year...new....happy

geez madness why don't you get all serious and shit

We don't think about this much but we see tragedy every day as ER nurses.We almost get used it. Some are worse than others. Some stay with you and haunt you.  You think about the person for days afterwards.

There are two kinds of tragedies: Those that happen to people through no fault of their own and those that happen because of stupid choices in life.  The inclination would be to feel more sorry for those that happen to people at random.  In the end, its all the same for whatever reason it happens.  The person will suffer.  The family and friends will suffer.

One thing about being an ER nurse, you really just how unfair life really is. You realize how much a lot of people are suffering in this world. Its reality and it hits you in the face on a daily basis.

How do we, as nurses, cope with it? I've been doing this a long time and I wonder how I have lasted so long considering all the bad stuff you see. Most of it I leave at the door when I go home.  I've developed the ability to let it go, maybe put it in a box.  I think people in ERs use humor a lot to get through.  We develop tough exteriors as a way of protecting ourselves.  That's only natural.

The thing is there are those cases that stay with you for a while.  Eventually you let them go too.  You just hope for the best for that person and their family.  Its all you can do.

hahahahahaha

working in the ghetto

I was thinking how much my ER has changed over the years. When I started, even though we were in the middle of a poor neighborhood, we were more like a suburban ER.  Our clientele was more suburban, white, very few neighborhood folks came in.  They went to another hospital in the neighborhood.  Then that hospital closed.

More neighborhood people starting to come in, but a lot of them still went to the county hospital downtown. I think eventually they figured out that if they came to us, the wait was less. They also figured out the chance of scoring some narcs was higher with us.

Now our ER has become what it always has been: an inner city ER in the middle of the ghetto.  We see lots of neighborhood people now.  We are seeing more of the folks living on the edge of society: drug users, criminals, drunks. People you would expect an ER in our location to see.  Its not unusual to have a heroin OD in one room, a crackhead in another and some guy getting arrested in yet another.

The rest of the hospital still maintains its suburbanite feel for the most part.  The areas of medicine that the hospital specializes in attract people from all over for admission. The specialties are where the money is in medicine. Thats where the money goes.  Those areas are brand new.  They have to be.  They attract the people with insurance where the reimbursement is better.  Its what those with insurance expect.

Meanwhile the ER looks like the  neighborhood we serve: rundown, falling apart.  We aren't a priority in todays healthcare.  Our patients are on medicare and medical assistance,  not money makers.

We live in a different world in the ER, compared to the inpatient side. We are like run down  island of the poor and dysfunctional in the midst of a shiny suburban mall.  No one pays much attention to us.

a Madness Christmas Eve

So I worked Christmas Eve.  I hadn't worked it in years.  I don't have to work holidays anymore because I have been a nurse since time began.  I did it for the money.  Yes, its true, it wasn't out of a need to soothe fevered brows at Christmas. I make triple time on Christmas.  Its all about the benjamins. I worked an evening shift.

Now, naive me, I thought it would be slow because, really, who is out on Christmas Eve? Everybody is all nestled snug in their beds and shit, right?  Waiting for the arrival of the Big Guy. Wrong. It was no different than any other night.We had the usual fun patients.Here's an ode to one of my favorites...

Join me kiddees as we sing that old favorite: "Sally the Crackhead Prostitute" (to the tune of Rudolph the Red Nosed Reindeer):

There were neck pains and chest pains, and headaches and finger lacs,
earaches and sore throats, and  calf pain and people with sore backs,
But do you recall, the most irritating patient of them all?

Sally the crackhead prostitute,
Had a very bad tooth pain
And if she didn't leave soon
We would all go insane.

All of the other patients,
tired of all of Sallys screams
knew that this ER visit
would cause them to have bad dreams

Then about eleven twenty three
The Er doc came to say
Sally with your silly antics
you won't get any narcs from me
Then all the ER staff loved him
they had to take no more
Sally the crackhead prostitute
get your ass out the door!