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Thursday, May 26, 2016

E coli as enemy combatant


Here comes news that there is a super freak e coli strain that has now arrived in the United states.  It is apparently considered an enemy combatant  because it's arrival was announced by the department of defense.  This is a super bug that doesn't respond to ANY antibiotic.  It kills 50% of the people who get it.

What this brings to mind is the sepsis extravaganza that is going on every hospital
in this country.  If you have a temp of 99 and a pulse of 101 you are a possible sepsis.

If your labs are off - OMG!!!!!!- you get the triple whammy .  Ceftriaxone, Flagyl, Vancomycin for you. There will be no germ left in your body dammit!!

This is only the beginning of a long line of resistant organisms.  It's a science fiction movie come true.

Tuesday, May 24, 2016

Cowardly chicken hawk donald trump dodged draft

Chickenhawk (also chicken hawk and chicken-hawk) is a political term used in the United States to describe a person who strongly supports war or other military action (i.e., a war hawk), yet who actively avoids or avoided military service when of age.


I am a veteran. So naturally I have STRONG feelings about veteran issues. I cannot stand people who use veterans (or even veterans who use their military service) for personal gain or attention.  To see one of the presidential candidates crow about being the greatest supporter of the military that ever lived sickens me. When they sponsor a fundraising event using veterans for political gain and lie about the results - where and to whom the money went, it enrages me.  Guess who I'm talking about? Yeah, that fucking idiot donald trump, a man who after 4 deferments,  wasn' t drafted due to " bonespurs" in his foot. Poster boy for being a chicken hawk.

Sunday, May 15, 2016

Even the lowly UA has become complicated


UAs. So easy. So routine. One of the easiest things I do as an ER nurse. Used to be anyway....

Now even the lowly UA has become complicated. Instead of taking the UA cup , labeling it and sending it off, now they have added steps.  You, my dears, the UA cup is no longer just a UA cup. It has become a complex specimen creating contraption.

Allow me to elaborate: Your friendly neighborhood urine cup now has a hollow tube in the middle. On the top of the container is a a needle with rubber over it.  Said urine cup comes with two specimen blood type tube with the usual rubber stopper. Once you get the specimen you have to put the tube on the needle and it fills the tube with urine all spiffy like. You send the tube to lab, not the specimen cup. The specimen cup is thrown in a waste basket with all the other urine specimen cups. For some reason the urine is not emptied out before being tossed. Apparently there is a gnome in the basement whose job it is to empty all the urine down the sewer....

My thoughts about all of this: just shoot me now.

Saturday, May 14, 2016

I wouldn't wish a nursing career on my worst enemy

My job has become overwhelming.  It used to be there were days when it wasn't that busy, when there was time to talk to my co workers, relax a little bit.  Those days seem to be gone.  There is not a day that goes by that it is not busy from morning til night. The waiting room is full.

The patients have become sicker.  I think most people think of ERs as places where people go for broken bones, appendicitis, car accidents, etc. Maybe that was the way it used to be.  Not any more. ERs have become high tech nursing homes.  Our patients are the elderly, the chronically ill, the mentally ill.

People are living into their 80's and 90's routinely these days.  Their health inevitably deteriorates the older they get.  They are the majority of our patients.  The next group is the chronically ill, those with heart disease, diabetes, cancer, the disabled,etc. Naturally they are in the ER more than most. Last but most certainly not least are the mentally ill.  There has been an explosion of mental health patients in the last five years, especially adolescent psych patients.  Due to lack of psych beds, they sometimes stay days in the ER waiting for a bed to open up.  They can be violent.

One other group I didn't mention are those who live at the bottom of society:  drug addicts, criminals, drunks, people whose lives are a pile of shit.  They make up a percentage of the ER traffic too.

When the patients are sick, they get more tests, procedures. Everybody gets an IV and IV meds.  They are complicated, a lot of work.

Add this to the fact that there every time I come to work I have about ten emails telling me the changes that have happened since the last time I was at work. 

Charting has become a nightmare.  We spend about half our time filling in blanks to make accrediting organizations happy.

Everything has become a protocol these days with many steps and lots of charting involved.

All this in the middle of dealing with patients and families fears, anger, demands.  Throw in short staffing and you have an overwhelming job that I wouldn't want my worst enemy to have. 

Wednesday, May 11, 2016

Duh, hey, Dr, maybe ya ought stop giving out narcs like candy...

At last, a well known doctor, Sanjay Gupta, is acknowledging that doctors are the ones who need to: read here on cnn

1) Finally acknowledge their MAJOR ROLE in the prescription drug epidemic. Ain't nobody else writin' those scripts...

2) Acknowledge that they need to stop giving out narcs like candy.

3) Stop using excuses about why they continue to foster the epidemic: The patients complaints will bring down patient satisfaction scores. Who cares?  Patents expect it. And they will continue to expect it until you stop. It's easier to do it and avoid confrontation. Why are you a doctor? Seriously.  Etc etc etc