Lucy one day over lunch. We were sitting in the break room discussing the grossest things we had come across when I starting telling her about the pulsating mass of maggots. Sally came in behind us as I was elaborating on the little critters.

"It was just vomit inducing Lucy," I said, taking a bite of my lunch. "They were squirming all around and I could hear them from across the room. They were swimming in a pool of juicy body fluid - it was disgusting."

Suddenly I heard Sally retch and run for the sink. Lucy twirled her chair around while I swung my head to the right, fork poised midway to my mouth. Sally looked up and me and instantly vomited in the sink.

"What?" I shrugged at Lucy. She started laughing as she pointed to my lunch.

I was eating rice and gravy.

Dear Penis

They called me back to the recovery room around 11:30 AM. I had traveled across state lines to be with my friend Kiki while she underwent a cystoscopy and a lithotripsy. Basically they wanted to blast a kidney stone and sneak a peak at her pisser while she was under. Good times. Good times.

I walked back through the recovery room hallways and rounded the corner to find Kiki wrapped head to toe in blankets. She looked like a mummy. A mummy who had imbibed in a little too much preserving fluids, if you know what I mean. Higher than a kite on a windy day.

"Hey Julie - I got a song for ya," she says.

Oh Lord.

Giggle Giggle.

"Hey - have you heard that penis song?" she asks.

Now let me preface this by saying that the stretchers in the recovery room are separated by curtains only. No auditory privacy. None. Zip. Zero. She then performs her first concert for the entire room.

"Deeeeeeeeeear Penis.............I don't think I liiiiiiiike you anymoooore................" she sings like a wino on the end of a 3 day binge. I hear snickers coming from the other side of the curtain.

"Oh! Wait Wait!" she says. "I'm gonna call Eric and sing it to him." I can't get to the stretcher fast enough - she has him on speed dial.

"Deeeeeeeeeeeeeeeeear Eric - I don't think I liiiiiiiike you anymooooooore," she sings into the cell phone as he picks up. I just shake my head. I hear someone snorting beside us.

I wish I had been smart enough to whip out my cell phone and video her. Alas, I missed it.

I'll give you the next best thing - Rodney Carrington singing his own Dear Penis song: