Not Paid Enough...

My night sucked....

Way too many drunks, way too many people getting their butt kicked, and too many who couldn't hold their own...

ER nurse got thrown up on TWICE last night..well almost three but the OD lady missed me.

The 1st was a good looking Marine...(If only I was 20 again!!) I forgave him... he lost it after I unwrapped his lacerated finger and he saw all the blood.. oh and he also fainted! He was so embarrassed and did I mention good looking?!

The 2nd..NOT so cute, a drunk (Schnapps and Flops) brought in by medics after being found down outside non responsive, with blood running out of his ears. Schnapps and Flops had a brain bleed and vomited everywhere including into ER nurse's hair during his stay..

Now why do I keep showing up for work?

How many can you take on??

23

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Say What??

I kid you not this is what a Dr wrote as an admission order---

"Treatment for Insomnia-warm herbal tea or milk, white noise at low level (tv or radio) and BACK RUB at HS (hour of sleep)" .

I am not sure what the Dr was smoking or the patient either for that matter, but that order is not going to happen... there aren't enough nurses as it is to take care of all the patients' "APPROPRIATE" orders...

Plus last I checked I work in the hospital not "Mona's Magical Hands Massage Parlor"!!!!

Got insomnia? Take a pill like the rest of us!

Nobody Move!!!

Fall Assessments on Everyone!!!!

At our staff meeting today the Boss revealed one more thing for us to assess while in triage. Starting immediately every single person that comes thru triage has to be given a fall potential score and we must then figure out how to prevent it from happening while in the ER .

Why now..because some family brought in Grandpa for agitation and while in the ER THEY were walking him around when he fell and fractured his hip. The family has gotten a lawyer and said it is our fault he fell and was injured because we did not educate them of the potential for falling and injury!!! Are you freaking kidding me?! What the hell is wrong with people now a days?!! Who doesn't know that the elderly fall? Plus wouldn't the family be better than me at assessing his fall potential?

So my question is what about toddlers just learning to walk? Every time they fall in the ER am I suppose to CT them? What about infants? Should I forbid parents from holding their babes because they might drop them, and do I have to fall assess the parents since they are holding the baby?

What about the potential of falling off the gurney? That could happen to anyone. Put the rails up? They could fall thru them or climb over them and fall...Hmm what to do??

I know...everyone who comes to the ER is immediately placed on a Back Board and strapped down and placed on a mat on the floor. That should solve the falling problem.

People's escape goating and stupidity..still no cure!

The Next Dozen are on Me!

Working in the ER I get a lot of interactions with the police.. almost as much as when I am driving (Er nurse has a little bit of a lead foot!!).

For the most part our interaction with the police consist of them dropping off their "gift" of a

(mental, injured, drunk, tweaking, screaming, spitting, fighting or any combination of) patient for us to deal with or they just need a quick "okey dokey for the pokey" otherwise known as a "clear to book" in jail. Then they are gone.

We also get their assistance when a patient is out of control and we need them to assist with restraining or tasing, as occasionally happens as we do not have security at our hospital (the suits don't deem us worth the expense of even a little old retired high water pants, white sock wearing grandpa). And then again they are gone..lickity split.

So this weekend when all hell was breaking loose, and I was running from one crisis to the next, multiple ambulances were stacking in the bay waiting to offload new disasters I was SOOOO appreciative that ONE officer realized what was going on and stayed with his perp and helped keep him in line during his stay, even though I know he was getting yelled out for not returning to the streets by his Lt.

So Mr LEO, to thank you I promise to slow down in your jurisdiction, and be mindful of those silly 4 way stops... well at least for this week!

Any Takers?

If someone were to offer me a million dollars right now I would walk away from nursing and never look back.

Actually I would settle for 250k, OK how about 100k...still no offers? Come on people.. work with me.. My night was so bad I am tempted to call off dead the rest of the week.

Alright since no one is willing to help me out I am off to bed I will blog later all about my nightmare night....

You smell smoke?

I will never understand my patients lying to me...

Do you think I am new at this, stupid, gullible, not paying attention, that you are the first to try these stunts or that I actually give a care what you do for recreation?

I actually don't care for the most part if my patients get high... it is your brain cells you are cooking not mine. What I do care about is if I ask tell me the truth. But time after time you patients look at me and bold face lie.

For the most part I already know this and just leave it at that but then there are patients that I absolutely need to know the truth to see if it is contributing to something I see that is concerning. Even in that situation you still chose to lie.. Why? Your blood will tell me how much you have had to drink and your urine will tell me what drugs are in your system. And when I get the results I will be pissed and confront you and for that little lie..no narcs for you and you get kicked out. So lets just skip that drama and tell me the truth.

Now for my other patients that like to lie are my pseudo-suicide patients. The games you are playing with your family I do not find amusing, nor will I fall for your attention getting BS. When you tell your family that you took an OD of pills and hand them an empty bottle I WILL KNOW THAT YOU ARE LYING and for that you get to drink charcoal or get your stomach pumped even though you are fine. Do not tell your family you took an OD of narcotics, I can test for those and when the test comes back normal I will be pissed. Do not tell your family you took an OD of sleeping pills and alcohol, cause I can test for those also and I can tell from your vital signs that you are lying. And when I have proof of this I will show your family and educate them on the games you are playing.

Do not try and fake seizures or unconsciousness either with me.. I have ways of proving your are faking and you won't like what I do to you...but me and my co- workers will get a good laugh out of it.

So in general don't insult me and my co-workers and think you can get one over on us. We are smarter than you, more conniving than you and have ways of making you pay.

Remember KY is always optional!! So just tell me the friggin truth!

Why me....

You know it is going to be a bad night when......

There is no one at home to make you a lunch, your latte girl is on vacation and the new girl has no idea your drink and you have to explain 10 million times and she still screws it up.. there is no parking when you get to work so you have to hike Mt Everest to get there, there is standing room only in the waiting room and they look like vultures at you when you walk thru the door , the first thing they say to you as you hit the floor "Really we aren't dumping on you" . And when you pitch in for take out your order is the only one messed up.

Damn I knew I should have called off.

Never Acceptable......

Foster Mother’s Pain Patch Is Responsible in 6-Year-Old Girl’s Death

NY Times
By AL BAKER
Published: May 20, 2008


A foster mother in Harlem has been arrested and accused of accidentally killing a 6-year-old girl in her care by placing a powerful medicinal patch on the child’s neck as treatment for pain, the authorities said on Monday.

The girl, Taylor Webster, was pronounced dead at Mount Sinai Medical Center in Manhattan on Sunday evening, and her foster mother, Joanne Alvarez, 54, was arrested and charged with second-degree manslaughter, which is a felony, criminally negligent homicide and endangering the welfare of a child, officials said.

The pain-relieving patch, known as a fentanyl transdermal patch, delivers through the skin a narcotic drug that is more powerful than morphine. Ms. Alvarez also gave the child some Motrin by mouth, the police said.

The strength of the prescribed dose is based on the patient’s weight. Ms. Alvarez weighs 260 pounds; Taylor weighed 59 pounds. A detective found that the label on the fentanyl stated that it should be kept out of the reach of children, the official said.


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Where do I begin on this one...? YOU STUPID FREAKING MORON!! You are so lucky you did not cross my ER doors with that child Ms Alvarez, if you had there would be nothing left of you to prosecute!


You brainless idiot you gave that sweet child a drug that is used primarily in advanced cancer patients who's pain is thru the roof. Fentanyl is *ONE HUNDRED TIMES* stronger than morphine and you gave it to a 56lb 6 year old! Where in your minute brain did this sound like a good idea?


Hey NY let me know when you need me to show up for jury duty! I hope they throw the book at you Ms Alvarez.



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Parents PLEASE do not treat your child's illnesses with your own prescription medications. We dose children's medications on their weight, and there are A LOT of drugs out there that are fatal to children when dosed wrong. For pain Tylenol/Motrin works great, if you think your child needs something stronger call their Dr, so this tragedy never happens again.

The patient always knows...

Old man Jacobs the sweet, lonely slightly kookie neighbor we all have in our neighborhood was brought in by medics last night after neighbors noticed that he was a little "Kookier" than usual.

Upon his arrival I asked him all the neuro questions I ask everyone..and the only question he had problems with was time... Old man Jacobs must have had a good 1943 because he was hell bent that was the year.

During my questioning he told me that he had felt a bit off for the last few years but he could not exactly say why. He said he had seen numerous Drs over the years but no one ever found anything but also never really did any testing. He stated that he felt they didn't listen to him and he hoped we could figure out what was wrong. To be honest I did not have high hopes for this. But if I had to have guessed right then I would have said senility or your basic geriatric changes.

All blood work was normal. Urine normal (Urinary tract infections in the elderly causes mental changes) EKG normal. Chest Xray negative. Old man Jacobs blood alcohol 0.00, and his drug test was negative. Time for a brain scan...

After returning from the CT scanner, and while waiting for his results he told me about being widowed a decade earlier and of never having had children, or any family for that matter. He considered his neighborhood his family, and enjoyed his daily walks as he stopped and chatted with some and gave gardening tips to others. He watched as the children grew and had made friends with all the animals.

Old man Jacobs with his peaceful voice and great story made me wish I was his neighbor..

I wished even harder that the radiologist was wrong with his diagnosis.. A large mass in his brain that was so big it was actually shifting his brain toward one side.

Old man Jacobs has brain cancer and when told of this the first thing he said was "Thank you" he thanked us for figuring out what was wrong and for telling him honestly and too the point.

As we were getting ready to transfer him to the big neuro hospital for care I asked him if there was anyone I could call for him.... he thought for a minute and asked if it was possible could I locate the neighbor who called for medics and apologize for causing them such concern and let them know he was ok and he would be home after he took care of something..

Anything for you Old man Jacobs.. in our brief few hours together you won my heart and reminded me why I put on those blue scrubs.

Happy Dance!!

Good News!!!!

Rumor is the Boss giving ER Nurse such a headache is on his way out!!

Hopefully he takes those new ugly blue scrubs with him!

Primum non Nocere

I am always the first to say that any monkey can pass the nursing boards when people express their awe that I am an ER nurse.

But truth be told, in actuality it is tough to get into a nursing program in our state. For most of the programs there is a 18-24 month wait list. It takes more than good grades to get in. You have to also be interviewed, have a good work history, go thru extensive background checks and be highly recommended by past and current employers and acquaintances.

Once in the program it is even harder to stay there. On the first day of class you can look around and know that come graduation 50% will have failed or bailed out.

With all the obstacles,work,sweat and endless nights studying to get your license it always amazes me that a nurse would do anything to jeopardize it. I protect my license with my life. It is what makes it possible for me to support my family and keep them well taken care of.

There are many ways to lose your license including practicing outside your scope, substandard care, falsifying documentation, assaulting patients, being convicted of DV in your personal life, and the one I find the most unbelievable the diversion of narcotics.

It is estimates by the ANA that 1 in 7 nurses has a drug/alcohol addiction. With approx 3 million nurses holding a license that is a lot of caregivers in need of help themselves.

I have worked with several nurses that have had drug issues and been caught diverting drugs but thru a drug rehab program for medical personnel have been able to keep their license all be with extreme limitations and hoops to jump thru.

They must first go inpatient for detox, after completing they must submit to random drug testing, attend either AA or NA weekly, have their work schedule modified, are not allowed any overtime, working nights, or be a supervisor. They are restricted from handling narcotics for at least a year, and must go thru psych counseling and comply with their recommendations. These requirements last for a minimum of 2 years but can be extended if they deem necessary or the nurse messes up.

When these nurses complete all that the state nursing board asked of them their record is cleared of all charges and their license is return to full activity, but for me I have a hard time just letting it go.

I have a hard time trusting them again and refuse to ever sign off on a narcotic waste with them, as I have no idea if the clear liquid in the vial is a narcotic or water. My biggest issue with these nurses is that generally they obtained their drugs by signing them out in the pyxis under the guise of medicating a patient in pain, and instead pocketing the med. And later when the pt request pain medication I have to refuse them because according to the records they had already been medicated. A patient has to suffer in order for them to get high.

And that I find unacceptable. Our patients trust us to care for, comfort and advocate for them. But nurses can not do that if they are high or preoccupied with how to get their fix instead of remembering "Primum non nocere" FIRST DO NO HARM"

Wakey Wakey ER nurse....

Last night I was suppose to be off, after working 5 nights straight and one hell of a weekend..I was looking forward to curling up in my bed with a good TV show and nodding off for a good nights sleep... It was not to be.

At 11:30pm my phone rang and it was the ER saying they were slammed and I needed to come in and help. The big hospital ER in the county got slammed and went on DIVERT, so the ambulances that typically go there came to us quickly filling us to over capacity causing us to go on Divert. That is when they called me... I might have said no, forget it I am already in bed, but they used an unfair tactic...they had my best friend who works in the ER call me and ask me to come in and help.. Of course I could not say no... damn her!

Here is a sampling of what pulled me out of my bed....

One pt was a surprisingly nice chronic drunk who was 5x the legal limit out riding his bike when he fell and at first appeared to have just facial lacerations and extremity abrasions. But since he was my pt we all know that would be too easy.. His head CT showed a brain bleed with numerous facial fractures and broken ribs. Off to the Level 1 trauma center for him.

Another pt came in with multiple burns to face/arm and leg after spilling the broccoli she was cooking... Her and her companions were placed in a room and while there they rummaged thru the cupboards and drawers were unable to sit still, turned equipment on and off, twitched and tweaked and generally scared her "roommate"... Broccoli my A** more like cooking meth and it exploded. A common hazard in that "line of work". I kicked her companions out and placed her in a chair next to the nurse station so we could keep a closer eye on her till discharge.. Once again this tweaker entertained the rest of the patients with her antics.

A tonsillectomy patient that was now bleeding post-op..never a good thing. Because this was my worst fear after my recent surgery this patient was pampered by me.

A co worker's child that had the "stomach flu" what we call gastroenteritis.. This child had such severe vomiting and diarrhea that he was beyond dehydrated and actually was in acute kidney failure. Not something we see in the young very often.

Of course there were numerous babies with fevers, and runny noses, several patients with broken bones, a child with an allergic reaction to his antibiotic, and patients with asthma exacerbation, and congestive heart failures.

All in all I stayed 4 hours and got paid for 8. Nice bonus and my patients were actually pretty decent, even the meth head.

I could get use to working 4 paid for 8. I wonder if they will let me make it a permanent thing?!

Self treating to the Extreme!!

Man Uses Knife for Self-Tracheotomy
AP
Posted: 2008-05-09 15:30:50
Filed Under: Health News, Nation News


OMAHA, Neb. (May 9) - An Omaha man struggling to breathe used a steak knife to perform an at-home tracheotomy. Steve Wilder said he thought he was going to die when he awoke one night last week and couldn't breathe.Wilder said he didn't call 911 because he didn't think help would arrive in time. So, the 55-year-old says, he got a steak knife from the kitchen and made a small hole in his throat, allowing air to gush in.


"It just blocked all the way and I just got up and I panicked," he told a local TV station, WOWT in Omaha. "Got a knife and located it and pushed in and blood went gush."Wilder suffered from throat cancer and related breathing problems several years ago. About that time, he had an episode where he couldn't breathe because his air passages swelled shut. He said that's what happened this time around.Doctors don't expect Wilder to suffer any adverse affects from the tracheotomy once it's healed.

Why can't more of my patients be this resourceful?!

Our Week

Happy National Nurse Week!!

Buzzed Geezers

Grandma and Grandpa went to the tavern this weekend for a nightcap...witnesses later called 911 after seeing them falling down while walking home.... Grandma had 'just a wine" and Grandpa "2 Gin and Tonics"...

Our State's Blood Alcohol Legal Limit 0.08

Grandma's Blood Alcohol 0.307

Grandpa's Blood Alcohol 0.431

One glass of wine and 2 Gins....? Righhhhhhhht!!

Final Answer...

"The crime of suicide lies rather in its disregard for the feelings of those whom we leave behind."
E. M. Forster quotes (English Novelist and Essayist, 1879-1970)

My ER beds have been filled the last several weeks with lost and desperate souls. We have never seen so many genuine attempts at suicide, that if not been found by someone would have been successful.

Working in the ER we get alot of pseudo suicide attempts. In actuality they are attention getting stunts, Lonely Laura takes a bottle of pills and then immediately calls 911, resulting in getting her stomach pumped and a consult with our emergency social worker(ESW), or Dumped Dan who cuts his wrist then calls his EX to tell her what "she " has caused him to do, resulting in police bringing him in, after tazing him, for sutures and a consult with a ESW. Each case causing family and friends to rush to the ER and giving the patient what they wanted=Attention.

These patients are very frustrating to deal with. They typically are very emotional, dramatic and manipulative. They treat their loved ones horribly and hold them fully responsible for their own self harm. They put their families thru these emotional rollercoasters time and time again.

They bring out the worst in us nurses.. resulting in us wanting to tell them how to do it right next time. But sometimes they figure it out on their own.....

This last week we had a 30yo paraplegic hang himself with the machine used to lift him out of bed leaving his wife and children behind; an elderly man who placed a hose from his car exhaust to his passenger window after losing his wife, a loaded gun was found at his side; a 50yo man who took a massive OD of pills and alcohol because he faced foreclosure on his house due to an injury keeping him from working; a mid 40's male who ran into traffic on the freeway after fighting with his wife; a 30s male hung himself when faced with an extended prison sentence; a 50 yo woman distraught over a relationship ending slit her wrist in front of her daughter, a 14 yo girl in teenage turmoil took everything in her parents medication cabinet, and finally a 12yo boy with a long history of mental/emotional problems in his short years, mixed alcohol and his psych meds. (These were just my night shifts, there were several more on the other shifts.)

These cases take a toll on ER staff for different reasons.. When they come in it is a fight to save a life they no longer wish to live. When the patient is "successful" the families are hit with the shock of it, then grief, anger, confusion, and guilt... I watch them go thru it before my eyes and I struggle to find the right words to console them.. Families flood us with Whys? and How could they?... The answers elude us.. Forever locked in their loved one.

I will never understand the dark place these patients find themselves, where there is no other solution or person to turn to.. But I hope I am able to prick a hole in that darkness by showing them I cared enough to fight the fight to make them "Failures".

Priorities.....

A mother calls 911 on her cell phone this weekend at 3 am because her daughter has a fever and she can not afford ibuprofen or Tylenol. 911 arrives and explains that they do not carry those medications on the ambulance.. she then demands to be transported to my hospital so she can get the medication.

She arrives with child whose Temp was 99.1 and sound asleep. She immediately demands the medications and also a PRESCRIPTION for more ibuprofen and Tylenol. Why the prescription? Because here in this state welfare will pay for it if it is written on a prescription pad.

Of course as she is making these demands she is rummaging thru her Gucci purse with her manicured nails for her cell phone! And people wonder why ER nurses are so cranky...

I can't imagine....

Illinois child badly hurt, hit by ambulance

Story Published: Apr 20, 2008 at 1:17 PM PDT
By Associated Press

SPRINGFIELD, Ill. (AP) - A 7-year-old boy is hospitalized with life-threatening injuries in Springfield, Illinois, after being hit by an ambulance. Springfield police say the child was riding his bike Saturday night when he was struck. The ambulance was not on a call at the time. The crew stopped, administered first aid and rushed the boy to the hospital.

Boys vs Girls

Last weekend was drunk teens in the ER.

Most of the males I get a kick out of.. usually the boys are full of bravado one minute, flirting with any female breathing the next, to at some point wanting their moms . These young studs throw out under-developed come on lines, and display those innocent trying to be the player smiles.. I really don't mind taking care of them and they usually are able to get a smile out of me with their antics.

On the other hand drunk teenage girls are a nightmare... their erratic behavior runs the gamut from hysterical emotional crying, to hair pulling, spitting, name calling, possessed brats. They want to fight anyone and everything. They want everything their way and if not they like to threaten and throw out that infamous line "You don't know who my dad/mom is.... your going to pay for this.." To which I usually respond that they are right I don't know who their parents are, nor do I care and it is her parents that are going to pay..and pay big cause an ER visit is not cheap.

Most teens don't realize that once they cross my ER doors their parents can't save them. If they are deemed at risk for self harm or threaten harm to others we as healthcare workers are bound by law to keep them and everyone else safe.. whether that is with chemical or physical restraints or with the assistance of law enforcement.

But as I always say ER nurses always get even with those patients that push too far or make the big mistake of attempting to dictate their care with threats.. nothing feels better than cutting off $150 jeans ... necessary of course in order to do a thorough physical exam.. and I am always thorough!

Out of the mouth of babes...

My son asked me one time how many penises I had seen

in my career as a nurse.....

Yep that sounds about right...

You blog also?

So I recently found out that one of our ER Drs also has a blog...

Not a bad thing except he blogs while he works. He sees a patient and then runs back to his laptop. He is even worse when the pt complaint is benign like a headache, toothache or generally is a gomer.

I don't think we are suppose to know that he has one.. as there have been several postings with critical comments about certain nurses. None yet about me, but I am not fooling myself that my day isn't coming.

Until then I debate whether I should tell him I know about his hobby and that he should do a better job concealing the ID of the people he complains about... or just keep it to myself until I need leverage??

Hmm evil ER nurse what do you think?

Ticket anyone?

This weekend we generously provided entertainment for our ER guests in the form of Meth Heads.

Meth users (Tweakers) are a whole different type of patient than the usual gomers that clog my beds. Meth users are usually brought in by police after their paranoid behavior has scared your Average Joe and they called 911 to get them dealt with. Or by families that are in fear of losing their loved one from the extreme weight loss, physical deterioration,depression or during one of their crimes sprees that support their habit.

Tweakers are not easy patients to take care of. Almost 100% end up in restraints for their own safety and ours. They are extremely paranoid, psychotic, have gone days without sleep, are aggressive and confused. They are convinced that everyone is out to get them, including the patients next to them. They hide behind the curtains and doors to their rooms and skittish when you make a movement towards them. They hear voices and see the boogy man around every corner.

There is nothing I can give a tweaker to reverse their symptoms except time. Don't get me wrong I can always sedate them,but by the time they cross my ER threshold they are in the advanced stages of addiction and the damage they have done to their brains is permanent, not to mention what they have done to their appearance..meth mouth, mite-bites all over their skin, and the dramatic weight loss.


Even if I were to sedate them, when it wore off they would still be in the same condition. It can take months to years for their dopamine and other neurotransmitters to start working again. They will spend that time in severe depression,have parkinson's like symptom, at high risk for suicide and relapse.

What makes this drug so hideous is that people get hooked from the first hit because of the huge rush/high they get. But what is used to make this drug destroys the pleasure center in the brain. Plummenting these addicts into deep despair, causing them to use more and more Meth more often to try and achieve that first high and pull themselves out of the hell they find themselves in. A viscious cycle that goes round and round.

It is during this cycle that they come to our ER, and sadly entertain my other patients. I wish during these shows I could gather together the communities youth so they can see how glamorous and cool this drug is. Line up the chairs and hand out the popcorn.. I guarantee the drug use would go down.

Methamphetamine Ingredients

Lye-Ether-Iodine-Draino-Ephedrine-Battery Acid-Paint Thinner-Brake/Lighter Fluid-Acetone-Amnonia-Red Phosphorous(road flares)-Lithium Batteries-Cold Medicine

911-What is your emergency?

When you call 911 because Grandma is having a heart attack you expect Paramedics/FF to be there within minutes. That is not always the case... The reason... because someone is having DENTAL PAIN and has called 911 to transport them to my ER!

I wish I was kidding but I am not. I have seen this time and time again, people calling 911 for the most stupid reasons. Most of the times these patients also fall within the same demographics.. state assistance, a litter of kids, unemployed, alcohol and drug issues and lacking in both common sense and education . Basically those mucking up the gene pool.

Some of the reasons I have seen people call 911 and get brought in....

*Dental Pain *Constipation *Ingrown Nail

*Ear Pain (in a child) *Cold symptoms *STD check

*Sore Throat * Hiccups *Boils/Wound Check

I have also seen people call 911 with a "medical issue", get transported in and the minute they cross the ER doors hop off the gurney stating all better and walk out. They simply wanted a ride to this part of town, this happens alot when the county fair is happening.

It is the policy of the local fire department to transport anyone that calls to the ER if that is their request no matter how minor or stupid the medical complaint even during the day when walk in clinics are open, and all on the tax payers dime!!

There lies the problem.. there are no consequences to abusing 911. They can't be penalized for being lazy or moronic. But if we started charging them for transporting of non medical emergencies to the hospital I think it would drastically reduce these calls.

And that is a win win situation all around. Grandma will get immediate care and transport. The tax payers will be saved money and there will be less idiots in my ER beds, meaning I can finally get my breaks... I wonder if 911 does meal runs?

Broken Trust...

Girl dies of treatable illness after parents
pick prayer over medicine.

By ROBERT IMRIE, Associated Press Writer
WESTON, Wis. (AP) - Police are investigating an 11-year-old girl's death from an undiagnosed, treatable form of diabetes after her parents chose to pray for her rather than take her to a doctor.An autopsy showed Madeline Neumann died Sunday from diabetic ketoacidosis, a condition that left too little insulin in her body, Everest Metro Police Chief Dan Vergin said.She had probably been ill for about a month, suffering symptoms such as nausea, vomiting, excessive thirst, loss of appetite and weakness, the chief said Wednesday, noting that he expects to complete the investigation by Friday and forward the results to the district attorney.The girl's mother, Leilani Neumann, said the family believes in the Bible and that healing comes from God, but she said they do not belong to an organized religion or faith, are not fanatics and have nothing against doctors.

Mother Teresa, Roman Catholic nun "It's the greatest poverty to decide that a child must die so that you may live as you wish."

As I read this story I immediately was flooded with so many emotions. Anger at the parents for not getting their baby help with a disease that is so easily dealt with. Angry that family members did not call 911 sooner. The paramedics could have started her treatment right there in the house and transported her to the ER with the help of the Weston police. Frustrated that another child died because their care was in the hands of adults who put their own beliefs above the interests and rights of the child. Sadness for the family/parents of Madeline for having to deal with her loss, and know that they are responsible. And of course immense heartbreak for the loss of innocent sick Madeline who had all her trust in these adults to protect her and keep her safe and died knowing they failed her.

While I myself do not believe in organized religion or God, I respect that others do. I understand that when it comes to healthcare there are various ideas in the role religion and God play. I respect and understand that there are various types of healing based on faith, culture and traditions. I believe that they all can go hand in hand with modern medicine but not in place of it. We have seen this scenario play out time and time again and in the majority of cases the end result has been fatal. In most of these cases it has involved children in the hands of fanatical parents. At what point does society say enough and step in and protect these children's lives and rights? Since when does the parent's right to freedom of religion super cede the child's right to live?

Two questions that need answering soon, because in not having those answers we as a society are responsible for this broken trust and these lost lives.

The Price of Complacency..

This month we had a mandatory meeting on preventing injuries at work. This is always a big topic in health care. Health care workers (HCW) are at high risk for injury from their environment, ergonomics, patients, families and the tools we use. This meeting's topic was needlestick injuries.

Each year there are between 800,000-1,000,000 reported needle stick injuries to HCW. Out of that number it is estimated that 63% are incurred by nurses. With each injury there is the risk of exposure to Hep B/C, HIV, TB, Syphilis, Malaria and other infections. It is estimated that one in eight patients has one or more of these conditions.

HCW's are employed in an occupation that ranks second only to manufacturing in amount of time loss injuries. Every nurse in his/her career has a greater than 78% of getting a needle stick injury, from that stick they have a 30% of contracting Hep B, 3% Hep C, 0.3% HIV.

I have rolled that dice twice and won. My first stick was in the beginning of my career and the risk was minimal. My second was the one that took years off my life from the worrying.

I had a non English speaking undocumented homosexual Hispanic male patient in with high fever, sweats, one viral illness after another for months with large weight loss (Xray neg for TB) I was transferring blood from a syringe using an 18g needle (this is a big one) into a blood culture tube. For some reason I flinched and stuck the needle into my hand. I remember just staring in disbelief at the needle for what seemed like forever. When I return to reality I pulled the needle out, changed it, finished the transfer, then washed my hands and walked out of the room. I didn't mention it at all to the patient, and he didn't even realize it had happen until the Dr talk to him and asked for him to sign a release so that we could test him for diseases. I was so thankful that night that our Dr was Spanish speaking, and the patient agreed. I know of other nurses who's patient refused to allow the testing, and that nurse has been subjected to every 3 month blood testing for years.

My worrying was quite extended due to the fact that our employee health nurse was on vacation and I could only get the results from her. When the blood is drawn it is labeled with a number and not a patients name and we are not given the number. Only the employee health nurse has that information otherwise I would have just went to the lab and got the info I needed. I finally got the good news weeks later that the patient was negative for all tested. You should have seen the happy dance I did!

Since that stick 2 years ago I have had several bodily fluid splashes but nothing as serious as that incident. Working in the ER I know puts me at greater risk due to the type of patients that I deal with and the fact that I have often get into wrestling matches with them, and I never know what they have in their pockets until I get their clothes off. But I try to be more careful and more attentive when I have a sharp in my hand, where before I think I had become complacent.

A complacency that could have cost me everything.

Coming soon to an ER near you....

My ER has always been pretty relaxed about what the nurses wore to work. I think they were just happy we showed up. There were nurses that still wore the typical nurse scrubs , but most wore scrub bottoms and tshirts.

I hate nurse scrubs, I feel like a slob, and surprisingly find them very restricting of my movements..weird I know, so I typically wore cargo pants with a tshirt. I looked presentable, never had any complaints that my attire was hazardous to my patients health, never was revealing- granted I typically wore all black but I was comfortable and I thought that was the most important thing considering what I did for a job.

Well now the big-wigs have decided that we should all wear the same outfit, dark blue nurse scrubs. Why? Well some idiot voiced concerns that we could be bringing home MRSA and every other forsaken bug out there to our families on our clothes, so the hospital should provide us scrubs to change into. That is the dumbest thing I have ever heard.. really it is. I would love to find the person who voiced that concern and show my appreciation.


Since the nurses didn't have any input into what we would wear, and why should we, not like it is us wearing it for 10-13 hours straight, oh wait yeah it is, I thought I would fantasize about the uniform tops I would have picked out for the ER...

If only I was in charge.......