Thursday, June 30, 2011

Sorry

For the lack of update-ness. I went on vacation and found a really good mixology bar so I have nothing to contribute except that I figured out I apparently DO like whiskey. Journey of self discovery and inner wisdom. Anyway. I'm back to the fuckery tomorrow for several days straight so I'm sure I'll have plenty to contribute. But for now, it's vodka Arnold Palmers and baseball at home, hooray!

Friday, June 24, 2011

The Great Divide

So, I've noticed a great issue of debate among ER nurses lately- one that will surely go along with other important controversies such as abortion, dark chocolate vs. milk chocolate, and the Rolling Stones vs. the Beatles- whether to deny or provide the med seeker fix.
Other than a select number of ballsy doctors who just don't play with these people, just about anyone who comes into the ER with generic abdominal pain and a multitude of allergies acting a fool will get some Dilaudid prescribed. Since a bullshit complaint against a doc is still a complaint in their eyes, the powers that be at Hood Hospital pretty much force them into it.
This is where the nurses come in. You can't just say no to an order because you believe your bi-weekly-call-light-happy visitor's complaint is not legit, but you can deliver it in a way that is not ideal to them.
Yup. If I have a patient I know to be a drug seeker, I sure will give that 2 mgs of Dilaudid in about 200 ccs of saline over about 10 minutes. Lots of nurses I genuinely respect will give it fast as requested, give the people what they want, and hope they will STFU and stay off the call light. This often works, but I won't do it.
Here's my logic- first, I'm not here to get you high. I give pain medicine slowly, as I was taught to in nursing school. If you wanna complain that I did things by the book and pushed your narcs too slow, I believe that is actually one issue that my gutless management will actually back me up on. And second, I do not reward foolish behavior. If you come to my ER, lie to me, take time away from my other sick patients, act abusive and generally unruly, I do not want to give you any motivation to come back by giving you your fix. And I don't wanna teach you that you'll get what you want by being demanding and rude. I don't know if this will actually deter anyone in the future, but I do know that it satisfies the idealistic part of me, as well as the passive-aggressive asshole part of me.
So, other nurses. Where do you stand on this issue? Discuss with your coworkers on your next lunch break (ha). I guarantee it's more interesting to them than your opinion on abortion.

Thursday, June 23, 2011

What the ER Staff is Actually Talking About at the Nurse's Station

I feel like I've been doing a lot of complaining lately, but damn, has it been horrible up in here at Hood Hospital, guys. Anyway. I'm kinda bored with it and I'm not even expecting to be able to go pee or take a lunch anymore, so I'm really just pleasantly surprised when I'm not getting poop all over me or getting sworn at. So I'm going to skip the latest rant about asstards running the asylum while I have 3 patients at death's door at once and just tell you for a bit about how the ER staff deals with pain and suffering.
As you may have learned from ERP's pain scale, ER staff have chronic rectal pain. For obvious reasons. If you have any questions go ahead and click on that link there.
Oddly enough, we've had an ongoing discussion similar to this one for about a year and a half now, but more focussed on the tools necessary to do your job. For example, "Oh, you picked up a shift with the B team this weekend? And doctor slow as hell is here? Dude. Go ahead and grab about 6 of those surgical lubes and hold on to them so you don't run out on Friday."
Multiple surgical lube packets will usually suffice from day to day, but if you have ICU holds or it's a full moon, yeah, you're gonna probably need to go down to central supply and get you some industrial size lube out of the urinary cart. If any of these things happens to fall on a Monday or management is here as charge because we're short staffed, you best skip on down to sono and borrow their big bottle.
If any of the above happen and you also happen to be working part of a day shift, no amount of lube will help and you need to call the pharmacy to upgrade to Lidocaine jelly. See if they can throw in some Toradol for the impending inflammation.
Lately it's been bad enough that my work BFF and I decided that we need to appropriate the HurriCaine spray for this purpose. The pain of our shifts is now measured in how many of those little straws we have to tape together to reach the site of our pain.*
Yes, this really is how I survive all the foolishness from day to day. I'm not real sure if I want to know what this says about me as a person.


*Hood Nurse and Hood Hospital Inc. do not actually endorse the off label use of Hurricaine spray in the rectal region. Please do not try this at home.

Tuesday, June 21, 2011

I'm Done.

Man. This week was an ass whip. I mean. Wow. There are no words. Abusive foolishness, minimal pee breakage, fussy midlevels, broken coffee machines.
Sometimes after 12 hours if getting screamed at by 500 pound patients that I'm not moving them right when I'm simply trying to help them get out of a pool of their own waste, or getting screamed at and getting needles swatted out of my hand covered with the HIV positive blood of the IV drug user who complains that I don't start my IVs gently enough, or getting kicked out of a room by a patient because I "think I can do anything I want because I'm a pretty lil' white girl", scores of helicopter family members of patients with nothing wrong with them demanding painfully stupid ass shit from me (yes, let me just ignore my lady over here in A fib with RVR so I can run around the hospital to find you the surgical bouffant cap you have now requested 6 fucking times, because you need that for some reason) I really kind of wanna say screw all this and dance on a pole for a living or something. I mean, leaving work with my dignity intact is not going to be an option in my life, obviously. I probably wouldn't get any medical benefits but I'm much less likely to be showered in feces and blood.
Stupid desire to help others. Limits my career options every time.

Sunday, June 19, 2011

There's Something Wrong

with a grown ass man who checks into the ER for pink eye and then has his mama go up to the triage desk and yell and scream and act a fool demanding to see the freaking house supervisor and asking for the complaint line because someone who walked in with a gun shot wound was triaged before her son. REALLY?
Also, with an adult woman who is legally allowed to drive a car trying to tell me her kid needed antibiotics to fix his neck soreness after a car accident.
And with people who bring in their family members because acting strange and agitated after drinking an 18 pack of beer, and then get pissed of when they aren't immediately taken back to a room.
We have a nurse here who works triage exclusively. That completely blows my mind. If I had to deal with this shit every day, I would probably be done with humanity and nursing after about 2 weeks.

Tuesday, June 14, 2011

Web MD Fails us AGAIN

Patient:Um, yeah, I need to check in and be seen by the doctor.
Hood Nurse: Sure, let's get you fixed up. What's going on today?
Patient: I think I have cervical cancer. I'm having all the symptoms.
Hood Nurse: Okay. Like what kind of symptoms?
Patient: Cervical cancer symptoms! Are you guys gonna check me for cancer or what?
Hood Nurse: Okay. Well, I can't put cervical cancer check in here for your reason for visit so I just need you to tell me what the problem was that made you come in today.
Patient: Well, I mean, like it hurts when I have sex and I got this discharge and I looked it up on the internet and it told me that was the symptoms of cervical cancer.
Hood Nurse: What color discharge? Is there an odor to it?
Patient: Yeah. It's yellow.
Hood Nurse: Have you been having unprotected sex?
Patient: Uh, yeah.
Hood Nurse: Listen. I don't want you to worry about this cancer thing right now, because your symptoms sound more like an STD to me at the moment. We'll check you here to be sure, and we'll give you a referral for a place that can do a pap smear to check for cancer, but I don't want you to get to anxious about this. Web MD says about 99 percent of everything is cancer, so yeah. Web MD is not your friend.

Sunday, June 12, 2011

I Guess We're Grading on a Curve Now

Actual fire medic report I got last night:
"Well when we got there she was having a lot of trouble breathing and so we put her on our CPAP and her O2 sat went from 60 to 75%, so we thought that was pretty good."

You did? Great. I guess that is passing.

Thursday, June 9, 2011

Chief Complaint of the Night

Finger pain x 20 years

YUP.

Tuesday, June 7, 2011

Nuggets of Wisdom From Triage

Hood Nurse- Sir, have you had your flu vaccine this season or your pneumonia vaccine in the past 5 years?
Patient's wife, still in her McDonalds uniform, answering for him- No, we don't get the flu shot because the government's using those to poison us.
Hood Nurse- Cool. Well, I could see why you wouldn't want one then.

Monday, June 6, 2011

Well, that is something

One of the dudes I work with is the kind of person no one messes with- he's a big tall guy, but he's also one of those people who exudes a vibe of absolute zero bullshit. As a result, he ends up at the triage desk a lot just because he really helps keep the foolishness in the waiting room to a minimum.
This usually works for mere mortals, but it still doesn't deter some of our regulars- so I'm sitting up in the booth while he's at the desk on a particularly busy night when this chick with vague back pain and allergies to every non narcotic in existence comes up to the desk for about the 15th time demanding a room and meds.
He explains to her again that we do not hand out narcotics in the waiting room and that no rooms were available, so her 5th visit this month might take a little longer. She huffs and puffs, rolls her eyes and says, "Can't you GIVE ME SOMETHING!?!" He then opens a drawer at the desk, digs around, pulls out an emesis bag and hands it to her with a totally straight face.
She didn't come back up to the desk after that.

Saturday, June 4, 2011

How is it

..that I can day in, day out, deal with vomit containing identifiable food chunks, bloody trach suction shooting onto my chest, bodies dripping various fluids, and feces coming out of places it shouldn't without batting an eye, yet when it comes to taking out a bag of trash that I know contains a large dead rodent, I can't get from my backyard to my curb without retching and screaming like a little girl?
Seriously. Rats. What is wrong with me?