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!

on this day

On this day when we all get together with our families, I ask that you remember our soldiers who are away from their families all around the world.  Right now 150 marines are waiting to go into a very dangerous situation Sudan to rescue Americans there. Say a prayer for all of our brave men and women today.

Merry Christmas.

an ER night before Christmas

TUESDAY, DECEMBER 20, 2011

an ER night before Christmas

Gather around kiddies and let Madness read you an ER version of Twas the Night Before Christmas:

'Twas the night before Christmas,the ER is jumpin'.
The chaos at triage is really quite somethin'.
The charts are all stacked in the new patient bin,
I think to myself: we NEVER can win.
The patients are nestled all snug in their beds,
while visions of Dilaudid dance in their heads.
The doc has his gloves on, and I have the tray, its off to that abscess, as I lead the way..
When out in the lobby there arose such a clatter, I sprinted for triage to see what was the matter.
The lobby was chaos, a sight to behold, every other person seemed to have a bad cold.
When what to my disbelievin' eyes did appear,
a frequent flier named Herman we do not hold dear.
With a shuffle, a groan and blood curdling scream, (oh no this can't be happenin' its all a bad dream!)
He appeared with a backpack, along with a sack, and shouted quite loudly: there's somethin' wrong with my back!
He was cursin' and cryin' and carryin' on, he looked around widely and asked for nurse Don,
Or Susan or Wendy or Alan or Fred,
Do something somebody and get me a bed!
By the way I am hungry, haven't eaten in a week, I need a warm blanket and footies for my feet,
I need a glass of water with a whole lotta ice, Now go please hurry, I don't wanna ask twice!
He went on a cart, told you gotta wait your turn, you been here enough, when are you gonna learn?
I turned back to triage, looked straight ahead, trying to stave off that feeling of dread
As I stifled a yawn and was turning around, Up to the window this jolly man came with a bound,
He was dressed in scrubs except with a red and white cap, His face appeared tired, like he jus' woke from a nap,
He was pushing a cart that was laden with sweets,
Some kind soul had come through with the sweet treats.
He asked to be let in, and rolled the cart on through, stopped at the reg desk to give a cookie or two,
He walked back to the HUC desk, gave a wink to the crew,
Asked everybody: What can I get for all of you?
He resembled Santa in a very odd way,
He smiled and laughed and had this to say:
Tomorrow is Christmas, oh what can I bring?
What can I bring to make your heart sing?
Oh Santa, dear Santa, somebody spoke up and said: we just want some peace, all this racket to cease,
Santa nodded and said he'd see what he could do, to make a nice christmas for this emergency crew.
"Goodbye!" Santa said as he rolled the cart out, "Merry Chirstmas to all!" he said with a shout,
I went back to triage to see what difference I could make,
I looked around slowly, did a quick double take
Herman was gone, his bed tied up with a bow,
I asked another nurse: where the heck did that silly Herman go?
He was here just a minute ago, I swear it, I do, yelling and cursing and crying boo hoo.
We searched back and forth and to and fro too,
Then sat in our chairs and gave one collective: Whew!
Oh Santa had been there we all knew it clearly, the man with the scrubs had blessed us quite dearly.
Herman was gone, it was all just so good,
We had a good Christmas Eve that night in the 'hood.

the Airing of the Grievances

I'm a little late with this...Festivus was officially yesterday, but I've been busy.  So I have to do this today.  Yes, its time for the "Airing of the Grievances", one of the hallmarks of any Festivus celebration.

So, of course, my grievances will be geared toward my job. (what a shock)

#1 I understand the need for more efficiency and clarity when it comes to charting, thus the coming of the electronic medical record. Hey I really don't mind it, except it has done nothing to make things more efficient.  It has added lots of time to charting. As time goes on, "tHe EvIl ChAnGerS" (see Dec 12 blog post), are coming up with more and more blanks to fill in. My job has mostly become blank filleriner.  So, don't lie and say EMRs improve health care.

#2 I understand the need for more safety when administering medications, thus the invention of the drug scanning device. Every medication we give now requires us to log into the computer, scan the wristband,
scan the med, chart the med...no big deal right? Wrong. ER nurses often give multiple meds. (You can never give too many meds right?)  We can give compazine, benadryl, zofran, dilaudid for the simplest case of nausea and vomitting.  Safety comes at the expense of more time consumed.

#3 Once again, I understand the need for more safety when administering medication, thus the pharmacist these days check every med that we administer.  They have to approve it before it appears in the pyxis and we can take it out.  Wonderful right? No mistakes. Wrong.  It can take, depending of the day, up to 45 minutes to get the approval.  Delaying care, making care less efficient.  We can override a lot of meds, but no oral meds, including things like tylenol, motrin, aspirin.  We can't be trusted to take those out without approval.

#4 I appreciate when I get a gift from someone in an effort to show appreciation for what I do through the year. However, when that gift costs about $1 and bears the logo of the group giving it out, I'm sorry, perhaps I am ungrateful, but don't bother. I break my butt for our ER and you and this is the thanks I get? Another nail in the coffin.

Thus ends this years Airing of the Grievances. Good night.

Dear Mr. drug seeker..

Dear Mr. drug seeker:

Some friendly advice: When you come in for pain and nausea and after you are triaged, tell us you are heading for mickey d's before you go back to a room, then you chow down in the lobby, we are probably not going to take you very seriously...

In fact, we will look at you as a moron.  The triage staff will document your activity in the waiting room.  The doctor will look at it and you will get tylenol.  Except for your gourmet meal at Micks this was a waste of your, our, and the taxpayers, money.

Sincerely,

and with a shitload of affection,

Madness the nurse