After an almost one year hiatus, I am back to bloggin'. Some of you know why I had to make my blog private for a while.. it seems as though the dust has cleared so I am peeking my head out from underneath my proverbial rock.
I am oddly comforted by looking at my day planner with all those perfect little folders and calendars filled with multi colored inks and highlighting.
Let's see, what's new.. still taking classes, started a new job with my hospital in which I split my time with bedside care and IT. I joined 4 committees and I am chairing one. I am enjoying my role in making a difference for my patients and colleagues and I definitely feel like I am growing cognitively and professionally.
I'm tired.
The kids are getting bigger and more independent each day and I am astonished at how quickly the time is passing. I'm turning 40 in less than a month and I don't understand how that's possible. 40 is how old my parents are NOT ME!
I don't sleep well.
My mind races with possibilities and programs and positive impacts I can have on patients.. on entire populations, really. I think about things I learned in class, a funny thing a patient said, the proud look on my kids' faces when they do something they are happy to have accomplished.
I hate decorating my house and spending money on furniture.
I realize with an odd mix of vulnerability and pride that when my teacher says the name of a disease, faces of people who have been diagnosed with said disease immediately pop into my head and their observations about what it's like having it also come to mind. It's a blessing and a curse to be a big picture thinker when dealing with life and death because it's never as simple as giving a pill or looking at trends in labs.. it's thinking about how a newly diagnosed diabetic is at the wedding of a niece and is suddenly scared of eating cake for the first time in his life. It's someone who is dealing with pain 24/7 and getting slapped with the label of "drug seeker" and begins mistrusting healthcare workers. It's a morbidly obese woman who is so big she can't even roll from side to side on her own to get cleaned up and who feels that she's less of a person because of years of insults and people looking down on her. It's a woman with end stage cancer too weak to even stand and pivot to use a commode and who's being pumped with diuretics that are not only draining her body of excess fluids but of rest when all her tired body wants to do is sleep but she doesn't want to sit in urine-- and the family in total denial who wants to send her to rehab to regain that strength when her weakness is from end stage disease.
Sounds horribly depressing, right? The kicker? I get involved in all of this.. with all of these patients and families and I think I get to do this!
I could live off cranberry orange scones from Wegman's and Sushi from my favorite place in town. And beer and wine.
Welcome back to my world! :)
Thursday, September 5, 2013
Wednesday, November 21, 2012
Gargoyle Lady and Home Economics as a Penn State Major
Gargoyle Lady has finally reached legend status within my hospital.
After my exceptionally mean post about her, she was admitted back to my hospital on 5 additional, separate occasions. She's only in her 60s and now has used up her LIFETIME allotment of Medicare money.
She assaulted a nurse for following hospital policy by documenting her home meds (which included narcotics) and trying to send them to the pharmacy to be locked up. (per protocol)
Then things went downhill.
She was discharged to a LTC and she assaulted a caregiver THERE then claimed she was having chest pain. She asked to be sent to our hospital but her family member told he it's pretty clear that hospital doesn't want you there (basically because we had to get the police involved when she harmed one of our staff). She was heard on numerous occasions berating said family member and calling them.. um depracating names because of sexual preference and yet this family member turned around and made negative comments on a social networking site about my hospital.
Now, this patient is known to possess the power of "Beetlejuice" in that no one dares even whisper her name. She's basically referred to as "she who shall not be named". Thanks to recent events, word is, she will NOT be back. Although I find that too good to be true. Anyway I thought I would mention it because I know how mean my Gargoyle post sounded, so I thought I would present further evidence that would prove that it is not just me who is tired of dealing with her.
On a more positive note, I had a quite lovely elderly female patient over the weekend. In conversation she mentioned she went to Penn State. I asked her what she majored in and she said "Home Economics". I was very interested in this because I had never heard of Home Economics as a major course of study before. Quite honestly, I think the world might be a little better place if it were something that at least a small amount of class time is dedicated to. (especially for MALE students ;) ) Then I asked her if she taught high school home ec. with that degree.. shockingly, she said no. Turns out, she was hired by the local power company to teach women how to cook using electric...?? (that got me wondering exactly how old this lady is! haha!) She went on to explain back then houses primarily used gas for cooking. (I had no idea about this). According to her, in the 1930s electricity wasn't widely available to the general population (really?) so they used coal, wood or gas in the cities for cooking. In the 1940s and 1950s she taught home makers how to cook a 5 course meal using only electric. She said she and another woman traveled to various houses of women who purchased electric stoves as a routine service provided by the electric company. This also explains a HUGE bias against the use of gas cooking that my Dad had when he came to visit me in my first apartment. (my grandparents were in their 30s when they had him in 1945, so that would put them right in that age bracket of people who used gas or coal "back in the day" for cooking.. and electricity was considered the "rich folk" option.) Which then reminded me of the bias among the old against breastfeeding. I recall my husband's Grandmother's look of disgust when she learned I was nursing my first born (then later my second) and her saying "that's what poor people do". Very interesting how society can color your perceptions; at times doing you a disservice.
Then I had an old guy pt. who kept yelling and yelling and yelling because he didn't want to be alone. He was driving me frickin CRAZY. I had a ton of stuff to do and he kept yelling , "HHHEEEELLLP MEEEE!! Then would go in and he's all "hi." and winking and smiling and trying to touch me. Did I also mention he was extremely hard of hearing? So while I was in with him, I was talking to him loudly. He kept saying "WHAT?" and then answering questions I wasn't even asking him. Then he says, "STOP HOLLERING WHEN YOU TALK TO ME!" So I say (still loudly, but not screaming), "Okay." and he said, "WHAAAAAATTT?! I CAN'T HEAR A DAMN WORD YOU ARE SAYING!" Seriously dude?? LOL
It's a wonder I don't do shots of the hand sanitizer on tap outside every room.
After my exceptionally mean post about her, she was admitted back to my hospital on 5 additional, separate occasions. She's only in her 60s and now has used up her LIFETIME allotment of Medicare money.
She assaulted a nurse for following hospital policy by documenting her home meds (which included narcotics) and trying to send them to the pharmacy to be locked up. (per protocol)
Then things went downhill.
She was discharged to a LTC and she assaulted a caregiver THERE then claimed she was having chest pain. She asked to be sent to our hospital but her family member told he it's pretty clear that hospital doesn't want you there (basically because we had to get the police involved when she harmed one of our staff). She was heard on numerous occasions berating said family member and calling them.. um depracating names because of sexual preference and yet this family member turned around and made negative comments on a social networking site about my hospital.
Now, this patient is known to possess the power of "Beetlejuice" in that no one dares even whisper her name. She's basically referred to as "she who shall not be named". Thanks to recent events, word is, she will NOT be back. Although I find that too good to be true. Anyway I thought I would mention it because I know how mean my Gargoyle post sounded, so I thought I would present further evidence that would prove that it is not just me who is tired of dealing with her.
On a more positive note, I had a quite lovely elderly female patient over the weekend. In conversation she mentioned she went to Penn State. I asked her what she majored in and she said "Home Economics". I was very interested in this because I had never heard of Home Economics as a major course of study before. Quite honestly, I think the world might be a little better place if it were something that at least a small amount of class time is dedicated to. (especially for MALE students ;) ) Then I asked her if she taught high school home ec. with that degree.. shockingly, she said no. Turns out, she was hired by the local power company to teach women how to cook using electric...?? (that got me wondering exactly how old this lady is! haha!) She went on to explain back then houses primarily used gas for cooking. (I had no idea about this). According to her, in the 1930s electricity wasn't widely available to the general population (really?) so they used coal, wood or gas in the cities for cooking. In the 1940s and 1950s she taught home makers how to cook a 5 course meal using only electric. She said she and another woman traveled to various houses of women who purchased electric stoves as a routine service provided by the electric company. This also explains a HUGE bias against the use of gas cooking that my Dad had when he came to visit me in my first apartment. (my grandparents were in their 30s when they had him in 1945, so that would put them right in that age bracket of people who used gas or coal "back in the day" for cooking.. and electricity was considered the "rich folk" option.) Which then reminded me of the bias among the old against breastfeeding. I recall my husband's Grandmother's look of disgust when she learned I was nursing my first born (then later my second) and her saying "that's what poor people do". Very interesting how society can color your perceptions; at times doing you a disservice.
Then I had an old guy pt. who kept yelling and yelling and yelling because he didn't want to be alone. He was driving me frickin CRAZY. I had a ton of stuff to do and he kept yelling , "HHHEEEELLLP MEEEE!! Then would go in and he's all "hi." and winking and smiling and trying to touch me. Did I also mention he was extremely hard of hearing? So while I was in with him, I was talking to him loudly. He kept saying "WHAT?" and then answering questions I wasn't even asking him. Then he says, "STOP HOLLERING WHEN YOU TALK TO ME!" So I say (still loudly, but not screaming), "Okay." and he said, "WHAAAAAATTT?! I CAN'T HEAR A DAMN WORD YOU ARE SAYING!" Seriously dude?? LOL
It's a wonder I don't do shots of the hand sanitizer on tap outside every room.
Monday, November 19, 2012
I almost killed someone yesterday.
I have a paper to write for my class but I can't concentrate because I need to process yesterday's events.
30 something woman whose only medical history is asthma was admitted with a migraine that hasn't resolved for several days. She has an adorable special needs son and a husband visiting with her in her room. Neuro doc orders an IV med for her, and asks me to administer IV zofran about a half hour before administering the med. For those of you curious what med it was, its initials are D H E (I don't want this entry popping up on any search engines so I added spaces). Pharmacy at my hospital was closed for the day, had to call main campus to get med couriered over. Med finally arrives. I pre dose her with zofran. 30 minutes later, I came back to administer the med. Her family was still in the room. I hold the syringe by the IV line and push it in so the IV fluids carry it into her bloodstream. She said, "Are there any side effects to this med?" I said "the Dr. said most common is nausea so that's why I pre dosed you with zofran." she said "Okay". 5 minutes later, call light goes on from her room, I walk in. She said "I am having chest pain.. it's so bad.." she starts crying harder than I have ever seen a person cry.. it must have been excruciating. I disconnected the IV from the hub. Because she said chest pain, I immediately grabbed a nasal cannula from the supply cabinet and put her on 4L of oxygen (usually I would do 2 but because of her asthma I opted for 4). Then I heard her breathing get louder and louder and a light bulb went off like a red neon sign: ANAPHYLAXIS GET HELP NOW" I hit the emergency number and called a rapid response. I didn't hear an announcement over the system.. when the charge nurse came in, I asked her to stay with the patient. I shouted down the hall to the other RN "Please, get me 50mg IV benadryl for room XXX!!!" I RAN to the ICU and yelled is there a PA here? A doc? Anyone? I just gave a med and the pt is in anaphylaxis. An ICU nurse came over with me and she looked at me and said "It's okay.. I will help you." my hands were shaking uncontrollably. The patient's special needs son sat quietly in the corner watching Toy Story 3; seemingly oblivious to the fact that his mother was on the brink of death.. Husband white as a sheet stood in the corner by the son. ICU nurse pushed benadryl which was drawn up and ready and waiting to be given. PA said to get 20 mg solumedrol. I ran and got that, drew it up, handed it to the ICU nurse. Respiratory Shows up, puts a mask on her. Patient starts retching, vomits. I take the wash basin out of her bathroom and put it by her. She starts to cry again, vomiting subsides. PA sits right by her, watching her, and put her hands on her head and talks quietly to her. I can't hear what she is saying, but it is helping. I feel so lost, I don't know what to say. I feel like I should be the one comforting her but I can't.. I feel too guilty. The ICU opens up a bed for my patient. While the ICU personnel assemble the paperwork and the room, I stay behind. I stay in the room. I look at the husband and I say, "I am SO sorry. I had no idea that would happen.." my voice trails off..i fight back tears. He said, "I know you didn't know, it's okay and she is okay.."
I know clinically I handled everything correctly, but for some reason, that doesn't make me feel any better. I am really rattled by this and quite honestly, I feel afraid to go back to work.
30 something woman whose only medical history is asthma was admitted with a migraine that hasn't resolved for several days. She has an adorable special needs son and a husband visiting with her in her room. Neuro doc orders an IV med for her, and asks me to administer IV zofran about a half hour before administering the med. For those of you curious what med it was, its initials are D H E (I don't want this entry popping up on any search engines so I added spaces). Pharmacy at my hospital was closed for the day, had to call main campus to get med couriered over. Med finally arrives. I pre dose her with zofran. 30 minutes later, I came back to administer the med. Her family was still in the room. I hold the syringe by the IV line and push it in so the IV fluids carry it into her bloodstream. She said, "Are there any side effects to this med?" I said "the Dr. said most common is nausea so that's why I pre dosed you with zofran." she said "Okay". 5 minutes later, call light goes on from her room, I walk in. She said "I am having chest pain.. it's so bad.." she starts crying harder than I have ever seen a person cry.. it must have been excruciating. I disconnected the IV from the hub. Because she said chest pain, I immediately grabbed a nasal cannula from the supply cabinet and put her on 4L of oxygen (usually I would do 2 but because of her asthma I opted for 4). Then I heard her breathing get louder and louder and a light bulb went off like a red neon sign: ANAPHYLAXIS GET HELP NOW" I hit the emergency number and called a rapid response. I didn't hear an announcement over the system.. when the charge nurse came in, I asked her to stay with the patient. I shouted down the hall to the other RN "Please, get me 50mg IV benadryl for room XXX!!!" I RAN to the ICU and yelled is there a PA here? A doc? Anyone? I just gave a med and the pt is in anaphylaxis. An ICU nurse came over with me and she looked at me and said "It's okay.. I will help you." my hands were shaking uncontrollably. The patient's special needs son sat quietly in the corner watching Toy Story 3; seemingly oblivious to the fact that his mother was on the brink of death.. Husband white as a sheet stood in the corner by the son. ICU nurse pushed benadryl which was drawn up and ready and waiting to be given. PA said to get 20 mg solumedrol. I ran and got that, drew it up, handed it to the ICU nurse. Respiratory Shows up, puts a mask on her. Patient starts retching, vomits. I take the wash basin out of her bathroom and put it by her. She starts to cry again, vomiting subsides. PA sits right by her, watching her, and put her hands on her head and talks quietly to her. I can't hear what she is saying, but it is helping. I feel so lost, I don't know what to say. I feel like I should be the one comforting her but I can't.. I feel too guilty. The ICU opens up a bed for my patient. While the ICU personnel assemble the paperwork and the room, I stay behind. I stay in the room. I look at the husband and I say, "I am SO sorry. I had no idea that would happen.." my voice trails off..i fight back tears. He said, "I know you didn't know, it's okay and she is okay.."
I know clinically I handled everything correctly, but for some reason, that doesn't make me feel any better. I am really rattled by this and quite honestly, I feel afraid to go back to work.
Monday, October 15, 2012
School, work, gym, lather, rinse, repeat
My schedule is jacked lately. With the kids at school during the day, I have more time to get school work done, and also more time to go to the gym and do house projects, etc. etc. My nursing class requires an inordinate amount of writing so I find blogging a little less therapeutic than I once did. I also have less of a need for an emotional outlet now that I have colleagues to vent to and talk to about nursing trends, latest technologies, etc. I also FINALLY got a personal trainer and started going to the gym regularly. I have noticed a pretty marked increase in my energy level and I have been feeling much better overall, which is great because I feel like I can focus better mentally.
I really love the nurses I work with. We support one another and we laugh and have such a great time. Better still, we take such great care of our patients because we are truly a team. :) We still have issues with certain doctors, but you can't have everything. My coworkers and my patients are what makes my job awesome. It's stressful and miserable at times but I can't imagine doing anything else.
Story time! One of the docs was giving one of the nurses a hard time and she had a really rough assignment. It was a bad day overall so the hospital supervisor brought a tray of fresh baked cookies from the cafeteria for us. While we had a miraculous moment when we could all eat and talk, the doc asked if any of us has any baking soda. I said, "baking soda? What for? Are someone's ABGs outta whack, doc?" (medical people will get that reference.. I'm too tired to explain it right now haha) and he said, "No, I have an ulcer in my mouth and I want to put baking soda on it.." and then the nurse he was being difficult with about 20 minutes prior said, "how about some salt..."
LOL!!! Mean? Yes. Funny as hell? Oh yeah. lol The doc did laugh, even he saw the comedic value in her comment, even if she was trying to inflict pain on him.
Anyway, back to the writing thing I really hate APA. I hate technical writing. I love ideas and plan making and reading other people's thoughts and ideas and then it gets all fucked up with things like putting a period in a certain spot after a nursing journal name or listing authors a certain way. It reminds me a lot of early computer programming languages. We had to be so precise in the typing in each line for the program to function properly, the truly creative energy of computers were lost to many people. Then along came windows based programs and the computer mouse and the computer finally took off. APA is like that to me because I feel as though it encumbers me by requiring so much effort in the mechanics of my papers that I lose some of my creativity. I realize it's necessary to write in that manner and I am sure I will get used to it but I'm sorry to say I don't think I will ever garner a love for that sort of dry academic writing.
And some of the journal articles I have had to endure reading? Good LORD. It's like some jackwipe decided to use the biggest most vague words out there and decided to weave together sentences so damn complicated you have to read each one--slowly-- at least three times and when you finally understand what they are saying it becomes blatantly obvious the writer either has a tiny penis and lives in his parents' basement, or is a female with "face like bull" and likes to punch everyone else in the face with an obscenely obscure vocabulary and an astonishingly strong proclivity for bull shit.
Anyway.. thanks for reading. And I promise. No bull shit up in here. No sirree.
Thursday, August 30, 2012
Hospitals need to start working smarter, not harder
One thing I have learned about healthcare in the U.S. is that in general, medical management of disease is fragmented, inconsistent, and frequently ineffective. Some of it is due to noncompliance, but I believe more of it is due to an incomplete picture of a patient's medical history- and with the technology we have available to us right now, that's a shame.
For example, say a patient presents to the emergency department with severe abdominal pain, fever, vomiting, diarrhea, electrolytes off, etc. There could be dozens of explanations for these symptoms. Labs are done, vitals obtained, current meds reviewed, allergies verified/documented, scans performed, possibly a lumbar puncture done. The Dr. has a verbal medical history, likely from the patient (who isn't feeling well), or from a family member who may or may not have been very involved with the pt's care over the past 30 years. The length of stay and positive outcome for the patient hinges on an accurate diagnosis and, in many cases, that diagnosis comes from a lot of what boils down to detective work.
What if, instead a patient presents to emergency with the same set of symptoms, but an electronic health record is available on the patient. A list of specialists the patient has seen for various issues over the years is attached. Various labs drawn over the past 10-20 years are seen so not only a baseline can be seen but trends can also be seen, graphed and visualized. New data (vitals, labs, tests) obtained from this visit is added to the patient's health record as well as a current list of meds from the pt's last Dr. visit. A computer program begins taking all this new data compares it with old data, and begins suggesting possible diagnoses based on an algorithm. New tests are suggested by the program to narrow down the possible causes further. While at first glance, it seems like the computer is doing what the brain of a physician would be doing while trying to diagnose, it's really used more as a tool since the program is only as good as the information put into it, plus there's really no replacement for a good old fashioned physical assessment in a lot of cases.
Right now, there is a HUGE disconnect when patients see more than one specialist and the family Dr./health care provider isn't kept up to date on that pts condition. To further complicate matters, now imagine what it must be like for the internal medicine Dr. to try and pull all those disciplines together and come up with a plan of care for the patient whose drs probably are not communicating with one another. Very VERY frequently "the left hand doesn't know what the right hand is doing"- and there is no excuse for that in today's world with the technology we currently have available.
It's funny how before I worked in a hospital, I thought a lot of this stuff was already in place. It's logical, isn't it? Come on, America, we can do better!
Tuesday, August 28, 2012
DON'T... TELL... *ANYONE*!!!
I curse more than I should. I laugh at inappropriate things. I think Honey Boo Boo Child is frickin hilarious. I drink to unwind. I like to smoke an occasional cigar. I rock stiletto heels and a low cut dress. I have fabulous friends who are incredibly with it and cool. By all rights, I'm a god damn Paris Hilton with a syringe in my hand. (well, my boobs are better)
My secret?
I'm a nerd. I read research articles for fun. I read about advances in nursing care, medicine, customer service, business, and the relatively new field of pharmacogenomics. And if there's one thing I love more than reading about all those things, it is talking about it. This isn't new. In high school, everyone called me the female Cliff Claven. That hasn't really changed about me. Maybe that's why I like being a nurse so much. I have my own captive audience (trapped in a room with me, no less!! :) ) who generally hangs on my every word --and takes it as gospel! haha!
I could stay cooped up all day for weeks and as long as I have a soft chair under my ass and a good book in my hands and/or an internet connection, I'm happy. I do like to hit the party scene once in a while and catch up with friends, but it's a very infrequent thing. Primarily, I'm an unsocial little bookworm with a penchant for the written word.
Which is why tomorrow, I embark on a new adventure.. tomorrow, I begin the next step in my academic journey. Tomorrow, I start classes for my RN to MSN bridge program for a Master's in Nurse Administration.
Don't tell ANYONE, but... I'm kinda excited. ;)
Monday, August 20, 2012
My new fave Doc and the "Curse of Dr. Smartass"
There was a standout resident when I was at my first hospital of employment. Very personable, unpretentious, smart as a whip, and fabulous with the patients. He's now one of our internal medicine docs!! I can't tell you how much we all enjoyed working with him this weekend and how happy the patients were with him. Oddly enough, he was in the same class as Dr. Super Shitty. LOL
I love listening to him talk to patients. He actually communicates with them more like a nurse than a doc. An example of Dr. Awesome's patient interactions goes like this: "Wow, that sounds really painful, I'm so sorry you are feeling like that. :( How about we try xyz to help with that and if that doesn't work, we have a few other tricks up our sleeves. Don't you worry- we see this a lot, you will be feeling better very soon. I promise." What a joy having him with us and what a stark contrast to his former classmate. lol!!
In other news, had one of the most difficult patients ever over the weekend. She's a frequent flyer, has been in and out of our hospital every few weeks for several weeks at a time since March. She has a laundry list of issues, but her biggest issue is that she tortures the staff. Even worse, she was an RN in a major city hospital in a trauma unit and she is extremely intelligent (has a PhD in nursing) and she's also incredibly demanding. Going into her room is a 45 minute minimum visit. Plus, she's on contact precautions for VRE in urine, she uses the bed pan (frequently), and she gets 18 pills at 9 am (I'm not exaggerating), plus q8 hr IV antibiotics, q4 hour IV narcotics (supposed to be prn (as needed) but are basically atc (around the clock) ). She's part Gargoyle (sits indian style perched in the center of her bed surrounded by pillows), part Drill Sargent part Drama Queen.
Her story is she was exposed to an exotic bird about 10 years ago and contracted a severe illness from a virus that becomes airborne once excreted from the bird. (I am not putting the name of it on here in case someone who knows her googles the virus and sees my blog). Anyway, she wasn't feeling well for a while. Saw Dr. after Dr. finally after a few months a Dr. told her to tell him EVERYTHING she did for the past few months.. she mentioned the bird and he ran some tests and it turns out she had it- and several other people she knew were also exposed. She is on long term steroid therapy due to adrenal insufficiency, asthma, insulin dependent diabetes, unbelievably high blood pressures- even with a slew of BP meds, non healing wounds, spontaneous hematomas, chronic constipation (oh how I love manually disempacting people just prior to a fleets enema- two days in a row) brittle bones that can break from just looking at them (side effect of long term steroid use), a severely compromised immune system and she gets I G G therapy monthly which costs over ten thousand dollars per treatment (Medicare is kind enough to foot the bill for that), I'm sure I'm forgetting a lot, but you get the picture.She'd actually be a great person to give to a nursing student because she loves to talk and teach and because she's extremely complex and understands her specific disease processes very well and enjoys talking about them and answering questions about them. Most of all she'd be a great nursing student case because it would weed out those students who can't cut it in nursing pretty fucking quick.
Here's what it's like taking care of her.
me: *walk up to her door, begin donning gloves and putting on gown*
Gargoyle Lady: *in sarcastic tone* "Oh, it's time for the pharmacy, again."
me: "it sure is! how are-
GL: "pleasse get this wrinkle out from under my butt.. move this pillow from under my leg, no not like that.. PLEASE just move it UP"
me: "Oh you mean back-
GL: "Yes, UP just like that"
me: "ok, let's get these pills started" *scan wristband* "name and date of birth, please?"
GL: "Gargoyle Lady 666... these pillows aren't right. I need you to stand them up straight-ohhh my back ohhh my God I can't stand it!!"
me: *move pillows from horizontal to vertical*
GL: *condescendingly* "Nooooooooooooo not like that" *motioning hands vertically* "like THIS" *motioning horizontally*
me: *turning pillows back how they were*
GL: "now stand them up"
me: "so you want me to fluff them a bit?" *fluffing pillows*
GL: "no, I want you to stand them up, yes, just like that."
me: *start scanning pills. Get about 5 done*
GL: "When you get a minute, I need a box of tissues"
me: "ok" *scanning pills 6 through 8*
GL: 'While you are in here, can you tell me what my hemoglobin was and what my blood pressure as at 3 am when they rechecked it after the IV labetalol?"
me: "sure, as soon as I'm done scanning these.." *scanning pills 8-10.. 'damn, the prednisone still isn't entered into the pharmacy system, have to manually admin this one in' phone rings.. aide calling to tell me she can't hear the BP in my dialysis patient, I need to recheck it manually.. tell her 'I will go in there next..' scan pill 11*
GL: "ooohhhh I think I need to have a BM .. GET THE BEDPAN.."
me: *put down pills go into bathroom, get bedpan*
GL: "ah that's it.. I sure have a headache I wonder what my blood pressure is right now. You know you have to check it before you give me my labetalol.."
me: "the aide just checked it 30 minutes ago.."
GL: "It could have dropped too low for me to take it... oooooooooooohhh the pain ah ah!! The bm is RIGHT THERE please help me get it out!!"
me: "I have to get some lubricant"
GL: "OH PLEASE PLEASE HURRY! AAAHHHHH"
me: *remove gown, remove gloves, wash hands go to supply closet down the hall, get lube, get her tissues she asked for. put items inside doorway of room -
G: "OOOOHHH AAAAHHH OOOOH IT HURTS HURRY HURRY"
me: *cheerily* "okay.. getting gowned up!" *use hand sanitizer, put on gown, put on gloves, put on another set of gloves (crucial step when shithole spelunking) tie gown, take 2 steps toward bed-
GL: *flatly* "I think I got it" *pulls brown finger out of her own rectum
me: * 'well, that will go well with her breakfast seeing as how she can't walk to a sink to wash her hands'*
GL: "ohh OHHHH there's MORE!! Please help me!!"
me: *squirt lube on double gloved index finger, start coaxing out poo balls*
GL: "aaahhhh AAAAAAA ohhhh DIG DEEEPER! It's right there!"
I will spare you the rest of the story. Now, imagine 24 hours of weekend spent just like that.
Oh, so the Curse of Dr. Smartass? One day while 3 nurses were chit chatting with Dr. Smartass (actually he was the Dr. that came to talk to the guy with the trach who was driving me crazy two years ago.. I posted about it here: http://codebabe.blogspot.com/2010/07/best-of-best-and-worst-of-worst.html) about Gargoyle Lady he said (jokingly):
"That's because she was a nurse. All you nurses end up like that."
To which my jaw dropped with a combination of disbelief and despise said in a low tone, but quite distinctly 'youuu fucker.." The combination of his saying that and my F bomb in response pretty much had us all in utter hysterics for about 5 minutes. Dr. Smartass can be assured, if I do turn into Gargoyle Lady. I'M ASKING FOR HIM EVERY TIME I GO TO THE HOSPITAL!! lol
Thursday, August 9, 2012
How Dr. Shitty always ruins the day: What not to do if you are a hospitalist
My patients are primarily followed by the the Internal Medicine group with my hospital. (at my other hospital we had a mix of internal medicine and residents). Sometimes we have a PCP doc with hospital privileges (they ROCK, by the way. The patients love them and the nurses do too.)
Enter Dr. Super Shitty. King of All that is Wrong with Internal Medicine Doctorin' ™. When I work with him, I basically hum "I'm an asshole" by Dennis Leary the entire day. (usually something reserved for my husband when he pisses me off, so you know this doc has some serious talent)
What could Dr. Super Shitty possibly do that is so annoying? Let's see...
1. Rounding on all the patients (usually about 20) between 8-9:30 and telling at least half of them they are getting discharged. Except, he has no intention of even starting any of the med recs or paperwork until after he takes his lunch hour at 1 pm. Then, while the RNs are doing their 9 am med passes, we are greeted with patients in the process of taking off their telemetry, asking to have their IV sites taken out and wearing their damn street clothes. Then they get pissed off when you break it to them that nobody goes home until after lunch because that's when the paperwork should be done.
2. Except, Dr. Super Shitty does NOT start the paper work as promised at 2 pm for those patients, oh no. You see, he is busy ignoring requests for things like pain meds for people admitted with intractable pain and requests for an order for kayexalate for a patient with a K of 5.2. Because we really LOVE giving that to people anyway. Oh, and the order a few hours later to send c diff stool sample on the same patient? Brilliant. (and I understand everyone has bad days when things don't happen in a timely manner but this is ALL. THE. TIME. every time he works. It's at the point now where as soon as I see he is assigned to our floor, I want to turn around and punch out as soon as I clock in) As a result, close to a dozen patients are furious at 5 pm when they finally are ready to go home.
3. Super shitty also is terrible about communicating with family members- I spend my whole day talking to families about matters I know nothing about and playing case manager too (they are typically on call on weekends). He also refuses to obtain DNR orders from a patient who has a copy of a living will and verbally tells the nursing staff that you don't want to be resuscitated int he event of a code. The form is flagged on the chart-- all Dr. super shitty needs to do is have the already willing to sign patient sign.. but there the form sits. All day.
which leads to...
oh yes.
Doesn't the patient code.
And don't we have to initiate CPR.
Thank GOD her cardiologist showed up and said "She does NOT want that! We have spoken at length about this just today. She said she was going to ask the IM doc for the form since he had the chart.. *flipping papers* Why wasn't this signed?!" * flipping more* .. she has severe arthritis and was unable to sign her general consent.. Code babe, you were in the room with me for the conversation, will you witness this? I'm signing this form as patient unable to sign." I witnessed it, of course. I also witnessed a woman's last few minutes of bone cracking chest compressions she didn't even WANT.
The only people I feel worse for than the RNs and the patients on our floor, it's the other internal medicine docs who have to listen to his signoff and then clean up all his messes and put out all the fires he causes. It's a similar thing with RNs.. there are some nurses that habitually don't check labs, always forget to tell you important things and leave you with IV sites that are blown.
So, in sum. Please, if you work in a hospital, don't do shit like that. kthxbye
Enter Dr. Super Shitty. King of All that is Wrong with Internal Medicine Doctorin' ™. When I work with him, I basically hum "I'm an asshole" by Dennis Leary the entire day. (usually something reserved for my husband when he pisses me off, so you know this doc has some serious talent)
1. Rounding on all the patients (usually about 20) between 8-9:30 and telling at least half of them they are getting discharged. Except, he has no intention of even starting any of the med recs or paperwork until after he takes his lunch hour at 1 pm. Then, while the RNs are doing their 9 am med passes, we are greeted with patients in the process of taking off their telemetry, asking to have their IV sites taken out and wearing their damn street clothes. Then they get pissed off when you break it to them that nobody goes home until after lunch because that's when the paperwork should be done.
2. Except, Dr. Super Shitty does NOT start the paper work as promised at 2 pm for those patients, oh no. You see, he is busy ignoring requests for things like pain meds for people admitted with intractable pain and requests for an order for kayexalate for a patient with a K of 5.2. Because we really LOVE giving that to people anyway. Oh, and the order a few hours later to send c diff stool sample on the same patient? Brilliant. (and I understand everyone has bad days when things don't happen in a timely manner but this is ALL. THE. TIME. every time he works. It's at the point now where as soon as I see he is assigned to our floor, I want to turn around and punch out as soon as I clock in) As a result, close to a dozen patients are furious at 5 pm when they finally are ready to go home.
3. Super shitty also is terrible about communicating with family members- I spend my whole day talking to families about matters I know nothing about and playing case manager too (they are typically on call on weekends). He also refuses to obtain DNR orders from a patient who has a copy of a living will and verbally tells the nursing staff that you don't want to be resuscitated int he event of a code. The form is flagged on the chart-- all Dr. super shitty needs to do is have the already willing to sign patient sign.. but there the form sits. All day.
which leads to...
oh yes.
Doesn't the patient code.
And don't we have to initiate CPR.
Thank GOD her cardiologist showed up and said "She does NOT want that! We have spoken at length about this just today. She said she was going to ask the IM doc for the form since he had the chart.. *flipping papers* Why wasn't this signed?!" * flipping more* .. she has severe arthritis and was unable to sign her general consent.. Code babe, you were in the room with me for the conversation, will you witness this? I'm signing this form as patient unable to sign." I witnessed it, of course. I also witnessed a woman's last few minutes of bone cracking chest compressions she didn't even WANT.
The only people I feel worse for than the RNs and the patients on our floor, it's the other internal medicine docs who have to listen to his signoff and then clean up all his messes and put out all the fires he causes. It's a similar thing with RNs.. there are some nurses that habitually don't check labs, always forget to tell you important things and leave you with IV sites that are blown.
So, in sum. Please, if you work in a hospital, don't do shit like that. kthxbye
Tuesday, July 31, 2012
I've been quiet, I know
A lot of things have been going on as of late. The hospital census has gone through the roof and the average length of stay for each patient is about 1.5 days. Which means I am constantly doing discharges, getting admissions, and basically chasing my tail at work. Still enjoying my job and my coworkers, but I have found that when I am home I really need to try not to think about work so much. (as my abused patient entry can attest)
On a personal note, something else has been happening. One of my best friends is currently battling Acute Myeloid Leukemia.She was my first friend growing up and we attended school k-12 together. We were in each other's weddings. We were pregnant together. Our children played together. She had some flu like symptoms a month ago and they found the leukemia. She went on to lose her eyesight, develop brain lesions, a fungal infection, becoming septic, then go on a vent. (which she is off of thank God). She's geographically very far away from me right now and it's really REALLY hard for me to wrap my brain around what's happening with her. This is NOT how it's supposed to be. She's such a beautiful, amazingly talented, incredibly compassionate person. We are not even 40! This is not how it's supposed to be.
I don't have very many readers but can I just ask you to please consider getting registered on the bone marrow registry? http://marrow.org/Home.aspx All you have to do is answer some health questions and they will mail you a cheek swab kit with a SASE in a few weeks after submitting the swab, you will get a registry card.
Thanks for reading. ♥
On a personal note, something else has been happening. One of my best friends is currently battling Acute Myeloid Leukemia.She was my first friend growing up and we attended school k-12 together. We were in each other's weddings. We were pregnant together. Our children played together. She had some flu like symptoms a month ago and they found the leukemia. She went on to lose her eyesight, develop brain lesions, a fungal infection, becoming septic, then go on a vent. (which she is off of thank God). She's geographically very far away from me right now and it's really REALLY hard for me to wrap my brain around what's happening with her. This is NOT how it's supposed to be. She's such a beautiful, amazingly talented, incredibly compassionate person. We are not even 40! This is not how it's supposed to be.
I don't have very many readers but can I just ask you to please consider getting registered on the bone marrow registry? http://marrow.org/Home.aspx All you have to do is answer some health questions and they will mail you a cheek swab kit with a SASE in a few weeks after submitting the swab, you will get a registry card.
Thanks for reading. ♥
Friday, July 6, 2012
He's walking!!!!!!
Remember a few months ago when I blogged about facebook stalking my patients to see how they are doing? ( http://codebabe.blogspot.com/2012/04/yeah-i-admit-it-i-facebook-stalk-some.html)
He's walking!!! It sounds like he will be able to return to work in August!! ♥
That's all I have for now, just had to share that. :)
He's walking!!! It sounds like he will be able to return to work in August!! ♥
That's all I have for now, just had to share that. :)
Monday, June 18, 2012
Dear Abusive Sack of Shit,
The world does not revolve around you and the way you think things should be. You aren't the genius you think you are: you are nothing more than a bully and a coward with a narrow view of the world. You look for women who have a history of being abused and you latch onto them and their vulnerabilities like a vulture. In most cases, you chose to be like your father because in your eyes, he was powerful, and he couldn't be hurt. You learned to secretly hate your mother for her being so weak. You can be an ex con, a chiropractor, a lawyer, a teacher. No matter what your day job, you are a fucking monster behind closed doors. For those of you that don't raise a hand to her so you don't think that's abusive: you're an asshole, too. You don't fuck with someone's self esteem and berate them and criticize everything they do and get away with thinking it's okay because you didn't physically damage her. You hate yourself and you take it out on those closest to you. Understandable how you hate yourself, you are a disgusting piece of shit.
You teach your daughters to take abuse. You teach your sons that's how to treat a woman. The repercussions of your fucked up logic and egocentrism laced with self loathing and paranoid accusations over the most ridiculous minutiae make you look like an even bigger fool than you already are.
Just know this, big man:
Every time you hit her, not only her fear but her hatred grows. She becomes used to your torment, desensitized to your abuse. Your constant picking and insulting and demeaning and control and domination is building a fortress within her. Because you see, there's a part of her you can't touch, and that's her spirit. She may feel trapped by you (by no mistake on your part), but eventually, there's always that possibility that going to prison won't seem like so bad of an option. Maybe it will feel even more like a vacation. And it WOULD be a vacation, because prisoners have more rights than she does living with a miserable son of a bitch like yourself.
I remember a patient I had in clinicals for nursing school. Sweet woman in her 60s in for gall bladder removal surgery. Sat with her and talked with her for a while and she shared with me that her husband passed away due to diabetes complications just last year. I said, "Oh I'm so sorry" She said "Don't be. He used to beat me, I hope he rots in hell." Then she smiled so brightly. :)
Is that the type of way you want to be remembered? Is that the payoff you seek? If so, keep on with your bad self.
If you are reading this and you see the tiniest bit of yourself in this, do everyone on this earth a favor and get counseling, get castrated and for the love of all that is holy, stay the hell out of relationships of any kind until whatever the hell screw you have loose is fixed. I'm tired of caring for bones you've broken and drying the tears of your victims.
(In case any of you ever wondered why I'm not a psych nurse? This is exactly why.)
You teach your daughters to take abuse. You teach your sons that's how to treat a woman. The repercussions of your fucked up logic and egocentrism laced with self loathing and paranoid accusations over the most ridiculous minutiae make you look like an even bigger fool than you already are.
Just know this, big man:
Every time you hit her, not only her fear but her hatred grows. She becomes used to your torment, desensitized to your abuse. Your constant picking and insulting and demeaning and control and domination is building a fortress within her. Because you see, there's a part of her you can't touch, and that's her spirit. She may feel trapped by you (by no mistake on your part), but eventually, there's always that possibility that going to prison won't seem like so bad of an option. Maybe it will feel even more like a vacation. And it WOULD be a vacation, because prisoners have more rights than she does living with a miserable son of a bitch like yourself.
I remember a patient I had in clinicals for nursing school. Sweet woman in her 60s in for gall bladder removal surgery. Sat with her and talked with her for a while and she shared with me that her husband passed away due to diabetes complications just last year. I said, "Oh I'm so sorry" She said "Don't be. He used to beat me, I hope he rots in hell." Then she smiled so brightly. :)
Is that the type of way you want to be remembered? Is that the payoff you seek? If so, keep on with your bad self.
If you are reading this and you see the tiniest bit of yourself in this, do everyone on this earth a favor and get counseling, get castrated and for the love of all that is holy, stay the hell out of relationships of any kind until whatever the hell screw you have loose is fixed. I'm tired of caring for bones you've broken and drying the tears of your victims.
(In case any of you ever wondered why I'm not a psych nurse? This is exactly why.)
Friday, June 1, 2012
How I became a nurse after exactly 1 day of clinicals.
I was in my first semester of nursing school. We were on the oncology floor and we were allowed to "pick" the patients we wanted to research, assess and care for. I worked on the floor below that one (the cardiac floor) as an aide, so I had some semblance of familiarity with the hospital. Thanks to that, I was not particularly timid about answering call bells or checking sugars or whatever the RNs needed. The RNs were in report and I asked them if there was a patient they felt needed a little extra TLC for the day. (I chose that approach over "ooh do you have anybody GOOD" with 'good' meaning multiple system failure and tons of meds and labs to learn from) I suppose even from the beginning I've been much more patient focused rather than disease focused. The nurses looked knowingly at one another and said, "Well.. there is one.. but.. this is your very first semester and your first clinical?" I steadily looked at them and said, "Whatever it is, I can handle it.."
And with that, I had my very first nursing student assignment. A tiny little woman with inflammatory breast cancer. Her left breast was the size of a football. She was admitted a few hours prior. She was incredibly sweet, a little confused, and extremely anxious. Her younger brother was in the room with her. He's lived with her and cared for her for years. He was a little backward, but very nice. He told me she doesn't like Drs or hospitals, and that last month she told him she thought she felt a lump in her breast when she was in the tub. Since he's her brother, he felt awkward asking to see it, but he told her maybe a Dr should look at it. She said "no no no! If a Dr. sees it he will tell me I'm dying!". The brother didn't push, and she bathed only twice weekly and kept quiet about her breast after that for a few weeks. Then the day before her admission to the hospital he asked her about the lump and she started to cry and showed it to him. He called for an ambulance.
Drs came in and spoke with her, wrote for dry dressings to go over the wounds on her breast. She needed dry sterile dressings loosely applied with no tape. Why? Her breast was spotted with black necrotic tissue due to her paper thin skin being unable to stretch with the rapidly growing tumor and the skin split opened and subsequently became seriously infected. (according to the Dr's estimation, the tumor grew from a golf ball to a football size in 4 weeks).
The RN for this little lady gladly gave the reigns to me in caring for this woman after seeing me interact with her..the patient responded very well to me and trusted me completely- much moreso than any of the other professionals who came into the room.
I provided am care (washed her, applied lotions, etc). And then attempted to dress her wounds on her diseased breast. She looked down and really looked at her chest.. and started to hyperventilate. I told her to look at me... I put my hand on her arm. "We are going to cover that up and give you medicine to feel better, okay? Deep breath..relax. I'm with you." There was no way that gauze was staying on her without tape, but I didn't want to tear her skin. So I had an idea... I called the maternity floor and had them tube me those mesh panties they give to new moms.. I slid her swollen breast through one of the leg holes of the mesh panties and slid the dressing underneath. Then I buttoned up her gown.
My instructor came into the room with the RN to admire my handiwork. Not long after, the hospice case worker and the Dr. arrived to break the news to her and her brother. She had about a week left, if that.
The news should not have hit me like it did, it shouldn't have surprised me. Luckily, I was out in the hallway when I heard it (and not in the patient's room). I briskly walked around the corner to the nurse's station. Everything became blurry, my throat tightened. Deep breaths.. deep breaths.. A question entered my left ear "Are you okay?" it was one of my classmates. I answered shakily, "She's on hospice.. she's going to die.." And she hugged me. The RN and my instructor walked over. "Do you need to talk?" I answered, "Not now.. I need to be there for her. I can process all this later." I went into her room and sat with her and her brother.
I held both their hands and talked to them about the inpatient hospice facility she would be going to. How beautiful it is, how great the staff are, etc. I printed out a bus schedule for her brother and told him he can sleep at the facility to be with her if he wants. He liked that.
About 2 hours later, the transport team arrived to transfer her to inpatient hospice. I hugged her and said my goodbyes. I hugged her brother and told him, "Just be with her. You don't have to tell her any magic words, there aren't any. You are giving her the greatest gift a person can give by keeping her from being alone."
I cried heavily the moment the elevator doors closed, her little hand lifting from the stretcher in a final wave of goodbye.
I turned to one of the nurses who debated on whether or not to give her to me and I said, "Maybe I couldn't handle it after all..." She put her hand on my back and she said, "You handled it like you've been a nurse your whole life. Welcome to the profession."
And with that, I had my very first nursing student assignment. A tiny little woman with inflammatory breast cancer. Her left breast was the size of a football. She was admitted a few hours prior. She was incredibly sweet, a little confused, and extremely anxious. Her younger brother was in the room with her. He's lived with her and cared for her for years. He was a little backward, but very nice. He told me she doesn't like Drs or hospitals, and that last month she told him she thought she felt a lump in her breast when she was in the tub. Since he's her brother, he felt awkward asking to see it, but he told her maybe a Dr should look at it. She said "no no no! If a Dr. sees it he will tell me I'm dying!". The brother didn't push, and she bathed only twice weekly and kept quiet about her breast after that for a few weeks. Then the day before her admission to the hospital he asked her about the lump and she started to cry and showed it to him. He called for an ambulance.
Drs came in and spoke with her, wrote for dry dressings to go over the wounds on her breast. She needed dry sterile dressings loosely applied with no tape. Why? Her breast was spotted with black necrotic tissue due to her paper thin skin being unable to stretch with the rapidly growing tumor and the skin split opened and subsequently became seriously infected. (according to the Dr's estimation, the tumor grew from a golf ball to a football size in 4 weeks).
The RN for this little lady gladly gave the reigns to me in caring for this woman after seeing me interact with her..the patient responded very well to me and trusted me completely- much moreso than any of the other professionals who came into the room.
I provided am care (washed her, applied lotions, etc). And then attempted to dress her wounds on her diseased breast. She looked down and really looked at her chest.. and started to hyperventilate. I told her to look at me... I put my hand on her arm. "We are going to cover that up and give you medicine to feel better, okay? Deep breath..relax. I'm with you." There was no way that gauze was staying on her without tape, but I didn't want to tear her skin. So I had an idea... I called the maternity floor and had them tube me those mesh panties they give to new moms.. I slid her swollen breast through one of the leg holes of the mesh panties and slid the dressing underneath. Then I buttoned up her gown.
My instructor came into the room with the RN to admire my handiwork. Not long after, the hospice case worker and the Dr. arrived to break the news to her and her brother. She had about a week left, if that.
The news should not have hit me like it did, it shouldn't have surprised me. Luckily, I was out in the hallway when I heard it (and not in the patient's room). I briskly walked around the corner to the nurse's station. Everything became blurry, my throat tightened. Deep breaths.. deep breaths.. A question entered my left ear "Are you okay?" it was one of my classmates. I answered shakily, "She's on hospice.. she's going to die.." And she hugged me. The RN and my instructor walked over. "Do you need to talk?" I answered, "Not now.. I need to be there for her. I can process all this later." I went into her room and sat with her and her brother.
I held both their hands and talked to them about the inpatient hospice facility she would be going to. How beautiful it is, how great the staff are, etc. I printed out a bus schedule for her brother and told him he can sleep at the facility to be with her if he wants. He liked that.
About 2 hours later, the transport team arrived to transfer her to inpatient hospice. I hugged her and said my goodbyes. I hugged her brother and told him, "Just be with her. You don't have to tell her any magic words, there aren't any. You are giving her the greatest gift a person can give by keeping her from being alone."
I cried heavily the moment the elevator doors closed, her little hand lifting from the stretcher in a final wave of goodbye.
I turned to one of the nurses who debated on whether or not to give her to me and I said, "Maybe I couldn't handle it after all..." She put her hand on my back and she said, "You handled it like you've been a nurse your whole life. Welcome to the profession."
Wednesday, May 30, 2012
Getting MRSA from The Hopper
My little lady patient was about 93 lbs-- and 93 years old. Tiny little thing, and cute as hell. She was very pleasantly confused and ate like nobody's business. When I got report the offgoing RN told me "I made her toast with jelly and coffee, she was wide awake at 5 am complaining about how no one feeds her in this place!"
it was 7:05am when I walked into her room and she said, "When is breakfast, I'm starving!!" I reminded her she had some toast already but "if she wants, I can call for her real breakfast". Called for her, peeked in her chart and see Dr. progress notes "failure to thrive", "BMI 17.2", "decreased appetite" hmmm.. something is not jiving. This woman appears to eat very well while here, so not a typical failure to thrive case at all. Also, she had a non healing lower leg ulcer, so the Drs were thinking i wasn't healing because she wasn't eating enough (plus her BMI is low).
I scroll though charted Is and Os.. every meal for 4 days 100% eaten. Interesting.
I talked to her and asked her what she eats at home. (she lives with her son) Then she told me all about how money is tight, she doesn't get a lot to eat at home, etc. etc. (And I think, "I have seen this before." ) A little while later the son came in. I spoke with him for a bit about her wound culture that's positive for MRSA and what is means for him. (frequent handwashing, wearing a protective gown, etc etc) I gave him educational materials on it, too. He was very freaked out by the MRSA, it took a lot to calm him down about it. Then I stressed the importance of nutrition for her wounds to heal. He said he understood and that money is very tight and it's hard to pay for her medicine and food. (he was very thin too) At that point I asked case management to provide a list of resources to him to help him pay for food and medicine. So many people deal with those very issues, it is heartbreaking. Worse still, you practically require a degree just to figure out how to navigate the systems just to apply for assistance. Every organization has their own way of doing things.. totally frickin nuts. And frustrating.
Anyway, a little while later, my little lady asked me when I was going to have lunch. I said oh in a little bit. And she said, "will you come in here and eat with me? It's so lonely here eating all by myself.." awwww!! I really really wish I could have had lunch in her room with her, she asked SO sweetly.. but can you just IMAGINE if an infectious disease doc had happened by and saw THAT?? Or the State Dept of Health??? lol I told her I would do my computer work in there with her and keep her company while she ate, though. So THEN didn't she take a bite out of her grilled cheese and start saying "have a bite! It's really good! I want you to have some!" and began trying to shove it in my face.. okay.. here's the thing.. I wouldn't take a bite out of a sandwich my own husband or children took a bite out of.. and here's this (albeit adorable) woman with MRSA asking me to take a bite. OH HAIL NO! LOL!! She was way cute, though and I felt badly turning her down, but even I have my limits. haha!!
Then the little peanut started talking about her infection "I don't know where I might have picked it up. I don't go much of anywhere and I don't even use public hoppers!" (hopper=toilets in case you didn't know) So I explained "germs are everywhere, even the grocery store. As we get older it's just easier for us to get sick from them.." I thought I explained it pretty well but she was hard of hearing and confused so everyone up and down the hall and everyone in the physician charting area heard me yelling, "Germs aren't always from the hopper! You can get them from touching a grocery cart handle or even from touching the mailbox!!" I must have said the same thing about 10 different ways and each time I got louder and louder.
She answered with, "When are you gonna eat? You've been in here for 45 minutes! No wonder you're so skinny!" I asked her if she's sick of me yet? And she said "YES! Eat your lunch!" and got a devilish little grin.
I removed my contact precaution gown, then my gloves and rolled them up and put them into the garbage and proceeded to step outside the room and announce to fellow employees and family members of neighboring rooms alike within earshot, "I am going to have some lunch. Then I am going to use THE HOPPER."
it was 7:05am when I walked into her room and she said, "When is breakfast, I'm starving!!" I reminded her she had some toast already but "if she wants, I can call for her real breakfast". Called for her, peeked in her chart and see Dr. progress notes "failure to thrive", "BMI 17.2", "decreased appetite" hmmm.. something is not jiving. This woman appears to eat very well while here, so not a typical failure to thrive case at all. Also, she had a non healing lower leg ulcer, so the Drs were thinking i wasn't healing because she wasn't eating enough (plus her BMI is low).
I scroll though charted Is and Os.. every meal for 4 days 100% eaten. Interesting.
I talked to her and asked her what she eats at home. (she lives with her son) Then she told me all about how money is tight, she doesn't get a lot to eat at home, etc. etc. (And I think, "I have seen this before." ) A little while later the son came in. I spoke with him for a bit about her wound culture that's positive for MRSA and what is means for him. (frequent handwashing, wearing a protective gown, etc etc) I gave him educational materials on it, too. He was very freaked out by the MRSA, it took a lot to calm him down about it. Then I stressed the importance of nutrition for her wounds to heal. He said he understood and that money is very tight and it's hard to pay for her medicine and food. (he was very thin too) At that point I asked case management to provide a list of resources to him to help him pay for food and medicine. So many people deal with those very issues, it is heartbreaking. Worse still, you practically require a degree just to figure out how to navigate the systems just to apply for assistance. Every organization has their own way of doing things.. totally frickin nuts. And frustrating.
Anyway, a little while later, my little lady asked me when I was going to have lunch. I said oh in a little bit. And she said, "will you come in here and eat with me? It's so lonely here eating all by myself.." awwww!! I really really wish I could have had lunch in her room with her, she asked SO sweetly.. but can you just IMAGINE if an infectious disease doc had happened by and saw THAT?? Or the State Dept of Health??? lol I told her I would do my computer work in there with her and keep her company while she ate, though. So THEN didn't she take a bite out of her grilled cheese and start saying "have a bite! It's really good! I want you to have some!" and began trying to shove it in my face.. okay.. here's the thing.. I wouldn't take a bite out of a sandwich my own husband or children took a bite out of.. and here's this (albeit adorable) woman with MRSA asking me to take a bite. OH HAIL NO! LOL!! She was way cute, though and I felt badly turning her down, but even I have my limits. haha!!
Then the little peanut started talking about her infection "I don't know where I might have picked it up. I don't go much of anywhere and I don't even use public hoppers!" (hopper=toilets in case you didn't know) So I explained "germs are everywhere, even the grocery store. As we get older it's just easier for us to get sick from them.." I thought I explained it pretty well but she was hard of hearing and confused so everyone up and down the hall and everyone in the physician charting area heard me yelling, "Germs aren't always from the hopper! You can get them from touching a grocery cart handle or even from touching the mailbox!!" I must have said the same thing about 10 different ways and each time I got louder and louder.
She answered with, "When are you gonna eat? You've been in here for 45 minutes! No wonder you're so skinny!" I asked her if she's sick of me yet? And she said "YES! Eat your lunch!" and got a devilish little grin.
I removed my contact precaution gown, then my gloves and rolled them up and put them into the garbage and proceeded to step outside the room and announce to fellow employees and family members of neighboring rooms alike within earshot, "I am going to have some lunch. Then I am going to use THE HOPPER."
Friday, May 18, 2012
On Bonanza and Ramadan
The nursing school class I was in was quite a cast of characters. Most of the people in it were in their 30s and 40s (one of them was a higher up HR exec at an international company and 62.. he wanted to be a nurse after he retires. He's probably one of my favorite people on this earth. He embodies the saying "young at heart").
Another one of my favorite classmates from nursing school was Wendy (not her actual name). She wore traditional Muslim garb, worked as an LPN for years in a nursing home (now returning for her RN) and she was funny. as. hell. Never in a mean way, never in an "off" way (I'm sure classmates of mine thought I was a total perv at times with some of the crap I said haha!) but always in a unique, clever way. For example, one day we were sitting around waiting for a non broken VCR to be brought into the class people were saying "who even uses a VCR and more??" Wendy said "I do. We keep it in our basement at home." So we asked the obvious question "What do you watch on it?" She shot back "Bonanza, of course." We seriously almost peed ourselves right there.
The best story about Wendy, however, happened during our clinical rotation to the ER. We were allowed to talk with and assess patients and to add any additional info we may have gleaned to the nursing and/or medical staff. Now, for a little background, the hospital this rotation happened at was called St. ____ ; so when Wendy appeared in the room of a sweet little elderly German-American couple, no one was really sure how they were going to respond to a woman wearing a Muslim headdress and scarf. Surprisingly, things went extremely well, she got in a great history and physical assessment and they were incredibly comfortable with her. As she was gathering her papers and getting ready to walk out the elderly woman said, "I think it's WONDERFUL that St. ____ still hires nuns as nurses! We will tell all our friends to come here!"
Wendy smiled and walked out to see her clinical group practically with tears in our eyes from trying to stifle the laughter. We asked Wendy "Are you going to tell her?" She deadpanned back: "Are you CRAZY?"
Interesting how because of Wendy's sweet personality, warmth, and quick wit, she was perceived as one of "their own" (interestingly, Wendy is also black). If all of us had a positive experience with someone who is different from us, just think how much better the world would be.
I grew up in a small coal town. The first time I ever saw a black person (besides on Sesame street) was on field trips to NYC and such. Finally when I went away to college (the first time out of high school) I became friends with people from all kinds of backgrounds. Never really anyone from the Islamic faith, though.. until I started to work in the auto collision industry. From there I met, who was for me, the embodiment of what a true follower of Islam should be.
He went by "Doc" (he held a PhD in philosophy.) He managed a car rental business inside our office. Every day he went outside with his little mat (don't know what they are called) and he prayed kneeling toward meccah. In front of a bunch of meat and potatoes/rough around the edges techs in the body shop. Doc exuded gentleness and caring to everyone he spoke to in business and as a coworker.
Now, when most people think about "Muslims" they think of terrorists and extremists. I think of Wendy and Doc. What I saw in them made it pretty clear to me that God gives us his "guidelines" for how to live life in many forms; it depends on your particular part of the world/culture as to which one will work the best to help you achieve spiritual awareness/oneness with Him. Once you learn to accept that there's no one RIGHT way to be like God (all loving and forgiving and wise) then you can let go of the need to prove to everyone that you are right and they are wrong and learn to simply be an example to them. Doc and Wendy both proved that very thing to me. They didn't make me want to convert to Islam per se.. but what they did do was show me God has given us MANY paths to him; just as a loving God should. :)
Another one of my favorite classmates from nursing school was Wendy (not her actual name). She wore traditional Muslim garb, worked as an LPN for years in a nursing home (now returning for her RN) and she was funny. as. hell. Never in a mean way, never in an "off" way (I'm sure classmates of mine thought I was a total perv at times with some of the crap I said haha!) but always in a unique, clever way. For example, one day we were sitting around waiting for a non broken VCR to be brought into the class people were saying "who even uses a VCR and more??" Wendy said "I do. We keep it in our basement at home." So we asked the obvious question "What do you watch on it?" She shot back "Bonanza, of course." We seriously almost peed ourselves right there.
The best story about Wendy, however, happened during our clinical rotation to the ER. We were allowed to talk with and assess patients and to add any additional info we may have gleaned to the nursing and/or medical staff. Now, for a little background, the hospital this rotation happened at was called St. ____ ; so when Wendy appeared in the room of a sweet little elderly German-American couple, no one was really sure how they were going to respond to a woman wearing a Muslim headdress and scarf. Surprisingly, things went extremely well, she got in a great history and physical assessment and they were incredibly comfortable with her. As she was gathering her papers and getting ready to walk out the elderly woman said, "I think it's WONDERFUL that St. ____ still hires nuns as nurses! We will tell all our friends to come here!"
Wendy smiled and walked out to see her clinical group practically with tears in our eyes from trying to stifle the laughter. We asked Wendy "Are you going to tell her?" She deadpanned back: "Are you CRAZY?"
Interesting how because of Wendy's sweet personality, warmth, and quick wit, she was perceived as one of "their own" (interestingly, Wendy is also black). If all of us had a positive experience with someone who is different from us, just think how much better the world would be.
I grew up in a small coal town. The first time I ever saw a black person (besides on Sesame street) was on field trips to NYC and such. Finally when I went away to college (the first time out of high school) I became friends with people from all kinds of backgrounds. Never really anyone from the Islamic faith, though.. until I started to work in the auto collision industry. From there I met, who was for me, the embodiment of what a true follower of Islam should be.
He went by "Doc" (he held a PhD in philosophy.) He managed a car rental business inside our office. Every day he went outside with his little mat (don't know what they are called) and he prayed kneeling toward meccah. In front of a bunch of meat and potatoes/rough around the edges techs in the body shop. Doc exuded gentleness and caring to everyone he spoke to in business and as a coworker.
Now, when most people think about "Muslims" they think of terrorists and extremists. I think of Wendy and Doc. What I saw in them made it pretty clear to me that God gives us his "guidelines" for how to live life in many forms; it depends on your particular part of the world/culture as to which one will work the best to help you achieve spiritual awareness/oneness with Him. Once you learn to accept that there's no one RIGHT way to be like God (all loving and forgiving and wise) then you can let go of the need to prove to everyone that you are right and they are wrong and learn to simply be an example to them. Doc and Wendy both proved that very thing to me. They didn't make me want to convert to Islam per se.. but what they did do was show me God has given us MANY paths to him; just as a loving God should. :)
Thursday, May 10, 2012
I hope Rob Zombie likes cocaine
Because I heard my escapee cocaine colon dude win Rob Zombie concert tickets ON THE RADIO a few days ago on a local station. He gave his first name, last initial with his distinct sounding voice AND state the hometown the coke gut was from AND when asked what kind of work he does, he hesitated and said.. "I'm.. unemployed."
yeah, until he sells a few thousand bucks worth of blow that she shot out of his rectum at the Rob Zombie concert.
I seriously couldn't make this shit up if I tried.
Wednesday, May 2, 2012
On tanning and fat asses and pretty blondes
We've ALL got problems. Some of them are just more visible than others. Some people wear their eating issues on their ass, other people meet society's conventions of "normal" yet live in absolute filth. Some people live with domestic abuse, still others live a life of misery because they are all alone. Whether it's how a person looks, how they view food, how they see the world or how others see them.. NO ONE is in any place where they can look at a morbidly obese patient, for example, and say "that's disgusting, how could anyone let themselves get like that?!" Make no mistake, nobody LETS it happen. 600 lbs doesn't come from the occasional slip up at the McDonald's drive through. 600lbs comes from trying to fill a void, self loathing for doing so and lather, rinse, repeat. A thyroid condition or a crappy metabolism on top of an overeating disorder could become a perfect storm for morbid obesity.
In health care, a very large person can be extremely difficult to care for, and I can bet you that the biases people have against the obese show to the bariatric patient. They tend to be very withdrawn and make less eye contact than most other patients. They are embarrassed as fuck to be the size they are and totally dependent on staff that give subtle or not so subtle cues that they are disgusted by them by the looks on their faces when they have to "lift that roll" to apply nystatin powder or that they avoid them because they are afraid they will have to assemble a crew of people to get the patient cleaned up.
I will confess something here. I truly believe that people won't like me as much if I don't keep up with my appearance. Take away the makeup and the hair and I'm as awkward as a 13 year old. People perceive that looking "pulled together" all the time makes me seem like a person who has it all together. In actuality, I envy women who have the freedom to just leave the house with a bare face without so much as a glance in the mirror. I would be HORRIFIED if anyone saw me how I look when I first roll out of bed. (well except my family, I'm not that crazy lol) I will also confess that the first 2 years I was married I made it a point to wake up before my husband so I could put makeup on before he saw me. I suppose all of that could be considered vanity but I think truth of the matter is that it's an insecurity. What this means is, in actuality, I'm not that different from a 600 lb person in that, I am very affected internally by how others perceive me. Which just proves we are all way more alike than any of us realize- and that's kind of nice because that means we aren't really ever alone. And why it's shitty to look down on anyone who has a problem because we ALL have them.
Look at this blog (hell, look at the name of the blog).. you know why I put my actual picture on it? Because I don't think anyone would give a rat's ass about what I have to say unless they see it's coming from someone "pretty".
I am getting older (only 2 more years to the big 4-0!) and I am seeing the wrinkles start and noticing things start to go south here and there. I can only hope that when I'm elderly and the conventional beauty of youth has completely faded from my face that I finally get to feel the freedom that comes with not giving a shit what anyone thinks about me, and the wisdom to know that what I say carries enough meaning that it doesn't matter whether or not it came from someone attractive. But until then? Bring on the lip gloss.
Friday, April 27, 2012
Yet another simple act of kindness gets me smacked in the crotch.
Did you know that hearing aids are not covered by insurance? (at least not by Medicare) They cost 2,000.00 This leads me to wonder if residents at nursing homes call "dibs" on hearing aids when residents pass on. Can you just imagine?
"Aw poor Betty, she was only 92.. may God rest her......... WHAT? She promised ME her hearing aid! GET AWAY FROM HER DRAWER! NURSE!! NNNUUUURRRSSSEE!"
Anyway, being so aware of the cost of hearing aids and the fact that if one were to get lost, that person may likely go the rest of his/her life without being able to hear; it's kind of a big deal if one goes missing during a hospital stay.
Enter a sweet 87 year old with a quick wit and a gummy smile save for a solitary tooth jutting from her middle lower gumline appearing to be approximately 2 inches long... and she calls it Old Faithful.
I mean, really how can you not love this lady? LOL
Anyway, she was discharged back to a local nursing home. I thought she had a hearing aid when I saw her the day before, but it wasn't in when the ambulance crew got there and I didn't see it listed anywhere on her belonging list. I thought maybe I was just imagining she had one and she was a little confused so when I asked her if she wears a hearing aid she said "I don't think so."
About 30 minutes after she was picked up, a cleaning lady came out of the room and asked me if I was "looking for this.." and she held out a hearing aid. I was SO HAPPY she found it because 1. the poor old lady wouldn't be able to hear a damn thing without it 2. Desperate Housewives was a new episode that night and she loves that show (we talked about it a lot lol) and 3. I'm usually not wrong about stuff like that, so it was reassuring that I wasn't losing my marbles.
Now, the next step, getting it to her. The nursing home was about 10 minutes from my house, so I called them and told them I was going to drop it off for her. The nursing home is HUGE. It's owned by the State and there's several buildings to the complex and one of the towers has like 9 floors or some shit. Nonetheless, I was there for nursing clinicals a few years ago, so I was relatively familiar with it and thought I wouldn't have too much trouble navigating my way around.
What I didn't take into account was the fact that it was a Sunday night and pretty much every entrance was locked and the building she was in was in a section that I was completely unfamiliar with. It was also an unseasonably warm, balmy March night and there were tons of vehicles filled with loud teenagers driving around in the lot. (not sure why they were hanging out at a nursing home..) I was a little on edge seeing as how it was dark, I had just worked 13 hours for the second day in a row and I was sore and tired. Also, the lighting wasn't very good , so while I was walking around looking for an entrance I could get into, I accidentally walked over this little bendy stripey pole thing that was poking out of the grass by a sidewalk and whacked myself in the lady station. Of course, I was so mortified that someone might have seen that, the pain was totally muted by my trying to remain composed during a feigned attempt in acting as though nothing at all happened.
Then I happened by an area with large windows and inside I saw a bunch of tables set up and a group of people in their 20s-50s sitting at tables and one person standing there dressed all in black and talking. "Oh great, I can't go in there, they are having an AA meeting.", I thought to myself. Finally, I broke down and called the lone receptionist lady and told her where I was and that I was standing outside the building where the meeting is going on with the big glass windows. She said "A meeting??" I said "Yeah, there's a whole bunch of people sitting at tables and there's a pastor talking to them. Looks like an AA meeting.." She said, "Okay, I will be right down and I will wave outside the door so you will see me. You can hand me the hearing aid out there." She came out a right by where I was and she said "Are you talking about those people over there?" and she pointed at the people sitting at the tables. I said "Yep! That's them!" She said "That's not an AA meeting, that's the CNAs taking a break!!" We both started cracking up and I said, "Well wait to break it to them that they look like a bunch of AA members until AFTER I pull away in the parking lot, OKAY?" lol
At least it was a good Desperate Housewives on that night. And I had frozen peas in the freezer and wine in the fridge.
Monday, April 23, 2012
My patient ran away with cocaine in his colon
Did NO ONE freaking pay attention to the Just Say No campaign in the 80s except me??
Today, I am going to blog in the third person because I am getting bored with writing as myself . Meet one of my patients from over the weekend.
Damn. I knew I was drunk last night but, fuck, how did I end up in the hospital? *rolling to the side* oh mann a cop is in here! Son of a bitch how am I going to get out of here? My mom is going to kick my ass.. wow the judge told me to stay out of trouble, I'm going to go to jail now, no doubt. I'm glad I swallowed those 4 bags of cocaine when I got pulled over, bought me some time to figure out how I'm going to get out of this mess. I hope one of the bags doesn't open.. if that happens I will OD and then I will really be fucked. *dozes back off to sleep*
What.. time is it..? Oh man my stomach is killing me. ooh it hurts... I hope one of those bags didn't bust open...wow.. if I happen to shit one of these bags out soon, I will be able to do a line of coke right here in the hospital.. *looks to the side* Oh wow!! The cop is gone! I should try to escape.. hm.. where would I go? I better text one of my buddies and see when he can come get me. I can't believe my luck that the cop left!!
Someone's in here.. oh, she's my nurse. I'm.. not sure what to make of this.. she actually seems to care that my stomach hurts and she's not talking to me like I'm some stupid drunk douchebag. She's giving me IV nausea meds too. And extra chicken broth. This is nice but I gotta get out of here..
I'm in the bathroom right now and nobody is bothering me.. if I put my street clothes on and unscrew the hub of my IV from the tubing like..this..oh ... cool!! Holy shit! I could totally mainline this shit if I keep my IV in!! This is my chance to get out. I will leave the detached IV running in the bathroom with my gown and telemetry box on the floor and just casually walk out..
Okay... back to first person..
State police: "Yes are you the RN who was caring for the pt. who escaped earlier this morning?'
Me: "yes"
State police: "Can you please tell me your full name and title?"
Me: "Sure, it's _____ _______, RN"
State police: "Date of birth?"
Me: "I'm not telling you that!" *laughter*
State police: *silence*
Me: "You need that don't you.."
State police: "Yes."
Me: Fine, it's XX/XX/XXXX (I used my actual birth date)
State police: Ok. Can you tell me what happened.."
I gave him a statement and I was a little annoyed once I told him everything that happened. There was an officer in the room right up until 5 am. Upon doing some googling I found out the patient was on parole and had a pretty long rap sheet. Not to mention the fact that if that cocaine packaging had split open, he would have ODed right on the spot and DIED (and I would have had to try to save him), or he could have passed the coke and snorted it all in the bathroom AND DIED (and again I would have had to try to save him). or he could have stashed it where a confused old patient could have gotten a hold of it (okay that's a stretch but still, WTF??) Not only that, but the cop who was watching him never told anyone he was leaving or why ...suddenly it wasn't important to watch the guy.(probably staffing related but still, tell us what's going on) To top it all off, we called the cops IMMEDIATELY when the guy got away. They didn't even bother coming to look for him and took 6 hours to call back after we notified them.
My hospital doesn't really have a security dept.. (they have 1 maintenance man who doubles as security) and I have to be honest when I say I don't feel very safe sometimes.
I will also say I'm kind of glad he got away because I really didn't want to be remotely involved in what will happen when he passes that cocaine. Especially without any police or security to protect myself, my coworkers, or my patients.
So, Mr. Cocaine Colon, be gone with you. And next time I hope they take you someplace else that has an actual security dept.
Today, I am going to blog in the third person because I am getting bored with writing as myself . Meet one of my patients from over the weekend.
Damn. I knew I was drunk last night but, fuck, how did I end up in the hospital? *rolling to the side* oh mann a cop is in here! Son of a bitch how am I going to get out of here? My mom is going to kick my ass.. wow the judge told me to stay out of trouble, I'm going to go to jail now, no doubt. I'm glad I swallowed those 4 bags of cocaine when I got pulled over, bought me some time to figure out how I'm going to get out of this mess. I hope one of the bags doesn't open.. if that happens I will OD and then I will really be fucked. *dozes back off to sleep*
What.. time is it..? Oh man my stomach is killing me. ooh it hurts... I hope one of those bags didn't bust open...wow.. if I happen to shit one of these bags out soon, I will be able to do a line of coke right here in the hospital.. *looks to the side* Oh wow!! The cop is gone! I should try to escape.. hm.. where would I go? I better text one of my buddies and see when he can come get me. I can't believe my luck that the cop left!!
Someone's in here.. oh, she's my nurse. I'm.. not sure what to make of this.. she actually seems to care that my stomach hurts and she's not talking to me like I'm some stupid drunk douchebag. She's giving me IV nausea meds too. And extra chicken broth. This is nice but I gotta get out of here..
I'm in the bathroom right now and nobody is bothering me.. if I put my street clothes on and unscrew the hub of my IV from the tubing like..this..oh ... cool!! Holy shit! I could totally mainline this shit if I keep my IV in!! This is my chance to get out. I will leave the detached IV running in the bathroom with my gown and telemetry box on the floor and just casually walk out..
Okay... back to first person..
State police: "Yes are you the RN who was caring for the pt. who escaped earlier this morning?'
Me: "yes"
State police: "Can you please tell me your full name and title?"
Me: "Sure, it's _____ _______, RN"
State police: "Date of birth?"
Me: "I'm not telling you that!" *laughter*
State police: *silence*
Me: "You need that don't you.."
State police: "Yes."
Me: Fine, it's XX/XX/XXXX (I used my actual birth date)
State police: Ok. Can you tell me what happened.."
I gave him a statement and I was a little annoyed once I told him everything that happened. There was an officer in the room right up until 5 am. Upon doing some googling I found out the patient was on parole and had a pretty long rap sheet. Not to mention the fact that if that cocaine packaging had split open, he would have ODed right on the spot and DIED (and I would have had to try to save him), or he could have passed the coke and snorted it all in the bathroom AND DIED (and again I would have had to try to save him). or he could have stashed it where a confused old patient could have gotten a hold of it (okay that's a stretch but still, WTF??) Not only that, but the cop who was watching him never told anyone he was leaving or why ...suddenly it wasn't important to watch the guy.(probably staffing related but still, tell us what's going on) To top it all off, we called the cops IMMEDIATELY when the guy got away. They didn't even bother coming to look for him and took 6 hours to call back after we notified them.
My hospital doesn't really have a security dept.. (they have 1 maintenance man who doubles as security) and I have to be honest when I say I don't feel very safe sometimes.
I will also say I'm kind of glad he got away because I really didn't want to be remotely involved in what will happen when he passes that cocaine. Especially without any police or security to protect myself, my coworkers, or my patients.
So, Mr. Cocaine Colon, be gone with you. And next time I hope they take you someplace else that has an actual security dept.
Tuesday, April 17, 2012
Yeah. I admit it. I facebook stalk some patients.
One of the most annoying things about working in acute care is you develop bonds with people, then you never find out how they are doing after the fact. (well, with the exception of some frequent flyers, and usually you don't want to know what's going on with them.:/)
I had one patient in particular in which facebook has been a wonderful way for me to keep tabs on his progress. He was 50 and presented with sudden and severe left lower extremity paralysis and some impairment on the right as well. SWEET guy, worked in healthcare himself for many years (I'm being vague to protect his identity). He noticed some mild paresthesia while playing catch with his 5 year old son the day before and when he woke up the next morning, he couldn't walk. His diagnosis after a series of tests and scans was transverse myelitis (of unknown origin). Lyme titres were drawn (ticks are HORRENDOUS in this area), and a slew of other labs were sent out. His plan of treatment was high doses of IV steroids and frequent monitoring. I actually had to transfer him over to the critical care unit because the docs decided it would be best in case his breathing starts to become affected (if the paralysis started to spread). The neurologist didn't really think it was necessary, but the census was low in the ICU, so I think they figured "why not".. better safe than sorry. I also think it was a good idea to transfer him there because he really needed a lot of company. (can you just imagine how scared he must have been?) He was TERRIFIED and I hated the fact that I had so many other patients to care for and I couldn't just sit with him and give him the attention he needed. Upon doing some reading about transverse myelitis, it looks like the more severe the paralysis is, the less likely a full recovery is. I was really hoping his movement would return as quickly as it left him (as I'm sure he was too) but with every passing day that became less and less likely. I can still hear him saying the day I admitted him to our floor saying "I was just walking yesterday.. I was playing ball with my son.. I can't believe this is happening.."
A few days later, I was thinking about him and I looked up his wife on facebook and her wall was set to private. I saw her mother in law listed. Clicked on the mother in law's wall (the patient's mother) and it was public. As of right now he still has paralysis and he is undergoing intense physical therapy at an inpatient facility.
He doesn't know it, but he has many secret little prayers going to him and his family.
Is it creepy that I'm checking up on him like that? Probably. But...
I had one patient in particular in which facebook has been a wonderful way for me to keep tabs on his progress. He was 50 and presented with sudden and severe left lower extremity paralysis and some impairment on the right as well. SWEET guy, worked in healthcare himself for many years (I'm being vague to protect his identity). He noticed some mild paresthesia while playing catch with his 5 year old son the day before and when he woke up the next morning, he couldn't walk. His diagnosis after a series of tests and scans was transverse myelitis (of unknown origin). Lyme titres were drawn (ticks are HORRENDOUS in this area), and a slew of other labs were sent out. His plan of treatment was high doses of IV steroids and frequent monitoring. I actually had to transfer him over to the critical care unit because the docs decided it would be best in case his breathing starts to become affected (if the paralysis started to spread). The neurologist didn't really think it was necessary, but the census was low in the ICU, so I think they figured "why not".. better safe than sorry. I also think it was a good idea to transfer him there because he really needed a lot of company. (can you just imagine how scared he must have been?) He was TERRIFIED and I hated the fact that I had so many other patients to care for and I couldn't just sit with him and give him the attention he needed. Upon doing some reading about transverse myelitis, it looks like the more severe the paralysis is, the less likely a full recovery is. I was really hoping his movement would return as quickly as it left him (as I'm sure he was too) but with every passing day that became less and less likely. I can still hear him saying the day I admitted him to our floor saying "I was just walking yesterday.. I was playing ball with my son.. I can't believe this is happening.."
A few days later, I was thinking about him and I looked up his wife on facebook and her wall was set to private. I saw her mother in law listed. Clicked on the mother in law's wall (the patient's mother) and it was public. As of right now he still has paralysis and he is undergoing intense physical therapy at an inpatient facility.
He doesn't know it, but he has many secret little prayers going to him and his family.
Is it creepy that I'm checking up on him like that? Probably. But...
Monday, April 2, 2012
It's all fun and games until someone orders an enema
Ah April Fool's in the hospital. I can't think of a better place to be. The problem is, you have to be clever with the pranks you pull because, with the potential for someone dying or even worse someone's right to privacy potentially violated (heaven forbid!), jokes have to be very carefully executed and done in a tasteful manner.
enter IM capability on the hospital computer system.
I'm not sure whose idea it was originally to give the staff the ability to IM each other not only at our campus, but basically, it allows staff to have an IM conversation anyone within the hospital network who happens to be logged on at the time. I have yet to have actually used the IM feature for anything useful at all, except to reference the occasional inside joke or say hi to an old co worker that I haven't spoken to in a while.
The other nurses and I realized yesterday that by typing in a dr's name, you can actually send them an IM (up until this point we basically harassed them the old fashioned way with pages and phone calls and used IMing to talk to one another). This was too good. We had our target chosen, the internal medicine doc currently assigned to our floor and the emergency dept. First nurse says "Let's send him a message that the patient in 230 had a tourniquet left on since am labs and her arm is dark purple!" um, no. First, we would never send an IM over something that bad, so he'd be onto us right away and second, well, that's just mean. So I said "Let's tell him a patient found a credit card on the floor with his name on it and to come and get it." but that didn't seem exciting enough.. then the next nurse said "Let's tell him "a confused patient has a credit card with his name on it and she won't give it back, what do you want me to do?"
PERFECT
Babe: Dr. K, a confused patient has a credit card with your name on it and she won't give it back! What do you want me to do?"
Dr. K (20 seconds later): a credit card? (they give out business cards)
Babe: yup, Visa (one of the other nurses said "what if he doesn't have a visa? I said "oh EVERYBODY has a Visa card" )
Dr. K: and it has my name on it? M___ K____ ?
Babe: yes, that's right
Dr. K: Who is this and what department are you with? (he only knows me by my first name, so he had no clue it was me)
Babe: It's your favorite weekend crew APRIL FOOL'S ♥
Dr. K: Why didn't you tell me sooner?! I already called the police! (this whole exchange took 4 minutes, no way he called the fuzz)
Babe: Sure ya did
10 minutes later, he walked onto the floor and we all put our heads down and started giggling.
Dr. K cleared his throat and announced, "I'm putting in an order:
Enemas. Everyone. Now."
What a great sport. lol
enter IM capability on the hospital computer system.
I'm not sure whose idea it was originally to give the staff the ability to IM each other not only at our campus, but basically, it allows staff to have an IM conversation anyone within the hospital network who happens to be logged on at the time. I have yet to have actually used the IM feature for anything useful at all, except to reference the occasional inside joke or say hi to an old co worker that I haven't spoken to in a while.
The other nurses and I realized yesterday that by typing in a dr's name, you can actually send them an IM (up until this point we basically harassed them the old fashioned way with pages and phone calls and used IMing to talk to one another). This was too good. We had our target chosen, the internal medicine doc currently assigned to our floor and the emergency dept. First nurse says "Let's send him a message that the patient in 230 had a tourniquet left on since am labs and her arm is dark purple!" um, no. First, we would never send an IM over something that bad, so he'd be onto us right away and second, well, that's just mean. So I said "Let's tell him a patient found a credit card on the floor with his name on it and to come and get it." but that didn't seem exciting enough.. then the next nurse said "Let's tell him "a confused patient has a credit card with his name on it and she won't give it back, what do you want me to do?"
PERFECT
Babe: Dr. K, a confused patient has a credit card with your name on it and she won't give it back! What do you want me to do?"
Dr. K (20 seconds later): a credit card? (they give out business cards)
Babe: yup, Visa (one of the other nurses said "what if he doesn't have a visa? I said "oh EVERYBODY has a Visa card" )
Dr. K: and it has my name on it? M___ K____ ?
Babe: yes, that's right
Dr. K: Who is this and what department are you with? (he only knows me by my first name, so he had no clue it was me)
Babe: It's your favorite weekend crew APRIL FOOL'S ♥
Dr. K: Why didn't you tell me sooner?! I already called the police! (this whole exchange took 4 minutes, no way he called the fuzz)
Babe: Sure ya did
10 minutes later, he walked onto the floor and we all put our heads down and started giggling.
Dr. K cleared his throat and announced, "I'm putting in an order:
Enemas. Everyone. Now."
What a great sport. lol
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