Up here in the normally frozen tundra, we are in transilvanian state of mind. It is so foggy you can't see the skyline. There has been little snow. Everything is gray and dreary and it feels like there is no hope in site. The Er is full of vomitters and diarrheurs and coughers and such. So in an attempt to elevate my spirits, I looked up medical humor on the internet. Here are the results:
Stupid doctors orders:
Elevate patient's scrotum while lying in bed
Please bathe patient. If nursing staff is too incompetent to do this, please inform me.
Apply Nystatin powder to groin and under weiner prn.
D/C orders from ER doc for 13yr old etoh pt. Under home d/c Rx: "Ass-kickin by parents PRN"
Nitropaste 1.5 inches to chest wall, q6h,
"TITRATE" to SBP> 90 by wiping off 1/4 inch at a time.
Keep bum covered, family request. I'm not kidding!
Humidified oxygen to liberate sputum.
Please, for the love of God, transfer pt to floor. Monitored bed not necessary.
ER acronyms:
BTSOOM - Beats The Sh*t Out Of Me
bugs in the rug - pubic lice
DILLIGAF - Do I Look Like I Give A F*ck
SOSFOLFOFNOF same old story frail old lady fell over, fractured neck of femur
BUNDY but unfortunately not dead yet
Ringo – (after Beatles drummer Ringo Starr) an expendable team member
BWS beached whale syndrome
Surgery report:
Pre-procedure: Suspected foreign object lodged in rectum. Radiology suggests may be golf ball.
Post-procedure: Foreign object removed from rectum. Sent to lab for analysis.
Lab report: Confirm foreign object is golf ball. Brand: Titleist.
Thursday, February 02, 2012
the Amanda Trujillo case
A nurse advocates for her patient, as nurses are supposed to and gets fired. It is the story of Amanda Trujillo, a nurse in Arizona.
Here is her story in her own words:
My name is Amanda Trujillo. I’m a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery. When I properly educated the patient using the allowed materials by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). The patient also had no idea that they had a choice about whether they had to get the surgery or not or that there were other options. They asked about hospice and comfort care and I educated the patient within my nursing license and the nursing code of ethics. The patient requested a case management consult to visit with hospice to explore this option further in order to make a better decision for their course of care. I documented extensively for the doctor to read the next day and I also passed the info on to the next nurse taking over, emphasizing the importance of speaking with the doctor about the gross misunderstanding they had about the surgery. The doctor became enraged, threw a well witnessed tantrum in the nursing station, refused to let the patient visit with hospice, and insisted I be fired and my license taken. He was successful on all counts.
More info at this website
Here is her story in her own words:
My name is Amanda Trujillo. I’m a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery. When I properly educated the patient using the allowed materials by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). The patient also had no idea that they had a choice about whether they had to get the surgery or not or that there were other options. They asked about hospice and comfort care and I educated the patient within my nursing license and the nursing code of ethics. The patient requested a case management consult to visit with hospice to explore this option further in order to make a better decision for their course of care. I documented extensively for the doctor to read the next day and I also passed the info on to the next nurse taking over, emphasizing the importance of speaking with the doctor about the gross misunderstanding they had about the surgery. The doctor became enraged, threw a well witnessed tantrum in the nursing station, refused to let the patient visit with hospice, and insisted I be fired and my license taken. He was successful on all counts.
More info at this website
Monday, January 30, 2012
ode to the med room
If you feel like you are going to lose it, you go to the med room. If you have to blow off steam you take a co worker into the med room and let er rip. You can gossip in the med room. You can make fun of patients in the med room. You can cry if you want to in the med room.
I talk to myself in the med room. I ask myself what I am doing in this God forsaken place? I call the patients idiots. I take a few deep breaths if a doc or coworker pissed me off.
Espescially in an ER, the med room is like the eye of a hurricane. It is a calm and peaceful place in the middle of a whirlwind. No docs, no techs, no management. The only people with reason to be in there are nurses. Its like our own secret clubhouse and it requires a secret code.
I for one, couldn't live without it.
Sunday, January 29, 2012
gaming the system
She presents with "back pain". Sitting in the triage chair she says just to check her vitals to see if she is okay. Vitals are of course, normal. She asks if there was something wrong with her heart, the vitals would catch it right? Ponders deeply whether she should be seen.
I can't make that decision, you have to decide. States she will go to the waiting room to think about it. Comes to the desk and asks to use the phone to call for a med cab home. Med cab company calls and is told patient was never actually seen in the ER. They won't come.
Guess what? She wants to be seen. Big surpise huh? She decided this could be her heart, she has had an irregular rate in the past. EKG done in triage = normal. Big shocker that.
You have just witnessed the most expensive cab ride you will ever hear of - about $2,000. All of it will be billed to you - the taxpayer.
I can't make that decision, you have to decide. States she will go to the waiting room to think about it. Comes to the desk and asks to use the phone to call for a med cab home. Med cab company calls and is told patient was never actually seen in the ER. They won't come.
Guess what? She wants to be seen. Big surpise huh? She decided this could be her heart, she has had an irregular rate in the past. EKG done in triage = normal. Big shocker that.
You have just witnessed the most expensive cab ride you will ever hear of - about $2,000. All of it will be billed to you - the taxpayer.
Saturday, January 28, 2012
waiter there's a fly in my soup
It seems crack addicts have sensitive palettes. The other day our cuisine just was unacceptable to said addict. Their light lit up immediately upon presentation of the entree. "I don't eat any of this stuff!". Geez, I thought scratching and conniving daily for that high, you would eat just about anything. But no, our friend wanted us to order specific items. Ala carte as it were...but alas, the kitchen was closed. Our poor friend was forced to gag down the entree presented....
When you go with a friend to the ER, why not be seen yourself for that pesky chronic complaint? That sore knee that has been bothering you for six months....hey you got the time right? After all the last doctor you saw was in jail...
Why not come to the ER for a second opinion on your tummy ache? Your own doctor is not telling you what you want to hear, so maybe the ER doc will unravel your complex condition. Also, if you been to 3-4 other ERs and are not happy with their service, come to ours, because we probably have the miracle cure you have been looking for...
We so appreciate it when you tell us when asked if you have a doctor, you say, "no I come here for my care". It makes us feel special that you chose our institution to meet your health care needs.....hey money is money and we'll take it any way we can get it.
When you know that you are going through alcohol withdrawl, grace our doorstep. We would be happy to stave off those shakes with a healthy dose of lorazepam. We will probably even start an IV and given the vitamins you are lacking. We'll make you feel good so you can go out and do it all over again.
Subscribe to:
Posts (Atom)