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Tuesday, July 29, 2014

hell no

There is an Ebola virus outbreak going on in Africa right now.  A terrible thing.  It starts with a fever, throat pain, muscle aches and headaches. Often times it affects the liver and kidneys.  People have trouble with bleeding.  Little can be done for it except supportive care and hope that the body's immune system can overcome it.  It has up to a 90% fatality rate.

There has been recent news of medical professionals there dying after getting the virus. Recently a man travelling in Africa who was a citizen of this country died over there.

Its a scary thing. The chances of it coming here are probably remote.  It gives me pause though..  We are trained to deal with disasters, including disease outbreaks and how we would handle them. Biological warfare.  Gas attacks. I learned about all of this in detail in the military.   I have to say that if there was an outbreak of some kind o a chemical or gas attack, biological warfare,
 I won't be the one caring for people.

That might sound selfish.  Hey you are a medical professional and you work in the ER, you are supposed to take care of us during these events.  Maybe....but I am not willing to sacrifice possibly exposing my family to something I could bring home.  Simple as that.

What are your thoughts?

Sunday, July 27, 2014

another nail in the coffin

I almost ran screaming from the building a couple of days ago at work. THEY were down the hall. The people with the clipboards. I won't say who they are.  I do not want to put their dreaded name on my
blog...
Lets just say the name of their company rhymes with my friend Tess Haney....yes its THEM, the people I have heard about on other blogs.  THE people that are hated throughout the land

They are the people whose job it is to gather the SURVEYs, make the SCORES, make our lives a living hell. I can't believe my hospital hired THEM.  The thing is the hospital keeps harping on saving money, but they are no doubt spending hundreds of thousands on this company.  ??????

I can just see what is going to happen with this.  People are going to be individually singled out with this. They are going to be "re-educated".  Doctors are going to be even more kiss ass than they are now for fear of getting a bad score.

This is just another nail in the coffin. I just can't stomach this stuff.  I mean seriously, the whole patient satisfaction thing is going to be a nightmare. The thing is, people who work in medicine really do the best they can. Our job becomes more and more difficult.  The patients are needier and more difficult to deal with. Now all of this is going to be hanging over our heads.  Its just too much.

Tuesday, July 22, 2014

bursting your bubble about nursing


Dear John/Jane Q. Public:

I am about to burst your bubble about nursing. You know the profession that is most admired, comes up number one in those polls? Those angels of mercy, Mother Teresa types? The ones that soothe your fevered brow?

Guess what? Nursing is a job. Thats all it is. The difference between your job and my job is that there are sick people at my job. My job is no different than your job. I punch the clock in and out. I do whats necessary to the best of my ability.

Here's the thing: I did not have a "calling" to this job. Mostly I went for this job because of its flexibility, security and variety. I didn't have a deep yearning to help people. Thats just a nice side part.

I do this job to help support my family. If I won the lottery, would I keep doing the job? Hell no. I would be out of there in a heartbeat. I'll let you in on a secret, Mr./Mrs. Public, this is just a job to me. I didn't set out to help humanity. I am not Florence Nightengale. A lot of the time, the job sucks.

I can just hear some people saying: You obviously never should have become a nurse. Blah blah blah. People have this distorted image of nursing as these people who have a need to sacrifice themselves for others. We are these angels of mercy put on earth to serve humanity. Makes me laugh. We do the job, cash the check, go home to the family and try to forget about the job. So don't put your ridiculous expectations on us and then be disappointed that we are just people doing a job.

Sincerely,

madness the nurse

Sunday, July 20, 2014

Which ER supplies the softest, most cuddliest and toasty warm blankie?


I'm thinking about starting a new local ER website. As a service to humanity.

On this site would be listings of every ER in the city and the waiting times on their websites. Listed in order of least waiting time to most. Length of typical visit.

In the interest of serving the community, there would be a list of whether the ER has:

1) box or bag lunches and their contents and rotation
2) types of (cold, icy) juice and selection of crackers
3) whether they supply warm, cuddly, toasty blankets.
4) footie availability and color selection
5) whether they have TV (with HDTV cable or DVD availibility)
6) probability of getting a cab voucher or bus token
7) probability of you scoring a script for percocet
8) probability of you taking an ambulance in for a sore throat and getting back to a room versus being put in the lobby
9) comfort of chairs in lobby and presence of TV, fish tank, vending machines (quality of snacks, selection of sodas), play area
10) whether your car can be valet parked on arrival

There would be a comment section in which you could name names about which docs at which ERs were Dr Feelgoods.

Oh the fun that could be had! The comments section could be entertaining in and of itself.

Hey...its a competitive world out there and patient satisfaction is the goal of every single solitary person in the ER, including of course, yours truly, thus the web site... 

Saturday, July 19, 2014

the land of make believe


I work in the land of make believe. In this land all of the nurses are perfect. We never call in sick. We have a sweet smile and a kind word for every patient, even that drunk guy who shit and peed himself. Intead of reacting angrily to being called a "fuckin' bitch", we de-escalate the crap out of that person for an hour if we have to. Cause thats the kind of nurses that we are...

We think all of the doctors are perfect. We don't mind if OCD doc orders 50 unnecessary tests, you just never know what evil lurks after all. We understand her concerns about liability. Who wouldn't? And if candy man doc orders dilaudid q 5 min, we give it with glee and push it in rapidly just like the drug seekers want us to. They are in pain after all...

We understand why the nurse upstairs is in an isolation room, busy, at dinner, on the phone, in the bathroom, and we wait patiently for her to call us back. Housekeeping is our best friend and we don't mind if it takes 2 hours to clean that "stat clean". Once again we will use our "de-escalation" skills to talk the family down. Thats what we do..

When the lobby is full and back pain Barney has come up to the desk for the 10th time in the last half hour, we will sympathize and offer him a cart in back of triage, who cares if there are already 8 carts lined up back there? There is always room for one more..

Last but most certainly not least, we don't mind going 6 or 8 hours without a break. Our patients need us and if it means missing a meal to take care of them, well - do you think florence nightengale every got a break? I don't think so...

Our ER is perfect. The nurses are perfect, it goes without saying our docs are perfect. Our care is perfect. We follow all the rules. We do everything they tell us to do. We never complain. We love everybody and want everyone to be happy...

How was your day?

Monday, July 14, 2014

man candy saturday - 2 days late - ode to Derek Jeter




"...now batting for the New York Yankees, the short shop, number 2, Derek Jeter...number 2..."

Sunday, July 13, 2014

Saturday night in the ER


What's better than this on a Saturday night in ER?  Here come the   police with 2 drunks, one of whom is belligerent shoutin': "I want to go motherf----kin' home!!"  Its actually a couple.  How romantic.  The other one is very quiet, lethargic, no problem.  Tha'ts the kind of drunk I like...

What is this? Two more drunks coming by ambulance?!  No room at the inn, so back of triage in a cart. Another couple.  Again one belligerent and the other quiet. There really is love in the air.

Who hung out the TWO DRUNKS FOR THE PRICE OF ONE SPECIAL sign?  Or maybe it was the ROMANTIC GETAWAY WEEKEND HERE sign?

OK, the foursome are dealt with, told to STFU.  Uh oh, is that toothless Matt the methhead at the window? Its gonna be a long night...





Yeah yeah I know sometimes the pictures have nothing to do with the subject, but it does in my warped little mind....

Saturday, July 12, 2014

bada boom bada bing

It is my contention that: The average drug seeker is an IDIOT.  They are a few sandwiches short of a picnic. When they were passin' out brains, they thought they said trains, so they said pass me by.  Bada boom. Bada bing.

When you choose to go to the same corporate system that has several hospitals in the area, here's a clue: WE ARE GONNA KNOW IT.  We will see that you went to blah blah hospital 10 times and now suddenly you are coming to ours..RED FLAG.  Why wouldn't you go back to your friends at blah blah hospital? Thought you would try a new drug source?  Unfortunately thats not gonna work for us.  Or you either.

I really don't want to hear how disappointed/angry you are that you are in pain and the doctor doesn't care. La la la.  Too bad, so sad, bye bye.

Thursday, July 10, 2014

you sick bastard

I'm still sick and I'm sick of it.  I finally went to the doctor yesterday and got some antibiotics. This is day 8.

ER nurses are not supposed to get sick.
 

Thursday, July 03, 2014

Dear Book Sellers, Magazine article writers, schools, TV shows, "guest blog post writers", People wanting me to review anything:

NO

Stop emailing me.

Wednesday, July 02, 2014

I'm a hard stick....



OK its July, people aren't supposed to be sick, but I am.  Achy, cough, sore throat.  Its very unfair. 

Tuesday, July 01, 2014

hey its the truth


whining doctors need to shut up

Health care is so ridiculous.  I see on a daily basis how ridiculous it really is. Millions and millions wasted every year on tests, treatments that are totally unnecessary.

We are doing MRIs on 97 year olds.  I mean really?  What are we going to do if it is abnormal? Surgery? Yeah right...but hell, why not?  The hospital makes a couple of thousand off that.  The radiologist lines his/her pockets with money.

These tests are done for profit. In non profit hospitals.  CT heart angios. Millions of unnecessary CTs. Angiograms.  Back surgeries that rarely work. But hey the surgeons make a ton.

Doctors go to classes to learn how to code things in order to maximize profit.  Healthcare is a money making machine for specialists and healthcare executives.  They're making out like bandits bankrupting our healthcare system.  They have learned how to manipulate the system for maximum profit.

Damn those medicare and medicaid patients and those with no insurance at all!  Medicare keeps decreasing reimbursement!  It demands we have good outcomes and is starting to not pay for bad outcomes! Who do they think they are trying to tell us almighty doctors what to do? Medicaid only pays so much.  Those with no insurance, well where do I start?!!!

I find it interesting that the one system that is government run is the one demanding the most of healthcare systems: Medicare.  It is linking payment to outcomes.  It is refusing to pay for hospital acquired infections.  It is setting standards for how certain conditions are treated and demanding the standards be met.  How could they?  How dare they practice EVIDENCE BASED MEDICINE?

Doctors view systems like Medicare as the ENEMY because they dare to require doctors to do what they should be doing.  They say they are "losing control of their practice" blah blah blah.  If you had done the right thing in the first place, you wouldn't be "losing control of your practice".

A government system, Medicare,
is proactively demanding better care.  Its the only healthcare payor that is doing that.  Hopefully Obamacare will do the same.  It has already started to do that requiring wellness checks be paid for by insurance companies.  Hopefully, these changes are only the beginning.

Now if we can only get doctors to stop whining about change.