Today was my first day actually providing patient care in the ER since my back injury. I only worked 8 hours (normally do 12) but man, oh man did I feel it. I wasn't necessarily in pain but my back felt like I'd spent the last 8 hours workin' the street corner in 5 inch stilettos fighting off the other hookers trying to take my space.
Phew.
Ibuprofen is my best friend.
My day started with an Air Life transfer for a cardiac patient. Acute MI. He was sleeping when I got report on him. Pain? "Not to bad Julie. It's about a zero or 1 on that pain scale thingy." Well perfect. IV meds infusing and he was good to go.
Then Miss SOB (shortness of breath, not son-of-a-female dog here people. Sheesh! Do you really think I'm that mean? OK well I am. And she was a bitch. But alas - I shall not SINK to the lower depths of bitter ER nursedom and call her names. Oh, OK I will. Cuz she was a bitch) walks in.
"I can't breathe," she tells me as I can hear her wheezing from the double sliding doors.
'No shit,' I think.
I take her back to the cardiac bay and hook her up to every wire we have. Well look at that! A fib with rapid ventricular response. Basically her heart was just a tickin' away - and not being very regular about it. I pushed a little Cardizem bolus through her IV and started a drip (IV infusion for my non medical peeps). Then I got to admit her to the floor and it took all of 30 minutes from request for a bed to actually reporting off. I love it when the ER gods of the universe decide to support my ass for a change.
The Air Life crew arrived during all of this and wanted report on Mr No Pain Chest Pain. Reported off to them and when they walked out the door only then did I realize they didn't bring me my chocolate. BASTARDS! They always bring chocolate. WTH?
"Where the hell's my chocolate?" I shouted after them.
"Budget cuts!" I heard as the pneumatic doors swooshed closed.
Well, shit.
What's the state of health care coming to when the Air Life crew can't bring us chocolate anymore? Someone needs to write their congressman or something.
My next patient was Mr. Gross Leg Abcess. He had multiple pustule scabbed "things" on his lower legs with one in particular that looked like Mt St Helens waiting to blow. Holy bulging pusbag batman! Hot, red, swollen - I could practically see the pus pulsating with every heartbeat.
I love wounds like that.
Dr. J and I opened that puppy up and got lots of nice green and yellow tinged pus out of it. Yummy.
Apparently when your right leg is 3.5 inches larger in circumference than your left leg, it kinda hurts. Who'da thunk? Aaaaannnnnddddd........ when you have a history of meth use, it takes a lot of Fentanyl to make your pain go away.
A lot like "make Julie stop breathing" doses. Holy crap.
Anyway, Gross Leg Abcess Man got admitted to med/surg for Vanco infusions and I&D of his abcess.
The rest of my day was filled with sprained ankles, runny noses (allergies in the summer? Shocking! I know. Tell me about it.), and lacerations. I didn't get a single trauma all day. I'm kinda pissed about that. It's funny how you miss things like that when you are off work for a while.
The best thing about today? I got called in so it was all time and a half. Yeehaw.
1 comment:
Yuck. I had a Killer abscess back in January on the inside of my thigh. My doc had told me to just put compresses on it, and I did that, but it got huuuuuge and I wound up in the ER a couple of days later because it turned me into a sissy bed-wetter from all of the pain. I've had 5 kids and THAT abscess was THE worst pain I've ever had. Yeah, they got some really lovely "stuff" from me that night.
But! I got some vicodin, percocet, AND the max dose of morphine that they could give me. And I don't have a history of drug use, but I was one happy bitch leaving the ER THAT night ;). Not to mention the fact that I was able to walk again. Best $100(copay) I've ever spent, I think.
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