Roll of the Dice...

All Kids Must Get Flu Vaccine, Panel Says
Posted: Wednesday 02/27/08 07:58 PM EST
Filed Under: Health News

Expanding the current recommendation by 13 years, a panel that advises the Centers for Disease Control and Prevention says every child in the U.S. between the ages of 6 months and 18 should get the flu vaccine yearly. The prior recommendation was for kids 5 years old and younger. "I think most parents do not understand how dangerous influenza is," says one pediatrician.

****While I totally agree that true influenza can be very dangerous to those that have a weakened immune system, the young and the elderly, I do not agree with wide spread immunization.

While I am an advocate of the CDC's current immunization schedule for the most part, I do not agree with this one. The reason being that the scientist base this immunization each year on a guess, an educated guess but still it is a roll of the dice if it will cover the next years flu strains, as evident by this years flu season where the vaccine only covers 40% of what is out there.

The CDC's other logic for this new immunization is that there will be less time loss for businesses, as their employees won't have to stay home and care for their sick children. Thanks CDC but I have no problem being a parent, and letting my employer know what my priorities are. My children.

So from my family to the CDC thanks for trying to save us from ourselves.. but I will CONTINUE to pass on this immunization for myself and children.

If only.....

There are days when I wish this really was a choice

... that the nurse could make!!!

Endangered species spotted..

I want to dedicate this post to those rare patients that have been rumored to exist but so rarely seen... THE NORMAL ONES!

I admit I was on a bitch roll..moody as all get-out. I know that several of my co-workers were tip toeing around me, I think that all the stress and poor morale is really getting to me in the ER. Nothing seem to help turn my disposition around. I even worked with my favorite Dr and I think that maybe we said 20 words to each other.. he freely admitted he was trying to stay out of my line of fire.. smart man, but really not the working environment I want to be responsible for..

That being said it was you my "normal" patients that kept me from completely losing it.

And what exactly does a "normal" patient look like? Let me list the characteristics.

1. First and foremost they know what "Emergency" means.
2. They have PCPs(primary care providers) and actually see them.
3. They know what hygiene is.
4. Can form complete and intelligent sentences.
5. Doesn't have an allergy list that contains Toradol,Nsaids,Morphine,Tylenol,Codeine...
6. Does not have a pain contract or careplan.
7. Understands that patients are seen in order of condition not arrival time.
8. Does not call me by name and wave from the waiting room as I walk in the hospital for work.
9. Understands the pain scale.
10. Generally has insurance or at least not a charity care patient.
11. Knows how to use Tylenol and Motrin and does.
12. Takes and completes medications prescribed.
13. Listens to medical education given.
14. Understands that I have more than one patient.
15. Never been tazed or 4 pointed.
16. Never had to be given Haldol or Narcan.
17. Does not require a dolly to get previous months ER records.
18. I don't know where their best IV start sites are from memory.
19. I don't know their med list better than my own.
20. And finally they Thank the staff for helping them.

I owe you for getting me thru this weekend.. I especially want to thank the couple that came back after their discharge to show their appreciation with hot donuts.. You get extra Dilaudid on your next visit!

Is that a fever? Typhoid? Mad Cow?

It is Friday morning and I head back to work tonight after having the week off. Not really looking forward to it..

Our ER is going thru big changes as there has been a overhaul of the hierarchy, and not all for the good.

Alot of the changes have been done without any input from the people it most affects.. THE STAFF! Not sure why that is.. I would think that in these days of nursing shortages that hospitals and really any facility would want to keep their nurses happy and thus employed with them.. I guess that would require actual fore- thought, and that appears to be lacking at my hospital.


So here I sit in bed 12 hours before my shift (why I am not sleeping?) hoping that I will come down with some as yet unidentified virus that makes me to weak to work, but yet strong enough to go out biking and enjoying what sun we have here in Feb. We all have heard of that virus, it is the one that brings our patients to the ER sunday night looking for the magically "off-work the next day" note, after trying to accomplish feats even their previous decade body baulked at.

As of yet not a sniffle to be heard, nor a cough mustered up enough to get my sleeping SO's attention.. I feel doomed to have to go to work.

12 hours and counting... no pressure right?!

We are not promised tomorrow

We all know this deep down and remind each other daily when we say "I love you" when we part, when we tell our kids not to run in the road.

In my 11 years of nursing I have seen death in many forms. I have seen the death of a future with a miscarriage, the unnatural death of a child, the welcomed death of a patient tired of fighting with an unrelenting disease, nonsense death of a teen out for a ride as the passenger, the final answer to an emotionally/mentally lost soul, the inevitable death of the smoker/drinker/drug addicted, and the death my hands can't fix.

We are not promised tomorrow... but yet those left behind feel betrayed and it is us the hospital staff that has broke that promise. Robbed them of the arms that once held them, the heart that loved them unconditionally and taken away the plans and dreams they had.

We are not promised tomorrow.. we as healthcare workers know this but yet our job is to give our patients and their families that tomorrow. Sometimes we can and sometimes despite all efforts we fail.

As a nurse the hardest thing I can say is "I am so sorry, we tried everything, but they are gone" I have said it more times than I ever wanted to, but each time I mean it with all my being.

And this is what I want my families to know.. with all my being I am sorry I failed, I tried everything I could, I mourn all these deaths,they haunt my dreams for weeks after,the what-ifs plague my mind, the faces and grief of the families touch my soul.

I will carry a memory of you and your loved one until my tomorrow never comes.

Time to put your big girl pants on......

Ok my dear co-workers you really set me off all weekend. Maybe I was being a little hormonal, but I can tell you honestly it had no role in me getting in your face and telling you to quit bitching and just do your friggin job.

We are a small ED and we are all aware of it.. but we all need to deal with the fact that our area is growing and we are smack in the middle of prime outdoor playgrounds. We are seeing more and more people who come out here to play and decide to stay.. and with that they are going to be using our ED for whatever reason they see fit. With that being said our bosses have decided that the growth has not quite met the requirments for us to increase our staff (we will cover that issue in another blog guaranteed) So some nights we are going to run our asses off and we must pull together and work as a team. So I have decided to put together some things you can do to help with that... please take notes.

1-When you have a pt that has a DC(discharge) written, do it. Don't think that by ignoring it, it will keep your beds full and free from taking new patients. If after a few minutes you don't do it someone will and I promise you won't like the next patient they place in that bed, for pulling that stunt.

2- We don't want to hear you whine about how heavy your pt load is. Ours in no piece of cake either. Whining will not get your pts out of the ED any faster. The energy you used whining you could have used calling the lab and asking WTF where are your results. And never never whine in front of pts and family.. you make us all look bad.

3-We all are going to have pts that really know how to push our buttons, especially if they are frequent flyers..and we all appreciate that, and when possible we try and take those pts for you, but if it isn't possible just buck up and deal with it.. you were never promised the ability to pick your pts nor liking them. Be professional and do your job. Standing around and refusing to care of the patient is childish and get you nowhere except ticked off coworkers and further behind.

4-If you are lucky to have gotten a lighter load than someone else the last thing they want to see is you sitting on your butt or surfing the net.. ask what you can do to help, usually the nurse will refuse your offer and say they got it, but offer anyway.. because if you don't they will remember and payback by a nurse can be ugly.

5-If your shift ends while all hell has broken out,offer to stay a little extra till we can at least tread water.. remember this doesn't happen every shift but when it does just you staying one extra hour can really make a difference.

6-When we are slammed the Techs/Hucs are NOT your personal slaves. They are already seen by most as being at the bottom of the food chain . Treat them with some respect and ask them for help. And for godsake remember to say thank you.

7-And Finally just taking a few minutes before you leave for home please stock your room with the basic supplies, linens. foleys, IV tray.. nothing is worse for a nurse than finding that she has to take extra time to run to clean utility to get her stuff.

Basically this posting is all about common sense and courtesy.. remember nurses are evil and have unbelievable memories.. pissing off your coworkers who have the ability to fill your rooms with demented,screaming,incontinent, railing crawling grandmas is just plain crazy..but if you insist..