Wednesday, January 23, 2008

I love this little guy. He just represents so much that can be left unsaid.

Tuesday, January 22, 2008

Ode to the Name

This post over at Musings of a Highly Trained Monkey stirred the recesses of my spiderweb covered brain and handed forth a few memories of crazy names I've come across. I often wonder if parents are seriously as stupid as they look or if they plan to slowly and deliberately torture their children as they go through school. Are they handing down retribution to their children for when they were made fun of in school?

"Well, I had to toughen up pretty quick when I peed on the teeter totter and all the kids called me Peeter-Potter until 12th grade. I'll show them! I'll name my kid.........."


I shit you not. No pun intended of course.

Pronounced Dee-Ar-ee-a

I stood there with the chart in my hand for a good 2 minutes. I stared at it not believing what I was seeing. I ran through every pronunciation in my head and I still could not wrap my tongue around it.

I hesitated. Fumbled a bit.


"Oh! That's us! It's dee-ar-ee-a."

"Um, okay. Come on back."

As I settled them at the triage desk I asked what they were here for. Yes, you guessed it...........

Diarrhea had Diarrhea.


Monday, January 21, 2008

Chicken Nuggets

We had a patient a few years ago that I'll call Mr. ChickenNugget. Oh, Mr. ChickenNugget was a joy to take care of. He came staggering in to the ER lobby clutching his belly and shouting "I BEEN STABBED! I BEEN STABBED!" The triage nurse escorted him back to her room and did a quick assessment.

She pulled open the lower half of his shirt and saw a small amount of blood smeared around his belly button. There appeared to be a tiny puncture wound in the middle of the blood. Initial vitals were absolutely normal.

"What were you stabbed with, Mr. ChickenNugget?" she asked.

"A Screwdriver! He got me with a screwdriver!"

Apparently, Mr. ChickenNugget was approached by "just some dude" in the Safeway parking lot when he was viciously (and for no apparent reason of course) stabbed with a phillips head screwdriver. He walked the 2 blocks to the hospital himself.

Triage Teresa brought him back to Exam Room 1 and gave me report. I went in to do my assessment on Mr. ChickenNugget, pulling the bedside ultrasound unit behind me. I figured Dr. Q would want to do a quick FAST scan.

I told Mr. ChickenNugget to take his clothes off and I would give him a gown. I turned around and reached into the cupboard next to the sink and grabbed the gown, an IV start kit, and some lab tubes. I turned back around with the gown in hand and immediately started laughing. I hate to admit it, but yes.............I laughed at my patient.

He had a tattoo over each nipple. On the right it said "SWEET" and on the left it said "SOUR". I shit you not.

How can you not laugh at that?

Mr. ChickenNugget followed my line of sight to his own chest and started laughing too.

"That's what happens when you get drunk and go to a tattoo parlor with your buddies," he said.

I immediately placed that on my What Not To Do In Life list.

So it turned out that he had not even been stabbed. There was a small abrasion on his abdomen but no depth to the wound. Mr. ChickenNugget had been scratched by a screwdriver.

I still think about him any time we have a stabbing come in.


Last Thursday's episode kept me so entertained that I fell asleep..............15 minutes into it. Sorry T-Dude. Once again I have no wonderful insight (heehee) on the episode. I can't even remember the first 15 minutes that I did watch.

Maybe next time I'll down some caffeine, take a couple of NoDoz (do they even still make those?), eat a bunch of sugar, and then plant my ass in front of the TV on the floor and not in the big, fluffy, overstuffed Lazy-Boy recliner. That was my downfall. A comfy chair, a cozy blanket, and a glass of whine, oops I mean wine. I was asleep as fast as a woman who likes to "shop around" gets called a whore in Southern Mississippi.

Sunday, January 20, 2008

Once Again For Your Viewing Pleasure

I know this has made the internet rounds a few times, but I laugh every single time I read it. A friend sent it to me via email, but I also saw it again today posted over at Nursing Voices. Hope you enjoy!

Come to think of it, this may produce a few more entries from me as I remember stories that go along with some of these. People are amazing creatures.

Subject: You know you are a nurse when

1) the front of your scrubs reads "Nurses... here to save your ass, not kiss it!"

2) you occasionally park in the space with the "physicians only" sign... and knock it over.

3) you believe some patients are alive only because it's illegal to kill them.

4) you recognize that you can't cure stupid.

5) you own at least three pens with the names of prescription medications on them.

6) you believe there's a special place for the inventor of the call light.

7) you believe that saying "it can't get any worse" causes it to get worse just to show you it can.

8) you wash your hands BEFORE you go to the bathroom.

9) you believe that any job where you can drive to work in your pajamas is a cool one.

10) you consider a tongue depressor an eating utensil.

11) eating microwave popcorn out of a clean bedpan is perfectly natural.

12) you've been exposed to so many x-rays that you consider it a form of birth control.

13) you've ever heard a patient with a nose ring, a brow ring, and twelve earrings say "I'm afraid of shots."

14) you've ever placed a bet on someone's blood alcohol level.

15) you've told a confused patient that your name is that of a coworker and to call if they need help.

16) your bladder can expand to the size of a Winnebago's water tank.

17) you have seen more penises than any prostitute could dream of.

18) you believe that not all patients are annoying... some are unconscious.

19) your family and friends refuse to watch medical sitcoms with you because you spend the whole time correcting everyone and pointing out upside down x-rays.

20) you don't get excited about blood, unless it's your own.

21) you've sworn to have "do not resuscitate" tattooed on your chest. Soon.

22) discussing dismemberment over a gourmet meal is perfectly normal to you.

23) your idea of fine dining is anywhere you can sit down to eat.

24) your idea of a good time is a cardiac arrest at shift change.

25) you believe in the aerial spraying of Prozac.

26) you believe that "shallow gene pool" should be a recognized diagnosis.

27) you believe that the government should require permits to reproduce.

28) you believe that unspeakable evils will befall anyone who utters the phrase: "Wow, it's really quiet, isn't it?

29) you have ever wanted to write a book entitled "Suicide: getting it right the first time."

30) you have ever had a patient look you straight in the eye ad say "I have no idea how that got stuck in/on/up there."

31) you've had to leave a patient's room before you begin to laugh uncontrollably.

Wednesday, January 16, 2008

The Elderly and UTI's

I walked into the room at 11 PM and was met with the sight of a 78 year old naked lady laying spread eagle on the stretcher.

Oh my.

"Mrs. Smith, you're naked," I said.

"Oh my," she giggled. "Am I?"

I giggled back. "Yes, you are. Let's cover you back up." I put her gown back on and pulled the blankets back up over her body.

She laughed. "OK dear, let's do that."

I rounded on her 30 minutes later. She was naked again.

"Mrs. Smith. You're naked again!" I couldn't help but laugh. She had a huge smile on her face, her arms were thrown back over her head, and she was giggling again. Like a little school girl.

"Oh my........giggle, giggle.........did I do that again? HeeHee."

"Let's pull these covers back up," I said as I put her gown on her and replaced her blankets once again.

"Thank you dear!"

I went to check on my chest pain patient next door. I returned to see Mrs. Smith in another 30 minutes.

Naked again.

Laughing hysterically.

"Mrs. Smith! What are you doing?" I laughed.

"What dearie?" she replied.

"You are naked again!"

"Oh my.........snicker, giggle......again? Oh my.....heehee. I don't know why I keep doing that. Giggle."

She was so pleasantly confused she then pulled out her catheter. She stared at it and started laughing. "What's this thing?"

I couldn't help myself. I was laughing so hard I had tears coming down my face. She thought everything she did was the most hilarious thing she'd ever seen, which in turn made me want to spend all my time in her room. She was extremely entertaining.

She finally settled down for the night and fell asleep...........naked.

One Flew Over the Cuckoo's Nest

I was sitting at the desk in ER the other day (why do a lot of my stories begin like this? Does this say something about where I spend most of my time?), when I heard a chirp.

"What the hell?" I said.

Chirp, chirp. Chirp, chirp.

I suddenly remembered my previous conversation with the EMS guys and figured they were playing a little game with me.

"I know it's those assholes with a bird call. I'm not even turning around," I said to myself. "I'll just sit here and continue charting and then walk away."

So I did.

The chirping got louder. Angrier. More frantic.

I giggled.

"They're not going to get me. Not this time."

I have a long standing relationship with my EMS crew. We love jokes. The more embarrassing, the better. The more we can make the other look like an ass, the better. I love those guys! We have so much fun.

So hence, I ignored them.



I started whistling back.

Whistle Whistle.

Chirp Chirp.

"Suckers," I thought.

Suddenly my pharmacist came around the edge of the desk. "Hey Julie, did you know there's a bird in your ER?" she said.

"No, that's just the EMS guys trying to be stupid. They have some bird call or something they're playing with."

"No it's a bird," she replied.

"No it's not. Really. They're getting me back from the other day."

"No Julie. It's a bird. It's right there............"

I looked up to see her pointing down the hallway. I stood up, leaned over the desk, and saw the damn bird - sitting right in the middle of the hallway.

Chirp Chirp! Chirp Chirp! He cocked his head as he talked to me.

Sigh................... Yes, apparently I am that stupid.

4 nurses, 6 slammed doors, and 18 cuss words later we had the bird in our hands and escorted him back outside for his return home.

15 minutes later the EMS crew was standing in the double doors pointing and laughing at me.

All in a day's work.

Saturday, January 12, 2008

I Know What's Important

You never know how valuable soda is until you are doing medical disaster work after a Hurricane and you are trading favors for Diet Coke.

Not those kind of favors! Get your mind out of the gutter. At least for a little while.

When I went to Mississippi with a group of nurses after Hurricane Katrina, we found that it's the little things you miss. The little things like Diet Coke. One of our nurses finagled a case of DC from some volunteer firefighters (I don't even WANT to know how) and we protected it like a meth head protects his last hit from his girlfriend's cousin's sister.

We had it wrapped up in our bedrolls, hidden from prying eyes. Whenever we felt the need to imbibe, we attacked the gym like Navy Seals on a mission to save the only person who knows the code to stop the nuclear bomb from exploding. One lookout, one distractor, one to grab the soda, one to hide it on a sideways pass, and one to just stand there and look good.

When we flew out and landed at the airport in Minneapolis, I think I downed 3 Diet Cokes within the first 10 minutes on solid ground.

It's the little things in life that matter.

Tuesday, January 08, 2008

Oh The Joys of Rural Living

Mr. Estupido did the smart thing and rode his bicycle to the bar to drink his 8 Rum and Cokes and 6 Bud Lights. He hopped his ass on that bike and pedaled fast and furious down the road to fulfill his nightly ritual.

That was about the only smart thing he did.

Around 11 PM he decided it was time to go home. He staggered out to the bike rack (as a side note - how many bars do you know of that have a bike rack? Hmmm? I'm not talking in the big city here - it's redneckville 100%), swung his leg over the middle bar, and promptly fell over. He had a nice long gash above his right eye and a few scratches on his right arm. He tried again.

And fell again.

You'd think that the people watching from inside the bar would help him. Nope. It's much funner to point and laugh (I have to admit I'd probably be laughing too).

On the third try he got it right.

He then pulled out of the drive and headed down the sidewalk towards home, blood running down his face.

About 3/4 of a mile down the road, he thought he saw something in the ditch by the golf course. His curiosity (that word just looks wrong) got the best of him and he went to investigate. Now I have told you all before what happens when you let your curiosity take control. It's a bad, bad, bad thing. Why can't we just say no? I know, I know. It's impossible. Sigh..................

Anyway, Mr. Estupido steers his bicycle toward the ditch. He squints his eyes to try and see more clearly, but the blood from his cut is clouding his vision. He tries to wipe it away with his arm, but only succeeds in making more of a mess. Wait, wait! He knows there is something there, he can see it moving! What is it? What is.........


He hits a deer.

On a bicycle.

Yes............... he did.

My first thought when I heard the EMS tones go off for a "bicycle vs. deer" was "you have got to be fucking kidding me." They weren't.

He ended up with a broken arm, 2 more cuts on his face (plus the original one), and an alcohol level of .320

The deer ran off. Unhurt we would suppose.

We Make Funnies

I spent half of today reviewing the ER log from 2007 for retrospective trauma entries. Basically I was looking for cases that should have been entered into the trauma system that for some reason were not. Usually related to under triage by the nurse and/or physician. I actually really enjoy reviewing these cases because it is absolutely hysterical what you find. Between admitting clerks who have no medical terminology background and physicians who apparently were on the tail end of a 48 hour stretch when they dictated - it makes for a fun filled 6 hours of reading.

When the admitting clerks register a patient, they must fill in a chief complaint on the admitting form. This usually is what the patient specifically says they are there for, such as abdominal pain, can't breath, chest pain, etc. Apparently, we need to do a little more training with some of our clerks, or be a little more aware of typos.

For example (exact spellings included):
  • Hell and hit head (I'd hit my head if I was in hell too - over and over and over and......)
  • here for a cathader (is that related to Darth Vader?)
  • cut all his finers (ummm..................where are your finers?)
  • turned both ankles (turned them where? Left? Right? Into the police?)
  • bitten twice by unknown (wouldn't you have recognized it after the first time it bit you? Or at least ran from it when it went at you a second time?)
  • history of vowel obstruction (good thing they weren't consonated too)
  • slash of gasoline (vs a dash or a pinch? Or maybe a guitar player from a rock band?)
  • left thigh from a dirt bike (what - did he grow a left thigh from the dirt bike? Borrow it from the dirt bike? Left his thigh on the dirt bike?)
  • kedney pain (apparently a new type of pain related to shoes?)
  • pains from having appendicitis out (this is just funny)
  • Fell likes passing gas (Sweet shit on a stick. Did he fall because he likes passing gas? Did we just need to know he likes flatulence? Does he feel like passing gas? Because apparently it's now OK to come to the ER whenever you feel the need to fart)
  • painful hemoridds (maybe they wouldn't be painful if he'd have just passed the gas)
  • toothpain and a bad smell (well maybe a shower would help)
  • ripatory dress (as compared to a non ripe............ shirt?)
  • sinkable episode (was this a near drowning?)
  • sour throat (If they watched what they put in their mouth, they wouldn't have such a bad taste in there)
  • dieraha (ummm...............hmmmmm......yeah)
  • crappy cogn (it took me a long time to figure out this was a croupy cough and not something to do with poop)
It's days like today that make me love my job.