Take a Tour of My House.....

Every year, nurses working in emergency departments around the universe morph into an attitude of mixed emotions. Some are happy, some are sad, some are hilarious, but most are just plain tired, crabby and burned out. Don't believe me? Walk around with me for just a few minutes, and you will have your eyes wide shut!

Back in the corner, or the "psych ward" as we like to call it, is a small hallway with six rooms. These rooms are the farthest away from any exit door, and the farthest bunch away from the triage desk. (You have no idea how important that part is!)The lighting is the same as the rest of the department, but somehow it seems darker back there. This is where the drug overdoses, alcohol intoxications, suicides and the majority of the medically stable mental patients are assigned - and that's just the nurses. (Ok, that part may be a stretch.) The nurses who work in the ward are ones who are always there. They like it. I think they thrive on other peoples demise to make their own life seem less dramatic. Regardless, the patients and the nurses both consider themselves regulars. The holidays prove to be the busiest time for the ward. People trying to off themselves every hour of every day, caught just in time to be drug kicking and screaming into our house - who do they think they are? Nurses are inclined to take active control of the situation with efficient ease and absolutely no conscience whatsoever. Everything can be controlled with a little duck tape and a few chemicals.

Moving to the north of the department, we have the "ICU". This is the part of the department nurses loathe. When we come into the beginning of the shift, we cringe while reading the assignment for these three rooms. They are located near the ambulance bay, and typically receive the most critical patients. Unfortunately, non-critical patients that get triaged to an ICU room, typically become critical for no reason at all. It's probably the ignorance of the healthcare worker. It's typical that the stupidest and least experienced nurses get assigned to the most critical rooms. Yeah, they taught that in charge nurse school.

Moving on around the corner, we have the orthopedic rooms. Anyone who wasn't paying attention while playing a contact sport ends up here. So obviously, lack of intelligence has become a theme for patients and staff! You will see there are broken bones, a little blood and lots of pain medication. That's the cool part. If you have ever seen anyone on narcotics for the first time you would understand. It's hilaroius.

Most of the time, at any given time of the day, there will always be a nurse or three and a few techs hovering around the "trough". This is a tiny, tiny room where all of the food is kept. There is a small table and two plastic lawn chairs, a small college sized refrigerator with an equally small microwave on top, and a set of cupboards. Just enough room to fit one whole body of proportioned size. (Which typically menas one half of a whole nurse over forty. They are big.) Hanging on the walls are three large poster boards filled with miscellaneous papers; managements attempts to educate the staff.

Down the hall and the the left you will see the chest pain/stroke rooms. If you are slobbering out of one side of your mouth and have a glazed look in your eye, this is the place to be. Have you ever seen a santa with chest pain? It will crack you up every time. Nurses sittin gon the side of the bed with their Christmas lists. Yeah, we get busy.

And finally, the last four rooms are hte worst. These rooms are equipped with all of the gyecological equipment known to man. You will find the wierdest looking cold metal objects in these rooms, and probably a male doctor or two happily holding their toys, waiting for the next victim. However, if you can imagine diving through a five hundred pound woman who hasn't taken a shower in a few weeks, complaining of a maloderous discharge and abdominal pain, the doctors may not be so happy. That's what nurses are for. We get all of the equipment ready and leave. After all, the doc is the one who is paid the big bucks, right? If they get to play with the pretty ones, they have to play with not so pretty ones as well.

So there you have it! A tour of my house. Come in a play some time. Just make sure you have a true emergency. Something like a limb torn off or an artery cut. Otherwise we are likely to kick you right back out.






Happy New Year!

Resource...Resource...Resource

It never ceases to amaze me that some of the stupidest people on earth are some of the most resourceful.  A drug addict may be so high that he can't speak, but he can sniff a cop a mile away and figure out how to get away from him.  A thirteen year old pregnant girl can't spell her address, but she can forge her mom's signature perfectly to have that baby without getting caught.

This particular night was...amusing.

It was Christmas, and the wind howled through the ER doors every time they opened.  Those of us who were approaching middle age and having hot flashes were thankful for the gust of wind and tiny snowflakes bursting through the door with EMS and a stretcher.  Hell, we'd flip a coin to get patients on slow snowy nights like this just to stand by the door and cool off!

The squak box hurled a 30 something male with multiple generalized complaints and more stable vital signs than most of us working that night into room 3.  The primary complaint was his tongue.  As he so eloquently stated, "My tongue hurts when I smoke."

Ok.  Most people would say, "Don't smoke."  But nope.  Not Dr. J.  he was the most unconcsiously thorough doctor I'd ever had the displeasure of working with.  Not only did everyone who was blessed with his presence get a Cat Scan, but a full work up was in order, just in case there was drama to be found.  On this night, there was drama.

The man with a sore tongue had three daughters at home, all under the age of seven.  Baby mama was somewhere in the house, and according to EMS, she was a little "anxious" when they took her husband to the emergency room.  Yet she had no information about his complaint except that it had been going on for three days now and she was sick of listening to him bitch.  What a concept.

Now, understand that most patients under the age of forty and in absence of a car accident or unfortunate injury, just need a therapist.  So they come looking to our department to find one at two o'clock in the morning.  This guy not only needed a therapist, but I would assume some heavy duty brainwashing medication as well.  However, he did have a goal.

While he was waiting the typical five hours to get tested for anything and everything Dr. J could possibly find wrong with him, the patient decided to rifle through the drawers in his room.  It was interesting that each time the nurse checked on him he had his hands full of stuff.  Most nurses don't care enough to look and see what's in a patients hand.  As long as it isn't sharp or bloody it's really of no huge interest.

But this guy was good.  Upon discharge, he requested a cab pass to catch a ride home.  Yeah, some emergency departments actually pay to get their fellow patients back home when there's no true emergency.  It's part of our guilt for saving their life.  As he was walking out, something fell out of his pocket.  A trail of little packets of KY jelly followed him from the front door to the cab.  

When the nurses returned to clean the room, and check the drawers, and all of the things they are supposed to do (although that rarely happens until the next shift), they realized that all the drawers were empty - free of all KY, tongue blades, oversized Q-tips, and oxygen tubing.

Ok, so he went shopping right?  Come to find out, that was absolutely the truth.  

Baby mama came in (via ambulance, of course) three hours later with oxygen tubing tied around her wrists, oversized Q-tips stuck (and I mean STUCK) up her hoo-ha, and one lonely tongue blade carved to a point and stuck through the lips of her ying-yang.  Apparently there wasn't enough KY to finish whatever they had started.

So the story was that they didn't have enough money left over (from buying the kids presents) to get each other anything.  They decided to have an "adult" night, and found that the excitement just wasn't there.  Baby mama stated, "My boyfriend said he knew of a place he could get some sex toys..."

Who can make this shit up?!?!?

A Little Salt and Peppa

One thing about emergency room nursing is the ungodly timing of patients and their problems. At the end of an unruly, incredibly busy day however, there seems to consistently be that one patient that makes all the hassle worth it. This is the story of Sam, the queen of spice:

It's barely seven p.m. and the new shift is sauntering through the department, in no great hurry to be awarded their room assignments for the night. Tara glances up at the clock over the top of her new glasses, crinkles her nose, and swears the second hand has been holding out on her, refusing to tick past the number seven. She scrambles to get the piles of paperwork together for the night shift when the charges nurse comes screeching around the corner, red faced and a crooked smile. "Tara, I really need you to see this guy in room 17. He is doubled over and in so much pain!" That's one thing about charge nurses. They must have taken a class in charge nurse school that disallowed them from recognizing "shift change".

Tara looked at her peer with fired up darts and stated very matter of factly, "Fine." What harm could there possibly be? It's not like she was going to have to do anything to the guy anyway. Her day was almost over, and frankly she couldn't have cared less if the guy was having a baby, she wanted to get out of that forsaken dungeon of an emergency department. However, room 17 was the cursed room of the day. If the patient only knew what he was getting himself into! Three people tried to die there today, none successful. Regardless, she took the triage papers from the charge nurse, and decided to at least do an assessment.

Peering around the corner to the cursed room, Tara almost felt compassion. An old man, in tattered clothes and scruffy hair was sitting on the edge of the bed, hunched over, with tears in his eyes. He looked up at the worn out nurse and the words started pouring like an unattended faucet. He raged on and on about how he was drugged four days ago...and he didn't have a place to sleep that night...and it was cold outside...and something was planted in his belly that was killing him.

"Great" Tara pondered, "another homeless guy that's cold and wants to snuggle."

Sometimes - no, most of the time - ER nursing uses the sixth sense. That's why we're great to have around in arguments. We have been trained to weed through all the crap to get to the ten-words-or-less-complaint. Sometimes the actual complaint is not stated with absolute clarity. Sometimes we have to pick up on phrases like "somethings been planted in my belly and it hurts" to start the decoding process of the actual problem. This is one of those times.

A typical assessment starts with just looking at the person in question. As Tara was flinging the hospital gown at the man who was demanding her full attention, and explaining how he needed to give up all of his clothes to wear only this one flimsy little garment, she noticed that every time he moved, a small wimper escaped his throat, followed by a deep breath. "What exactly hurts, sir?"

"My belly. It hurts all around here." He was holding each butt cheek with a hand and bending over the bed.

"That isn't your belly, Sam. It's your butt."

" I know, I know. But it hurts way up in my belly. I'm telling you somehting was planted in my belly! This is the only way I can move, if I'm holding my cheeks."

Now this is a point where the nurse who is soon hoping to go home makes the decision whether or not it's worth it to stay and enjoy the show. That night Tara decided to stay. What's wrong with getting paid overtime for a little action?

The xray of two christmas shaped salt and pepper shakers strategically placed in Sam's rectum told a much different story than said "abduction". Sam went to surgery and who knows where he landed after that.

Tara drug her tired body home, three hours later, and chuckled as she fell into a deep, tired sleep.

Has it Really Been Four Years??

I just found this blog that was created so very long ago. I didn't know it still existed - AND I didn't know the other blogs I created still existed. Incredible. So much has happened in four years. I believe at that time I was traveling a bit much for my family life, and working in the ER in my spare time. The result was a nasty, nasty divorce and a brand new wonderful life - although the cynisim remains the same.

I have returned to clinical practice full time for the past two years, so I have many, many stories to tell. Insomnia will be my guide and my assistant through this process, since I write much better when I'm sleep deprived and using memory recall at 3 am.

I could tell you about the dude who swore his dick was going to fall off from an ingrown hair, or the other dude who rolled in face down strapped to a backboard, declaring his innocence and convincing even me he was Jesus. But...for now I think I will wait. Are you even interested?

Now that I have found the flame to my once uninhibited passion of writing, I ask you, do you want to read?