Monday, June 24, 2013

I was jumped

One of my favorite triage presentations:  " I was jumped''.  Whats funny about it is that the person is usually jumped by someone they didn't know.  They were walking around and somebody just randomly attacked them.

Oftentimes the person will say, "I don't know if they thought I was someone else or what".  This seems to happen to women a lot.  Other women just randomly jumping them.

I just find it amusing, all this random jumping....

Sunday, June 23, 2013


I can't believe how much the nurse in this cartoon resembles me...

Friday, June 21, 2013

25 uses for duct tape in the ER

1)IV pole broke: Tape the IV bag to any nearby surface: the monitor, the wall, the patients relative, etc.

2) Demented Donald trying to get out of bed? Duct tape will keep him in bed.

3) Duct tape that irritating drunks mouth shut.

4) No security available to watch your suicidal patient? Duct tape will keeep them in bed and SAFE.

4) Out of arm slings? Fashion one out of a piece of cardboard and tape.

5) Patient hairy and need to put him on the monitor? Duct tape will remove that hair for lead placement.

6) Backboards all in use? Take the sliding board, some rolled towels and tape and fashion your own version of spine stablization.

7) Duct tape your manager to a chair.

8) Low on suture or staples: A quick and easy laceration repair.

9) Tape patients gown together for trip to bathroom.

10) Out of adult diapers: use towel and duct tape substitute.

11) Tape NG, ET tube, foley in place.

12) Tape patients wig or toupee in place.

13) Never lose it again: tape you pen, scissors, roll of tape, stethoscope to yourself.

14) Make letters RN on uniform so patients will know you are their nurse. You know how everybody gets confused...

15) Afraid your patient might wander off? Put their name on it, room number and attach to gown.

16) Cheap shoulder immobilizer.

17) Confused grandma will never pull out her IV again.

18) Tape your nostrils together for that smelly clean up

19) Cheap eye patch.

20)  Patient has hyperactive kid that keeps running around.  Tape to wall (see picture).

21) Duct tape educator to chair - no more of those irritating online quarterly education classes.

22) Patient keeps coughing in your face, won't cover their mouth - use as a mask.  Hey relax...they can still breathe out of their nose...

23) Doctor order an enema?  Duct tape them out at the triage window.

24)  Never get lunch? Tape a snack to yourself.  Tape a water bottle to yourself.

25) Tape the ER entrance shut when you get too busy.

Your thoughts?

Monday, June 17, 2013

I work in a hazadous waste dump

There are days I feel like I work in a hazardous waste dump.  A hazardous human waste dump.  Sometimes what we do is so gross.  It is gross to the point where I have to wear a mask with vaseline smeared in it in order to avoid vomiting.  Those are the times when I think: Why the hell do I do a job such as this?  I I insane?   Am I some kind of masochist?

These are the times when I think: THEY DO NOT PAY ME ENOUGH.  We should be making triple what we do. If the public saw what we really deal with on a regular basis they would be shocked:
Every disgusting thing that comes out of the human body has to be cleaned up by somebody and that person is a nurse.

From the smell of c diff to GI bleed to homeless feet to beer and cigarettes, we deal with it.  Day after day.  j

The worst thingl I ever smelled was burning flesh.  A doctor decided to removed some kind of skin growths in our ER (totally inappropriate).

Sorry this is a digusting blog entry, but it is the reality of what we do and Lord knows I'm all about being real. ...

Here's a question for you: What do you use to get rid of bad smells?  We use coffee grounds.

Friday, June 14, 2013

just trying to keep up

I am in the middle of hell week - five 12 hour shifts in 7 days.  The thing is I have 2 more days to go this weekend.  The first three sucked.  Monday we saw 60 more patients than normal.  That is 30% more than a normal day.  Did we have get staff to cope with it? Of course not, you fool you. Those are the days you feel like you have been run over by a truck.

What happen to the days when ERs took care of broken legs, appys, lacerations?  Those days seem to be gone replaced by patients who have multiple chronic problems and now they are in with a new one. Our patients are so heavy, so old these days.  They require so much care and, I guess, so many tests.  It is commonplace to see people in their late 80's and into the 90's.  It is also common to spend thousands of dollars in hospital admissions keeping them alive, when all they really want to do is die.

A typical shift brings a 98 year old decreased LOC who is intubated, on drips going to ICU.  In the next bed is someone from another country who is in isolation for possible TB.  Next bed over is a depressed combative drunk.  Next to them a heroin overdose.  Running between them are exhausted nurses trying to keep up.

Saturday, June 08, 2013

oh my

Sorry about the lack of blog entries but I keep finding these great things on the internet.

Friday, June 07, 2013

Nurses please read this

From the Huffington Post (this is why I love and respect my fellow nurses so much)
Today I ran into a Mexican restaurant to grab a quick lunch, and as I ate my meal I came across a table of nurses wearing hospital scrubs. As they chatted amongst themselves I thought about the many nurses my family has interacted with over the last five years, and I found myself filled with such appreciation for what these amazing women and men do for us.
It was in the Neonatal Intensive Care Unit that I initially saw how amazing nurses can be. My first child, Maddie, had been born almost 12 weeks premature, and the hospital staff, upon determining that Maddie's lungs were immature, rushed her to the NICU. There Maddie's life hung in the balance, and though my wife, Heather, and I longed to care for her ourselves, her condition made it so that we couldn't. We had to trust the NICU nurses to take care of our baby for us, and that was incredibly hard -- especially at night when we went home to catch a few hours sleep.
Sleeping was, of course, almost impossible. My sick baby was not with me, and the phone loomed ominously on the nightstand. If it rang before dawn it would do so for only one reason -- to tell us that Maddie had passed away. I can't tell you how scared I was of that phone ringing. Thankfully, it never did.
Each morning I called the NICU at 7:00 a.m. to get an update from the night nurse about how Maddie had done through the night, and the moments waiting for her to pick up the phone were horrible. Was I going to hear Maddie had done poorly and that things didn't look good? Or, if the nurse took a long time to come to the phone, did that mean that she and the other medical staff were desperately fighting to stabilize Maddie at that very moment (something I'd witnessed in person a number of horrible times)? My hands never failed to shake as I waited for the phone to be picked up.
Once the night nurse picked up, though, I began to feel better. She always told us about Maddie's night in great detail even though she'd just finished a long, exhausting shift. The lengths the NICU nurses went for Maddie were incredible. One night, we were told, Maddie wouldn't respond to the ventilator, and the only reason she survived was because the night nurses took turns hand pumping air into her lungs for hours on end until their hands were cramped and throbbing.
As amazing as all that was though, the thing I appreciated the most about the nurses was how they loved and valued Maddie. She wasn't just some nameless baby behind the glass of an isolette obscured by wires, medical tape, and breathing tubes. She was an amazing little girl named Maddie (also "Bunny" or "Little Mama" as they called her), who was beautiful and strong. I could see that they considered my daughter to be amazing and a gift, and to see others felt about her as I did was incredibly meaningful to me.
Maddie was finally released from the NICU, but there were a few times over the next 17 months when she came down with an infection and had to again be hospitalized. Those days in the hospital were both frightening and incredibly dull, and again nurses were wonderful to us. They were always there when we needed them, quick to bring a blanket or to explain what medications Maddie was taking. Like the NICU nurses, these nurses showed Maddie so much love, mooning over how cute she was and making faces at her to keep her entertained.
Though it still hurts to admit, on April 7, 2009, two days after she was hospitalized with a respiratory infection, Maddie passed away. On that horrible day there was a nurse who stayed by Heather's side the whole time, and I am so thankful for her kindness to my wife. There was a nurse that mattered to me that night, too, though she didn't stay by my side, bring me a glass of water or even say a word to me. In fact, I don't think I saw her until the very moment I walked out of the pediatric intensive care unit, but she made a difference nonetheless.
You see, that day my life shattered. I watched my daughter die in front of me, and it was an experience so horrific that even now it seems almost surreal, like, Did that actually happen? To me and family? But it did, and one of the things I remember most about it was how the key medical personnel there didn't make me feel like they found Maddie to be beautiful and strong or amazing and a gift. The lead doctor may have been under a great deal of stress, but the way he pronounced her dead was not right. It was more like a referee calling the end to a heavyweight fight than the end to a beautiful child's life. Then, as we held our dead child in our arms and kissed her goodbye, doctors stood behind the curtain discussing the specifics of what had happened with about as much feeling as mechanics discussing a broken down car.
It was only as I left the PICU that I felt humanity. There, sitting on a chair with a single tear rolling down her cheek, was my nurse. Her tear told me that she cared. About Heather, about me, and most importantly, about my beautiful Maddie.
That's what nurses do that is so important. In addition to all of their medical expertise, they bring a human element to the cold, sterile world of a hospital. Doctors do great things, but have a heavy case load that means they can only visit each patient briefly each day, but the nurses will hold your hand -- figuratively or literally -- and remind you that you are not alone, and that your life is valued even if it can't be saved.
When the nurses at lunch today finished their meal I wanted to thank them, but I didn't, and I wished I had afterward. I can do one better now though:
To nurses everywhere: You should know that you have made a difference to so many people in this world, my family included, and I cannot thank you enough.

Monday, June 03, 2013

might as well

"To  improve emergency room patient flow, we've replaced the front door with a  CT scanner".