Happy Thanksgiving

Happy Halloween

You all know how immature I am.:

What will I tell my boys?

We got the call that a 44 year old female was coming in hot with an asthma attack. She arrives in full arrest, lungs too tight to bag and the story is that she was getting ready for work when she told her boyfriend to call 911. Somewhere in the story as I was triaging, a by-stander had told EMS there was some meth smoking going on prior to the incident. Crap, now I have to call the sheriff and all that poo cuz she dies and we don't know what happened.

She looked well nourished, no meth teeth, no skin pickings. Coming in, she was a Jane Doe but we soon had a name and word that her estranged husband was in the waiting room, alone.

He had gone to the house to pick up his two boys age 5 and 7, when the first responders had just arrived. Slowly, we get the story that he was separated from her, that they use to be drug addicts and had been clean for over 5 yrs. He had left her in April because he thought she might be using again, but wasn't sure. She had a boyfriend living with her but he had left the scene as soon as he called 911.

All he could say when told that she was dead was "Oh my God, what will I tell my boys?" Over and over he said it. I thought I was going to lose it when he pulled out the cell phone and showed me pictures of two tow-headed cherubs. Seriously, peeps, this one got to Rachedy, the cold dark heart that never bleeds was almost a sniffling wad of snot.

After all was said and done, the sheriff found a meth lab in the house and were actively looking for the boyfriend.

It's been three days and for some reason I can't let this one go.

Damn.

Blog Dress

Do you blog in your PJ's and fuzzy slippers? Do you schlep around the house for hours feeling dowdy and uninspired while writing? I have found the answer to the blogging doldrums. Yes, fellow bloggers, I happened upon this today and realized that I don't have a dress to wear while I'm blogging. Check it out, get yours now while they last.



Here's the write-up (sales pitch):
Blog Writer Dress
http://www.modcloth.com/store/ModCloth/Womens/Dresses/Blog+Writer+Dress

* Description
* Measurements
As a full-time blog writer, you know that there’s no reason to sacrifice ease in the name of style when you’re swanning around for hours with your laptop in tow. This loose-fitting babydoll dress makes a perfect match of both with its functional button front, cuffed short sleeves, and dark grey trim. A star-like pattern adds to its charm, as do its useful pockets. Transition from typing at home to meeting up with your readers for cupcakes by adding a fitted blazer, grey tights and a high, sturdy pair of heels, and you’ll be feeling both comfortable and confident as you chat the night away. From Dear Creatures.

The Power of PoonTang

I know, I've been away for a while. I guess I just get sick and tired of all the bs that goes on everyday, it's worn me down. The same complaints, the same bald-faced lies to my face, the same crap from the charge nurses who expect us to take one patient after another who are not triaged coming straight back from the waiting room whilst they sit perched on their asses surfing the internet and taking breaks.

To top it all off, the hospital fired most of the doctors and got a new group in a few weeks ago, probably cheaper. Obviously these new docs are brand new graduates who appear to be deaf mutes. No offense or anything, but dude, (I say dude because not one single one of them is female) when I tell you a patient looks like crap and you ignore me until I'm paging your ass overhead to bring the glide scope, don't you think just maybe you should have at least acknowledged me with a wink and nod?

Whatever. My main beef this past weekend was Dr.POS who works maybe a shift a month, thank Dog. He's got a mouth that would make a sailor blush and he seems to have some sort of sex addiction. I know the ER seems to attract that kind of shenanigans but this takes it to a new level.

One nurse told me that she got a text one day from him asking her out for the evening. She has 5 kids, 3 of them grown! He told her he got her phone number from Facebook. When she told him no, he texted back to please stop wearing her granny panties to work and has since ignored her. Bitch, please and you didn't report his ass?

Apparently this is nothing new for him. He's gone through most of the scribes, if you know what I mean and most of them are under the age of 24. Yesterday there was a patient who had a rash on her butt and he's at the nurses station talking about it, making fun of her, saying it looks like she got slapped too hard by her boyfriend while having sex, using numerous curse words that started with the letter 'F'.

This guy is from some country that traditionally thinks of women as second class citizens. His wife is a Pediatrician and everybody says she's beautiful. He talks about her like she's a bitch from hell. Just goes to show, having an education doesn't give one class.

I guess what chaps my ass is that with all the equal rights stuff, the laws on sexual harrassment and women's lib having been around over 40 yrs now, there are still women who think when a man stares at her breasts instead of looking at her, who makes sexual innuendos the only way he converses and maybe he touches her too, that's okay because he's paying attention to her. Ladies!! Wake up and get real, use your power to out these guys. Have some self respect.

Thank you.

Sunday Humor

I can so relate to this:

The Worms Crawl In....

Being in triage is always an inspiration for blog stories. Just the sorry fact that these crazy fuckers are out among us is enough to take pause and thank your lucky stars that somehow you escaped lunacy for now.

A nice looking 20's something female comes into my room with epigastric pain for months but today is feeling something moving around, that something being what she thinks is worms.

I ask her if she's vomited, has rectal itching, weight loss, etc. Nicely she tells me that she has been reading on the internet about how worms can feel exactly like she's describing. She goes on to tell me that she also had googled about being tired and thinks that she might be diabetic and possibly has cancer in her bones because they hurt sometimes, too. She's tearful, says she is so worried.

I EMD'd her and sent her back. About 15 minutes later out she comes, sobbing because the doctor didn't believe her story and they wanted her to pay. Gasp, they wanted her pay!

An hour later Ms. Wormy returns. I see her checking in at the recept desk and she's holding a jar in her hand, showing it to the 8 month pregnant medic who is looking a little pale.

So, I walk out there and she spots me, showing me a jelly jar with a couple of earth worms in it and excitedly points to them and tells me, "Look what I vomited"!

Disclaimer: this is a different worm lady than the one I talked about a while back who brought the poop filled Coach purse in. Who knows, maybe they both saw this video on youtube:

Yack Yack Yack

So me and another nurse took a patient up to the floor the other day, something we don't normally do. Getting off the elevator, the nurses station was as quiet as a library. I yell out to the 5 nurses sitting there in silence, hey, can y'all help us get this guy into the bed? Out of the corner of my eye I see a stop light thing that goes from green to yellow. Like, wtf?

Anyway, in order to increase their patient satisfaction scores, all the nursing floors installed these things called a Yacker Tracker that monitors noise level. So some management hack decided to pay over $100 each for these things to keep the nurses station noise down?

I can just see one of those things in the ER. The siren on it would be going off non-stop.

Talk about a huge management bull crap idea. While up there, the unit secretary was still paging on some room intercom for different nurses to go to such and such room, which seemed much more annoying than a few nurses talking in the nurses station.

Makes a person want to yell fuck you all, grab a couple of beers and slide down an airplane chute!

Random

So I was in triage the other day and checked in this really good looking guy with knee pain, he'd hurt it playing basketball. I'm looking at his info and realize he's only 16 and by himself. So, I tell him he'll need to have his mother or another adult to be seen. He said his mom is coming and he goes back to the waiting room. A little bit later I hear incessant honking coming from the drive-thru and get up to see what's going on. This lady had pulled up right to the sliding glass doors within an inch, talking on her cell phone and honking like hell. I was confused, because nothing seemed wrong until I saw my knee kid talking to her at the car window. She's gesturing and yelling, so security goes out there where she rips him a new one, saying she'll come back after sonny boy is seen because she doesn't have the time right now. After explaining to her the deal, she proceeds to back her car up, narrowly missing a few kids who were walking around the car. She peels rubber and parks in a handicapped spot and comes into triage, demanding sonny be seen ASAP. I felt bad for the kid, he was sweet and cute and probably embarrassed by his bitch of a mother. Need I tell you how all that worked out?

Crazy dude comes in via EMS, had been found pretending he was The Hulk at McDonald's. We throw him in the rubber room where he proceeds to rip the locked door right off it's hinges. Ketamine 400mg IV later (yes, you read that right), he's out for 10 minutes, wakes up and gets himself out of 4 point leathers and picks up a 6 foot tall medic, bites his hand and throws him up against the counter bent over backwards. Said medic is now out on medical leave. After tackling him down with the po-po, he gets tubed, propofoled and sent packing to the ICU. I heard those beatches had reduced his propofol to do a neuro check and he woke up, ripped everything out and ran out of the ICU. Good times.

A young guy came in, found non-responsive in a parking lot. No ID on him, Temp was 107.3. We cool him off and CT him, drug screen negative and ship him up to the ICU. He woke up the next day gave them his name and his mothers phone number. Seems that he lives in a locked down psych ALF that he had escaped from. His mother says he lives there because he has an alter personality named Ed, and Ed is a serial killer. Nice.

And now, a song from our sponsor. A little Pink Floyd to identify with:

The lunatic is on the grass
The lunatic is on the grass
Remembering games and daisy chains and laughs
Got to keep the loonies on the path
The lunatic is in the hall
The lunatics are in my hall
The paper holds their folded faces to the floor
And every day the paper boy brings more
And if the dam breaks open many years too soon
And if there is no room upon the hill
And if your head explodes with dark forbodings too
I'll see you on the dark side of the moon
The lunatic is in my head
The lunatic is in my head
You raise the blade, you make the change
You re-arrange me 'till I'm sane
You lock the door
And throw away the key
There's someone in my head but it's not me.
And if the cloud bursts, thunder in your ear
You shout and no one seems to hear
And if the band you're in starts playing different tunes
I'll see you on the dark side of the moon

Prying Eyes

This blog is going private. If you want to continue to read here, please email me at Rachedynurse@gmail.com with your email addy and I'll add you. I'm sorry, guys.

Nurse Bloggers

I have to thank Living Dead Nurse for this award. Thank you!

1. Thank the blogger that gave you the award.
2. Sum up your blogging philosophy, motivation, experience, using 10 words.
3. Pass the award on to 10 other blogs you feel have substance




My blogging philosophy is to just say what I'm feeling at that moment and thus put some perspective on it. That was more than 10 words.

Here are the top blogs I read every day.
Call Me Nurse
Guitar Girl, RN
Madness: Tales of An Emergency
Room Nurse
New Nurse In The Hood
Those Emergency Blues
NYCRN
Nurse Me
New Nurse Insanity
Life In the ER: a Nurses
Perspective
Dr. Grumpy

Creepy People

I was thinking over some of the weirder people I've had in the past year or so and here are some of the real winners:

19 year old female comes in with abdominal pain, worked up numerous times. She's laying in the bed with the covers up to her chin, you would have thought she was 12. She had this older man with her who looked like a rat, actually. He was all up in her shit, when asked when her last menstrual was, he responded with the date. Freak. While being discharged, he didn't leave the room for her to get dressed. Found out later he was her step-father. I mean, whose father, let alone their step-creep knows when their last menstrual was?

Older gentleman comes in with his wife and a couple of her girlfriends. He had been discharged earlier that day after having a foley removed, now has clots and bleeding coming out of his pee pee. I go in and he's standing there stark naked, saluting the flag in all it's glory while the wife and her girlfriends are all a clucking. Geezus, man. Okay, I see you had some weird-ass penile implant back in the 80's, but what's up with you and all these old ladies?

One creepy dude was sitting with his mother, who was maybe 55 and totally cognizant of the situation. She had to have a rectal and he didn't budge. Who wants to see their mother get a rectal exam? What is wrong with that mother? Where do these people come from?

Not to mention all these guys who refuse to step aside while their baby mama gets a ride in the stir-ups. Bro, please.

Oh, and the young guy who came in with his "wife who is a doctor" crying and moaning over the worst abdominal pain ever, ever, ever. A urinalysis revealed he had 3+ yeast, along with a few other yucky things. How many guys have you sent home with Cipro and Diflucan? Can you say ManGina?

Don Draper will you marry me?

I'm practically apoplectic over the fact that Mad Men is back this Sunday.

I am seriously hyped, dear readers.

The premise of the whole show revolves around an Ad Agency, Sterling and Cooper. They had "real" accounts of the time, like Hilton, Channel, Lucky Strikes and Pan American. Right now there is a contest going on here. One can create an ad just like Don Draper would, using products sold today. Thanks to my talented son-in-law, here's one entry he created (My daughter wants the Mad Men barbie dolls, badly)



Uh, hmmm...moving on:

I'm going to get me a brand new box of Crayola's to sniff (hey, it brings back memories of 1963), pour a cold stiff fresh Diet Coke, sans the bourbon, and put fresh batteries in my electronic cigarette and blow huge fake smoke rings all over the living room. I'm gonna turn off the cell phone, put my hair in pin curls and pretend that I'm Mrs. Don Draper for an hour. Oh, God, what could I be thinking. No! I'll be wearing my lounging gown, drinking a high ball and laying on a divan with a come hither look on my face.

For those of you who are still able to hold your liquor, there is this and it's a drinking game for Sunday night, the premier of season 4.

If you have been living under a rock and are wondering what the hell Rachedy (aka Mrs. Don Draper) is babbling about, here's a peek at the season preview:


We now return you to regular blog posting.

Paybacks will be hell

I was reading a favorite blogger, NewNurseInTheHood where she talks about those freaks in ICU and what they want from us.

What they want is everything done and tied up in a nice red bow, so all they have to do is put the patient in their fluffy clean automatic turning beds and add the bunny boots, SCD's, Foley, wrist restraints and hang a fresh Propofol. Then, it's back to the nurses station to sit for another hour until they start their hourly rounds.

Last week there were a bunch of gift-wrapped papers with bows around them in the corner of the desk and I thought they were a school project for somebodies kid. Seriously, they looked like crap. Inside the wrinkled up mess were individual candles, apparently gifts from the ICU. Their new manager had brought them down and said they were relaxation candles and to help ourselves.

Well, after sitting there for days, somebody finally opened one and sitting right on top of it was a curly black pubic hair! Seriously, somebody up their doesn't mow the grass. Unbelievable, because we all know you couldn't pull a needle and a thread through their rectal orifice with a tractor if you tried.

Those C-word beatches! The game is on, you strident whores.

We're coming for you.

Okay, so I'm really immature

Some Scary Shit

I was doing lunch coverage and had only gotten a cursory report from the nurse who was going to eat. She said the lady in 4B was up for dispo and to get rid of her as soon as the chart came back. In the meantime, I'm in the room next door triaging an ambulance when the doctor comes to the door and says, "Rachedy, I ordered a GI cocktail on 4B, if you could just give it to her and tell her it's for the parasites, she can go." I had no idea what he was talking about, but as soon as I finished with the triage, I went into 4B and handed her the meds.

She had jet black hair like it had been dyed it with shoe polish. There also was a black scarf around her head that appeared to have about 10 years worth of dandruff on it. She looked totally nuts to me but I told her I was giving her the parasite meds and then I gave her the discharge instructions. There was some drama about what the name of the med was, but her daughter convinced her it was all good and they left after I got her $1700 in one-dollar bills out of the safe and gave it back to her. Seriously, all those dollar bills could have kept me at the Diet Coke machine for a long time, but I digress.

Fast forward a week. I hear loud screaming coming from the back where the isolation room is. I mean LOUD! Screaming that the parasites were eating her alive, " Help, help, help!" My curiosity was piqued and I mosied on down there.

The charge nurse is holding a large Coach purse away from his body and everybody is looking into it with their noses pinched shut. The crazy bitch had dropped a few loads into the purse and brought it in to prove that she had parasites. (Which she didn't).

I mean, seriously, she ruined a perfectly good Coach purse!

I Sing the Body Electric

It seems that the more corporate a hospital becomes we as nurses no longer have the autonomy of professional judgment about anything and we're not entitled to an opinion or even to express an intelligent thought. Despite our knowledge and abilities, we're just bodies worth only what we can contribute to the wealth of that soulless incubus known as the corporate master.

This is not dissimilar to the way that Walt Whitman portrayed the bodies of the slaves who were being auctioned off to plantation owners during his time. Our nursing skills are pegged to the gossamery with which we can kiss butts while running from one room to the next, and to keep our mouths shut except to keep saying, "Yes, I'll do that for you right away."

The word on the street is that tracking devices are coming for our badges. Management will be able to track how often a nurse went into a room, or any area for that matter and thus discipline based on these trackers. Maybe I should have entitled this posting 1984.

Oh well, there's nothing left to do but smile, smile, smile.

Douches in the Media

I am in a really pissy mood today. I had no air conditioning over the weekend, my PC crashed with viruses and my coffee pot broke. A/C is back up and running, a medic I work with removed the viruses I had, but apparently he also removed a few key items, so half my crap isn't working,and when it does it quits for no reason. Oh, and a nasty cramp in my calf woke me at 0630, causing me to catapult up out of the bed from a dead sleep, screaming. I'm sure the neighbors heard me because all the fucking windows were open.

But, in other business, yours truly just happened to see an article here a few weeks ago from a link on Facebook's ENA page. After reading the article I posted my opinion on the authors childish sense of entitlement and then I promptly forgot about it.

Until today. The same author wrote another article here apparently upset with Rachedy and a few others who bothered to waste their time responding. I seemed to really touch a nerve with this hand job as he wasted two whole paragraphs dissing yours truly and her momma. I cannot express how honored I feel at all this attention.

I am half inclined to email this douche and offer to have him come work a shift with me on a Saturday night during a full moon.

This poor excuse for a writer would more than likely not get it. I'm sure after spending an hour with me he would be on the phone to the state regulatory agencies complaining about some bullshit thing or other. I'm sure two hours without a pee break or a cigarette and probably a shot of bourbon, he would go home and type up more flaming crap that makes no sense. This probably explains his utter lack of proper sentence structure and just plain crappy writing.

One nurse on the ENA page wrote him a long letter, attempting to explain the process, to which he responded that his friend was much sicker than those he saw going back who had checked in after his poor friend had. His friend was there for chronic dental pain! He already was on pain meds and had been for four whole days.

Hey, I bet he'd run out of pain meds. Yep, that's probably it. Freaking piece of
wasted space.

I'm back

I know that you missed me, bitches. I've been absent from the blogosphere for a few weeks, yeah whatever. I wish I could say I took an exotic vacation or won the lottery but that wasn't the case. Besides having the summer cold from hell for a total of 3 weeks, I've been in a bad mood from all the overtime I stupidly signed up for.

I usually work weekends so I don't have to put up with the douche's from management and their douche bag minions, Mr. Testes, Mr. Lazy and that whispering whore let's-talk-with-our-inside-voices, the ex-first grade teacher.

So my one friend who is a charge nurse was pulled in the office last week and told that she was the weakest link among the charge nurses because the word on the street is that she is too nice. Say what??!! She was told to grow a pair or move on. Geezus, I've known her for many years and not only is she a nice person, but she has great skills as a charge nurse. But no, that's not what the huge Douche Sacs from management want.

Since a lot of people are signing up to work weekends it got back to them that the reason was because it was much nicer to work with my friend. So, they pull her off weekends and put Mr. Testes on last weekend. He fucked with me the entire day on Sunday, one patient after another, no medic to help me, just a day from hell. I said nothing to him, there is no way I'm going to let him see me sweat. I'm sure it bothered him because at the end of the day he told me I was the most difficult woman he's ever known. I just looked at him with no expression and told him better ones than he have tried to break me. Then he says "You're just saying that to pay me back for fucking with you all day." I said to back to him , "Oh, you were fucking with me?"

Nurses are quitting in droves, not even staying to finish out their last shifts and these mofo's are worried that somebody is too nice?

Just what kind of management theory are they operating on? Leona Helmsley seems sweet and kind compared to these fascists.

Worst Come, First Served

Just because you are coughing and sneezing louder than an elephant with a stuffed up nose does not make you priority number one. The guy who just came in with the thumper on his chest wins that prize.

The louder you vomit, sneeze, cry, moan, scream, whimper, and call out does not matter to me if I am in the middle of a Stroke Alert. Since I saw you out of the corner of my eye eating doritos and your girlfriend stroking your head, I decided that I don't like you. You're a level 3, which means you're probably going to get IV fluids and Zofran, but in the common sense world of people who don't think they are entitled, you would have stayed home, sipped on gingerale and when dinner time rolled around your mommy would have made you some chicken soup.

Just because you went to the charge nurse and complained doesn't mean that I'm impressed. What do you think this is? A restaurant? The DMV where you take a number and your turn is called? You going ape shit at the DMV is something I would like to see. The police dragging your sorry ass out of there in cuffs would make a great perp walk. But you wouldn't do that at the DMV, would you? Just because you're in the ER doesn't mean you can act like a fool and we're suppose to take it. So sit down, hurry up and wait, or better yet, make like a banana and peel.

When I saw the BLS ambulance coming in the door with 4 small children on it with you walking aside with your cell phone in hand and a Louis Vuitton bag on your arm I laughed when the charge nurse sent you all straight out to triage. Cold symptoms, indeed! Just because you called the free taxi, er ambulance, doesn't give you and your gaggle a free pass to a bed in the Pedi area.

Since I've got the summer cold from hell right now, my sympathies may be distorted. There's nothing I'd like more than to get me some good cough medicine and take a nice long nap. Not going to happen since I have to be up tomorrow at 5:15 sharp to get ready to go in and take care of more cough, colds, vomit and drama.

So, excuse me while I sneeze really loud and attempt to garner some sympathy from my dogs.

Ordinary Shift

Yesterday was a good day for overtime. I show up for an eight hour shift with my hair actually looking half way decent. Coming in at 11A gives me time to gussy up for the day, something that I never do when going in at 7A.

I start off floating, which is fun because I'm not really responsible for a group of patients, I just get to go around and triage ambulances and put out fires.

I just so happened to be standing by the ambulance triage when the EMT says to me, "Oh, hey, how are you doing? Remember that lady with the shoes the other day? Well, guess what? The shoes were in her room when we dropped her off." I commented that I didn't receive an apology call from that heinous daughter. Eye roll, sigh, gasp.

After a while, I get put in the halls which isn't too bad, except for the fact it's difficult to take vital signs because we have one, I said one rolling dinemap for all four halls, total 32 patients. Not to mention that maneuvering the COW is a challenge.

I'm typing up this guy who brings in a huge wad of MRI's and X-ray's and he tells me that he has run out of his pain meds since he lost his job and can't pay for the pain clinic, anymore. I'm thinking to myself does he think it's free to come here? I'm sure he was going to one of the pay as you go all cash pain clinics, of which we have 35 of them in my county. After the medical screening, he's told he has to make a co-pay for treatment or leave. I just love it when that happens. Drug addict number 15 of the day out the door without his precious Oxy.

Drug addicts aside, I get the cutest man who fell at his ALF and has a big boo-boo on the back of his head. He's alert but a little forgetful. After we patch him up, I tell him I'm sending him back home to which he tells me I'd better call his wife, she might not want him home. I guess he forgot he lives in the ALF. Seems that she put his 84 year old butt in the ALF because she's having an affair with a guy who is about 48. His wife is 60 he tells me and he thinks she only wants his money. Apparently he has a a huge house with a Mercedes in the drive. I feel bad for him, he was so sweet.

The lady in Hall 3 comes in with a headache x 3 days. She's got a shocking amount of unruly curly red hair, that seems to be all over the place. While typing her up, she tells me that she had fallen in the shower and thinks the bump on the back of her head might be the problem. So, I proceed to take a look when I notice bugs crawling through her frizzy mane. Geezus, bitch, do you know you have head lice?? Oh, she tells me, yeah, I have to wash it everyday and they just won't go away. Gawd, I just got the chills thinking about it, again.

All in all, not a bad day for an extra shift. Makes me think this job is okay, for now.

Douches Part Deux

There are so many douche bags to talk about and so little time.

So the other day another LOL comes in from Shaky Graves Nursing Home with Altered Mental Status. She looks to be about 90 pounds soaking wet and drier than a popcorn fart. Her lips are crusted with junk, her tongue looks like a prune and when I insert the foley I get about one drop of urine.

Following the ambulance in is her crazy douche bag daughter from hell. Oh, excuse me, she's an RN from New York and she just flew in to town. Well, fuck me dead, bitch. Like I care.

So, she's hovering like a helicopter over Mother and up my ass asking for a toothbrush, soap and water for a bath, ice chips, some Motrin and a Xanax. I tell her let's wait for her to be seen by the doctor, first. She huffs and puffs a little and in walks one of my favorite docs, a little petite thing with 5 kids who looks like she's 15. RN from New York tells her in a rude way to step out because we're in the middle of fluffing and buffing. She said this only like a New Yorker can. To which my favorite doc looks at her, puts her hand out and introduces herself. Nothing like a little southern charm. HaHa, you should have seen New York's face.

Anyhoo, we get to hanging some fluids, do all the usual stuff and this freak wouldn't stop with the constant demands. It was like she was tweaking on sugar or something and I felt like I was going to start twitching any minute. She intimidates enough that we get her some Xanax and a Motrin. One sip of water and she's coughing up a lung. I suggest we hold off because I fear she is aspirating. Nope! She says she'll take full responsibility for it and insists it be given. After discussion with Sweetness Doc, we decide we need to up our Press Ganey scores and give the meds. I crushed them, got some yummy pudding and let New York RN administer. (All documented as such in a very professional way, of course).

About 2 hours later she was on a vent. I wish I could have said told you so, but I'm not that way. I smiled and comforted like the dumb nurse that I am from the south.

Moving on, a dude with HTN whose wife was pregnant. He asks me if I can get her a stretcher to lay down on. Uh, sure. Just let me kick a sick patient off one so we can help you out a little. Douche.

19 year old female shows up as a psych hold after threatening to kill her brother with a knife. We go into the bathroom to take her clothes off and get a drug screen when she pulls up her leg, shows me her kitty cat and tells me it's warm and silky. Okay, sister we're out of here. With urine in hand, she's walking back to her stretcher, but unbeknownst to me, she had opened her gown in the back so her ass was fully exposed to all of the medic students who had just arrived for orientation. Fun times I tell ya. PsychoDouche.

Two 18 year-old frat boys come in with a couple of gigantic Red Bulls in hand and tell me that the car they were driving suddenly backed into a concrete pole and the windshield shattered. Okay, he had a little tiny .01cm sized lac on his eyelid and he was also extremely fucked up on something, I suspected Oxy and Xanax. They deny that, however. Doc Crotchety couldn't wake him up enough to get a straight story, but they did tell him that they thought the car ran into an overhanging branch causing the windshield to break all over them. Hmm, overhanging branch or concrete pole? They do like alike. Spoiled frat boy double douches.

Hip Hooray! A whole two days off. I think I'll give my precious little puppies a bath and watch Lee sing Hallelujah again on the DVR.

Extreme Douchery

I'm seriously starting to hate this my job. It's to the point where I'm thinking about going back to the unit.

I don't know how other ER's operate, but mine seems to suck balls lately. With the extreme douchebaggery of management, and the out of control douches who come in for bullshit and bring their psycho-bitch wives, girlfriends, daughters and sisters with them, I've just about had it.

We have this one charge who I've not mentioned who is the most mealy-mouthed freak of a ho I've had for a charge in a long time. She used to be a first grade teacher if that tells you anything. She only uses her inside voice to talk so you can never hear a fucking thing she says. She loves to give you stupid crap, like putting men in all your GYN rooms, then while you're in the room getting one triaged (immediate bedding, 'nuff said), she's paging your ass to go to another room for some bullshit or other. I try, but I can only wipe one butt at a time. Not good enough I suppose because you get a a look from her like you're somehow incompetent that you can't triage three people at once and have them all lined and medicated in five minutes.

Fuck her.

Anyway, I get this LOL from a nursing home who fell the day before and hit her head. She's non-verbal by history, and has a big blue egg on her forehead. I type her up and get her labs when her neurotic hysterical daughter comes in looking like her ass is on fire. Seriously, bitch! Like, take a chill pill. I proceeded to tell her the plan, only to be interrupted by her telling me things like "NO, I don't think she needs to be cathed, that's invasive," to "Where is that doctor?? She's been here 10 minutes!!" Gawd, what a C-word this one was. This hag was in her 50's, but when she talked to me she would roll her eyes and sigh. I'm not sure what she wanted and what it was that I wasn't doing for her. But, I'll tell you, just because she wanted me to come in and check Mothers diaper to see if it needs changing, doesn't mean I'm dropping what I'm doing with the dude who just came in from a house fire to attend to her every whim. It's all about triage for me and Mother was a level 5 at this point.

Fuck her, too.

I had called a transport ambulance to send Mother back to Serenity Hills and was just awaiting their arrival. Oh no, not good enough. I get more eye-rolling, more sighing (I think she's an old valley girl from the 80's, I haven't seen that much sighing and eye rolling since my daughter was a teen)-more hysteria because a skin tear was bleeding, complaints that she has seen ambulance after ambulance come and go and it's been an hour and why haven't they picked Mother up. Seriously, I want your mother out of here like yesterday, trust me you heinous piece of crap. The final straw is Valley Woman comes up behind me while I'm talking to somebody else and butts right in with a sigh and a shrill shriek that Mother's shoes are missing. I turn to look at her, I say nothing, I just look. She stands there, sighing, rolling her eyes, shrieking on and on about the missing shoes. Finally, I say I don't recall any shoes. She says, "I called Serenity Hills and they said she had shoes!!" Snort, eye roll, sigh. So I say , "Well, did you look in the room?" Well, that did it. She lost it. Total meltdown right there. With a super eye roll, a huge sigh and snort she tells me "WOULD I BE ASKING YOU ABOUT THE SHOES IF I HADN'T LOOKED?" Got to admit she has a point, but seriously, does she think I'm hiding the shoes? Lying about the shoes?

Yeah, I stole the shoes, that's it! Sigh. Eye roll....

Happy Nurses Day

I got my ass handed to me on Nurses Day.

Management was cooking up flapjacks so me and a few others including a student or two headed on over. My unit director was cooking while some manager in a nurses hat and white uniform was handing out plates. Bitch, please! You mean you really saved your nursing school hat from 1966? Is that how you see nursing, still? Probably, but I digress.

So there was a two pancake limit which didn't deter us. The students had already eaten so they lined up and then handed us their dollar size pancakes. We proceeded on over to the next line and were greeted by this:


SAUSAGE POLICY: NO MORE THAN TWO SAUSAGES PER PERSON. NO EXCEPTIONS. SEE YOUR MANAGER FOR ANY QUESTIONS.


Good thing I got that great breakfast, huh? The shit storm was about to hit. Between the crazy drug seekers in Xanax withdrawal and the really sick people, the place was beginning to sound like a jet engine idling for take-off.

Add to the mix a crazy nurse who forgets to take her ADHD meds and starts getting really loud with the chaos, Crazy Town was heating up and she was the Mayor.

I had in my room one squirrely benzo withdrawal lady, one drunk guy who was talking non-stop, one sweet lady with a dickhead husband who kept telling her to shut her mouth, and the sick lady who came in with bleeding from a left femoral cath site.

Bleeding Fem lady looked like Caspar. She had been tubed in the field for Altered Mental Status and the presence of copious amounts of blood in her bed. Upon arrival, she did not have a pulse. She also had no line. I was alone, except for two nursing students, a paramedic student, the doctor with his scribe and The Mayor of Crazy Town who showed up to flirt with a few of the paramedics.

I throw the doc a central line kit and some gloves, I instruct one of the students to start CPR and I crack the code cart. The Mayor is running her mouth, bouncing all over the place and accomplishing nothing. Oh, and in the midst of the all this debauchery, she finds time to stand at the foot of the bed and send a text.

I kick her out of the room with a few expletives to express my displeasure, screw the fact I'm the only licensed nurse in the room. I'd rather have glued my eyelids shut with peanut butter than deal with her dumb ass.

Boom! I hear a crash and look through the curtain to see that my drunk dude has fallen on the floor and is curled up in a ball with some blood coming from his head. I call out to our illustrious Mr. Testosterone charge nurse who is busy surfing the internet and tell him I have a man on the ground. Bummer for him he has to get up off his fully-sized bowling ball butt. Xanax withdrawal is also practically hanging by her telemetry wires, nothing I can do at the moment, I turn my attention back to my code. I compliment the nursing student on her awesome CPR. She's a very serious girl, she barely looks my way.

It was too late for trauma blood, she was dead. I'm even more screwed now, because I know I'll spend the next 90 minutes give or take on the phone calling all the appropriate agencies. Not to mention, the screaming I get from her private doctors, none of whom will sign the death certificate. In the meantime, the sweet lady leaves and I'm still getting my beds filled with sick people.

I finish up the paper work in record time, console the family, hug the daughter, tag and bag and send her off to the morgue.

It's only three, I have four more hours of this. I'll spare you, needless to say an eerie calmness came over me and I tuned out all the loud noises. Maybe I was just hungry. I think I'll head over here:

Code Blue

He was called in over the radio as a full code. A 45 year old found down in the yard by his wife.

He was a big guy with a full head of dark brown air. Wearing shorts and dockers, his tee-shirt long cut off, pieces of it peeking out from underneath his shoulders. His face was pleasant, now blue and flaccid. I couldn't look at it. We coded him longer than usual, with no return of rhythm or pulse. No medical history given, he was just a guy on a beautiful Saturday working in his yard.

The wife finally arrived with two of her girlfriends in tow. The utter angst on her face was enough for me to take her to his bedside and hold her while she cried. No, he takes no medications, no he doesn't smoke or drink, he's had no complaints at all about his health.

They had been working in the yard and she had slipped into the house for some water, only gone a few minutes. The overwhelming sadness I was witnessing felt surreal. I've seen hundreds of these codes in my career. How I can stand back and be an observer to such human emotion is a mystery. It doesn't seem normal to be so removed, clinically distant, an observer of another human being losing his life.

I wondered about this. Are medical professionals the ultimate actors? Do we learn to quell our emotions so well that we are affected in our personal lives?

No, but sometimes I question my sanity.

Instant Karma

I appeared to working the loony toons room, which is not to be confused with the critical room, but that day it was one and the same.

In bed A we have a 27 year old female who came in by ambulance, rather, free taxi with a 6 week history of RUQ abdominal pain. No N/V/D or fever. She seemed fairly honest about her history, says she's bipolar but doesn't take any meds because they make her crazy. Her solution is to just smoke the gonja. She talked about it the entire time she was with me, where she gets it from, who grows it, she was in love with it.

In bed B we have a 50 year old female with chest pain with no psych history who is sitting with her husband. After spending some time with A bed, I go over to check some vitals on B bed. Her husband is hunkered down in the corner with the curtain pulled tightly and is trying to tell me something. I lean down to hear what he has to say and he whispers "I'm her parole officer." Shut up!! Seriously, he showed me his ID.

Poor bed A. I felt sorry for a nanosecond.

When she was being discharged, her niceness turned totally into a bipolar, head-spinning, shrieking foul-mouthed shrew creature all because all her tests were normal and she was leaving with no narcotics.

Funny I would hear a Lennon song on the drive home.

"Instant Karma's gonna get you gonna knock you right on your head."

FU and the STD

I would love to be a fly on the wall when management has one of their brainstorming meetings.

With the end result of most of their decisions being money and marketing, it was no surprise when they came up with a name change for the Fast Track area. The reason being is that they were going to take 2 beds out of commission and call it Super Track. One nurse, quick in and out in about an hour. This all came with a brand new waiting area equipped with a huge flat screen and refreshments while the customer waits to be discharged home.

Never in their wildest dreams did they realize when they changed the name from Fast Track to The Flexible Unit and named the Super Track Dept that it was akin to when all hospitals in the country went to a universal color scheme for codes. The first time I heard a code brown called it was all I could do to not run screaming from the building with every other nurse on duty that day.

Anyhoo, Mr. Mighty Charge likes the sound of his own voice and is always on the intercom paging away at random. You can imagine hearing, "Nurse Jones, please report to the STD, you have a patient waiting." Or, "Nurse Smith, please return to the FU, Dr. Hyperbitch is looking for you."

The FU?? The STD?

More Asshattery

I got this mass message in my in box yesterday at work and I quote:

Since I sent out my last message, only a few nurses have come to the medication reconciliation class. You need to go to the Intranet and sign up for the class as we are fast approaching our deadline to have all nursing staff competent in this task. Yes, I know the class isn't linked yet on the Intranet, I'm looking into that. If you don't attend the 6 hour workshop and lecture, unfortunately you will be placed on administrative leave.

Sincerely,

Head up my ass clipboard Jack-off compliance officer nurse.

An Average Day

Just a few observations from a crazy day:

If you and your visitor both weigh over 300 pounds, don't sit at the foot of the stretcher next to each other. As you found out, they tip over.

If you bring your child in with fresh bruises on her face and arm, don't bother calling the nursing supervisor to complain about the nurse who called the sheriff. The supervisor and the nurse will have a good belly laugh over that one.

If you came in with the chief complaint of blurred vision, don't sit on your hall stretcher reading a paperback novel for all the staff to see. None of our doctors will give you Vicodin for the "eye pain" and we'll all be talking about your dumb ass.

Don't come in via ambulance with the chief complaint of "too weak to text." Your butt is going straight out to triage where you will be the last patient seen today.

If you bring in an X-ray of your broken ankle that you state was taken an hour ago at the walk in clinic and you're asking for enough Percocet to get you through the week because you're flying to Chicago tomorrow, at least make sure the date stamp on the enclosed CD isn't from 2 years ago. Dr. Crotchety was not amused.

If you're a 70 yr old lady, please don't keep coming up to the nurse as she's running by with her arms full and tell her for the 10th time that your husband has something to tell her. She doesn't care, the triage is done, the foley is draining, he's already gotten blankets, more blankets, slippers, ice chips, fluffed his pillow, gotten another pillow and, NO!, his IV is not bleeding. Have a seat, let us do our job, we've taken care of many patients with urinary retention.

Please, don't walk into a room with active CPR and ask to speak with the doctor running the code. The doctor might just be a little busy and he doesn't care that your mother has waited 30 minutes to get the results of her hand x-ray.

Thanks to our charge nurse today for buying us Pizza, you rock!

Pants on the ground

I don't know about you dear reader, but I suspect you probably feel the same as I do on this subject.

Guys with their pants half way down their three-letter anatomy is what I'm talking about.

This fool came in with left flank pain with nausea/vomiting x 2 hours. Tells me first off that he needs a work note because of this "shit." Cool, he has a job. Okie dokie on the work note, dude!

But, first I need you to give me a urine specimen and while you're doing that I'll go get the good drugs. BTW, If you are unable to provide said specimen I have to insert a catheter to obtain it. You have 15 minutes to provide.

I just love that spiel, hee hee.

He unwraps himself from the sheet as I turn to walk out of the room. Thump! Freaking moron has fallen flat on his face, pants down to his round and brown.

I want to say I was sympathetic and helped him get up. I would have but I was outside in the hall laughing so hard I almost peed my pants. Seriously, it was a full-fledged Depends moment, folks.

He dusted himself off, sauntered off to the bathroom with pee cup in one hand and pants in the other, unfazed by what had just occurred.

I'm placing bets that Mr.PantsOnTheGround has kissed the floor once or twice before.

Earth Day

My daughter was IM'ing me about some more of the shenanigans that her dad has pulled. He, being a tree-hugging hippie who eats nothing but tree bark and sticks from the yard has been having plumbing problems at his compound in the country.

It seems that he doesn't have the denaro to get the septic tank pumped so he decided to make an all green toilet. Being in cahoots with nature, he built a compost toilet for the house using kitty litter. I shit you not. It seems that once a day he scoops out the waste in the house and puts it into the heap in the yard where it returns to the earth to be used as fertilizer for the vegetable garden. EWWWWW.

I should have known back in the 80's when he built this dome-shaped structure next to the house to store his guy crap in that he wasn't quite right. I mean, the neighbors were asking him if the thing was going to take off.

Guess who won't be eating dinner at her dads house in the future?

I love mankind, it's people I can't stand- Linus

While toasting up my bagel and waiting for the coffee to brew this morning, I considered my current state of pissyness.

Normally I'm fairly even with my emotions. Didn't use to be that way, nope, I didn't. But since the great Pause, I'm like a man, baby. I've adopted the Jerry Seinfield school of thought, "Is this about me? No? Okay, then who cares?"

But fair is fair! Why on earth would there be four charge nurses on at the same time, all but one of them sitting around at the desk all day shooting the shit while the rest of us chumps run our asses off?

Yep, a little bit of hormone has worked it's way up and out and I'm ready to blow. Thus, this space to put things in perspective.

Bullshit! This is an outrage. One of the charges, Mr. Testosterone, is the favorite son. He can do no wrong, ever. His princess wife works with him, always gets the easiest assignment, the best medic to work her team and she never works weekends, ever. Mr. Testes will even call another nurse to do some of her dirty work while she sits at the desk cruising the internet with her prince charming.

Then there's The Gossip. Been a nurse 2 yrs, but has worked every area, knows everything and gives some of the younger nurses poor advice on how to manage a drip and a critical patient. He also is known to divulge information he is privy to such as who has been written up, who makes the most money and who management wouldn't let take care of their dog.

Both Mr. Testosterone and The Gossip are working on their advanced degrees, of course doing all their coursework online during work hours. God forbid one of them has to get up and do shit.

I could go on, but why bore. Obviously upper management likes things this way. It's all about the times, how fast we can move these pour souls out of the department making the numbers look great for Management.

I hate them all.

My delicate sensibilities are outraged at all this fuckery. But, does it have anything to do with me?

You know the answer.

Prince Albert

I was working triage and it was the usual 'tards with their coughs, abdominal pain and toothaches. My shift was almost over when my favorite medic, who I refer to as my work husband, comes to me and says that I need to see the guy sitting in the wheelchair right away. I'm thinking if this is more bullshit we're getting divorced and I'm gonna take up with that new and cuter medic, Dusty.

My work husband wheels him into my triage room and shuts the door behind him. The dude starts to unzip, I'm like down cowboy, save it for the nurses in the back.

Me: "What's the problem?"
Prince Albert (sobbing hysterically and panting): "I have a ring stuck on my penis!"
Me: (on the phone to charge) "I need a bed."

I decide to triage him at bedside and off we go with this fool holding on to the family jewels and whimpering like a dog. Once in the bed, two or three male nurses pull down his pants and a collective gasp ensues. Really, not really.

His one-eyed trouser snake was very engorged and black as night with a very tight metal ring of sorts around the middle of it.

Old Doctor Crotchety comes in and gets to work with his usual dead-pan-I-don't-give a-shit-about-anything look on his face. The ring cutter wasn't working, lubing the thing up with KY wasn't working, nothing. It was pure seriousness going on in that cubicle when Mighty Charge comes in with some weird ass tool he keeps in the back of his SUV from his days in Pittsburgh as a welder. He fires the thing up, grabs the guys candle stick and slices the ring right in half.

Me:"What kind of ring was that, sir?"
Prince Albert: "My girlfriends toe ring."

Rumor is that the night shift measured it as a size 6. I'm just saying....

Cold Cold Heart

Every so often a patient subtly takes a grip of my hardened heart and twists it into
mush.

Sandra, a 50 y/o female presented with DIB for the last week. History of smoking, no etoh, no drugs. She looked like she'd had a hard life. Her color wasn't dusky, it wasn't pale, it was a chronic sick color, but there was not a choice in my EMR for that description. While I'm checking her over and talking to her, she's telling me that she hasn't had insurance for a long time but that she had a new job at BigBoxChain making $10/hr, she was paying $100 a week in insurance and now she felt that is was time to get the DIB checked out. And, oh by the way, she tells me, she has had this lump on her breast for a while, too.

I'm telling her that we don't normally do mammograms in the ED but we can give her a referral. She tells me alright, but will I look at the breast and tell her what I think?

When I saw the breast, I maintained my clinical poker face, but inside I was shocked. The entire left breast was eaten away and in it's place was a mess of green slime and holes with a foul smelling odor emanating from beneath the X-large band-aid she'd applied. The mass looked like the kind of cancer I used to see when I did a stint with Hospice.

My heart hurt for this nice lady. I was also really pissed off. She hadn't been to a doctor because she had no insurance, but everyday I see people who have no qualms about coming to the ED for their bullshit complaints, never intending to pay a dime.

I hate it when patients get to me like that. I don't like to think about them after I leave the hospital, no sir I don't. I learned a long time ago that one must hang their hat when arriving to work and to pick it back up when leaving. It saves a lot of heartache and it keeps one sane.

I'm home now, I've got my two precious Shih-Tzu's sitting next to me, I'm watching my favorite crime channel on TV and drinking a cold Diet Coke. I'm winding down so I can get up and do it all over again. I know I'll be tempted to look her up on the computer tomorrow to see what her dispo status was.

I also know that I won't. It's just too too hard to take on the pain of the world.

So tomorrow I'll clock in, hang my hat at the door and start the day anew.

Bush Gardens

At my facility we lovingly refer to the female rooms as Bush Gardens. Once in a blue moon yours truly is placed there for a shift, really not that bad of a deal since it has its own female tech who loves to do all the pelvic exams and caths. The annoying part of it is dealing all day long with the bull crap drama.

She c/o vag itching x 1 week and had not used any OTC meds, claiming only Diflucan will help. I gave her a pee cup for the clean catch and waited for the PA to see her. In my facility we have this great process called QMP, meaning if the patient is not deemed a medical emergency, they need to decide if they want to stay and be treated after forking over the co-pay, or they can opt to leave. Well, Ms. Drippy creates a scene about how she is from XXX state up north where she has Medicaid. However, she had no card to prove it. But, what a shock! Ms. Drippy had no money to pay for the visit, either.

As she was escorted out by security after refusing to leave, she's yelling down the hall, "You bitch, you took my urine!!"

The ICU

I worked in the ICU for a long time and decided baths, turning q2 and bunny boots weren't my thing anymore. Don't get me wrong, I did it because I loved it.

Precepting new nurses can be a challenge and I always admonished them to listen to what is being said in report, do a head to toe assessment upon arrival and take it from there. Somewhere along the line, or maybe it's the East of the City White Bread hospital I'm working in, the ICU has decided that the ER nurses are stupid, clueless and basically lazy.

Case in point: 54 y/o presents sitting up 90 degrees, retracting with a sat of 81%, respirations around 40. Two hours after Lasix, Bipap and multiple Nebs, he's on a cannula , looking reasonably comfortable, though not out of the woods, yet. I call up to the ICU to give the report. The first question out of ICU newbie nurses mouth is "where is the IV?" I mean come on, you really think I'd send a patient up there without two 18 gauge needles in each arm? I mean, Hahaha! But, I digress. The last statement ICU makes before I pack up the patient is for me to be sure and tell the paramedics to bring an Ambu bag with a peep valve on it. ICU newbie nurse tells me they gets "lots" of patients from the ER who come up needing to be tubed the instant they get there because the medics brought the patient up without a peep valve on the Ambu.

Driving home I'm trying to make sense of the need for said peep Ambu bag. The patient wasn't intubated, did he think we were going to bag him all the way up the elevator to the 5th floor?

I can hear it now while I sit in the puke green chair in my manager, Mrs. W's office, explaining how it was all my fault that a patient on a nasal cannula whose respiratory rate was 22 was not being bagged with an Ambu that had a peep valve on it and he suddenly needed tubing upon entering the doors of the ICU.

Next they're going to want them bathed before transport.

Full Moon Madness

I remember being a nursing student in the 1970's and a patient came in with the diagnosis of a
full blown psychosis. He was a nice looking man in his 40's who woke up in the morning yelling at his tearful family and all who would listen that he was God. He had a history of a brain something or other in the past but the scan of his head (did we do CT of the head back then?) was negative. Neurology had no answers. Internal Med had no answers. The Psychiatrist had no answers as he had no history of any psych disorders. This God stuff went on for 3 straight days. On the 4th day he became normal again, sat up in bed and asked for breakfast. The only diagnosis that anybody could come up with was Full Moon Madness (FMM). He was discharged that afternoon.

I remember being skeptical, laughing it off like I knew it all. In the years since then I have come to be a true believer.

This full moon stuff is some shit.