Put the gun down.

So there are some really cool things you get to see when you are a nurse.  Okay let me rephrase that when you are a nurse you think you see cool things.  This is one of those things.  So we get a shotgun wound patient.  Sound exciting?  Well it would be in our rural area since that doesn’t happen often.  The city I am sure its and every night episode.  How ever not only is this a 12 gauge shot gun there is not “real bullets”  just bean bags.  Apparently a suspect was holding a gun.  Got two warning shots with a 12 gauge shot gun.  Patient comes in with it still embedded in his leg.  The cool part was he was wearing sweat pants and the sweat pants when inside his leg.  The pants acted like a catcher mitt and kept the bean bag from exploding in his leg.  Freaking cool.  Not for him but to watch it being removed.  Yea I know I am sick.  But hey when the cops say put the weapon down, they mean business.

Grinds my gears: Dr Dumbass

So I get along with all my ER doctors, which is over 10 of them.  All but one…Dr Dumbass is her name.  I have no idea where the hell she got her degree but I guess someone has to be the bottom of the class percentile.   Let me show you a glimpse of her dumbassedness (made up word I know).  We use to carry around IV trays.  It had the needles, start kits and tubes and whatever else we needed to start an IV.  She actually wanted us to store ice on it so we would be prepared to grab a lactic acid (blood draw that needs to be put on ice asap).  We all looked at her in the meeting like um…wth.  Does she not realize the ice will melt and be water?  See what I am dealing with.
Well this past weekend she actually pissed of the whole crew.  That is pretty amazing.  First she pissed of a nurse that is never angry.  She was upset that the patient wasn’t placed into a gown.  This is why the nurse did not.  The patient was in a gown…however the pants, shoes and socks were still on.  The patient had obviously broken his ankle.  The nurse knew the doctor was bad for signing up for a patient and not seeing them forever.  The high top shoe was helping hold it in the correct position and he knew as soon as the shoe came off the swelling would be bad and wanted the doctor to remove the shoe.  He was trying to avoid more damage.  “For a broken ankle/foot, use a soft splint (a pillow or a heavy towel) to immobilize the area. The person's shoe should not be removed.” college of emergency medicine excerpt.  She bad mouthed him in front of the patient with another nurse.  Which was inappropriate. 
Next she highly pissed me off.   I was triage nurse and had a shortness of breath infant.  Mind you we get a lot of shortness of breath only to find out it’s just congestion.  However when mom uncovered infant from car seat I could tell he was having difficulty.  I scooped him up, weighed him quickly and headed to an open room.  Called the doctor over our volcera and another nurse to assist.   The only thing I had in the computer was Shortness of breath x1 day congestion x 2 with fever per mom.  When the doctor arrived I was placing the infant on the monitor and the other nurse was getting the IV stuff ready.  She barked orders to get a line and o2.  I was already in the process of getting o2 on.  He was 89% on room air and using all of his little muscles to breathe. I explained to the doctor that I had a weight and vitals except temp.  I would get it after the line was completed. We both attempted with no luck.  He was very dehydrated.  Respiratory arrived and I let them do a treatment first and explained to the doctor I had not forgotten the temp.  She said that is fine.  After the treatment and IV access I obtained a temp.  This is all within 10 mins of the infant arriving.  The nurse that was helping me over heard her bad mouthing me to the other doctors about incomplete vital signs.  I was pissed.  I had to avoid her the rest of the night because of I was afraid I would go off on her.
Next she was the one that was pushing for the undress for success.  She doesn’t care why you are here you will be completely naked and place in a gown.  Every time I was assessing my patient she would rush in.  I made it a point to say I sorry you didn’t give me enough time to get them in the gown and get your urine for you yet.  She was too stupid to understand I was being sarcastic.   I really hate this lady.  I really don’t think she understands.  She can power trip us all she wants, Bad mouth me in front of my patients, and be a know it all she wants but I will never be extra helpful like I am to the other doctors.  I will never automatically get a urine or blood without her orders in the system.  The other doctors will be first in their requests.  I will never make your job easier.  I will always correctly educate my patients and take care of their needs first but never for your convenience.   You will learn if you piss of your nurses you will never earn their respect nor their willingness to help you out.

Grinds my Gears: Lazy Charge

So we have a charge nurse that really was good at his job.  He applied to flight nursing and was declined due to his weight.  He is about 70 lbs. over weight.  Yes this job can do this.  Why?  Because you are in a helicopter which can only allow a certain amount of weight on board.  You never know what size your patient is going to be so they can help manage the weight by controlling how much the nurse and paramedic weigh.  Anyway ever since he was unable to get his dream job he has really slacked off.  I mean he literally sits around and plays on his phone, looks at car parts on eBay or house shops online.  Even during the busiest times of the night.  This really irks me.  What irks me more is that he has been schedule to do triage and he find every opportunity to avoid it.  His main excuse was that he is bad luck in triage.  If he goes out there 10 more sign in.  Well that’s changed now I am the black cloud of triage.  In fact one doctor will ask me when am I scheduled for triage in hopes he will be gone before that.  It’s not like I get backed up.  They just seem to all load off a bus or something.  Anyway besides the laziness he is trying to take most of the credit.  He will sit there all night plugging in the vital signs from the monitor and checking our charts.  He does help catch mistakes.  He then “knows” the patients yet he never set foot in the room.  When day shift comes in he rattles off report like he actually did something.  This seriously pisses me off.  He is a great guy outside of work.  We all figured he was burnt out and upset about the job loss.  However this has been going on for MONTHS now.  I really don’t want to rat him out. Because I don’t want to make it worse.  So do I confront him or go straight to the boss?  I am not the only one that has seen this.

I Can't Breathe!

It never fails.  When you are going to have a bad case it always seems to arrive the first hour of your shift or the very end of it.  This one showed up about and hour before quitting time.  Unresponsive.  Vital signs are great and he snoring.  So I am cutting clothes off, while triage nurse gets info, someone is starting a line and getting blood and then I alert the ER doc.  Who isn't happy that we waited this long.  That would be the triage nurses fault since he is also the charge nurse.  But what do I know.  Anyway.  The doc gets history from family which doesn't help.  No one seems to know what this guys  new depression med is or if it's a narcotic.  So the doctor orders Narcan to reverse possible over dose.  He has had 2 rounds of it no luck.  Doctor orders Remazicon just in case it's a benzo over dose.  I on the other hand would like to shove a catheter in this guy so we can get a temperature and output.  Before the ER doctor wakes him up and I can't get a Urine to find out what the hell he has taken.  Nope off to CT scan where the dude wakes up screaming.  I can't breathe!  I can't breathe!  All the while thrashing around on the CT table.  Needless to say  he was breathing just fine.  Now the unresponsive is acting like a full blown bath salts patient.  Fantastic.  No Urine now...and no CT.  Back to the ER to sedate the patient because he is still thrashing and yelling at the top of his lungs.  Apparently the Remazicon worked.  So lets put more drugs on board.  Makes plenty of sense to me. Now the doctor is thinking about intubating the patient.  Wouldn't that have been easier in the beginning?  She then mentions remind me to intubate first ask questions later...Welcome to the night shift rodeo.

Strange case

So here is a strange case for you.
Patient comes in with girlfriend.  Apparently refuses to be placed in a gown.  All he wants is stitches and to go home.  Upon going into room to find out why with the Er doc, I noticed a man who is swollen on the left side on the head.  In fact, the swelling is so bad he cannot open his left eye.  Apparently he fell off a ledge and landed head first.  He continues to insist to the doctor all he need is stitches.  The doctor explains that he needs a full trauma work up.  Especially since it was a 15ft drop when he face planted.  Er Doc explained that he could have fractures, air or blood in the brain.  Patient continues to argue.  All the while the girlfriend has this shit eating grin on her face.  Doctor tries to appeal to her to no avail.  Even after multiple attempts of the doctor explaining this could lead to permanent disability or death.  20 mins later we were able to start an IV, get blood and order x-rays and CT’s.  To which she say all he needs is an x-ray why do we need blood or a CT.  I tried to explain why.  Of course she is looking at me like she has he medical degree.  I once again get the ER doc.  Who spends another 15mins explaining this isn’t burger king you can’t order of the menu.  He explained we need to cover all bases so nothing gets missed.  I explain to them that if they are worried about financial payment that we have many ways to help with that.  She just ignored the lowly nurse. Doctor examines the patient and I assist.  He could feel the fractures of the nose.  He explains this as he is examining the patient. He also has a cut that will need suturing but that is the least of his problems.  The girlfriend bitches about CT the neck when all his injuries appear to be the head.  Did I mention she still had this shit evil grin on her face now?

The girlfriend then bitches about the extra bag of fluids and how all the hospital is pretty much doing is making the bill more expensive.  No matter how much we try to justify why we were doing a procedure or med she always had an excuse.  No matter the risk of death or injury she still was a smart ass.  The doctor mention that he had a case that was look less severe and she had blood and air where it didn’t belong.  They both then complained that due to 1 case they were going to have to all the same tests. 

Third time the doc had to explain himself.

Finally results are in:  You have a fractured nose, zygomatic process, air and blood that don’t belong, a crushed eye socket and now you need to be transferred to a trauma center for surgery.
You would think the light would go on.  HELL NO!  Now the girlfriend states it’s just like a broke arm.  Cast it and go on with it.  Now you want money for a surgery.  GAUGHGHGHGHGHG!  By this time my patience is about gone and I want to strangle this lady.  I explain to her why there is a difference.  Nope I am the dumb nurse and she is a Medical professional.  Which by the way the doctor comments in one of his educational sessions.  That if she had a degree in medicine she could have cause to argue with him.  He would be happy to explain everything to her and why these steps need to be taken. But unless she is a doctor she will have to understand that everything he does is for the concern of the patient’s safety and well being.
She still sat there with a shit eating grin.  Even argued that she could drive him to the hospital despite us telling her that it was unsafe for the patient.
Did I mention said patient was intoxicated?  I still wonder if she beat him with a bat.  I don’t know about you but if my significant other might die I would want everything possible done for him.  Unless I wanted him dead….which is what vibe I was getting from this chick.  Stupid people shouldn’t breed!

Things that make you go hmm: You cut yourself where

• Lady came in fell off a chair and landed on her hootchie…on the post of the chair.  It took 3 stitches to repair her hoo-ha. Ouch…along with major bruising to her buttocks…her friend tells her…that’s a new way to get wood Hun…sounds like my friends..lol
• Guy was jumping out of a tree to land in a lake.  Limb broke huge laceration to foot with possibility of tree still in foot.  Surgery anyone?  Look like string cheese…ouch
• Inmate got clocked a few times in the face, laceration to the eye lid ouch..2
• Guy came in I have a small cut to the hand.  Take of towel to see he degloved his finger.  Don’t know what that is see picture below…warning a bit disturbing.
• Inmate sliced open his abdomen just so he could get a holiday away from the jail…that’s a whole new meaning to a dream vacation.

Apparently this dude got his wedding ring caught on something…it was similar to this but his pointer finger

I snorted cocaine at the Er

I have learned and seen some crazy things at the Er but yesterday toped them all. Being a nurse for the last 5 yrs still qualifies me as a new nurse not a seasoned one. So when I saw an order on my screen that said cocaine nasal at bedside for doctor I was floored. What!? Really that says cocaine right I ask the season nurse sitting bedside me. Yes you haven't heard of that? Umm no. What the heck is it used for. So to educate those that don't know it's a great vasoconstrictor. The patient had a really bad nose bleed and the older doctors still use it to control the bleeding. Wow is all I could say. I would have a field day with that had i been the patient. I have a legal reason to have crack in my system...lol or hey everyone I went to the Er and snorted cocaine legally lol. I know I am sick. But hey that would be funny As hell. Dear mom I promise i never did drugs till yesterday in the Er I snorted cocaine. It was great. Could you see your mom now?? Mine would still bust my ass. Still learning new things everyday.

- Posted using BlogPress from my iPad

Filet-o-nuts

So I have seen some gross and wild things from being a nurse.  Weirder ones now that I am an ER nurse but this next patient tops them all.  I had a patient that came in with testicular pain.  Which if this is a sudden pain make the patient Emergent because the chance they might be twisted.  Which can lead to many severe problems.  So I mark him Emergent and rush him to the next open room.  We proceed to get more info on him.  Apparently this gentleman of 50 some years old has been suffering from erectile dysfunction.  Because he was so frustrated he decided to try to cut his nuts off.  Right down the seam.  Looks pretty close to the picture above.  You could see his testicles because he cut the sack wide open.  We rushed and got the male doctor.  Who mind you is also a coroner.  (More stories on him later)  He walks in and says dear lord and walks right back out.  Tells the head nurse who is also male to get some wet dressing applied immediately while the surgeon is being called.  The Male nurse is doing this pee pee and kick in the nuts groin dance while being instructed on the dressing needed.  The doctor is still looking a little green while trying to tell the surgeon what this patient has done.  Wild…and is it weird that I wasn’t grossed out?  I was like cool.  While the male population looked at me in their various shades of green.  What?  I didn’t say I didn’t feel bad for him…I did at least shoot him up full of Morphine.

This week is Zombie week

So this week is dedicated to Zombie.  If by the way you are weak in the stomach then you best not read this post.  I had a patient come in a few weeks back.  He walks in to my triage.  The computer tells me his chief complaint is an abscess.  Non medical folks: An abscess is a collection of pus in any part of the body that, in most cases, causes swelling and inflammation around it.  He has it covered with a bandage so I can not see it.  But this guy isn’t acting right.  He barely answers my questions and seriously is out of it.  His girlfriend seems to want to tell me what is going on but can’t.  I had to pull his teeth just to get him to talk to me.  I told him that I don’t know how to help him if he doesn’t answer my questions.  He mumble to most of my questions.  I take him back and he gets up from the wheel chair and about tumbles into the floor. By the way he was here for an arm abscess.  He said he could get up with no problem.  At this point I am hollering for our male nurse to help.  He gets him into the bed. We get him connected to the monitor and all.  I tell the doctor something is up with this guy.  Either the infection is so bad he is weak or he is truly on something.  While the doctor talks to the patient the girlfriend leaves and pulls me aside.  He apparently shoots up with Morphine.  He has been squeezing at this place on his forearm for awhile.  Most likely where he shoots up.  It look like something out of a zombie flick.  The skin was literally rotting off this dude’s arm.  Most people come into the ER with an abscess the size of a quarter.  The doctor makes and incision and removes the pus by squeezing.  Like a giant zit.  So if you’re a zit popper this would be a dream to you.  Here's is a mild picture of an abscess.
His was 4 times this size and the skin had forced itself open.  When the doctor squeezed this thing it look liked chunks of his arm fell out.  IT WAS AWESOME!!  I know I am gross.  But that’s one of the reasons I became a nurse.

Being a Nurse always means TMI

Being a nurse you are told things and shown things that you wish you could pluck your eye balls out or shove sharp instruments in your ears.  So if your squeamish don’t read any further.

First there was this family came in and the 63yr old male was here for swollen scrotum.  Pretty swollen and apparently been oozing.  Since I was in triage I place him in a young new nurse’s room.  Not on purpose mind you but let just say she had never saw anything like that I was pretty shocked.  But not as shocked as the Hospitalist that went in to talk with the family because the patient was going to be admitted.  She walked in and was getting some history when the daughter 31 yrs old drew back the sheet and exposed her dad’s junk.  Which was weird anyway but was made worse when the daughter lifted up her dads nuts and said see most of the swelling and chaffing is here.  I have been rubbing Vaseline on his scrotum to help with the pain.  Mind you the 63 yr olds girlfriend was also in the room AWKWARD!
How about the 18 yr old with Herpes that made her boyfriend leave the room because she didn’t want him to know that she had herpes.  Lovely.  Hope he was using a condom.Which also reminds me of the guy with Herpes so bad it went all the way to his butthole.  Which was really hard to see.
The women who come in all the time for vaginal pain.  I really think they love the doctors looking at their privates time and time again.  Nothing starts my day off than watching one of the doctors cram their arm up a big girl’s hooha.. sheeh.
Believe me I have seen too many woman’s crotches to count. See I have this thing right here as she spreads her legs…. Not to mention peckers..dear lord I have seen more of them than a street hooker.
Then of course you always  have the rambling patient that can never get to WHY ARE YOU HERE.  Well I have this cough and this hang nail on my toe. Also about 2 years ago I had left knee surgery. But now my right knee hurts…AHHHHHH

Drugs not hugs

Yes it’s time for another drug seeker moment…
So my day was running pretty good until a male nurse that I worked with informs me that I need to do a catheter on a female patient.  There is an unwritten rule that female nurses get to to the female caths and male nurses get the male caths.  I really don’t care.  I just do the caths and go about my day.  So I grab the catheter kits and walk into the room of a 30 yr. old that is having problems urinating.  The male nurse is administrating her pain meds.  She tells him is that my diladid?  He reply’s “yes”.  “Hmmm…it can’t be 1mg.  I don’t feel it yet”  “It’s not.  It’s only 0.5mg,” replies male nurse.  “Well that explains why I don’t feel it.”  He leaves and I shoo out her mother and daughter to the hall so I can place the urinary catheter.

She informs me that her equipment is correct like the text book and that she is easy to cath. 
First off TMI…second off how many caths has she had or is she checking out herself in a mirror.  Good grief.  So a little alarm goes off in my head. WARNING:  your about to encounter someone that comes into the ER way to many times.  She then tells me she doesn’t like crying in front of her daughter and begins boo hooing because she is in pain.  Procedure not started by the way.  Boo hooing to the point that the entire ER can hear her.  Including her daughter that is in the hall.  I tell her that hopefully placement of the cath will help with the pressure and relieve her pain.  Cath goes in…crying gets worse.  800ml of urine obtained.  Which isn’t 2 days worth of not peeing.  Which the patient informs is how long its been since she has peed.  I tell her I will let the doctor know that she is in pain.  I told  him.  He wanted to wait till CT is done so we can see what is going on.  Okay I let patient know.  She goes to CT and then comes back with no CT.  Did I tell you this wasn’t my patient??  I hear blood curdling screams and shouts of no no no I hate this place.  I run to the room to see what all the commotion was.  Apparently the Doctor has pissed her off because he won’t give her more drugs to help with the pain so she can be knocked out for her CT.  Because she can not lay like a dollar bill.  I try my best to calm her to no avail.  She is yelling about suing and killing herself and scaring the crap out of her daughter at this point.  I still try to calm her down…no luck.  I talk with the doctor.  She has the choice of CT scan or leaving.  I explain she is having bladder spasms.  So he mentions taking out the cath.  I walk back the screaming lady. “ Ma’am let’s remove the cath and see if that helps the bladder spasms,”  I explain calmly and as nice as possible.  She screams your not touching me !!!!   I try to explain the importance of removing the cath.  She said its helping her pee.  I tell her that the pain escalated after the cath and hopefully this will help with the bladder spasms….to make the story shorter…NO was the final answer..which lead to the Doctor coming into the room with security.  Because at this point the whole ER can hear her screams.  He calmly tells her what her choices are.  She tell him no one is listening to her.  So he gives her the chance to speak by saying…Yes ma’am go ahead I will not talk and I will listen to you.  Which causes her to scream see no one will listen…
Good grief.  The doctor stuck to his guns.  He had a feeling that she had done this before. So we were at a stale mate.  He just told me to leave her be that when she was ready she will come to us to get CT or get cath and IV out.  So I did…until the yelling commenced again and I joined security back into her room.  At which point security informed her that she need to calm down or she would be escorted off the property or mental health would be called.
We left the room…and she took out her own cath and INT…lovely.  I spent forever documenting on this idiot to cover my ass.   She walked out with out signing her AMA forms.  BTW her drug screen came back for: Pot, opioids, tricyclics and benzos…yup and she even told us she was a Nurse and didn’t take any prescribed meds.  Wish this test would have been back before she left.  We did find out she used a fake social security number…and yes she was an LPN in New york…lovely
DAMN IDIOTS

New hospital: New headaches

erI know I have been in the new hospital now for awhile.  I should have put the post up months ago but I was just hoping it would get better.   So here goes.  We went from a 15 bed ER to a 30 bed ER.  With no more staff…well let me rephrase that with staff in waiting.  Meaning techs that are waiting to take their boards.  Now I am all for new grads since I was one of them but I think we have had enough time to know when the move was going to be.  But its taken forever for them to get new nurses.  I just don’t understand the facility was being built for at least a year why haven’t we trained our new staff?  Because this place is ass backwards.  So now we are in the new hospital were we have 4-7 patients a piece.  When we had 3-4 patients a piece.  Our charge nurse never had patients unless covering for a lunch but now have to take rooms.  Meaning there is no one to bail you out if your drowning. Heaven forbid if you call in sick or take a vacation.  You feel bad leaving your fellow nurses shorter.
There are 32 inch TV’s in everyone of the rooms but there are only 16 monitors in the entire ER.  WTF?  Okay I understand that you are going to put the less critical patients in those rooms but for those of you that are nurses…what do you give ankle breaks or migraine patients???  Narcotics!  Hello how many have given narcotics to those that don’t usually get strong medications?  So when their O2 sats drop from 97 to 82 there will be no way to monitor it.  So you have to drag a vital signs machine in to check them every so often….hmmm more patients less help more work for the nurse.  Does it sound like I have the time to freaking do that?  Of course not.  The tech is even more stretched with all the EKG’s and other commands that the doctors are barking out.
I Actually admitted a patient that had the initial vital signs and then the vital signs before they went up.  Why?  because that nurse didn’t have time to go back around to do it.  Their was a chest pain and a shortness of breath patient that was a little more pressing.  How safe is that? The boss knows but he has his hands tied.  Apparently we aren’t seeing 7 more patients a day than from the old ER.  Even though most of those people were waiting in the ER waiting.  Now they are sticking their heads out of the rooms and barking orders as we run by.  I need a warm blanket, can I have a drink, where is the bathroom, is the doctor ever going to see us?  Sure your tooth ache is my major concern asshole.
Try working night shift where you suppose to stock these 30 rooms.  Yea whatever.  We use to have 2 hours of no patients.  And now we have 20 or more at 3am.  Why?  Because we are located right off the interstate where any traveler can just stop on by.  Yippee!
I use to love my job.  Don’t get me wrong my long weekend sucked but now I dread everyday.  What sucks is we are so short they beg you to come in on your day off on the other rotation.  You are so tired from you shift you don’t want to even think about coming in on your day off.  On the long week you worked 3 12’s and a 8 or  2- 12’s a 10 hour and an 8 hour shift.  But now on our long week its mandatory to work 4 –12’s on your long week.  The government sucks because when you work your ass off and get overtime, they tax the hell out of you.  So it’s not even worth the overtime. GRRR.
I am so aggravated.  They keep telling us it will slow down once the new wears off.  Its been 2 months.  NO CHANGE PEOPLE!  Took make matters worse…I found out that we are the 2 busiest ER in the company and the least paid.  Everyone else makes critical care pay.  Which is 3 dollars more an hour…talk about feeling under appreciated!  So that’s my new hospital rant.  More stories to follow I am sure!

Code blue = Blue hand

 So we had our first code about 2 days after the doors opened on our new facility. In fact I think I have seen more codes in this facility that all the years in the old hospital. This guy came in blue and nonresponsive. He was alert and breathing when EMS picked him up. He just slowly started to crash the closer he got to the ER. This was the longest code that I have ever done and the most things I have ever done in a code. I usually man a station unless I am the runner then I do a little bit of everything. We would do a few rounds of CPR and get this guy back. Intubate him and get him back. Then his heart would slow down again…leading to more rounds of CPR. Which I participated a lot in. I also go to place and NG tube (tube down nose) to help pump out contents from his stomach. First fast emergency one I did. I am use to setting up my stuff and having some organization. Anyway in the process of place said NG tube the “new” suction on the wall decided not to work…and well let just say in the process of trying to get it to work my shoes became covered in lovely, smelly, chunky green liquid. Great right. Finally with the help of the charge nurse we figure out the “new” suction’s issue. The company they went with fitted the canister with the wrong size canister…wow that was brilliant. Anyway back to the patient who was now stable with none one doing CPR. I was now inserting yet another tube, this one in his privates. While in sterile gloves he goes Brady on me…so the other nurses who were still in the room….began CPR while I quickly finished the procedure and then I joined back into the cycle of CPR on this guy. We were trying to keep him stable enough for Med flight to swoop in and take him to a Cardio hospital. Finally we get the right med combination and he becomes stable and Med flight shows up and takes him. We did the first code we flew out. Since now we have a helipad. I got to help load the patient. It was awesome!
The next day I couldn’t figure out what I did to the top of my hand. I was telling my charge nurse I figured I hit it on the door jam on one of the rooms. I had a huge knot on top of my hand. She chuckled…what? Show me how you did CPR. So I did…ouch I yelled. I got it…pushing down on this big guy with my hand on top of my other hand…I bruised the heck out of it. I knew I was exhausted from all the extra CPR we did. I didn’t realize I could injury my hand so bad.

Nursing shortage Rant

It’s not like every nurse hasn’t blog, bitched or mentioned the nursing shortage.  But the sad thing is a lot of it has nothing to do with the need of nurses.  More of the almighty buck is more important than staffing nurses.  I understand that it’s a business but if you make the floors to short there are more chances of human error.  The hospital is being redone and our ER is expanding to a 28 bed ER from a 18 bed one.  They were nice to hire new nurses for day shift but nights will no be receiving any more help.  Nothing new because day shift always has plenty of nurse while nights gets to run around with their head cut off.  Now don’t get me wrong there are nights that we are dead.  Doesn’t happen often.  There have been nights where we are completely full and some in the waiting.  So now we are going to be bigger with 28 rooms and 4 nurses.  I hate to say it you know everyone and their mama are going to come to the ER just to check out all the new rooms and stuff.  We will be slammed for at least the next couple of months…ugh I dread it. And don’t even get me started on the new layout.  Where you can’t see half the patients and everything is spread out.  Plus the room won’t be able to hold the stock it use to have.  Which means we will have to carry more crap in our pockets.  Not like I don’t get stabbed when my fat ass sits down..ugh Oh yea we are right off the interstate now…more critical patients and less help.  WHOO HOO!  I wish I could take vacation for the next couple months…

Those of you that are nurses or heck work in public at some point and time have ran into a pervert.  You know the one that always make some sick comment while your trying to do your job.  Last month I had a old man asked me to marry him.  Then another nurse asked me to please take the meds to bed 1a because he was grossly hitting on her.  Not that I pay much mind to that.  So I said sure not a problem.  Of course this guy is half drunk and he proceeds to tell me how hot I am and I bluntly change the subject to if he is allergic to this or that.  Which I get a no.  Then he proceeds to say if I smile at him much more he is going to just melt…ugh. He tries to get even more perverted when I cut him off and explained that I don’t believe my hubby would appreciate that especially since he is a pretty big man who gets jealous easily…**lie.  So sue me I embellished a little.  But he shut the heck up.  But the icing that takes the cake is the pervery old man that was drunk and I had to cath him.  Oh baby rub it hard when you clean it…ugh really? Gross…what I wanted to say was um I can hold it with 2 whole finger don’t think it will do much for me.  Instead I just stuck the catheter in and he shut up.  Glad he wasn’t into pain.  Cause if he would have said I like it rough I would have vomited on him.
*lets not forget the perverts in the nursing home who try to pull u into bed or grab your boobs either..sheesh.
So guys tell me ur perverts that you have ran into?  and how do you handle it?

Code Blue: Baby blues

Of all the codes in the ED, baby code blues are by far the worse to ever encounter. It would be great to wish that no one in the ER would ever have to see one but that will never happen. We had one the other night and it was my 2nd one. My first one I was just a runner. The one that just gets items that the other nurses or doctors yell out. This time I was in the code. A place I would rather not be. In fact my mind went completely blank when the call came in. I couldn’t remember how to CPR. I just blanked out. How embarrassing would that be if I just stood there. Not knowing what to do! I shook it off, grabbed the computer and help set up the room. Everyone manned their stations and it appeared I would have to document and be the runner because we only had 3 nurses and 1 tech. When the baby of 16 months came in she was blue. The crew was not allowed to put in a line because they were a BLS crew. The ALS one was too far out to get their first. So all that was started was CPR. My charge nurse was leading the code. He was trying to get an IO in her leg. (IV that goes directly into the bone when a line can’t be gotten) The tech was doing compression but you can tell it was getting to him so the charge nurse took over while our other nurse was pushing meds. In the process of charting my computer crashed but since I always prefer paper charting I was kind of of relieved. It was the longest code of my life. Why? Because I was the one telling the doctor when we could push the next med that might just help this baby. She would ask how much more time till the next epi and I would have to tell her 2 mins to go. My watch felt like it was broke because it was ticking so freaking slow. After 35 mins of this code the doctor allowed the parents in while we were still doing CPR. She needed them to see that we were doing all that we could. We all knew she was waiting to tell them that it would be time to stop. The mother already realizing this was in tears and asked if she could hold her baby now. We called the code 45 mins later and she held her little baby. She rocked and cried while dad held her. Grandma wailed. Those of us that couldn’t contain their tears walked quickly out of the room and the rest of us with tears in our eyes tried to remain strong. Setting up chairs and passing out tissues. Its beyond sad when a little one is lost…its just devastating.

Crazy, Rodeo Patients

So I got called upstairs to CCU because security (Rent a cop) couldn’t help the nurses control a patient that was waking up from a drug overdose. He ripped his tube out and was trying to hit the nurses. In fact when me and my tech showed up there was 5 nurses and one security. I helped hold on leg while the tech was holding the other one. Let just say while the CCU nurse was trying to strap down the legs the tech and I went for a ride in the air. He thru our heavy butts just about into the floor. I felt like I was riding a bucking bronco. Finally the Nurse supervisor got an order for a medicine to help calm the patient. What a freaking 1mg of Ativan? Really…like that would do anything. But after the patient attempted to bite the nurse who should have known better about her arm placement…the sedative calmed him enough for him to think rationally. We were able to get his restraints back on. I did notice that rent a cop was standing in the corner looking like he was going to crap his pants.

Tied down and drunk

Had the cops bring in this patient that was very drunk and very agitated. In fact he was strapped to a back board with his hands tied behind his back. He was cussing and trying to spit at everyone. (Of course all he was doing was spitting on himself because the cops had some sort of mask that prevents them from spitting. Pretty neat wish we had them for the ED. Anyway he was here due to a huge laceration to his leg. Unfortunately he was too agitated to even look at the leg let alone let the doctor repair it. So Geodon it was IM in the leg to help him calm down. Wasn’t helping that the cops were irritating him even more. Doctor said I wish they would stop. So being the mouth that I am told them if they wanted to get back before time to clock out they would have to let the patient relax. That way the medicine could take effect and the doctor can fix the leg. They were happy to oblige.
Finally the med was effective. She wanted a urine on him so she could do a drug test on him. I let my new grad do the cath but he was having difficulty. I was teasing this new grad that I was training. I told him that my shift leader might be the vein whisperer but when it came to caths I was the cath whisperer…lol So without missing a beat the cop said..so you talk to penis for a living…lol Guess so…you know what they say nurses see more penis than a hooker does…lol So he did a number to his leg. Had to have sutures internally and then staples on the outside. He went back with the cops have out of it from the Geodon. Love Geodon!

In the right place: In the Wrong time

*not actual photo
So my family and I were eating at an ice cream outside the ice cream place. While we were eating at the picnic tables an employee from the ice-cream place pulled out into traffic and was rear-ended. Send both cars to ricochet off each other and across on coming traffic. Luckily there was a retired EMT eating in his truck and he saw the commotion to. I checked on the female in one car while he checked on the male in the other car. The one that I check on was in shock but was not hurt. Other than her crying and checking out her car. Found out later she was in a wreck earlier that week too. She couldn’t have been more than 18. Anyway while I was checking on her the guy from the other car was yelling bloody murder. So after assessing and determining that she would live, I ran over to check on the guy. It sounded like the EMT needed help. He was bleeding from his head and his wrist was definitely broke. It wasn’t angled normal anymore. He was screaming at the EMT to do something about the bleeding before he died. Course the EMT told him no offence but I don’t know you or your blood. So I told him to keep his hand there for pressure. I would be right back.
I went back to the ice-cream joint and got their “first aid kit” . Why is that in quotes? Because it was a joke of a kit. I open it at the accident site to find 2x2 to stop the bleeding. It would have to do for the moment. I put on the gloves and then while the EMT was hold his wrist in place I put one on the other hand for him. I told the male to move his had and I replaced it with fluffed up 2x2 and then reapply pressure. The boss from the ice-cream place followed me. She asked what she could do. Since 911 was already called I asked her to find me something bigger than the 2x2 that were in this box. She did and I just placed those over top of the 2x2 that were on the guys head. I asked the EMT would he like the ice bag for the wrist since he was using his hand to help immobilize his injury. He ask me why? Omg. Without a beat I replied to help with that swelling that was happening to the guys wrist.. Oh that might be a good idea….good grief ya think? ICE BAG was a joke by the way because it was almost the size of the 2 x2 dressings. SHEESH. who makes these first aid kits the smurfs?
Next the cops show up and tell us that the ambulance will be here shortly. The EMT asked who they called. Apparently the crew from a town up. WTH? Considering there were 2 crews in this town. It was forever before they showed up. In fact the tow truck had removed the girls car already. 10 mins after that the ambulance arrived and right behind them was the 2nd tow truck. How sad is that? Well that would have really sucked if we had to do CPR that entire time. Even the EMT guy had to agree on that.

Teenage Truths

I know that the world is different that it was 10 years ago.  I knew that kids were having sex at a alarmingly younger age.  What I didn’t realize was just how mean some of them are.  Had the 13yr old female come in because she might have been gang raped.  13!  What the hell.  So I have to go in to the exam room because the male doctor needs a chaperone to keep everyone honest.  I knew it was a possible rape but I did not expect to see this child close to my daughters age.  She was dressed in her hospital gown with this look of fear.  When the doctor asked what happen this is what she told us.  She went to spend the night at her friends house and apparently she didn’t know that there wasn’t going to be any parents there.  Let alone a party. The mother who looked mortified just repeated…she was spending the night at a friends house a sleep over…she looked like she was going to burst into tears.  The child, babe yes child because she is far from an adult states I was drinking just like everyone else and woke up with my pants around my ankles.  She states she hadn’t had sex before and wasn’t sure if she was raped.  She didn’t think she was.  Under her gown was in black permanent marker from her chest down to her privates smiley’s, dike, slut and many other foul language and pictures.  Who could be so cruel to do this to a child but other children.  What is wrong with kids today.  I was almost in tears with the mother.  I just don’t get it.  The mother was mortified and in shock.  She knew the parents and just assumed that this was a “normal” sleep over.  I was so upset that I probably spent a hour lecturing my children about underage drinking and being safe.  Please remember to talk to your kids start early before they get to that teenage age.  You know the age where they do listen to you.  I hope those kids get into trouble and I hope nothing happened.  But its in the court system now.