Oh man, oh man. A while back I wrote about one of the worst patients I've ever had- a verbally abusive patient in "sickle cell crisis" who it turned out, only had the sickle cell trait.
Well, fate was kind to me, because recently he came back. I was working in a different part of the ER at the time, but I happened to go to lunch at the same time as the nurse and doctor taking care of this little a-hole. They brought up his name, and my heart skipped a beat. I made sure to mention his slight exaggeration about his health condition, and about his nasty little habit of lying about having a ride, and gave them a quick overview of his behavior during his visit with me.
Sure enough, the nurse called his mom about whether she was actually driving him home, to which she apparently responded, "Hell no! He knows I don't have any money to put gas in the car!"
Hmm. Guess who got sent home with a Toradol shot? Dilaudid breakfast combo canceled.
There you go. Be nice to your nurse, ladies and gentlemen, if for no other reason than karma is a bitch.
Monday, April 19, 2010
Tuesday, April 13, 2010
adjectives aren't gonna save you
First look nurse is officially the job from hell. You sit at the check in desk, ask people about their complaints, and ideally, see who needs to go straight back to a room immediately. Usually, though, its just sitting at a desk while the same three idiots walk up every five minutes to tell you one more reason why they really need to go back to a room STAT for their headache or abdominal pain.
At least I have the comfort of the check in form- the little piece of paper where they put in their demographic information, name and chief complaint. The things people come up with to write in the chief complaint section are hilarious. Not just because of the terrible level of literacy among our patients ("can't breath good" is a pretty common one) but the qualifying adjectives are a riot. You can tell they were well thought out- yesterday we had a lady check her daughter in because her eyes were still a little swollen after half a course of steroids. Her complaint on the form- SEVERE allergies. Severe you guys. This might require a trauma room. It's as if the patients here think that if they come up with a good enough adjective, that they won't have to sit in the waiting room with all these people. It was the same shit all night, too- the people with serious illness kept it pretty simple- but you have no idea how many forms I saw with "serious rash", "severe cough", or "abdominal pain that feels like an explosion". Listen. Just because you check in for "terrible, horrible, no good, very bad STD", doesn't mean you get to skip the 7 hour wait. It sure is entertaining when you try, though.
At least I have the comfort of the check in form- the little piece of paper where they put in their demographic information, name and chief complaint. The things people come up with to write in the chief complaint section are hilarious. Not just because of the terrible level of literacy among our patients ("can't breath good" is a pretty common one) but the qualifying adjectives are a riot. You can tell they were well thought out- yesterday we had a lady check her daughter in because her eyes were still a little swollen after half a course of steroids. Her complaint on the form- SEVERE allergies. Severe you guys. This might require a trauma room. It's as if the patients here think that if they come up with a good enough adjective, that they won't have to sit in the waiting room with all these people. It was the same shit all night, too- the people with serious illness kept it pretty simple- but you have no idea how many forms I saw with "serious rash", "severe cough", or "abdominal pain that feels like an explosion". Listen. Just because you check in for "terrible, horrible, no good, very bad STD", doesn't mean you get to skip the 7 hour wait. It sure is entertaining when you try, though.
Monday, April 5, 2010
Hateful
Wow. Well, I've been kind of a slacker at updating, but I have my reasons- I kind of worry that all of this comes across as a giant bitch fest half the time.
So I'd like to take this opportunity to clarify- I'm not a completely hateful person. I don't, in fact, despise all of my patients- actually, I really, really like most of them. It's just a lot funnier to tell about the ones that call me a hoe and expect me to bring them a cheese sampler than it is to tell you about the ones that tell me how I'm kind and beautiful and how I should get a raise.
It's hard to think of those people sometimes. Especially when you start your shift like I did last week. I'm going to create a mental picture here. I've been at work 5 minutes. I go in to see the first patient of the day, who is a woman in her 40's with a mild pneumonia who is about to be discharged. I walk in with her papers to find her sitting in bed with an emesis bag in her lap as she leans over the bed rail and spits mucus on to the floor, all over the monitoring cables. She greets me by silently pointing to the mucus on the floor. When that fails to impress me, she proceeds to complain to me about how she hadn't eaten a thing all day and that she had asked for some iced tea and some bread 2 HOURS AGO. Now 10 minutes into my shift, I had already reached my bullshit capacity, and my response to her was, "Ma'am. If your cough is so terrible that you can't control yourself enough not to spit all over the floor, I don't think it's a good idea for you to eat anything right now. I'm gonna get you one more breathing treatment, and then you can go home and eat your food there. Thanks."
Crap like that can ruin a shift so fast.
That being said, I've had some of the most wonderful people under my care lately. I took care of a woman who kept converting in and out of A fib- she was sick enough to warrant a trauma room yet she complained about absolutely nothing. Instead, she and her husband spent the night telling me about their kids and grand kids. They hugged me goodbye when they went up to the floor. They told me to make sure to tell me parents how proud they should be that I was such a good nurse at such a young age, and asked for my address so they could send me a thank you card.
That same day, I took care of a young guy with a massive throat laceration from a chain breaking loose from his chainsaw. He probably came within centimeters or less of severing his jugular, yet he spent most of the evening joking around with me and the doctor about how he wanted her to put some stitches on the other side so he could get a face lift. I was tempted to leave work and take him and his wife for a beer.
I hope it's clear that I take care of mostly people who aren't incredibly notable but are still remarkably patient, gracious and funny despite our average 6 hour waits. It's just so easy to take them for granted when the argumentative whiners, the "how much longer"s, the drug seekers and the ones working for performance of the year seem to take up 95% of my time.
It sucks, since it's unfair for the patients who act right- especially since most of them are actually sicker. I feel like I'm aware of this, too, and it makes me all the more pissed off at the patients who waste my time by treating my like their personal waitress.
So, I'm trying to work on this. A lot. I think if I spend more time thinking about the sweet patients than the awful ones, then I'll generally be a happier person. And the true challenge- if I learn to set better limits with the a-holes (something I still really suck at doing, because I still want all my patients to love me), I think I'll spend less time banging my head against the wall as soon as I leave the room and more time getting stuff done. I just have difficulting knowing how to stand up for myself when someone is being disrespectful but not outright swearing at me. Someone needs to teach a class on that- "Overcoming condescending tones and general douchebaggery for first year nurses". Now that's a CE I would pay money for.
So I'd like to take this opportunity to clarify- I'm not a completely hateful person. I don't, in fact, despise all of my patients- actually, I really, really like most of them. It's just a lot funnier to tell about the ones that call me a hoe and expect me to bring them a cheese sampler than it is to tell you about the ones that tell me how I'm kind and beautiful and how I should get a raise.
It's hard to think of those people sometimes. Especially when you start your shift like I did last week. I'm going to create a mental picture here. I've been at work 5 minutes. I go in to see the first patient of the day, who is a woman in her 40's with a mild pneumonia who is about to be discharged. I walk in with her papers to find her sitting in bed with an emesis bag in her lap as she leans over the bed rail and spits mucus on to the floor, all over the monitoring cables. She greets me by silently pointing to the mucus on the floor. When that fails to impress me, she proceeds to complain to me about how she hadn't eaten a thing all day and that she had asked for some iced tea and some bread 2 HOURS AGO. Now 10 minutes into my shift, I had already reached my bullshit capacity, and my response to her was, "Ma'am. If your cough is so terrible that you can't control yourself enough not to spit all over the floor, I don't think it's a good idea for you to eat anything right now. I'm gonna get you one more breathing treatment, and then you can go home and eat your food there. Thanks."
Crap like that can ruin a shift so fast.
That being said, I've had some of the most wonderful people under my care lately. I took care of a woman who kept converting in and out of A fib- she was sick enough to warrant a trauma room yet she complained about absolutely nothing. Instead, she and her husband spent the night telling me about their kids and grand kids. They hugged me goodbye when they went up to the floor. They told me to make sure to tell me parents how proud they should be that I was such a good nurse at such a young age, and asked for my address so they could send me a thank you card.
That same day, I took care of a young guy with a massive throat laceration from a chain breaking loose from his chainsaw. He probably came within centimeters or less of severing his jugular, yet he spent most of the evening joking around with me and the doctor about how he wanted her to put some stitches on the other side so he could get a face lift. I was tempted to leave work and take him and his wife for a beer.
I hope it's clear that I take care of mostly people who aren't incredibly notable but are still remarkably patient, gracious and funny despite our average 6 hour waits. It's just so easy to take them for granted when the argumentative whiners, the "how much longer"s, the drug seekers and the ones working for performance of the year seem to take up 95% of my time.
It sucks, since it's unfair for the patients who act right- especially since most of them are actually sicker. I feel like I'm aware of this, too, and it makes me all the more pissed off at the patients who waste my time by treating my like their personal waitress.
So, I'm trying to work on this. A lot. I think if I spend more time thinking about the sweet patients than the awful ones, then I'll generally be a happier person. And the true challenge- if I learn to set better limits with the a-holes (something I still really suck at doing, because I still want all my patients to love me), I think I'll spend less time banging my head against the wall as soon as I leave the room and more time getting stuff done. I just have difficulting knowing how to stand up for myself when someone is being disrespectful but not outright swearing at me. Someone needs to teach a class on that- "Overcoming condescending tones and general douchebaggery for first year nurses". Now that's a CE I would pay money for.
Wednesday, March 24, 2010
Original, at least
One of the better conversations I've overheard in a while-
Doctor: Sir, have you been doing drugs tonight?
Patient: Well, yeah. I was at my family reunion.
Oh, okay. As long as your family was there, I guess.
Doctor: Sir, have you been doing drugs tonight?
Patient: Well, yeah. I was at my family reunion.
Oh, okay. As long as your family was there, I guess.
Friday, March 19, 2010
Well, hell.
I guess I'm gonna have to start monitoring my comments. There has been a disturbing trend on blogger lately where people whose names are in Japanese characters leave me vague comments along the lines of "Confucious say man who stand on toilet is high on pot......", except the "......" parts are all individual links to some kind of lipstick lesbian Asian girls porn site.
Great. Listen, trolls. NO ONE READS THIS. Except like, my family and a couple of other awesome people who happen to be amused by medical stories told using lots of swear words and hillbilly ghetto slang. Put that shit on Perez Hilton or some other blog people actually comment on. It may get taken down, but at least people will see it before it does. If you're gonna post that crap on my blog you might as well just go outside and hand out some fliers to the animals in the fucking woods, because it will get you about as much traffic as my blog will.
Reporting this stuff is pretty much impossible, with as vague as all the policy violations are when you try to do it. So, I have a suggestion for you, Blogger. As everyone should know by now, everything on the internet is about pornography. I think we should all adjust our expectations accordingly and put a big red button on top of every Blogger profile that says THIS BLOG IS A FRONT FOR PORNOGRAPHY.
Ahem. I accept check or money order, Blogger. Your move.
Great. Listen, trolls. NO ONE READS THIS. Except like, my family and a couple of other awesome people who happen to be amused by medical stories told using lots of swear words and hillbilly ghetto slang. Put that shit on Perez Hilton or some other blog people actually comment on. It may get taken down, but at least people will see it before it does. If you're gonna post that crap on my blog you might as well just go outside and hand out some fliers to the animals in the fucking woods, because it will get you about as much traffic as my blog will.
Reporting this stuff is pretty much impossible, with as vague as all the policy violations are when you try to do it. So, I have a suggestion for you, Blogger. As everyone should know by now, everything on the internet is about pornography. I think we should all adjust our expectations accordingly and put a big red button on top of every Blogger profile that says THIS BLOG IS A FRONT FOR PORNOGRAPHY.
Ahem. I accept check or money order, Blogger. Your move.
Thursday, March 18, 2010
Stupid and ANGRY
Shit that has actually been said to me this week alone:
My baby has a virus, and you guys didn't even give him any antibiotics. I can't believe I waited 9 hours and brough him back twice in one day for you to tell me to give my baby Tylenol. I did that like, 6 hours before I brought him up here. His fever came back. That other doctor told me about that Pedialyte. Give me one of those to go.
That Norco you gave me didn't do anything! What is this? No. I want some more Norco. I am not taking a shot of Tramadol. Whatever. I know Tramadol and Toradol are the same thing. My Grandma was on that. What do you mean you're gonna give me a shot in the shoulder? I've never heard of that! The Tetanus shot goes in your shoulder? Uh, no. The Tetanus shot goes in here (pointing to forearm). That's the one that makes the bubble. TB test? Whatever. Same thing. No. I'm not gonna take that. No. I'm refusing it. Ugh. You guys aren't doing shit for my pain.
Yeah. Tell that doctor I'm gonna report her. For what? I've been sitting here and my blood pressure has been fluctuating and no one has been monitoring it.(Has been on cardiac monitor that entire time and has has BPs between 160/80 and 140/70). Whatever. That's bullshit. I don't think you guys think I know anything. That shit affects your kidneys. I know that. You don't treat blood pressure like that in the ER? That's bullshit. You guys haven't done shit for me. (Got a full chest pain workup and 4 hour repeat of cardiac labs). You guys just kept me here to keep me here. I don't even think you did a test on that blood. That shit is racist. I think you just kept that blood in case you need it. Whatever. Just take this IV out. I WILL BE REPORTING YOU.
I'm gonna quit nursing and create an accrediation based on browsing WebMD, half watching Discovery Health and word of mouth from your ex girlfriend who used to be a CNA for 6 months. That way, all these people can all get their licenses- I'm think a doctorate of douchebaggery with a concentration in medicine, and they can all treat each other in whatever way they seem to think is appropriate. Then they can all GTFO of my ER. Now please.
My baby has a virus, and you guys didn't even give him any antibiotics. I can't believe I waited 9 hours and brough him back twice in one day for you to tell me to give my baby Tylenol. I did that like, 6 hours before I brought him up here. His fever came back. That other doctor told me about that Pedialyte. Give me one of those to go.
That Norco you gave me didn't do anything! What is this? No. I want some more Norco. I am not taking a shot of Tramadol. Whatever. I know Tramadol and Toradol are the same thing. My Grandma was on that. What do you mean you're gonna give me a shot in the shoulder? I've never heard of that! The Tetanus shot goes in your shoulder? Uh, no. The Tetanus shot goes in here (pointing to forearm). That's the one that makes the bubble. TB test? Whatever. Same thing. No. I'm not gonna take that. No. I'm refusing it. Ugh. You guys aren't doing shit for my pain.
Yeah. Tell that doctor I'm gonna report her. For what? I've been sitting here and my blood pressure has been fluctuating and no one has been monitoring it.(Has been on cardiac monitor that entire time and has has BPs between 160/80 and 140/70). Whatever. That's bullshit. I don't think you guys think I know anything. That shit affects your kidneys. I know that. You don't treat blood pressure like that in the ER? That's bullshit. You guys haven't done shit for me. (Got a full chest pain workup and 4 hour repeat of cardiac labs). You guys just kept me here to keep me here. I don't even think you did a test on that blood. That shit is racist. I think you just kept that blood in case you need it. Whatever. Just take this IV out. I WILL BE REPORTING YOU.
I'm gonna quit nursing and create an accrediation based on browsing WebMD, half watching Discovery Health and word of mouth from your ex girlfriend who used to be a CNA for 6 months. That way, all these people can all get their licenses- I'm think a doctorate of douchebaggery with a concentration in medicine, and they can all treat each other in whatever way they seem to think is appropriate. Then they can all GTFO of my ER. Now please.
Wednesday, March 10, 2010
An open letter to nursing home "nurses"
Dear nurses?/clowns?/hobos someone is paying to take care of sick elderly people?:
Please stop. Seriously. Stop sending stupid stupid shit to the ER ALL THE TIME. Even as I say this, I know it is absolutely too much to ask for you to stop sending over patients for lab values that were drawn two weeks ago that are abnormal, but have been treated already, instead of just calling the doctor. I know it's really a lot to ask for you to take a second blood pressure before sending a patient over for hypotension, so that we don't get them here and waste our time working up a patient with a pressure of 120/80. I know that's really a little too much to expect.
I won't even ask this of you. But please advise, just for next time-
If EMTs show up to your "CPR in progress" and the patient is looking at you and looking around the room while you do compressions, they probably always had a pulse. You just didn't feel the pulse because you are terrible at being a nurse and you should stop forever.
A "little grandma seizure" is not a thing. A Grand Mal seizure is a thing, but they don't come in little size. Only grand. Like grande. Or large.
If you walk into a room to find your patient cold, pulseless, and in rigor mortis, they have been dead for some time. Please don't call an ambulance. Call the funeral home. Quit doing compressions. You're just beating up a corpse.
Nausea is not a reason to stop all medicines. Especially when said medicines are for seizures or diabetes.
Also, guys. I'm really sorry to keep I keep interupting you at night. I know you're very busy sleeping or watching Cheaters, and that you just got here and you don't know anything about this patient, but sometimes I just have to call and check just to make sure you're serious. I know I shouldn't really be surprised by anything at this point, but you guys always manage to out do yourselves.
Congrats on that,
xoxo, Hood Nurse
Please stop. Seriously. Stop sending stupid stupid shit to the ER ALL THE TIME. Even as I say this, I know it is absolutely too much to ask for you to stop sending over patients for lab values that were drawn two weeks ago that are abnormal, but have been treated already, instead of just calling the doctor. I know it's really a lot to ask for you to take a second blood pressure before sending a patient over for hypotension, so that we don't get them here and waste our time working up a patient with a pressure of 120/80. I know that's really a little too much to expect.
I won't even ask this of you. But please advise, just for next time-
If EMTs show up to your "CPR in progress" and the patient is looking at you and looking around the room while you do compressions, they probably always had a pulse. You just didn't feel the pulse because you are terrible at being a nurse and you should stop forever.
A "little grandma seizure" is not a thing. A Grand Mal seizure is a thing, but they don't come in little size. Only grand. Like grande. Or large.
If you walk into a room to find your patient cold, pulseless, and in rigor mortis, they have been dead for some time. Please don't call an ambulance. Call the funeral home. Quit doing compressions. You're just beating up a corpse.
Nausea is not a reason to stop all medicines. Especially when said medicines are for seizures or diabetes.
Also, guys. I'm really sorry to keep I keep interupting you at night. I know you're very busy sleeping or watching Cheaters, and that you just got here and you don't know anything about this patient, but sometimes I just have to call and check just to make sure you're serious. I know I shouldn't really be surprised by anything at this point, but you guys always manage to out do yourselves.
Congrats on that,
xoxo, Hood Nurse
Subscribe to:
Posts (Atom)