Rape Calls

HA... does administration really think that I am going to answer my phone to work on Halloween????? I am running out of town (without phone) and going to a college football game. It is bad enough that am on call tonight for sexual assaults. Before you get your tighty whities all tied up..... sexaul assaults are a serious events, but come on. 75% of the calls that I get dragged out of bed for at 2am are horse crap.

Examples of last Halloween:

1. Woman reported that the devil raped her..... Me thinking does she means rapist was in a costume???? Nope, she reported that she took a road trip to hell and when she said no, he stuck his pitchfork.... you can guess that one:) Come to find out she was just released from jail and had used their phone to call the hot line. She was thinking she could score some dilaudid for being raped.

2. Woman reported that she was raped because he only gave her $20 instead of the agreed $25 for a blow job.... I referred her to the police and suggested that she report theft of services.

3. Woman reported stranger rape, which to me is one of the most dangerous. I come flying off my secluded mountain, run and set up my cameras and kits for her arrival. She gets there, police in tow for them to wait on my results. I get her in the room, start questions and exam just to find out.... "I wasn't really raped, I was just worried about the smell and fluid coming out of me, the assholes in the ER told me that it would be awhile before they could take me back, do you think that you can just give me a antibiotic and a pain shot?" I about decked her.

Finally, my favorite....

4. Guy, dressed in drag for Halloween, reported that he had gotten a little drunk and was doing body shots with a some hot chic that he just met. After a while, they went back to his place, hot chic asked him if he wanted blow job he said yup, after he gets his rocks off hot chic asks how he feels about anal play, he reports that he said he was up for anything..... after having his salad tossed, he reported he just thought she had a strap on at first and it felt good, till he felt something hot shoot in him. Come to find out guy in drag for Halloween was drunk ended up in gay club and found another guy in drag.... How the hell is that sexual assault????? Why the hell did I drive 45 minutes into town at 4am for that????

With this being Halloween night, I am sure I will be in for some crap tonight.

What I found just too funny in the shift!!!

When I just can't control what comes out of my mouth :)

Hunting season:
We are just overrun with hunters doing stupid things this time of the year. Now don't get me wrong, I am 100% for hunting, as long as I don't have to clean the deer. But come on, a little common sense would help.

Patient came rolling in all dressed in camo and blood, I expected accidental shooting or some trauma. Nope. He had fallen out of his deer stand and had a bloody nose. This is were my mouth gets me in the most trouble. I ask, "did you get yourself a deer?" He says, "nope, but I saw a bunch of turkeys." I say, "yup, I see a bunch of them in here every day."

Halloween:
Just love seeing kids all dressed up. I understand wanting kids to be safe, but really??? have them line up and walk through the ER to collect candy? Is that the best way to prevent them from getting sick????? Anyway, I didn't know they were coming and I didn't have candy, yet trooping though the ER they come. Now they were just too cute holding out their bags with me having nothing to give. So, I grabbed band-aids and gave handed them out like they were the coolest thing on earth. Kids loved the special stickers, as I called them. They were 4 and 5 years old. However, a little boy had a clue, he told me in the most logical voice that "these are band-aids,"
I said, "yes they are," he said, "we don't need these, no treat we give a trick" Without thinking, I said, "yes, you do when they give you that flu shot down the hall." Man, the look on his face was pure horror, then he popped off with, "not me, I can't eat eggs and no eggs is no shot." Then he kicked me..... I laugh so hard tears started rolling down. That is when it just got cute... Little girl came running up and put her sponge bob square pants sticker right on my knee saying "don't cry, the shots don't really hurt.

Caught off Guard

Have dealt with death many times. It is a weekly and/or sometimes a daily occurrence. Most of the time I am able to separate myself and my emotions from the situation. We can show empathy without feeling the burden of the loss of a love one when we are there to support the family at their time of need. However, there are times that something just hits a cord and takes a person off guard. Thursday was one of those days.

Patient presented via POV, family ran in and yelled daddy is not breathing, out to parking lot we run, find guy pulse-less and not breathing. Onto the ground he goes, start compressions, call for gurney, bagging begins, run him to room while trying not to fall off of stretcher while giving compressions. Hook up to monitor, throw in a IO, rhythm check (asystole), start ACL meds. obtain ISAT, CBG, find his K+ to be 7.8, in goes bicarb, regular insulin, CA+, rhythm check (holy crap we have a rhythm, but it is v-tach). Shock him, resume compressions. on and on this goes, he gets a rhythm, we feel a pulse, we start hypothermia protocols, then he bradys down back down, loses pulse and here we go again. Over 3 hours we go and go because he his showing promise or at-least signs of promise, he comes back then we loss him. Then came the time that there was no more that we could not do anymore for him and time of death is called.

The death did not bother me, I knew that we had done everything possible. Dying is a part of life, at-least the last part of life. After everything we had done, after talking with family, after getting the body transported back to the morgue, my guard was let down. I was not in the mind frame to brace myself against families emotions and grief. That is when I was caught off guard. I rounded the corner and basically tripped over a young girl. She was just sitting in the corner of the room, lights off, with tears running down her face. her expression, her eyes, the sense of her complete loss was just over powering. There was nothing I could do, I just put my charts down and sat next fer her. I couldn't say or do anything that would make her feel better. We just sat on the floor in the dim room. It is not death or not being able to save everyone that bothers me, it is not being able to comfort those that are living.

Okay, now that I went off on my little rant, maybe I can get her out of my head.

Crappy Ghost

An extremely modest man was in the hospital for a series of tests, the last of which had left his bodily systems extremely upset. Upon making several false alarm trips to the bathroom, he decided the latest episode was another and stayed put. He suddenly filled his bed with diarrhea and was embarrassed beyond his ability to remain rational. In a complete loss of composure he jumped out of bed, gathered up the bed sheets, and threw them out the hospital window. A drunk was walking by the hospital when the sheets landed on him. He started yelling, cursing, and swinging his arms violently trying to get the unknown things off, and ended up with the soiled sheets in a tangled pile at his feet. As the drunk stood there, unsteady on his feet, staring down at the sheets, a hospital security guard, (barely containing his (laughter), and who had watched the whole incident, walked up and asked, "What the heck is going on here?" The drunk, still staring down replied: "I think I just beat the crap out of a ghost." Happy Halloween

Deserted...

Not sure what was going on today.... we all were looking around for a mass casualty to come in as the day was passing. It might have been the weather, today was the 1st nice non-raining day we have had in a month. In 8 hours I only counted 19 patients..... This is not something I am use to. God only knows we are going to make up for it tomorrow.
Now, I am just going to curl up to a stack of homework and applications for student funding.... Work was better!!!

Why it is not a good idea to use drugs!!!

Patient came in twitching, screaming, and wild eyed. It took three of us to get the guy into the "special room." We finally got to the bottom of this guys problem. He had taken some of his aunts medication and thought it would get him high, amitriptyline. After awhile he decided to smoke some pot because the amitriptyline had not gotten him high in the 20 mins since he took it. thirty minutes later, the fun began. He reported that the people came out of the TV and sat their talking to him. more disturbing was that it was aliens that he was watching on the tv. Over time the conversation turned on him and he started thinking that the aliens were going to dissect him while he was alive. This is when he took off running out the door. OH it does get better, apparently the aliens could track him via the GPS locator's thay had sewn into his clothes. police found him running down the street screaming and naked. later on, when the drugs in his system had worn off, patient reported that he always gets a little paranoid with pot. Combine that with the oddball very rare side effect of hallucinating with amitriptyline, this patient had one hell of a drug cocktail.
Lessons learned: don't take someones medications and stay away from drugs.

Too Funny

Strange laws that are still on the books.

Indiana:

You can get out of paying for a dependant's medical care by praying for him/her. (Good thing to keep in mind next time I am up there.... how does it go... Hail Mary???)

You may not bathe between October and March (I think some of my patients here must be from Indiana)

New York

The penalty for jumping off a building is death. (Hmmm.. wonder how they enforce that one?)

These just make no sense, not that the above ones did....

DELAWARE
Condoms may only be sold by doctors and wholesale druggists.
MAINE
Condom sellers must be licensed and the license must always be on public display.
NEVADA
The use of condoms in Nevada brothels is compulsory. (Really!!! )

Busy, Busy, Busy

Not sure what is going on, but we have had a increase in the acuity of the patients coming in. I wonder if all the hospitals are getting their butts kicked as hard. It had gotten so bad today that I opened up the rooms to hold 2 patients instead of the normal 1 patient per room and our trauma bay I opened up to 4 patients. 5 vents in the ER at the same time is not a fun day for a charge nurse, staff nurses, nor the Docs. To put the number of patients into perspective. We have 30 rooms in the back that can hold 60 patients, but normally we try to keep to them private rooms, and we have 2 trauma rooms that can hold 4 patients in each, 1 minor med area that has 6 rooms that can hold 2 patients each, plus our lovely stretchers we can place along the halls. I am on call for Sane the next 36 hours and looking forward to the TNCC class I have to teach the next 2 days. A little role playing trauma will be a nice break from the real trauma, and hopefully no one gets assaulted. Don't get me wrong, I love the trauma, codes, freak accidents, and at times the clinic side of working in the ER, but this week has really brunt me out. Need a recharge :)

ouch

Now this ends the day on a good note....
guy comes in and we are told that it is a possible stroke. One minute we are talking to him and hooking everything up, the next he stopped breathing. Felt for a pulse, found none, thumped him, that did no good, started CPR and after 10 to 15 compressions I hear, DAMN IT, I look down and he is awake, did rhythm check and he had a NSR. Now that is one of the reasons that I became a nurse. Outcome for him was that he did have a stroke, we have no clue why he arrested, but he should be fine.... Just a little sore for the 1 broke rib, opps

Okay, you are sick so you get to be a jerk

Some how, it has been commonly believed that when you are sick, you have the right to treat everyone like crap. I worked triage today and here are a few of the wonderful praises I received.


7am:
Him, "What do you mean I can't go right back, are you an idiot, can't you see I am in pain"

Me, "I know you do not feel well and I will get you a room as soon as possible"

Him, "You just let them cut in line on me, they came right in and you gave them a room, you are a racist cracker"

Me, "you have a back pain for 6 months, they cut off their finger, they get a room first"

8am:
Her, "this is bulls##@!, why can't I bring my McDonald's back, I paid for this"

Me, "It is policy that there is no food or drinks allowed in the back, as I point to the 4 large signs displayed in the waiting area. You should not be eating, you complain of abd pain, and n/v"

Her. "you bi@# h, you can't tell me what to do"

9am:
Them, "I have been here for 30 minutes waiting on a room, my head is killing me, can't you just take me back?"
Me, "Sorry, I do not have a room for you at this time, when one comes open I will place you in it"
Them, "you just expect me to sit out her with all of these people, I am going to catch the swine flu and then I am going to sue you"

10am
them, "i waited all this time and the doc sent me home with nothing, I have the flu and he won't give me an antibiotic"

Me, "the flu is a virus and an antibiotic will not help"

Them, "fine then you have it," then he spit on me

10:30
patient asked me what determines who gets seen first, I told him that the sickest have a higher priority, he then falls to the floor and look up at me and states with a straight face, "I keep fainting, you saw it, I get to go straight back now, right"

11am
Patient walks in and asks "are you busy today, can I be seen fast?
I say yes we are busy, but it depends on your acuity to how fast you get seen, the sickest are seen first.
then they just threw their clip board at me

these are just a few. Today I have had food, clipboards, soda and an unknown object thrown at me. I have been called every name in the book. I have been spit on and threatened with violence. All because people had to wait for a room, wait to be seen, not happy with the toradol prescription, and referred to walk in clinic.

I just love my job some days!!!

Bored and ranting

Okay, so it is raining and chilly out, which means that it would be dumb of me to go putter in the garden, play with the goats, chase the chickens, or do what ever chore that needs to be done. Due to the weather, my joints are stiff, swollen, and sore. Wow that makes me sound old. I am 33 years old and had bilateral knee replacements less than a year ago due to complications of EDS. So, no I am not that old. In fact, after my surgeries I would say that my quality of life has improved greatly. However, I do have my rough day, like today with the weather. I am one of those stubborn people who refuse to take medication for pain relief. This is for two reasons, 1. I am afraid of becoming addicted to narcotics. I have seen this too many times with clients coming and out of the ER searching for pain medications when they no longer needed them. I do not want to become one of those clients. Reason #2, I know that over the years I will need more surgeries. When that time comes, I do not want to have any tolerance built up with medications. I would like to be able to have the pain medication work without having to increase the doses over and over again to get just a little relief. So, back to being bored. Not sure what i am going to do. Maybe bake some bread, laundry, or something. What ever i do, I need to stop spending my day off from the ER looking at other ER blogs. :)

Sexual assault

I am awoken at 0330 to voice on the other end of the phone. A woman has been sexual assaulted and i need to come to town to examiner her. These calls always leave me with a sinking feeling. I do this work because someone needs to be there for these victims, but I wish that one day there would no longer be a need for my position. I doubt that that day will ever come. Statistics show that 50% of sexual assaults are not reported and that every 3 minutes someone is sexual assaulted. This is a shame. Even though most assaults are done my someone that knows the attacker, I have found that the most violent, dangerous, and life threatening victims that I examine are assaulted by strangers. (Please don't think that I am saying that known attackers are gentle, not all are). Thankfully, those assaults are not as prevalent as known attackers. This morning it was a stranger that had attack this woman. So, since I am knocking around the facts in my brain to unwind a bit. I thought I would post some stay safe information to maybe prevent at least one person from a stranger attack.

•In any situation you should always be aware of your surroundings.
•Stay in well-lit areas.
•Walk on the side of the street facing traffic. Walk confidently at a steady pace.
•Avoid walking were assailants can hide, such as doorways, bushes or alleys
•If you believe you are being followed, walk quickly to a lighted area and where there are people.
•If you believe a car is following you, turn around and walk in the opposite direction or on the other side of the street.
•If someone stops you and wants directions or anything else, reply to them from a distance. Do not get too close.
•If at any time you feel you are in danger or need help, attract people in any way you can. Scream as loud as you can. If you are carrying a self-defense product such as Mace, pepper spray or a stun gun, use it and run.
•When you are in your car, lock the doors. If you are not in your car, keep the doors locked so that no one is able to enter your car and hide in it.
•While walking to your car have your keys in hand and ready to unlock the door. Before you get in your car look inside to make sure no one is hiding inside.
•While driving, if you think you are being followed, either drive to a well-lit public area or drive to a police station.
•If your car breaks down, open the hood and attach a white cloth to the antenna and get back in your car and lock the doors. If someone stops to help, remain in your car with the doors locked and ask them to call the police.

Why is everything always wrong in the newspaper?

Today I found out that something was actually done to help protect a child that I filed a mandatory report on. I have been watching all over the news about a sex offender that was arrested, but never linked him to the report that I had made well over a month ago. It is great that something was done, but what frustrates me is that the facts behind the report that I filed were listed in the paper wrong, over and over again. The police report made it look like the cop found out about a crime due to a nurse "misunderstanding" the facts and mandatory reporting another possible abuse case. So frustrating. Thank god for laws that protect us when we mandatory report. I hope that officer feels good about the job he did making nurses look like idiots. At least something was done to protect that child. No matter how it came about.

Are you kidding me--- RANT

I just love being short staffed!!! I wish the suits could explain to me how in the world they expect someone not to be killed without staff. Over the past year, they cut or per diem, forced overtime, then cut overtime. Then they took away our sick time, decreased our PTO time, cut our hours, laid off staff, and told us if we had over time that we could be fired. Now, we are forced overtime again. I give up, are they kidding me, do they really think that what they are doing is staff. Today for example, had 3 resp distresses that we placed on vents, 2 with norepi, one with dopamine. Another one sent the to cath lab, which I had everything done in 19min (one heck of door to balloon). had 2 overdoses and one that was status epilepticus. this was all before 1300. during this time, I had one tech and a emt student. So the question is, HOW IN THE HELL IS THIS SAFE STAFFING???? Okay, that is just my little rant.

Pulmonary Edema

And we wondered why they were so sob. This had an oh crap factor to it!!! Per protocol, had x-ray done prior to doc coming in room, when I saw it, I grabbed a doc fast. We have four on and the first one I saw got dragged into the room.... He was not so happy at the selection process :)

Moms

I have no clue why people are so stupid. Here are two examples:

Mother did not fill prescription for albuterol updraft, son has asthma attack, so instead bring to ER, she give a tap water updraft because it looks just like the albuterol. Kid gets to the ED, is suffering from hypoxia. We have child on a simple mask and child's O2 Sat's goes up to 98%, off of O2, Sat's drop to 79% and child becomes confused and screams nonstop because he is "seeing" snakes allover the room. Tell mother to keep O2 on or child will end up on a vent. So what does mom do???? you guess it, she takes off the O2 stating that child is not comfortable. She than sneaks out to smoke and comes running in when child ends up in resp distress, which leads to cardiac arrest, we code child and he survives, but is probably has anoxic brain...... WAY TO GO MOM!!!!

6 year old comes in the ER with her heel basically shave off. Ask mom what happened, she was playing on the steps and cut foot on piece of glass that she broke the day before. Mom was mad because she told the 6 year old to pick up the glass and she got what she deserved. My questions are why did the mom not be a mom and pick up the glass herself when it was broken? My god this was a child.