Puppies and rainbows

Well, what can I say? I feel like I'm living in the twilight zone right now. After weeks and weeks of a-raping, we have now been clearing out our waiting room and lately even I, the queen of crazy douchebags, have been caring for nice patients. For real! Plus, my husband and I went to the shelter and adopted us an adorable dog that looks like a tiny lamb, so overall I am in a freakishly good mood.

I took care of a super sweet lady last night with a broken hip who actually thanked me for putting in a foley! Yeah. It was actually kind of sad since the fools on dayshift apparently hadn't been asking about the 3 P's or 5P's or whatever they are for the 4 hours they were taking care of her, so by the time I asked her what she wanted to do about the whole peeing with a broken hip issue, she was about to go on herself, but she was too polite to say anything. Poor lady. So I put in a catheter and actually talked to her about what the hell was going on and all of a sudden I was Florence Nightingale to these people. Before I took her upstairs, her son actually said to me, "You're a wonderful nurse. Thank you so much for taking such good care of my mom." Seriously. Just for doing my job. If all my patients were that way, I would do this job for free.

That's just how it's been lately. Both of my ICU patients last night gave me hugs as I dropped them off at their beds. One was actually my first experience with TPA, and it is pretty awesome. We got her within 2 hours of onset 0f symptoms and you could see the changes! She came in with slurred speech and right side weakness- by the time she went up to the ICU, her speech was clear and her right arm was at full strength. I was so excited I was actually jumping around her room at one point. I'm sure her family was all, "get this one some Ativan please", but I was crazy excited. I've never seen anything so cool. Just overall, very cool people for a couple of days. Even the floor and ICU nurses have been nice! I don't even think I'd be shocked if a little pack of cartoon birds and chipmunks and shit started following me into my rooms and helping me insert NG tubes and clean poop like I was Cinderella or something.

Yeah, I know that because of all this, when I go back to work triage tonight probably all of our frequent fliers will come in via vanpool and fake syncopal episodes or seizures in the waiting room. I'll probably get cussed out by 10 different girls for not taking them back to a room immediately for their pregnancy tests and coochie rashes, and their two-fer babies with 98.9 degree fevers and runny noses will probably vomit on me. I'll probably triage 8 to 9 combative drunk men with complaints that have been going on a year or longer, and I probably won't get to go pee until 3 AM and I'll go home to find my new dog has pissed all over my belongings without remorse, but you know what? It's worth it. If I get one day of awesome patients and 364 days or the other stupid bullshit, it's still worth it to me. I'm happy, damn it.

Totally badass

So, I think one of my weaknesses at this job is going along with the fuss a lot of people make about their medical conditions. A good deal of the people I see are being treated for problems I've had before- sprains, breaks, gastroenteritis and nasty upper respiratory infections- mostly at home with zero drama. When I have to deliver morphine for something that turns out to be a stomach bug or send someone home with Hydrocodone, but apparently not enough, for a sprained ankle, I kind of want to punch something. Bitch, please. Suck it up.
But lately. Wow. I've taken care of a couple of people so tough and badass that all I could do is sit back in admiration.
We had the adorable young stabbing victim. He was on the way to the bar when a guy flagged him down in the road. He said he normally wouldn't have stopped but that the guy had his kids with him and he wanted to help. He picked the man up to bring him somewhere for help, and the man stabbed him in the stomach and ran off. This guy drove himself home about 10 or 15 miles, where his sister then brought him up to the hospital. He probably had a good 4 inches of intestine sticking out of his abdominal wall. He didn't scream or cry. He strolled in casually where we brought him back to a trauma room- the only fuss he made at all was when I had to start his two 16 gauge IVs- and by made a fuss, I let him squeeze one hand while I started the IV with the other and he looked away. He never once asked for narcotics, but he did want to know what kind of antibiotics he was getting. He was a little nervous about getting transferred for surgery. He looked at me and said "Can't you just push it back in there?". I laughed and told him that he probably wouldn't want it done that way. He smiled and said,"No, it's cool. Just dump some of that hand sanitizer you guys use on there. It'll be fine." Hilarious. I was sad to see him go.
I took care of an older man recently who had fallen off his roof at about 6 that night. Not doing anything stupid like lots of our patients, just trying to clean the gutters. He fell about 10 feet but he stuck it out at home and tried to take some Aleve. He came it at 1 AM cause the pain got worse. I was pretty freaked out that he had broken something important or had a traumatic injury to an organ, yet he was incredibly patient about waiting to see a doctor and very sweet and funny. I got him some Fentanyl and we x-ray and CT'd just about everything- nothing life threatening going on, but homeboy had broken off a chunk of his scapula. Yeah. It was just floating around in there while he was chilling at the house with his OTC pain meds.
Then last week. I took care of a lady with a Hemoglobin at about half of what it should be. I asked her if she'd be feeling dizzy or weak. Yeah. For a while now. But she was trying to get in a clinic. She didn't want to come to the ER and bother anyone. Was a little freaked out about getting transfused. No, it's fine. I'm really okay as long as I'm lying down. It's been like this three weeks and the only time I wanted to pass out was going up some stairs. I talked her into the transfusion and finally got her upstairs to a bed. She'd been a hold in the ER most of the night with zero complaints.

I realize it's a little extreme. But I love patients like this. There's something very refreshing about taking care of people that actually belong in the ER, but it's even more refreshing when you can tell that they don't even think of treating the ER like a Starbucks. I wish there was some kind of medal of honor I could give them so that they could go out in the community and be like, "Yeah guys, look at this. I had a legit painful illness but I handled it like it was nothing. I'm a badass, fear me." At least I get to give them IV pain meds. I guess that's the next best thing.

Beautiful, terrible

Last weekend, as things were finally starting to get together, a middle aged lady checks in. She's been having some neck pain for some time now, and just can't seem to shake it. She's been going to her primary care doctor, but nothing has seemed to help. The doctor orders a couple of tests and some pain meds. Pretty routine ER stuff.

Then the call comes from the radiologist. They found a tumor- a massive one- on the lady's brain stem. Pretty grim diagnosis. Everyone kind of freaks, the charge nurse and the doctor are calling around to try to get the lady into a hospital that has a neuro ICU. The doctor goes in and delivers the news. We expect disbelief. Tears. Hysteria.

Everyone is a little dumbfounded when this isn't her reaction. She smiles, and says "It's alright! I'm just glad I know what the problem is. I've got the Lord in my life. I know I'm gonna be okay." We get the transfer in order, and she leaves peacefully, waving and thanking the staff.

Wow. That's real faith. A lot of us say we believe in God, but to believe in him enough to face a death sentence out of nowhere and still be completely unshaken? To leave for the neuro ICU via ambulance with a smile on your face? I'm certainly not there.
I've talked about this a little before- being here really shows you what people are capable of. And not usually in a good way. Usually I see the selfishness and cruelty people are capable of. The stupidity and ignorance and the most disgusting kinds of manipulation. I wish I could adequately describe what it feels like when through all that, you see the best of what people are capable of. It's almost like a punch in the stomach. It absolutely takes your breath away. I'm still crying thinking about this woman. I usually feel pretty good about myself compared to all the awful people. But putting myself next to someone with a heart this pure, it's pretty humbling. It's a pretty good reminder that I'm not so great, and I have a lot of growing to do before I can be anywhere near as awesome as some of the patients I take care of.