Monday, September 29, 2008

A Lesson Learned

I've been a nurse long enough that you'd think I could fish out the drug seekers vs those truly in need of narcotic intoxication within seconds. I know, I know - you'd think I could. I'd certainly think it.

Apparently, we both would be wrong.

48 y/o disheveled, dirty, matted hair, no teeth, 5 tattoos, holey clothes wearing man presents to the ER with a yelled complaint of "I need Vicodin! Badly!" He also happens to be holding his shoulder.

"Were you injured sir?" I ask.

"Yes," he replies. "I fell over the guardrail last Thursday when I was walking along the highway by the rest area. My shoulder has been killing me ever since."

Pulses present and equal, grips equal, no numbness or tingling, cap refill brisk - flashing neon sign saying "Drug Seeker!" flashing across his forehead. Well at least in my mind it was.

Triaged to wait a bit.

35 y/o woman dressed in a business suit with perfect personal grooming habits and a polite demeanor presents with the complaint "I think I have another kidney stone." She's slightly bent over and holding her left side. She dry heaves into an emesis bag I give her and her b/p and heart rate are elevated.

"I'm sorry but I just couldn't wait to see my primary physician on Monday. I've been dealing with the pain for 2 days now and I just couldn't take it anymore. I'm really sorry to even have to come in."

I admit it, I was sucked in by her politeness. It's such a foreign concept in the ER. Seriously - someone throws us a polite bone and we jump all over it like starving dogs.

"We'll get ya back just as soon as we can." I told her.

Apparently, I am an idiot. Yes, I am admitting it now.

The gentleman had dislocated his shoulder and it had been out of place for 3 days. 3 DAYS! No shit he had pain, eh? Our lovely lady friend was found to be a doc shopper and drug seeker from multiple hospitals over the ENTIRE STATE. She'd learned the game, and she'd learned it well.

I learned a huge lesson that day. It wasn't such a pleasant look in the mirror for me.

Friday, September 26, 2008

And So It Begins (Or Ends)......

Yes my lovely readers, it is that time of year again. The time when we can all give a big sigh of relief and relax into our comfy over stuffed recliners with a big glass of cold beer and a bag of chips. The time when we can prop our legs up and have blissful silence since the screaming kids are finally asleep in bed. The time when we can pick up our remotes and turn on the TV and say..........

"What the HELL were they thinking?!?!"

Yes, my friends. It is time for ER on NBC.

Last night was the season premiere for the FINAL season. This is it. We'll never have a season premiere for ER again. I feel like we should bow our heads for a moment of silence.

Uh, nope. Can't keep my mouth shut that long.

First and foremost - why the HELL do they have to keep killing off characters in these huge dramatic ways? Tell me! Helicopter crashes, ambulance explosions.........pashaw. Can't someone just die of a nice simple heart failure or something? I mean really. And then, to top it off, they kill one of the best characters on the show. One of the few that actually spoke their mind. Oh yes - I know, I know. Those of us that speak up tend to get killed off. Sigh......

Numero Dos: That was quite an interesting way to get an airway on Pratt. Using the IV drip chamber and spike? Creative. Anyone actually ever seen this done? Anyone actually ever heard of it? Though I have to give huge props for the writers putting in the tidbit about the other supplies not being located where they were supposed to be. Now that's true to life people! True - to - life. Apparently when some people get a job in an ER, they forget how to put shit away since their mommies aren't following them around anymore.

Number 3: Does cyanide make people high? That little girl was acting like she was doped up on morphine and having one hell of a trip. My experience with this is that the patient actually doesn't feel good. At all. Sometimes they're not even awake. Sometimes they be sleeping at my buddies house called The Morgue. Oh, props again for the bitchy mom though. Spot on.

Numero quatro: When the hell are the guest spots? We need them already. Paging Dr. Green.

Number 5: Isn't it nice that they knew exactly the place to go in with the needle into fake-hero-man's leg without a quick bedside ultrasound to define the area? And the make up artists really need to look further at pictures of infected legs - that one just looked a little bruised and slightly red. Certainly not something that my doc would have ran and got a needle for right away. It was also quite convenient how they skipped over "Airway" to drain the leg first, and THEN said "Prepare for intubation." Yep, cuz we all know that draining a wound is so much more important than having an established functioning airway on a possibly septic patient. A-B-C's people! A-B-C's.

Damn, I love this show. I do.

And yes, I shed a tear or two for Pratt last night. Let's keep that one our little secret, shall we?

Tuesday, September 09, 2008

On Vacation

Relaxing in the sun, spending time with friends, and going to see Kid Rock at the Puyallup Fair.

Will return when I find my brain again.

Until then....................