Monday, June 28, 2010

Blog Treasure!

Holy crap. You guys know I never link to anything like, ever. But wow. If you enjoy me, or my blog, or both, you must get thee to New Nurse Insanity: Fundus Chop! STAT. She commented on one of my posts earlier this week, and I just finished reading like, page upon page of her blog until I looked out the window and was like, oh balls, the sun is coming up.
I'm pretty sure I want to kidnap this girl and make her come work at hood hospital and be my BFF. From what I gather from her blog, not only are we the same age and have been ER nurses about the same time, but she is freaking hilarious and likes the same stuff as me. I mean, seriously, homegirl regularly talks about beer and comics and lol cats and has a whole post about how much she likes beards on dudes. Thank you! I am strongly pro-beard. My husband grows a fabulous red beard and it is hawtness.
Anyway, I digress. Just get over there and read her super amazing blog before I talk about and all day and get a message from her to the effect of, "Hey creeper, stop talking about me on the internets and carry on with your F word filled tirades about fake seizures, kthanx." Seriously. DO IT NOW.

Thursday, June 24, 2010

The prepaid plan.

Really, really. I think we need to start allocating call light calls like cellphone minute plans. You get a very large and reasonable amount for free, and after that we start to charge you an additional fee. That way you use it responsibly. And you don't call me on the call light after I was in the room literally 3 minutes ago because you refuse to take your shoes off in the bed and your sandal fell off your foot and you want me to put it back on your foot. No ma'am. That'll be 10 cents a call for that. It'll be a dollar a call if you specifically request a nurse to find you a kleenex, even though the secretary just asked you if there was something she could bring you. REALLY?

By the way... this was literally based on a real patient that I had last night who called me 5 times in a span of a minute to get me to pick up her glasses for her off the bedside table. Oh, and did I mention she could turn herself and reach them? Because she could. It was bad enough that the young man across the hall from her, who had been in the room half an hour, had already caught on. When I went into the room to start his IV, he said, "Oh, you're gonna start an IV? You better hurry up before room 6 calls you again! That lady's got you runnin!" Wow.

Friday, June 18, 2010

What have I become?

So the other morning, I was drinking some beers after a long terrible shift with some of my work buddies, and we're talking about this guy that comes in all the time acting like a total jackass. That night he had immediately started cussing at the staff and had to be hauled off by the cops after telling one of the nicest doctors we have that he was going to kick his ass. I made some comment to the effect of "Dude, it would have been totally awesome if the cops had tazed his ass." I listened to myself and kind of had this epiphany like, wow. That was actually pretty effed up. Especially because at times, I mean it. I say shit like this sometimes, and I look back and try to think about what the nursing school me would have thought about some of the things I say and do.
I was never prepared for some of the feelings I have towards these people. Not even a little bit. I was never prepared for the kind of power these people would have on my emotions. I knew patients and their families could break my heart. They still do sometimes. But I never thought that they could make me feel disappointed, or enraged, or guilty, or completely disillusioned with life in general.
I never in a million years thought that I would be in a situation with a patients family member where they were literally pissing me off so bad that I would be looking her thinking, "I totally want to punch this bitch in the face right now."
I never could have imagined people could be cruel and abusive enough about wanting drugs that I could look at another human being and think "I really wish that I could just send your horrible ass home with a trash bag full of Dilaudid and syringes so you could go ahead and OD and end your miserable existence."
And when I rationalize this crap, this isn't actually how I feel about these people. I don't hate anybody. But I hate the shit that they do. So much. And I hate the things it does to me. I was thinking just the other day about how much time I spend on a daily basis dealing with people trying to get something out of me. People playing games. People trying to hustle me out of food and cab vouchers and other shit they can buy for themselves but just don't want to. People trying to trick me into giving them drugs. People trying to get out of work or sue somebody. People trying to play games with their families by being intentionally obtuse or dramatic. People trying to demand to be seen sooner by yelling and literally throwing cell phones or cups of their own piss at the staff here. I feel like every day is a con.
Thinking about that shit makes me so angry. But what makes me angrier is how many people I doubt and don't treat with the kindness I should because of the cynicism that has become my existence. How awful I feel when I see someone come in and I think to myself that they're full of it, and then find out later that no, they're actually really sick.
But really, who can I be angry with about this? It's my fault that I let this get to me. It's my own shortcomings as a person that lets this place change me. I don't know why I can't just walk away from it. Why I have to respond to all the bullshit. Like last night. I was in triage. The fast track bullshit patients were all waiting, and the first look medic and I were talking. A lady walks in the door literally about to keel over dead- unable to talk because she couldn't breathe, white as a sheet and sweaty- we had run out of wheelchairs and rushed her back to a trauma room in my wheely triage chair. I start her IV and we get her on BIPAP, we run back up to triage to make sure no one else has checked in.
This asshole walks up to the nurses station and tears into us about how we were liars because we got a room for that lady and not for him, and he was just here for something simple. He threatened to report us to our HR director. Instead, I stupidly tried to explain to him the ER process. Dude. If you aren't dying, you get to wait. Probably in a sassier tone, I'd say. And he mocked me. Like a 5 year old. And he told me to shut my mouth, that he wasn't even talking to me. And it got ugly from there. I yelled at the asshole. We ended up calling the cops. I could feel my face flushing and my heart racing. He shut up. He stayed and waited until the day shift got there.
This shit still upsets me. Partly because I feel like I was really disrespected with no consequences at all. But mostly because I let him get the best of me. I should have smiled and written my managers number down on a piece of paper for him. I should have kept my cool. But I didn't. I let him make me angry, and I showed my weakness.

Sometimes I think that if I went somewhere else- somewhere where people acted right, where management gave a shit, that I'd be happier. But the more I look in on the problems I have at this place, the more I see myself. My patients can't make me feel this way. They don't make me sluggish and cranky at home. They don't put the thoughts in my head when I think sometimes that I'd like to kick their asses of the clock. That's me. That's my own issues and shortcomings. And there's not a hospital in this world that I can go to escape that.

Friday, June 11, 2010

Sick or stupid?

I've noticed a strange, strange phenomenon. Especially lately. Everyone I get in one particular night is either A)too stupid to function with nothing wrong or B)trying their hardest to go be with Jesus.
Night A was the night before last. I come in to some serious fuckery with a lady being admitted for hypoxia and apparently, TB, which was the dumbest thing in the whole world. This lady was 34 with no med history except for bipolar disorder and alcoholism. Her hobbies included smoking and smoking. She had a cough, shocker. Her x-ray showed pneumonia. Everything was fine, until some family practice admitting doctor lost his shit and decided she had TB because she lived in a halfway house with some other women, and she was coughing up streaks of blood. Really. If I had pneumonia and continued to smoke 20 effing packs a day for 3 months, I'd probably have blood streaked sputum, too. So there was a whole ridiculous mix up about getting her into a respiratory isolation room, which just led to her staying in the non-respiratory isolation room in the ER for 7 hours, because who cares about the ER nurses, those fools probably have been exposed a thousand times anyway. This leads to us cutting her off from her favorite past time, and subsequently, to her trying to light up in the room with her oxygen on not once, but twice. Awesome.
At least she was nice, unlike the douchebag my charge nurse put next door. This moron seriously checks into the ER because according to him, he lives in a house with some cokeheads who apparently leave their coke lying around all over the countertops and tables and such, and he wanted to get his blood drawn and tested for drugs because he might have touched some and it might have gotten in his system. When I explained to him that the ER does not run labs on demand and that we don't even do blood tests for drugs but urine tests, he cops an attitude and informs me that he already did one of those tests at home and it came up negative and that he was paying, like, 400 bucks for this visit and he wanted a blood test. I decided to let big Bulgarian doctor deal with his ass from here on out, because I had reached my capacity for foolishness. Bulgarian doc offers him one more urine test, which he begrudgingly accepts- he then precedes to bitch about how long he's waiting to get his results, the fact that the results showed that he had THC in his system and how we were "motherfuckers" because of it, and how long it was taking him to get discharged. OH MY GOD I DON'T CARE SHUT UP. You are lucky we didn't MSE your stupid ass to begin with. 8 hours total is nothing. If it were up to me, you would have waited 48. Outside. Because you are too stupid to even warrant a room.
Add another 15 stories like this one and you have my night.

Last night, on the other hand was bananas- I take report on a 60 something lady who looked about 80 something with no veins, on dialysis with gastroparesis puking her guts out with a blood pressure of 289/150 that the doctor refused to treat because "it's like that because she's vomiting and that's bad medicine"... okay. Gets admitted, I call and let the admitting MD know about the pressure before she goes upstairs, who precedes to freak out on me about why the pressure hasn't been treated, in a conversation that ends with me telling him, "I don't know if you know this, but I'm a nurse and that means I can't write orders for blood pressure medication. Only doctors can do that. That's why I'm calling you." He apologizes and puts her on a Cardene drip and I ship her up to ICU. At the same time I've got a non english speaking dude with an ugly CHF excerbation and some nasty diabetic ulcers, a lady who attempted suicide by taking a shit ton of blood pressure meds who is attempting to escape, and an old lady with chest pain and a heart rate of 160.
I get everyone fixed up and admitted and get a sweet lady with terrible oxygen sats and 2 ginormous pulmonary emboli- we need to give her blood thinners but she also has some sort of terrible chronic vagoo bleeding lady problem. Yikes. Then I get an allergic reaction who's totally freaking out and a little old paw paw on the ambulance from the nursing home who is pissing straight blood and now has a fever and is looking suspiciously septic-shocky. I start a second IV on him and get him a new catheter that's all set up for bladder irrigation and give report to the day shift.
WTF? Why can't some of the stupids check in on sick people night and get put in my rooms next to some of the sick people so I can get a break? I guess maybe they do, but they wait for 9 hours like they deserve and then leave without being seen like always. Oh well. I'd rather take care of the sick ones any day.

Saturday, June 5, 2010

Am I getting punk'd?

Seriously? My "orientation" to triage (I've done it multiple times, but apparently we were doing the ESI system wrong I had be reeducated 1984 style) really seemed like a prank training exercise along the lines of the "bambalance" 911 call. Not only was it dirty P and Vag G night- how we are not MSE-ing these idiots, I don't know, what the hell, go to the health department with your clap please, thanks- but I think I saw some of the stupidest complaints EVER.
Guy brought his daughter in because she closed her finger in a drawer a week and a half ago. Her nail was still black. It didn't hurt.
Guy came in for a "rash" on his chin that was clearly acne. ACNE. Good lord. Get some soap and wash your face. This is not an emergency.
My favorite, however, was the guy who came in because he couldn't maintain an erection. Seriously, bro. Your boners are not an emergent issue. GTFO. The worst part was, he actually talked the doctor into prescribing him Viagra! Bitch, please! That is not going to discourage behavior like this. I can see the GlaxoSmithKline commercials now... if you feel like erections are a problem for you, go to the nearest ER, maybe even in an ambulance, and demand Viagra by brand name. You totally need a pill as opposed to the real answer for why your bird has quit and is no longer legit. Discussing it with your doctor will take longer because he will ask questions, as opposed to this ER doctor who will just give you what you want so you will shut up. If you have an erection lasting longer than 4 hours, seek medical attention in that same ER because they probably deserve it.