Very Classy

Just when I thought I had seen it all... Woman comes to the ER after her husband is brought in by medics for suicide. He is being kept alive (he arrived brain dead due to trauma) for possible organ donation and until she can be located. She comes running into the ER hysterical.... with boyfriend in tow!!

Oops!

Quickest way to bring an ER to a standstill and tons of firefighters come running with bunker gear on at 1:32 am.... Burnt Toast. Poor nurse she was so embarrassed.... and the firefighters.. weren't too amused either....

Look Mom I am Famous!!

W hen I started this blog I meant it as a way to vent and meet other healthcare workers feeling the same frustrations... never did I imagine that people from around the world would find this let alone read this... amazing and humbling..here are where some of my readers are from out of the last 100 visitors...

Australia, Iceland , Russia , United Kingdom
German, Indonesia, Pakistan, Malaysia
Poland, Canada, Netherlands, Singapore,
Egypt, Israel, Beligum, New Zealand, Austria,

Brazil

GCMs

In our ER using the term "Frequent Flyer" to describe patients that practically live here is a big no no and grounds for a write up for being judgmental and derogatory... so I use the term "Gold Card Member". Typically GCMs are drug seekers with a list of allergies to all non narcotic and OTC pain relievers.

One such patient came in this week while I was working Fast Track (the area of the ER that is open from noon to midnight that is designed to see quick cases, typical walk in clinic patients..we get most the GCMs during operation hours) and this is how he started our interaction...

"Hey lets not waste anymore of my time, the stuff you been giving me is garbage... I need something better and a lot of it cause I can't keep spending all my daylight hours here..it is summer man and I got things to do!"

Nope no reason to be judgemental here...

Entitlement

Illegal Mexican family brings their daughter to the ER for hives with unknown cause. Dr orders chewable benadryl.. we don't carry tablets only IM shots,IV dosing, capsules and benadryl elixir with 14% alcohol. These are all unacceptable dosing as this is a very minor minor allergic reaction. Here is my discharge conversation with the parents..

Er Nurse- Hi Mr &Mrs "Lopez"...Do either of you speak English or should I call for a translator?
Mr Lopez- Yo hablo un poquito english.
ERN- Great ......."Maria" is having an allergic reaction, she needs to take benadryl as prescribed on this prescription. You can fill it at 24 hour pharmacy.
MRL- You aren't going to give her something now.
ERN- We don't have chewable, and she doesn't need an injection.
MRL-How am I suppose to get to the pharmacy at this hour.
ERN- You drive.
MRL- I can't drive there I don't have a drivers license. So you need to fill it for us.
ERN-How did you get to this ER ?
MRL- I drove.
ERN- Great now you can drive past the pharmacy on the way home. Have a nice night.

It really amazes me you patients that think I owe it to you to make your life easier. I didn't force you to come to the ER if you had an ounce of common sense, and weren't so frigging lazy your life would be easier and I wouldn't have to work so hard to support the medicaid system.

Bad day...

In order for people to see me at work they generally have to be having a bad day... and then there are some who's day has turned into a full nightmare...here are 3 recent

Middle age woman at a friend's summer party has a bit to drink and falls thru their 2nd story windows.. Fracturing her left hip and femur


2nd Middle age woman falls 5 ft from a ladder, landing her chest on a fence post, piercing her left chest and tearing away a chunk of breast tissue and popping her 30yr old breast implant. It seriously looked like a shark bite it was so extensive.

22yo male gets fired from his job comes home and argues with his girlfriend, decides he is going to find a permanent solution to his problems. He unfortunately does not check how much weight the cord that he chooses can hold. Because he truly is having a bad day the cord breaks and he lands face first onto a dresser.. We end up sending him to bigger city trauma center with numerous facial and jaw fractures.. not quite the permanent solution he was hoping for but definitely he will have permanent reminders of this day.

Thank You

CheckList

Dear Drug Seeker,

Thank You for complimenting me on my youthful appearance, despite the fact that I look in my mid 20's I am not. While I may appear to look like a new grad I have been doing this for 10 years so that compliment you gave me to distract me from your seeking behavior did not work and instead just irritated me.

For future reference when coming to the ER looking for drugs there are a few things that clue me into your game.. here is a list for you to print off memorize and use as a check list before trying this sham again.

1. Get out of your car with your act already started. You never know who will see you in the parking lot jumping out of your vehicle or running. More believable is family member running into ER grabbing w/c or walking in bent over with family supporting you on either arm.

2. Dress appropriately for the weather. When you come dressed for a blizzard in 90 degree weather I wonder what you are hiding under those sleeves.

3. When I ask you questions appear to search for answers. No one remember everything about how their injury/illness occured. Answering all my questions in one breath before I ask them tells me you aren't new at this.

4. When I pull up your sleeves dont blame the old IV marks on a blood draw this week. especially the ones on your wrist and back of arm.

5.Don't have allergies to Tylenol, Codeine, Motrin, Toradol, Morphine, Ultram, Darvocet.

6. Never rate your pain a 10/10 while munching on Doritos or laughing with your buddies

7.Don't lay on the floor and moan and cry while looking to see if we are paying attention. Instead I recommend pacing the floors stoically while periodically leaning over for a couple deep breaths. This is more effective.

8. Don't TELL me what your treatment plan should be including medication and dosages.

9. Remember who your Dr is and never state you are just passing thru on vacation.

10.And finally remember to remove your arm band that you receive at the other ER today.

I guarantee using this list will make your next try more successful and we can just skip the superficial compliments and me incurring additional L&I claims from all my eye rolling.

Sincerely~ ER nurse

Headshaker..

Another head shaking weekend in the ER. Here are some stories of our DNA donors...

**Teenage couple 15 & 16 come in for STD testing, after he has burning and "gross stuff" dripping out. She admits to not being a virgin when she slept with him, he was shocked, Me? Not so much.

** A guy threatens suicide when he is arrested for drugs thinking he is going to come to the ER and we will protect him from going to jail with a mental eval hold... Wrong, our SW eval'd him and sent him on his way..side trip 1.5 hours not quite the 72 he was hoping.

**Female brought in by medics for eval at police request after she is found asleep/passed out in the aisle of local grocery store...seems she took a bunch of oxycodone then decided to go shoplifting in order to buy more.

**16 yr old girl out partying with her friends when they notice she is not responsive and shallow breathing.. being teens they did the "smart" thing and decide to drive her home. Once there they can't get her out of the car and are forced to get her parents. Dad calls 911 who intubate on arrival and bring her in to us. Blood Alcohol- 356.== 4.5 times the legal limit. While I was caring for her, mother asks who is going to give her daughter "The Talk", about responsible drinking.. Hmmm HELLO PARENTS, that is YOUR responsibility, my job is to save her ass, not raise it!

**There was a local house party with a large family gathering when friends arrived and get into a confrontation and shotguns are fired with people scattering on foot and in cars. One car loaded with 3 guys crashes into a telephone pole a block away and they take off on foot. Guy#1 has facial lacs from glass and calls a friend to come get him. She calls 911 asking for directions to the nearest ER. We are it. During triage they change their story numerous times...
Guy #2 was tracked down by K9 officer and decided to resist the cute puppy.. Bad idea-- we counted more than 38 bite marks over his right arm,flank and thigh.
Guy#3 decided to give up and also brought in by police for facial laceration.
During all of this #1 denied being involved nor knowing 2&3 despite when he thought we were not looking he would go talk to them-- during which our ER was crawling with cops from 5 different jurisdictions...Dumb Ass. He left like the other 2 in handcuffs and us laughing at his stupidity.

After this weekend I need to get my neck eval'd for repetitive motion injury..I wonder if I can claim L&I?

MIA

New nurse shows up for first day orientation, is shown around the unit and then disappears. No joke. We have not seen her since, and that was 3 days ago. Now I know that nursing can be hard but come on.. only lasting 20 minutes on a unit? That has got to be a record!!!

I Accept

What a difference these EDs are from the little magoo ER I use to work at. Here was ONE of my 12 hour nights this last week....

*Arrived to a packed house... parking lots jammed, people sitting/ laying all over waiting room with average wait time for "GOMERS" 4+hours.

*Broke hospital record with most ambulance arrivals =15 in 40 minutes. And all really sick and crazy.

*3 walk -in MIs (heart attacks)

*8 months pregnant here on vacation, out boating when her water broke...arrived via EMS and delivered 7 minutes later! Its was a boy!

*Teenager brought in by mother out of control assaults mom in ER...Amazing show of force by staff, including security and police. She spent the next few hours in a locked room by herself, crying for her mom to get her out.

*24 yo female walked in with asthma attack that needed intubation.

*Some idiot threw his/her lit cigarette into the bushes in the parking lot resulting in a small fire... guess who's truck was parked next to this bush...yours truly! Bastards!

*Drunk woman brought in by medics and police after drinking 3 bottle of wine and fighting with husband... shortly thereafter began throwing up said wine all over the gurney, herself, floor and wall... and then i hear "Nurse i think my tooth came out" And guess who you think got to search thru her dinner and wine looking for this tooth? Yep me again!! Woohoo I am on a roll!

*Found out the triage RNs here carry pepperspray. I like that about these nurses. They have no problem defending themselves!! You go girls!!

And that was just a snippet of some of my patients that night!

At the end of my shift the ER director arrived and spoke with the charge nurse and then asked if I liked working for them even after a night like that.... if so she wanted to offer me a full time position based on all stuff she heard about me. Hmmm let me think about that a--- never mind Hell yeah I'll take the job. This is damn fun.

Not fresh meat..

Dear EMS & Law Enforcement,

Yes I know that I am new to these ERs, but I am not new to your games... please show me some friggin respect and quit with the over used come on lines and leaning on the counter under the guise of introducing yourself, just to get a look down my scrub top. Grow up guys.. you give your badges a bad name.

And Dr "Rico Sauve", your reputation precedes you. I heard about you when I was at Rural ER. Your blatant comments are offensive make my skin crawl, and only scream short man compensation. Sorry not interested in becoming Ex Wife #4, especially after I heard how 1-3 cleaned you out. So quit hitting on me before I foley cath your little buddy with a chest tube...ky lube always optional. Love Er Nurse

Crazy, I am so Crazy....

Been crazy busy bouncing back and forth between the two ERs. I don't know what the hell I was thinking... I can barely see straight I am so friggin busy and tired..

I will write more later about the recent cases I have seen on my shifts..here is a sample.

• a young female comes in with rectal pain after "experimenting" with young stud boyfriend.
• Motorcycle crash at 120mph
• C1-2 fracture after fall.
• HIV test request in young guy
• 35yo Diabetic pt with a Do Not Resuscitate order

This ER nurse is off to take a nap....