'Tis The Season......

For a Christmas Miracle. There is no other explanation for this.


Mrs. Jones looked in her rear view mirror and saw her 5 year old unbuckle herself from the car seat. "Melinda! Put your seatbelt back on right now!" Melinda started to laugh and climb over the second seat into the third seat of the van. On her way over the seat she kicked her younger sister, Samantha, in the head. Samantha (2 years old) started to cry.

"Melinda! GET BACK IN YOUR SEAT!" Mrs. Jones started to slow the van down and pull towards the edge of the road. Her 13 year old son was in the passenger seat beside her listening to his ipod and bopping his head along with the beat.

Mrs. Jones put on her blinker, continued to slow the van, and waited for a safe place to pull over.

She hit black ice at about 50 mph.

She slid sideways, fighting for control of the vehicle. She heard Melinda scream and saw her body slam up against the side of the van. Then they rolled. Twice.

Mrs. Jones felt the van flipping, heard her children screaming, and saw her daughter fly out the window just before the final thud of the van as it landed on it's top. But it wasn't Melinda that flew out - it was Samantha. The 2 year old.

Total silence.

She looked to the passenger seat and saw her son looking back at her - fear in his eyes. She released her seatbelt and landed with a thump on the roof of the van. She glanced into the back of the van and saw Melinda laying in a fetal position on the roof above (now below) the rear seat. She wasn't crying.

Mrs. Jones said she remembered screaming "OH MY GOD! OH MY GOD!" as she crawled to the back of the van. She saw that Melinda was awake, staring at her. She started to cry as Mrs. Jones got closer. "Mommy, my neck hurts!" she sobbed, but she moved her legs. She moved her legs and reached out for her mom. Mrs. Jones scooped her up and pushed her into her son's arms, as he had unbuckled himself by this time also.

She crawled out the broken side windows to find Samantha. She had to crawl under the empty car seat on the way out. She saw the straps still buckled and couldn't comprehend how Samantha had gotten thrown out of the vehicle. She was sobbing as she slid out the windows, cutting her hands and lower legs on all the broken glass.

"SAMANTHA!" she screamed. She gained her footing and slid and tripped her way back behind the van. Mrs. Jones was terrified of what she would see.

She saw Samantha.

She saw Samantha standing in the snow in the ditch sucking her thumb and crying. She was uninjured.

Apparently she had landed exactly like that as the van flipped over. The only marks around her were the flattened snow from where the van hit and her 2 footprints - which she was still standing in. Mrs. Jones ran to her, scooped her up, and went back to the van.

The motorist behind them picked them up and brought them to the ER. We promptly immobilized and examined Melinda, Samantha, and Mrs. Jones. The son felt fine and didn't want to be seen. A few Xrays and a couple of CT Scans later we had our diagnosis...........

Bumps, bruises, and a few cuts.

Yes - that is it.

An unbuckled child, a child who slips out of a car seat, a van rolling on black ice, and we have no major injuries. NONE.

Tis the Season!

And let us never forget the Reason For The Season - Jesus.

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.

Oddities of the Universe Unite!

It always amazes me how just being a nurse attracts the weirdest situations. Sometimes you are standing in line at McDonald's wearing your scrubs (wondering how on earth that little, tiny french fry on the floor became such a mass of squished goo), when the lady in line behind you starts telling you about her copious vaginal bleeding and how many clots she's expelling, while all the other customers are trying not to vomit and silently throwing their ketchup away.

I've even experienced many of these interesting scenarios just driving down the road. You never know what will be on the other side of that corner. If Mel is with you, you can be assured that something crazy or completely hysterical will happen. She attracts the oddities of the universe like flies on the sticky strip of life. I really think she should start working in the Emergency Department. She'd fit right in with the rest of us who are one taco short of a combo plate.

Last year at about this time, Mel and I decided to take a drive to Boise to escape the duldrums of a deep, depressing winter. Can I just take a moment here to say I hate snow? I seriously hate snow. It starts off white and sparkling and amazing. In 4 hours it is crap - and when it starts melting off at the 7th month, it turns into liquid shit. By the 3rd day of snow, I'm ready to pull my ass up to the top of the local skyscraper (all 2 stories of it) and start screaming obscenities nonstop. Kind of like the gentlemen we admitted to the psych hold room last week.

Mel picked me up in the boonies where I live. When we hit the end of the road at the highway, Ms. Eagle Eye Mel looked to the left and spotted an upside down truck in the snow about 1/4 of a mile up the road. A white truck - in white snow. I was oblivious to the situation since I was seizure dancing in the front of her van, rocking out to Third Day, swinging my hair and screaming "Turn it up bab-eeeee!" I think she might have even punched me to get me to pay attention the fifth time she asked me, "Is that a wreck over there?" I finally stopped my seizure dancing and followed the line of sight from the tip of her finger to the corner.

My control freak personality emerged. "Get over there!" I yelled.

Jumping out of the car, we ran to the truck. The cab was pretty much intact, but the bed had been ripped away from the frame. A local cowboy was bent down at the passenger window with his cute little wrangler butt sticking up in the air, trying to help the passenger crawl out of the vehicle. They were having a little difficulty getting her seatbelt undone (but I was enjoying the view), so I started ordering Mel around (bossy little wench that I am), "Go get coats, blankets, whatever you can find". By this time, a few more vehicles had stopped and Mel "borrowed" the needed items.

I turned my attention back to the passenger. I knelt down beside the cowboy and stuck my head in the window. I ran through the whole "Does your neck hurt? Did you lose consciousness? Any pain in your back? Yada, yada, yada," conversation. She kept denying everything. "I'm fine. I'm fine," she kept saying. Mr. Cowboy Man finally got her seatbelt undone and starts pulling her out the window.

"Wait!" she yells. "I can't feel my left leg"

"Ah Crap, Immobilize! Immobilize!" I think. Until the lady so very calmly says to us........................................................




"Actually, I don't have a left leg."


She was an amputee. After the shock wore off, I couldn't help but giggle. I looked at Mel and thought, "This is all your fault."