I work tonight... Let the fun begin!! Friday, October 31, 2008
Thursday, October 30, 2008
Stethoscope...Danskos..Taser.. ready for work!
Once again ER Nurse is working way too many shifts.. we have been crazy busy and flu season hasn't even begun yet...Here is a snippet of some events that has ER Nurse proposing routine tasing just to make me feel better.
23yo M in for asthma crying on his gurney because his O2 probe was "Too Tight".
19yo M with Fx ankle from skateboarding who reports not wearing a helmet because the "Type" of skateboarding he does doesn't require a helmet...
24yo M Jehovah Witness in for abd pain who refuses blood draws because of his religion...
26yo M who only drinks "a couple" quad shot lattes a day in with SVT- Heart rate- 268
The Fs on state assistance who come in 2 weeks late on their periods with "Abd Pain" for their "free" pregnancy test, then come back at 16 weeks for "Abd Pain" for their "Free" ultrasound to find out the sex of their baby. ---Since me the tax payer has to pay for all this "Free" care I think I should have a say in the tests ordered...right?!
The parents who bring in their feverish infant daughters but refuse my In/Out cath for urine... because then their dtrs won't be Virgins anymore.
78yo F brought in by concerned dtr who was afraid her mom "Might" get pneumonia this year.
21yo M brought in by mom after smoking marijuana for the 1st time and not acting himself.
23yo M in for asthma crying on his gurney because his O2 probe was "Too Tight".
19yo M with Fx ankle from skateboarding who reports not wearing a helmet because the "Type" of skateboarding he does doesn't require a helmet...
24yo M Jehovah Witness in for abd pain who refuses blood draws because of his religion...
26yo M who only drinks "a couple" quad shot lattes a day in with SVT- Heart rate- 268
The Fs on state assistance who come in 2 weeks late on their periods with "Abd Pain" for their "free" pregnancy test, then come back at 16 weeks for "Abd Pain" for their "Free" ultrasound to find out the sex of their baby. ---Since me the tax payer has to pay for all this "Free" care I think I should have a say in the tests ordered...right?!
The parents who bring in their feverish infant daughters but refuse my In/Out cath for urine... because then their dtrs won't be Virgins anymore.
78yo F brought in by concerned dtr who was afraid her mom "Might" get pneumonia this year.
21yo M brought in by mom after smoking marijuana for the 1st time and not acting himself.
Monday, October 20, 2008
Boarding..
We are overflowing with patients both in the ER and on the floors. This weekend we have lived on DIVERT.. average patients time in the waiting room 6+ hours. We had patients in the ER for 15+ hours. And now because of this we are Boarding patients that need to go to PCU.
I hate boarding patients and this shift I have 3. I medicate based on a MAR and if I want to give more medication than the DR ordered on the MAR I can't just wander down the hall and ask.. I have to page the admitting Dr. If my patient has hypotension and I want to bolus him I have to call for an order.. this kills an ER nurse.
We work so independently.. we take care of our patients and then let the ER physician know what we have done...This paging, waiting for a return call. summarizing who my patients is and problems and what I think should be done and then the Dr asking tons of questions and then okaying my suggestion is going to be the death of me....
ER nurse needs a vacation.......
I hate boarding patients and this shift I have 3. I medicate based on a MAR and if I want to give more medication than the DR ordered on the MAR I can't just wander down the hall and ask.. I have to page the admitting Dr. If my patient has hypotension and I want to bolus him I have to call for an order.. this kills an ER nurse.
We work so independently.. we take care of our patients and then let the ER physician know what we have done...This paging, waiting for a return call. summarizing who my patients is and problems and what I think should be done and then the Dr asking tons of questions and then okaying my suggestion is going to be the death of me....
ER nurse needs a vacation.......
Sunday, October 19, 2008
Carribean?Hawaii? My Bed?
ER nurse has worked 131.25 hours in the last 2 weeks....
ER nurse needs a vacation.
Sunday, October 12, 2008
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Tuesday, October 7, 2008
Whoppers anyone?
SHE IS BAAAAAAAAACK!!
The drunk chic from the last 2 nights is back again for the 5 time, after getting drunk and passing out at----- Hold your horses..Yep Mc D's bathroom again !
OMG... again BAL 0.387, this time enough is enough we are sending her to involuntary secure detox. If not for her own good then for my sanity... though I am half tempted to get her a Burger King gift card and a one way ticket to the next county!
The drunk chic from the last 2 nights is back again for the 5 time, after getting drunk and passing out at----- Hold your horses..Yep Mc D's bathroom again !
OMG... again BAL 0.387, this time enough is enough we are sending her to involuntary secure detox. If not for her own good then for my sanity... though I am half tempted to get her a Burger King gift card and a one way ticket to the next county!
Monday, October 6, 2008
Who wants to party?
Two recent LOL (Little ole lady) stories...
Medics bring in 74yo after being found down at home by granddaughter with a blood sugar 38.
Granddaughter guilt ridden that she went out with friends and was not there for Granny...
ER nurse explained to distraught granddaughter that it was not her fault... It was Grandma mixing Glyburide and her 1 1/2 pint to a 1/5 of whiskey a day habit.
Mother and daughter bring in 68yo old grandmother for altered behavior, thinking Granny as having a stroke... Head CT neg and all lab tests neg except one. When asked if the patient minded that her family was in the room during discussion of test results and diagnosis the patient was adamant that family stay... OK Granny everything looks great no stroke, head bleed or brain tumor but you might want to reconsider your use of cocaine! I thought the family was going to fall out of their chairs..
Medics bring in 74yo after being found down at home by granddaughter with a blood sugar 38.
Granddaughter guilt ridden that she went out with friends and was not there for Granny...
ER nurse explained to distraught granddaughter that it was not her fault... It was Grandma mixing Glyburide and her 1 1/2 pint to a 1/5 of whiskey a day habit.
Mother and daughter bring in 68yo old grandmother for altered behavior, thinking Granny as having a stroke... Head CT neg and all lab tests neg except one. When asked if the patient minded that her family was in the room during discussion of test results and diagnosis the patient was adamant that family stay... OK Granny everything looks great no stroke, head bleed or brain tumor but you might want to reconsider your use of cocaine! I thought the family was going to fall out of their chairs..
Have I met you before?
ER Nurse rarely refuses to care for a patient.. but tonight I have had enough it is someone else's turn to care for the 33yo alcoholic that keeps getting drunk and finding her way to the local McD and passing out in their bathroom.
Normally this would be an easy pt to care for .. but this would have been the 4th time in 36 hours I personally have taken care of her for a BAL >0.377 after sobering her to 0.06 hours earlier and sending her home.
Nope it is my turn to throw the temper tantrum today.... I won't do it and you can't make me--- so there!! :-p
Normally this would be an easy pt to care for .. but this would have been the 4th time in 36 hours I personally have taken care of her for a BAL >0.377 after sobering her to 0.06 hours earlier and sending her home.
Nope it is my turn to throw the temper tantrum today.... I won't do it and you can't make me--- so there!! :-p
Sunday, October 5, 2008
NH stunt
Dear Nursing Home Nurses,
It is NEVER EVER acceptable to send your patients to the ER via ambulance for the sole purpose of peripheral IV placement!
Love,
Your Very PO'd ER Nurse
It is NEVER EVER acceptable to send your patients to the ER via ambulance for the sole purpose of peripheral IV placement!
Love,
Your Very PO'd ER Nurse
Cold Shoulder...
Husband calls 911 after waking in the night and finding that wife is not her usually cuddly self and a little on the cold side.. Medics find her asystole..
On a side note...Medics bring her back and we admit to CCU...
Saturday, October 4, 2008
Come in IV form?
Attention ER nurses : New cure found for abdominal pain!!!
Peanut M&Ms!!
It is amazing that my patient who was crying in triage and rocking back and forth with pain was found munching on M&Ms on her gurney under a blanket and when reminded she was NPO and in the "worst pain" of her life she explained "but these really help I have to finish them or the pain will come back."
That is why I love this job.. I learn something new every day. And to think the cure was there all this time... in the vending machine down the hall.. I wonder what other diseases I could cure with $1.25 in quarters.
You can't make this stuff up...
Man shoots himself in arm after being denied sex
Story Updated: Oct 2, 2008 at 12:50 PM PDT
By Associated Press
FORT MYERS, Fla. (AP) - Authorities say a Fort Myers man shot himself in the arm after his girlfriend refused to have sex with him. The Lee County Sheriff's Office reported that a 29-year-old man and his girlfriend returned home from a bar early Wednesday morning.The girlfriend told deputies that her boyfriend wanted to get intimate, but she just wanted to go to sleep. When she refused, he became irate.Authorities said the girlfriend went to a spare bedroom, and several minutes later she heard two gunshots. She told deputies her boyfriend came into her room and threatened her. He then stumbled into the kitchen before falling into the oven, knocking himself unconscious.The man was treated for two gunshot wounds to the arm and was taken to jail.The man was charged with threatening violence and firing a weapon in an occupied dwelling. He was being held on $100,000 bail.
Story Updated: Oct 2, 2008 at 12:50 PM PDT
By Associated Press
FORT MYERS, Fla. (AP) - Authorities say a Fort Myers man shot himself in the arm after his girlfriend refused to have sex with him. The Lee County Sheriff's Office reported that a 29-year-old man and his girlfriend returned home from a bar early Wednesday morning.The girlfriend told deputies that her boyfriend wanted to get intimate, but she just wanted to go to sleep. When she refused, he became irate.Authorities said the girlfriend went to a spare bedroom, and several minutes later she heard two gunshots. She told deputies her boyfriend came into her room and threatened her. He then stumbled into the kitchen before falling into the oven, knocking himself unconscious.The man was treated for two gunshot wounds to the arm and was taken to jail.The man was charged with threatening violence and firing a weapon in an occupied dwelling. He was being held on $100,000 bail.
Thursday, October 2, 2008
40-50-60%?
It's that time of year again..Time to start making bets on what percentage of Influenza Viruses will be covered by this year's scientifically guessed vaccine. Last year it covered about 40% and it made the CDC look real bad so I think they learned their lesson and went to Vegas and let some professional guessers decide the concoction.
My guess is 53%---- anyone else care to guess?
Wednesday, October 1, 2008
Accident?
Very few cases split the staff at the ER. Usually there is a very clear right and wrong to what our patients have done that has caused their need to be there.
Police bring in a 20's female after an accident car VS pedestrian. Female was the driver and during triage she admitted to having been drinking earlier along with smoking chronic and being non complaint with her IDDM so her blood sugars were in the 400's.
Triaging her was extremely difficult as she was crying hysterically about the situation, I initially thought she was distraught over having hit someone... but I was unfortunately very wrong..
She was yelling and screaming and crying threatening to hurt herself because one of the paramedics had been mean to her.. Mean to her? One of our paramedics had packaged up her victim and prepared her for airlift to the major trauma center in the big city in critical condition..after completing this the paramedic was responsible for checking the driver... Seeing that the driver was under the influence was the last straw and let the driver have it.. Telling how she was going to go to jail for the rest of her life because her victim was not going to make it.
She had no sympathy from me. I hoped the book was thrown at her as well and I fully supported the paramedic. Other staff felt sorry for her and felt her " accident" could be contributed to her high blood sugar and thought the paramedic was wrong. I felt otherwise. There is no excuse for driving impaired whether drunk, high, or having uncontrolled DM, and in her case she was all three...
The driver during her stay got more and more worked up finally demanding to talk to the fire chief about his paramedic violating her rights to good care... Understanding the paramedics frustration I told her the only right she should be concerned about is the one for an attorney as she had killed someone..her victim had died.
I hope she writes a complaint-I will gladly except it.
Police bring in a 20's female after an accident car VS pedestrian. Female was the driver and during triage she admitted to having been drinking earlier along with smoking chronic and being non complaint with her IDDM so her blood sugars were in the 400's.
Triaging her was extremely difficult as she was crying hysterically about the situation, I initially thought she was distraught over having hit someone... but I was unfortunately very wrong..
She was yelling and screaming and crying threatening to hurt herself because one of the paramedics had been mean to her.. Mean to her? One of our paramedics had packaged up her victim and prepared her for airlift to the major trauma center in the big city in critical condition..after completing this the paramedic was responsible for checking the driver... Seeing that the driver was under the influence was the last straw and let the driver have it.. Telling how she was going to go to jail for the rest of her life because her victim was not going to make it.
She had no sympathy from me. I hoped the book was thrown at her as well and I fully supported the paramedic. Other staff felt sorry for her and felt her " accident" could be contributed to her high blood sugar and thought the paramedic was wrong. I felt otherwise. There is no excuse for driving impaired whether drunk, high, or having uncontrolled DM, and in her case she was all three...
The driver during her stay got more and more worked up finally demanding to talk to the fire chief about his paramedic violating her rights to good care... Understanding the paramedics frustration I told her the only right she should be concerned about is the one for an attorney as she had killed someone..her victim had died.
I hope she writes a complaint-I will gladly except it.
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