Happy New Year. Woohoo.
Resolutions:
1. Stop my ass from becoming the size of a small city
2. Whoa… I finally quit smoking this year. Amazing, now I can’t have that as a resolution. soooo…
3. Tell people when I hate them, or at least tell them that they suck a little more often.
4. Get a van.
5. Have more good times, and less bad. That’s what I’m talking about.
Be safe, please. Us ER nurses really don’t want to see your ass naked in a trauma bay. Call A Cab.
There are two rules in medicine that those in the Emergency Room should understand:
1. People will die.
2. We can’t change rule #1.
This is a hard story for me to tell. I was encouraged to tell it, though, as a way to help me work through what happened, and to “come to terms” with these things I see.
Every day I go to work, there is a tragedy of some sort. I see it every time I walk through the doors. I go for only twelve hours, three times a week. When you ask an ER nurse how their day went, the answer is usually dependent on how many people died. If I’m lucky enough to make it twelve hours without a death, it was a great day. When I have three die in my short time there…
My hospital is about 100 years old. It’s been worn, and the linoleum always looks dirty, no matter if it was just cleaned or not. The emergency department is divided up into zones. Zone One is the biggest, meanest zone, and is where most of the action goes. The department is always full, and the waiting room is always worse. In front of the Patch Phone is a plasma screen TV that keeps track of each room in the department, and in the corner, reads how many are waiting to get in. On this day in particular, there were 19. We were on divert, and even though we told the ambulances not to come… they would come regardless. My hospital is a Level One Trauma Center, and one of the top 10 hospitals in the nation for neurological injury and diseases. Anyone with any type of brain problem comes to us, no matter how overwhelmed we are. We are the best, and we take them. This day was no different.
There are four nurses in zone one, and one physician. When the patch phone rang that day, all the nurses tried to ignore it. We were closed to ambulances, and the hallway was lined up with patients. I answered the patch phone with the typical line, and the paramedic told me about the patient on the way. She was eighty years old, and was cooking dinner for her family when she fell to the floor. Not a word uttered, just down to the ground. Her granddaughter had just came to the United States from China, and remembered hearing about how to dial 911 in case of an emergency. When the paramedics got there, Mrs. A wasn’t breathing. With family anxiously waiting, the paramedics intubated Mrs A with a 7.0 ETT, taped at 28/gums. Airway, breathing, circulation. This is the creed we are all taught, and it is hammered into us throughout school. Without an airway, breathing doesn’t matter. If you aren’t breathing, we don’t care what your heart is doing, because without oxygen, it won’t be doing anything before too long. Mrs A’s airway was secured, and she was on the way to us.
Paramedics stated a 10minute ETA, and needed no further orders. We were closed, but it didn’t matter. When someone falls down and quits breathing, it’s one of two things: A heart or a brain. It wasn’t her heart, because her heart was still beating. That meant we were taking her, because we are the best at brains. I had rooms 1, 2, and 3 that day. These are three of the worst rooms. They are the rooms where we code patients, rooms where the sickest of the sick go. I moved a patient who was about to miscarry out to the hall, and pulled a curtain around her. We would use room 3 for Mrs. A. In a situation such as this, two registered nurses are needed. One documents things as they happen, second by second. The other RN takes care of the patient. Two of us were there. When a case such as this comes in, everything else stops. The stretcher was prepared, an EKG machine, rolling laptop, glucometer, and a million other supplies were prepared. To anyone watching, situations like these seem like utter chaos. To us, it is a symphony, composed second by second. All of us play our parts, and it comes together beautifully.
The physician was at the foot of the bed, and I was on the right side. I knew this time it would be more organized than most, because I was with my favorite doctor and a battle-worn expert nurse, who has served as my mentor. It was her, in fact, who encouraged me to write this down. Phoenix Fire wheeled the patient in, and transferred her to our gurney. At this time, a sort of zen took over in me. I noticed, of all things, Mrs. A’s hair. She was frail, and looked like a glass doll. For a woman of eighty, she looked so young. She had barely a wrinkle on her face… and her hair was beautiful. It came down to the middle of her back, and was jet black, streaked with silver. Asian women age so gracefully, and Mrs. A was no exception. She had a tube down her throat, providing her oxygen. She was in a mohair cardigan and blue shirt, which had to be cut off. I have always thought this is the worst part. I have to cut off these clothes, and I know that if I couldn’t save Mrs. A, her family would take those clothes home, carelessly cut apart, and that would be their last memory of their mother, grandmother, aunt, sister, and wife. I never like to cut the clothes off, but it has to be done, so I did it.
I’ll finish this later.
I wish I had a stash of them, that I could throw at the following people:
1. People who talk on their cell phones and drive
2. Selfish sons-a-bitches
3. The Inconsiderate
4. Most everyone, really
Maybe today was just a bad day.
To all of you who read this, you probably know Erin. She was in a car accident this morning at about 6:45. You haven’t personally been called, because her cell phone was in her car, which is mangled. She is OK, despite being pretty banged up. Preliminary news is that she has a fractured fibula, a fractured hand, a fractured rib, and many cuts, scrapes, and bruises, some of them big and bad.
On her way to work, a semi swerved into her lane on I-17, which in turn sandwiched her between said semi and the concrete median. She was going 65, and wearing her seatbelt (thankfully). As an ER nurse, I have to say that she is very lucky to be alive, much less talking (or rather, swearing). It is rare to see someone come out of something like this intact. She was stuck in her car for about 20 minutes, and the firemen (cute ones, she says) cut off her roof and passenger door to get her out.
I’ve just gotten back from visiting her, and being that her friends are like family, this is the easiest way I could think of to let everyone know. For those of you who would like her room number or any other information, call me at 623-533-6163. Her cell phone will, needless to say, not be in service. I don’t want to put her information up here, because I don’t want Steve Brunner prank calling her, and we all know he will.
Hopefully she will not need surgery, and will be home tomorrow. For those who are the praying kind, say a prayer that her roommate will stop snoring, and the nurses will keep the morphine coming.
So I learned the perfect recipe for a damn good time: Mix four guys in kilts, seven belly dancers, two bagpipes, and OutKast. Put ‘em all together on a boat with one drunk white guy who thinks he can dance, and mix all ingredients with free all-you-can-drink Margaritas.
Good times were had by all. Question: why is it that grown ass white men (particularly rich ones) find it necessary to dance? He apparently had just been let loose from the Curves Step Class, because he could do the step-touch and the hip thrust like no other, all while hunched over like he wanted to puke. Matter of fact, I think I may have puked a little in my mouth just watching the poor soul.
He was worse than Elaine on Seinfeld. Much worse. And that is hard to do.
So I finally got to go to my doc today, with no puking child in tow. It turns out that since I have quit smoking, I have gained 12 pounds. Yes, 12. Pretty soon I won’t have legs anymore, I will have lumps of pudge. Before long I’ll need a Hover-Round just to get to the fridge. I’ll be so fat that when I wear a raincoat, people will yell “Taxi!”
So I’ve figured out my problem. Used to when I got a craving, I would smoke. Now I eat. So I have to find another habit to replace eating before I turn into the white Oprah. Here are some of the alternatives to eating I’ve been throwing around:
1. Exercising: This is probably the most healthy, but alas, it cannot be. First of all, I don’t like exercising unless I’m in a gym, and I don’t want to (nor can I afford to) pay for a gym membership. Plus, I get the urge to eat at 4am. I can’t go running at 4am. Shane won’t let me. Plus I don’t like exercising, so it wouldn’t last. I would just go back to eating.
2. Typing: This was Shizzy’s idea, and I think it’s a good one. You can’t eat and type at the same time now can you? I’m sure I could find a way. There is a con though… I already type a lot. I’m on the computer a lot. Really I am. Pretty much when I’m at home, I’m either typing, eating, or sleeping. So then it would be typing and sleeping. I don’t know about that.
3. Cleaning: This is probably my best option. It gets me moving, I enjoy it, and it is more productive than the other things.
4. Shopping: Most enjoyable, most expensive, can’t do it at 4am.
So all in all, I think cleaning is my best option. We’ll see how that goes. I really have to stop it with the eating thing.
Good news at work: I get to wear whatever scrubs I want now. To hell with Royal Blue! Today I’ve chosen red. They’ve made a (feeble) attempt at “boosting morale” by letting us pick our scrubs. Really we need a manager, a different charting system, more staff, and new equipment. That might help morale. But I’ll take the change in scrub color. It’s better than nothing.
I had a doctor’s appointment today, but I didn’t quite make it into the building. You see, Rebecca has been ill. While I was at work on Friday, she spiked a temperature and got this strange rash on her body. She wasn’t any better on Saturday, so Shane (who was sick as well) took her to the urgent care clinic. The doctor (who apparently has x-ray vision) said they both had “walking pneumonia,” gave them $400 worth of prescriptions, and sent them on the way. He didn’t do bloodwork, no studies, no xrays (hence the vision), just looked at them and wrote a prescription. I disagreed with his practice (or lack thereof), but after all, he did go to school four years longer than I, so I was willing to give him the benefit of the doubt.
Rebecca is almost done with her antibiotics, and she’s worse today than she was before. The antibiotics did not help, she is still running fever, and she still has a rash. On the way to my doctor’s appointment (just a checkup, I have no cookie-tossing disease) she barfed. I’m talking all over the backseat thank God I wasn’t within three feet of her BARF.
My point is that now I have to go to her real doctor, instead of the doc-in-a-box. Her real doctor is a joy as well, telling me she has asthma, when she has no such thing. I don’t know what she has for certain, because I haven’t done a chest x ray or bloodwork… but I can nearly guarantee you she has 1. Simple damned allergies, and 2.) valley fever.
Neither of which are treated by antibiotics and inhalers. But we shall see. Like I said, I don’t have MD behind my name, just my mom/nurse/been around a lot of sick kids instincts.
I hope she gets better soon, because I don’t like cleaning up puke in the car, and I sure as crap don’t like seeing my baby sick. I think it hurts me more than it hurts her.
Now for the second issue, and a random question: Why, when someone gives you money, do they say not to spend it all in one place? What is that supposed to mean? Why can’t I spend it all in one place?
I have it, and I don’t know why. I’m not asking for it, it just comes around once a year, usually when it starts getting colder. A few years back I would have loved the attention. Now it’s rather annoying.
Lindsay Lohan pretty much sucks. I just watched the sucky “Confessions of a Teenage Drama Queen.” It’s nearly as bad as “Confessions of a Teenage Caveman.”
That was the second Teenage Caveman, if you haven’t seen it yet.
WOW it was SO BAD!!!
UPDATE #2
I peeked, and he figured it out. I really just tried to open it a little, but the paper tore…. and so I didn’t have any choice but to look inside at that point. I tried to lie. I tried to re-wrap. Damn my shitty wrapping skills!
However, I did get a sweet Christmas present. I’m enjoying it immensely, although I am no good with technology. ( I finally recieved something on my list for Christmas. Joey Whoa got me the Palm Tungsten E2, which is exactly what I wanted)
My problem is the whole bluetooth thing. First off, I wonder why they called it a blue tooth. That’s really rather disgusting, if you think about it. Blue teeth? Hm. Anyways, my laptop is old fashioned, so it won’t sync with the tooth. Now I have to get a wi-fi card, which should just come with the damned thing.
I got Epocrates though, and that’ll save me at least four years of time at work. I will be the master of productivity and patient outcomes! Tungsten will save your ass one of these days. I know it.
It also has a pirate game on it, and I suck at that as well. My ninja skills are lacking, and apparently my pirate skills are…uhh…not skillful. A ninja could have gotten that present open quick, and no one would have known. I must hone my skills, and fast.
That shithead opened his Christmas present when I was at work. He’s 30 years old, and he couldn’t wait until Christmas. He completely unwrapped it. It is no longer even under the damned tree.
I think it’s hilarious really. I sound mad, but I would have done the same damn thing. It’s probably my fault for hyping it up so much. After all, it is Sirius, and it does kick ass. I even pulled the “well now I’m just going to have to take it back to the store because you opened it” line. Ha!
So now he’s going to keep the Sirius, and I’m going to give him his original birthday present for Christmas. And I put that damned thing in my locker at work, so he’ll never get it. What a bad example he is for Becca. Joey Whoa, I am ashamed. Ashamed.
Here is my Christmas list. I know that I will get not one single thing on the damned list, but I made it anyways. I never get anything on the list.
1. PDA
2. IPOD
3. New Pot/Pan set
4. Digital Camera
5. FURNITURE
6. Nice Sunglasses
So I guess I should kiss all that stuff goodbye. I actually think my mom might get me furniture, I’ve complained about not having any for so long. We’ll see. Joey Whoa is now out of bed, so I’m going to hit the sack. Good night… or morning… whatever.
