99 year old male, agonal breathing, heart rate we are watching drop from 150 to asystole. Why are we not doing anything, because he is a full DNR. No Chest compressions, No airway management, No medications, No cardioversion, and No antibiotics. Are hands are tied and their is not a dang thing we can do. So, why do we have him in the ED?
Ah, it is a nursing home dump! Nursing home sent him over because of his agonal breathing and did not tell the EMS what his DNR until until after he was loaded in the rig. He arrived at the ED and we watched him die with in 5 minutes. Not coding him was the right thing to do, but still I am a fixer and that is why I work in the ED, standing there not being able to do a thing is hard for me.
Now,Back to the nursing homes... I figured I would make a short list of reason why a patient should not be sent to ED.
1. They have died (sorry, once dead there is not a dang thing we can do)
2. They are about to die and have a full DNR (Still we can not do anything)
3. If patient is normally confused; such as, dementia, don't send to ED for confusion. (I will send them right back)
4. patient has cloudy urine and fever, but just started treatment for UTI less than 24 hours ago (Can't do a thing on that but discharge back with instructions to continue home meds)
My favorite
5. Transfer to the ED due to short staffing is not a way to make friends with ED staff
As a side note, just because a person is in a nursing home, it does not mean that they are not human. I will call you and question why a person is in the condition they are when a simple bath and turning could have prevented their pain.
Saturday, January 30, 2010
Friday, January 29, 2010
Going to Haiti
With everything going on in the world, there is always the need for volunteers. I am part of a disaster response team and every year I have the opportunity to help someone. It is just a way that I can help others like I was once help.
With this said. I am nervous and frustrated at this time. I am to go to Haiti and was set to go two days after the earthquake. However, due to the united nations taking over, nurses are right now not allowed to come in due to safety reasons. So, my questions are, why not? I was supposed to go with the troops, and work within their wire. To me, this would mean that I am very protected. Now, the UN wishes for us to work else where, yet they are delaying our deployment for up to 8 weeks. Haiti needs nurse now and we are left with our hands tied. I really can't stand red tape!
So why am I nervous? I have been in manydisasters, yet something about this just leads me to believe it will be the worst that I have ever seen.
With this said. I am nervous and frustrated at this time. I am to go to Haiti and was set to go two days after the earthquake. However, due to the united nations taking over, nurses are right now not allowed to come in due to safety reasons. So, my questions are, why not? I was supposed to go with the troops, and work within their wire. To me, this would mean that I am very protected. Now, the UN wishes for us to work else where, yet they are delaying our deployment for up to 8 weeks. Haiti needs nurse now and we are left with our hands tied. I really can't stand red tape!
So why am I nervous? I have been in manydisasters, yet something about this just leads me to believe it will be the worst that I have ever seen.
Tuesday, January 26, 2010
Forget about that nuero consult!!!
Log roll patient, part of skull hit floor and baseball size piece of brain landed on foot. Yup, nuero is not going to do nothing with this! Forget about the burr holes we had requested earlier, you know us in the ER, we make our own.
When nuero called to ask why we cancelled, he thought I was joking when I said that they are on the floor. Nope, I was not teasing. Most on the floor and a few bits on my shoxs.
And no,Dr.sleepy, I am not being a smart-ass, just logical and stating the facts to you so you do not drag yourself out of bed for nothing. Next time, I will consult you on ever chronic HA at 3am to rule out a tumor if you keep being a snotty little boy
Saturday, January 23, 2010
Make a Nurse Smile
People have asked me why do you work in the ED. Some days I really do not know why, after being belittled, yelled out, and dealing with some of the most persistent drug seekers. However, those above are only a sample of who I take care of in the ED, and some patients just make you smile all day.
1. Little old ladies, who have reached the age that they just do not care what comes out of their month. They can say some of the most insightful and interesting things that I have ever heard. Example: One day, a very special 87 year old women, , who was slightly affected by dementia, stated to the doctor, "She is cute why don't you just date the nurse, marry her, and have a bunch of kids, if you get laid, you will be a happier man and less grumpy!"
2. Children are also the funniest little patients that a nurse could have. There is a age where children are just brutally honest, yet they only understand what they have been told and what they see. One such child, 5 year old male, told a nurse that if she was not a home wrecker than she would not be fat with a bastard child. Apparently, the mother of the child had said why too much in front of her child. Her ex-husband's new wife was pregnant.
These are just few of the patients, there are hundreds that just know the right way to make a nurse smile.
Wednesday, January 20, 2010
Just a small touch!!!
It is amazing how a sternum rubs can bring a person back to life when they are on the brink of death!!! Had three unresponsive, 2 from the jail, who just would not respond at all to gentle shaking, nor talking to them. One appeared not to be breathing (holding breath). One little rub and they are good as new!!!
My question is, do people really think we are that stupid? What is the sense in playing possum????
Monday, January 18, 2010
Feral Child
I have experienced many things in the emergency room, yet everyday something amazes me and I learn something new. We had a feral child in our department and when the doctor told me that I should take over care because the child was feral and the newer nurse was not handling it well, my response was that it was that all children are feral at times. I did not know she was dead serious!
What is a feral child????
A feral child (feral, wild, or undomesticated) is a human child who has lived isolated from human contact from a very young age, and has no (or little) experience of human care, loving or social behavior, and, crucially, of human language.
This child that I was taking care of had been found in a dog cage at her others home. When she was found she was a little over 4 years old. When I encountered her, she was 9 years old. Now there are many sources out there that can explain the importance of human contact, care, love and human language that the child do not experience and the outward causes.
This child had not experience much in her first four years of life, and did not have any lauguage skills, was impulsive, and a true wild child. Any simulation she was bouncing off the walls, just because she still was curious about everything. I watch her in a blink of an eye jump on the bed then onto the overhead pelvic light and swing across the room before any of us could stop her. The foster mother, who must have a heart of gold, caught her. The doctor and I just attempted to distract her with the drawers full of supplies. This gave us time to get her discharged!!!
Exam room after discharge:
Over head light broken and sharps container ripped from wall: called maintenance
every single package of gauze wrap, ace wrap, bandages, and everything else that was in the drawers completely opened and around the room. ky jelly and saline flushes all of the floor. Basically the room was trashed.
What caused her to go completely nits was that the foster mom grabbed the wrong bottle of meds, not her fault, so the child's med level went low. Child needed up draft, we all know what updrafts do to children.
Why did we give the child everything in the draws???
We can't blame the child for her actions, we did not want to physically restrain her and put her through more mental anguish, so we distracted her knowing it would leave on hell of a mess.
Now the techs did not quite understand our laughter at the room and refused to help us clean it up. I just think that they did not understand. I did not want to force them to help, I could have. So the doctor and I cleaned the jelly up, washed the walls, had maintenance come and help with the ceiling. It was quite a learning experience for me.
I have to say, this doc an I seem to get into many a interesting cases. I have learned a lot from her and it is nice that when things come up like this, she stays at my side through the crazy parts and the clean up. She has no problem helping me clean fecal matter off a person or being my medication bitch (her words, not mine).
Sunday, January 17, 2010
Rules of the ER
Okay, my last post was a bit depressing, so decided to post something on the lighter side. This list was sent to me by one of my fire buddies.
1) If it requires the ambulance team AND entire truck of firefighters
to transport you and safely place you on a hospital stretcher.....it is
time to go on a diet.
2) When you present to the Triage nurse, do NOT tell him/her that your
doctor called ahead. If you survey our waiting area, probably 50% of
the people waiting said the same thing.....and the other 50% use the
ER as their regular doctor.
3) When asked how much you weigh, please do not give the 'deer in the
headlights' look and tell us you don't know. It's a simple question,
simple answer.
4) Just because you have a phone and know how to call 911, we are NOT
impressed by your arrival on an ambulance stretcher. You had BETTER be
sick.
5) If you came escorted via EMS for multiple complaints that started
more than one week ago and your entire family followed the ambulance to
the hospital, you will be labeled a pussy and treated like one. Enjoy
the waiting area with your family.
6) One complaint/ailment per visit, please.
7) Just because you came in an ambulance doesn't mean you're going home
in one. You better start making arrangements now. I am NOT figuring
out how to get you home. Cab vouchers are NOT an option.
If you have one of these four, go to your own doctor in the morning:
A migraine; the Flu; a stomach virus; or a stuffy nose.
9) Do NOT ask us how long it will be. We don't know. I don't know
what is coming through my door 30 seconds from now.....and so I sure as
HELL don't know when you're getting a room.
10) We have priorities. We understand that you have been waiting for
2 hours in the waiting room. If you don't want to wait, make an
appointment with a doctor. The little old lady that just walked in
looking OK to you, is probably having a massive heart attack. THAT
is why she goes first!
11) If your mother is a patient and we ask her a question.....let her
answer it.
12) If your child has a fever, you had DAMN well better give it
Tylenol BEFORE coming in.
13) If you are well enough to complain about the wait.....you are well
enough to go home.
14) Do not utter the words "it is in my chart." I don't have your
chart! And I don't have time to call and get it! Just tell me.
15) We know how many times you've been to an ER. We can usually tell
if you are faking it during the first 5 seconds of talking to you. Do
not lie to us.
16) If you have diabetes and do not control it, you are committing
slow suicide.
17) If you are a female between the ages of 16 and 42 and your last
period was 28-35 days ago.....PLEASE don't waste our time if you are
here for abdominal pain and vaginal bleeding. Guess what???!!!
You got your period again!!!
18) Do NOT bring your entire posse with you. One person at the
bedside is all you need. It is really difficult to get around seven
people in the event that you are actually really sick.
19) Every time I ask you a question, I learn more about what is wrong
with you. I don't care if I asked you what day it is 4 different times!
Just answer the questions.
20) If you want something, be nice. I will go out of my way to piss
off rude people.
21) Our definition of "sick" is not your definition of "sick." If a
member of the ER staff says that someone is sick, it means that they are
in the process of DYING!!! They have had a massive stroke....are
bleeding out....are having a heart attack....or have been shot!
22) We do not consider a kidney stone "sick." Painful, yes.....but
sick, no.
23) At any given time, one nurse has up to 4 patients. One doctor has
up to 15. There is a law (similar to Murphy's Law) in the ER: If you
have 4 patients, one of them will be sick (see above definition)....one
of them will be whining constantly....one of them will be homeless....and
one of them will be a delightful patient. DON'T be the whiner!
Please.
24) If you see someone pushing a big cart down the hall at full speed
and you hear bells/alarms going off.....do NOT ask for a cup of coffee.
Someone is dying, you inconsiderate asshole. Sit down....shut
up....and let us work.
25) If you can bitch about the blood pressure cuff being too tight, or
the IV hurting, you are not in that much pain!
26) Physicians and nurses are NOT waiters. We are NOT customer
service representatives. This is NOT McDonald's, and you very well
may NOT have it your way. Our job is to save your life. If you
want a pillow, two blankets, and the lights dimmed......GO TO THE
RAMADA!!!!!
27) If you have any sort of stomach pain and you ask for something to
eat, you are NOT sick.
28) Do NOT talk shit about the other members of staff I work with.
That doctor that you hate? -- I work with him every day, and I know that he
knows what he is doing. I trust him a LOT more than I trust you. I
am NOT here to be your friend, and neither is he. I will tell him
what you said, and we will laugh about it. If you want a buddy.....go
somewhere else.
29) If you are homeless.....DON'T ask for a bus token or a cab voucher
to get home, it just confuses the staff.
30) PLEASE don't tell us how to do our job. Do we come to your place
of business and tell you how to do your job?
31) Please don't bring in a "show and tell." If you have to fish it
out of the toilet, it's really not necessary to bring it in. We will
take your word for it. If you did fish something out of the
toilet.....you may NOT use my pen.
1) If it requires the ambulance team AND entire truck of firefighters
to transport you and safely place you on a hospital stretcher.....it is
time to go on a diet.
2) When you present to the Triage nurse, do NOT tell him/her that your
doctor called ahead. If you survey our waiting area, probably 50% of
the people waiting said the same thing.....and the other 50% use the
ER as their regular doctor.
3) When asked how much you weigh, please do not give the 'deer in the
headlights' look and tell us you don't know. It's a simple question,
simple answer.
4) Just because you have a phone and know how to call 911, we are NOT
impressed by your arrival on an ambulance stretcher. You had BETTER be
sick.
5) If you came escorted via EMS for multiple complaints that started
more than one week ago and your entire family followed the ambulance to
the hospital, you will be labeled a pussy and treated like one. Enjoy
the waiting area with your family.
6) One complaint/ailment per visit, please.
7) Just because you came in an ambulance doesn't mean you're going home
in one. You better start making arrangements now. I am NOT figuring
out how to get you home. Cab vouchers are NOT an option.
If you have one of these four, go to your own doctor in the morning:
A migraine; the Flu; a stomach virus; or a stuffy nose.
9) Do NOT ask us how long it will be. We don't know. I don't know
what is coming through my door 30 seconds from now.....and so I sure as
HELL don't know when you're getting a room.
10) We have priorities. We understand that you have been waiting for
2 hours in the waiting room. If you don't want to wait, make an
appointment with a doctor. The little old lady that just walked in
looking OK to you, is probably having a massive heart attack. THAT
is why she goes first!
11) If your mother is a patient and we ask her a question.....let her
answer it.
12) If your child has a fever, you had DAMN well better give it
Tylenol BEFORE coming in.
13) If you are well enough to complain about the wait.....you are well
enough to go home.
14) Do not utter the words "it is in my chart." I don't have your
chart! And I don't have time to call and get it! Just tell me.
15) We know how many times you've been to an ER. We can usually tell
if you are faking it during the first 5 seconds of talking to you. Do
not lie to us.
16) If you have diabetes and do not control it, you are committing
slow suicide.
17) If you are a female between the ages of 16 and 42 and your last
period was 28-35 days ago.....PLEASE don't waste our time if you are
here for abdominal pain and vaginal bleeding. Guess what???!!!
You got your period again!!!
18) Do NOT bring your entire posse with you. One person at the
bedside is all you need. It is really difficult to get around seven
people in the event that you are actually really sick.
19) Every time I ask you a question, I learn more about what is wrong
with you. I don't care if I asked you what day it is 4 different times!
Just answer the questions.
20) If you want something, be nice. I will go out of my way to piss
off rude people.
21) Our definition of "sick" is not your definition of "sick." If a
member of the ER staff says that someone is sick, it means that they are
in the process of DYING!!! They have had a massive stroke....are
bleeding out....are having a heart attack....or have been shot!
22) We do not consider a kidney stone "sick." Painful, yes.....but
sick, no.
23) At any given time, one nurse has up to 4 patients. One doctor has
up to 15. There is a law (similar to Murphy's Law) in the ER: If you
have 4 patients, one of them will be sick (see above definition)....one
of them will be whining constantly....one of them will be homeless....and
one of them will be a delightful patient. DON'T be the whiner!
Please.
24) If you see someone pushing a big cart down the hall at full speed
and you hear bells/alarms going off.....do NOT ask for a cup of coffee.
Someone is dying, you inconsiderate asshole. Sit down....shut
up....and let us work.
25) If you can bitch about the blood pressure cuff being too tight, or
the IV hurting, you are not in that much pain!
26) Physicians and nurses are NOT waiters. We are NOT customer
service representatives. This is NOT McDonald's, and you very well
may NOT have it your way. Our job is to save your life. If you
want a pillow, two blankets, and the lights dimmed......GO TO THE
RAMADA!!!!!
27) If you have any sort of stomach pain and you ask for something to
eat, you are NOT sick.
28) Do NOT talk shit about the other members of staff I work with.
That doctor that you hate? -- I work with him every day, and I know that he
knows what he is doing. I trust him a LOT more than I trust you. I
am NOT here to be your friend, and neither is he. I will tell him
what you said, and we will laugh about it. If you want a buddy.....go
somewhere else.
29) If you are homeless.....DON'T ask for a bus token or a cab voucher
to get home, it just confuses the staff.
30) PLEASE don't tell us how to do our job. Do we come to your place
of business and tell you how to do your job?
31) Please don't bring in a "show and tell." If you have to fish it
out of the toilet, it's really not necessary to bring it in. We will
take your word for it. If you did fish something out of the
toilet.....you may NOT use my pen.
Tragic
Tommy-ray 09/23/93 - 09/22/96Andrew 03/28/95 - 09/22/96
Women called today, asked if I had her son who had been killed in a fatality a few hours earlier. I looked to see if we had his body. He never made it to us. Mother was frantic, she was notified via police, yet does not remember where they said he was. She could not comprehend her loss. I took her number and told her that I would find her son for her. What I found was four bodies. Four families had lost their children this morning. Four sets of mothers, fathers, sisters, and brothers who will always remember 1/17/2010 as the day their brother were killed. These young men had never come through my ED door's, yet I could not just pass the mother off as not my problem. She was lost, confused, and searching for her son. Once I found his remains, I set up transport for her and the other families so that the bodies could be seen at the funeral home of their choice. There are times that working in our profession that I wish we could just wall off all of the bad things that happen. Life and death can be ugly and most times it is. Very rarely do I see someone die in peace. It might be because I work in the ED and not on floor or in hospice.
Today was hard, hearing the mothers voice just brought back memories which I tend to suppress most days.I heard how I felt almost 14 years ago. What I most of sound to like to the ED nurse who took my call.
All of this death today was caused by drunk driving. I do not understand why it is so hard for people to understand that nothing ever good comes from drinking and driving. Today, those families will always remember. They will feel a sense of loss and grieve on this day every year, along with holidays, birthdays, and odd days here and there. Just as I do.
Friday, January 15, 2010
Please don't
I only say these things because it has happened!
1. If you find bright red fluid in the diaper, check to see what the color of the juice is that is in the kids sippy cup!!!
2. Gum stuck in the child's hair is not an emergency!!!
3. because your friend's child was potty trained at 12 month, which I doubt. Don't worry if you 15 month old is not.
4. I really do not care how long your labor was. I had 4 children all natural without pain medication and do not want to compare stories.
5. Please do not ask me if I think you kid is cute. There are ugly babies out there! If your child is one of them, instead of answering you, I will simply say what a cute outfit.
6. If you are in the ER for etoh and drug abuse and there are 4 of your kids in the waiting room, please do not ask me the best way to get pregnant..... My sugestion is fertilation.
1. If you find bright red fluid in the diaper, check to see what the color of the juice is that is in the kids sippy cup!!!
2. Gum stuck in the child's hair is not an emergency!!!
3. because your friend's child was potty trained at 12 month, which I doubt. Don't worry if you 15 month old is not.
4. I really do not care how long your labor was. I had 4 children all natural without pain medication and do not want to compare stories.
5. Please do not ask me if I think you kid is cute. There are ugly babies out there! If your child is one of them, instead of answering you, I will simply say what a cute outfit.
6. If you are in the ER for etoh and drug abuse and there are 4 of your kids in the waiting room, please do not ask me the best way to get pregnant..... My sugestion is fertilation.
Thursday, January 14, 2010
Blown
Just love going to the eye doctor. Afterwards I walk around for hours looking like I have one heck of a nero problem. Along with a headache because I went to my boys basketball game under the bright lights.
My Blooper
Woke up this morning, jumped in shower, coffee while I dressed. Proceeded to drive the 45min through country road to the city. Walked into work, clocked in, made assignments. While making assignments, I noticed that we had 1 too many nurses. Hmm... I thought, It will be a fight to decide who wants to go home because everyone does. 30 minutes later I realized it was my day off!
1. In my dummy defense, I have worked the last 11 days.
2. It would have been nice if someone gave me a heads up when I walked through the doors! Instead they found it funny.
3. Really need to work on life not being so automatic.
What is sad is that this was not the 1st time I have done this. I do it about once a year. Last time, I did not realize it was my day off till the end of the shift. I had 5 days on, 1 day off and another 7 days on. Somehow I was off a day on when day off was. With us always being short nurses, everyone thought I was called in.
Wednesday, January 13, 2010
Frustrated
Okay, just a little frustrated. 9 months ago, I started planning for this trip to Mexico for a month of volunteer medical corps. My husband just vetoed all plans!!! I understand he loves me and is worried that something could happen, but hell I could be walking the dog and trip over a log and something could happen. So, those who read my blog, any ideas on how to convince he that I am a big girl?????
Triage adventures
Between family, school and work, have not been able to post the last few days.
I normally do not work triage, but every once in a while I need a break from the code and trauma rooms. Triage is always frustrating and at times funny as hell.
1. Woman is brought in by family, C/O heart stopped last night for 4 hrs, my response was did you feel it stop? Do you have a defibrillator? What made you think it stopped? Her response, my doctor is crazy and said I had a perfect heart, but I use to work on the cardiac floor and I know something is wrong!!! I did compressions till it restarted.
2. Woman came in tweaking, C/O told to come here so that I could be admitted for surgery. My response, do you have direct admit orders? Who is the Doctor admitting you? Her response doctor said the only way that he would pull the two teeth that I have is if I get sick and am admitted, but I need meth patches while I am here... I really had no response after that (At Least not one I could verbalize)
3. Young woman came in, C/O bumps on clitoris. My response, when did they start? are they anywhere else. Her response, started after I felt bad for this guy and only charged him $10.00 to lick me, next time I'm gonna charge him $25.00......
4. 15 year old male came it with mother, C/O nonstop itching in genitals. Mother reports that she has found him in his room a just scratching and scratch, he told her it was itching and that is why his pants where down and that he only was using the lotion to help the itch...... Okay, give me a break here, mom needs to get a clue that her baby is no longer a baby.
I normally do not work triage, but every once in a while I need a break from the code and trauma rooms. Triage is always frustrating and at times funny as hell.
1. Woman is brought in by family, C/O heart stopped last night for 4 hrs, my response was did you feel it stop? Do you have a defibrillator? What made you think it stopped? Her response, my doctor is crazy and said I had a perfect heart, but I use to work on the cardiac floor and I know something is wrong!!! I did compressions till it restarted.
2. Woman came in tweaking, C/O told to come here so that I could be admitted for surgery. My response, do you have direct admit orders? Who is the Doctor admitting you? Her response doctor said the only way that he would pull the two teeth that I have is if I get sick and am admitted, but I need meth patches while I am here... I really had no response after that (At Least not one I could verbalize)
3. Young woman came in, C/O bumps on clitoris. My response, when did they start? are they anywhere else. Her response, started after I felt bad for this guy and only charged him $10.00 to lick me, next time I'm gonna charge him $25.00......
4. 15 year old male came it with mother, C/O nonstop itching in genitals. Mother reports that she has found him in his room a just scratching and scratch, he told her it was itching and that is why his pants where down and that he only was using the lotion to help the itch...... Okay, give me a break here, mom needs to get a clue that her baby is no longer a baby.
Friday, January 8, 2010
I will never figure this out..
1. How a patient can walk into the emergency room, walk to their bed, undress, and get into bed. Then they hit their call light to be pulled up in bed because they are uncomfortable. Will never figure it out. Just wish some of these patient were a bit lighter!!!
2. How a patient can call 911 to go to the emergency room, then when they get there they say "nope, don't need a doctor, just needed a ride down town."
3. How a patient can have 10/10 abd pain, n/v, than proceed to ask for a cheese burger and coke form the cafeteria. My answer is, nope, don't want to reload you for projectile vomiting that you complained of.
4. How someone can really justify calling a nurse any number of names, and in some case threaten to assault them prior to the nurse giving them their pain shot. A little common sense would say that nurse get to pick what gauge needle she uses.
2. How a patient can call 911 to go to the emergency room, then when they get there they say "nope, don't need a doctor, just needed a ride down town."
3. How a patient can have 10/10 abd pain, n/v, than proceed to ask for a cheese burger and coke form the cafeteria. My answer is, nope, don't want to reload you for projectile vomiting that you complained of.
4. How someone can really justify calling a nurse any number of names, and in some case threaten to assault them prior to the nurse giving them their pain shot. A little common sense would say that nurse get to pick what gauge needle she uses.
Wednesday, January 6, 2010
Child Abuse
The question that I pose to all of you is.... Can you really tell the difference between child abuse and a genetic disease? Do we that work in the ED think outside of the box when we see injuries that could be caused from abuse? Do we just become cynical and assume all suspicious injuries that we see are related to child abuse?
This might not be an entertaining or funny post, but after the news I received today, I believe that it is worth a mention.
Case: 9 year old male covered head to toe in bruises, sclera on left eye was red, shoulder dislocated.
mother reports that child just bruises easy, that child was swinging on monkey gym and fell screaming that his arm hurt.
Both mother and child wore what appeared to be older hand me down clothes. Mother might have completed 5th grade, but very doubtful that she went any higher. The child did not have any medical insurance, not even medicaid. When reviewing the chart, the child had been to our ED many times for dislocations, bloody noses, rectal bleeding, and sprains. This child had scars that looked like he had never had medical treatment, so some of his wounds turned to scars were wide and gaping.
So what would you think???? Looks like abuse, sounds like abuse, it is abuse... right????
Lucky, I work with some great doctors!!! The resident was assuming abuse and had the police on line. One of our ED doctors told him to hold on. Dr. Great came to me and asked about what I experienced with EDS as a child, and what type of injuries that my younger son had encountered. You see,Dr. Great thought there was something off about the abuse allegation because of the mother and son interaction. No, this doctor is not familiar with the disease process of EDS, but he had thought that it sounded some what similar to the injuries that my son and I suffer from.... So he asked, then he looked up the disease.
Some of the common injuries that come with Ehlers-Danlos syndrome (EDS), include dislocations, easy bruising, vessels in eyes are very fragile, the lining of the intestines can easily tear, which leads to rectal bleeding. Minor injuries heal poorly and leave wide gaping scars.
So, after the doctor found all of this out, he came up to me with a very odd request... Can I pull your skin, he asked. At first, my response was pardon me? He then proceeded to tell me what he was thinking and prior to him going into the room he wanted to see and feel how the skin reacted when pulled. Those with certain variants of EDS have very elastic skin. Anyway, long story longer.... Doctor Dx the child with EDS and sent him to a specialist for a biopsy to confirm the genetic disease. Today Dr. Great called me and told me that the child that everyone thought was abused indeed had EDS that was confirmed by the test. Social services have been set up to help this mother find the resources to help this child.
So what is my point???
1. Look at the whole story prior to calling it abuse.
2. Most cases are abuse, but for that 1 in 1,000, 1 in 10,000, or even 1 in 100,000 it is a disease.
3. If you do not understand or know something, go look it up or ask, no matter if that person is lower on the totem pole than you. Everyone knows a little something that another does not.
Ok, Done with my rant
Tuesday, January 5, 2010
Cold, Cold, Cold...
We normally do not get below 20*F, nor do we get snow!!! This year we have had snow twice and they are calling for -5*F, no that is not a typo -5*F!!! With the decrease in temperatures we are having an increase in homeless coming in looking to get warm. I normally talk with them prior to them checking in to see if they are cold or seeking treatment. Yes, I am a sap. I do not have the heart to kick them out of the waiting room. I just do not feel like having a bunch of bumsicles coming in with hypothermia and frost bite because I kicked them out of the waiting room.
Monday, January 4, 2010
23 weeks...
23 weeks and 23 visits. I can't wait till this pregnant female hits 24 weeks because than we can just divert her to L&D.
Week 1.... I missed my period and think I might me pregnant, can you test me? no, well I have abdominal pain.... Instant pregnancy test
Week 2 ... I get nausea in the morning, can i have a pain shot? No, well have abd pain..... instant treatment
Week 10... Can you do a ultrasound so I can tell the sex? No, I have abd pain and think I am spotting... instant ultrasound
Week 16.... I have abd pain can you tell me the sex of the baby now that I am further along?..... ultrasound.... it's a boy
Week 23.... How long before I can just give birth, so tired of being pregnant.... 40weeks!!!! I have abd pain, knee pain, nausea, sore throat, on and on... can I have a pain shot?
Now this can go on and on.... I could tell you every visit from week 1 to week 23, what a waste of medical resources....
Week 1.... I missed my period and think I might me pregnant, can you test me? no, well I have abdominal pain.... Instant pregnancy test
Week 2 ... I get nausea in the morning, can i have a pain shot? No, well have abd pain..... instant treatment
Week 10... Can you do a ultrasound so I can tell the sex? No, I have abd pain and think I am spotting... instant ultrasound
Week 16.... I have abd pain can you tell me the sex of the baby now that I am further along?..... ultrasound.... it's a boy
Week 23.... How long before I can just give birth, so tired of being pregnant.... 40weeks!!!! I have abd pain, knee pain, nausea, sore throat, on and on... can I have a pain shot?
Now this can go on and on.... I could tell you every visit from week 1 to week 23, what a waste of medical resources....
Sunday, January 3, 2010
My One Weakness
Well, I hate to admit my one and true weakness, but the cat was let out of the bag today. A person can puke, poop, pee,and bleed on me. However, mucus just gets to me. Most of the time I can hold the gag in or think pleasant thought. I have worked in my ER for over six years, with the same staff and same doctors and they never had an inkling to my aversion and my gag reflex when it comes to mucus. Well today, I was helping another nurse with one of her patients. This patient had a foul, rank, and obscene Odor to her. It was not fecal or urine, No clue what it was but it was bad! I turned away from her for one minute and when I turned back she had runny, snotty, foul mucus all over her face. The mucus combined with her unique smell just sent me over the edge. I made an attempt at a graceful departure towards the bathroom, but only made it as far as a trauma room. With my head over a biohazard can while I looked done at bloody towels and pads from our recent trauma I dry heaved till I thought I was going to pass out. When I finally thought I had composed myself, I made my way to the nearest bathroom. When I encounter the patient in the hall, but this time she reached out to grab my arm with her slimy hand. That is when I just couldn't hold it in anymore. I made a dash towards the bathroom and lost all of my cookies. Unfortunately, I had not locked the door.... Next thing I know one of my favorite doctors was in the bathroom with me holding a syringe filled with zofran. Between gagging I was trying to tell him that I was not nausea just disgusted and that last time I got a shot I passed out (Don't like needles:) Long story longer... he gave me the shot, I passed out, when I woke up I had half ER staff surrounding me on a gurney. (ER nurses worst nightmare!!!) At first they thought I had morning sickness, nope took about 15 minutes to convince them I was not pregnant, not sick, did not need 100 or so tests to dx my illness. I just got disgusted and gagged. Once they all figured it out, They spent the day making sniffing, snotting, and every noise possible that might make me gag..... The feeling of the ER love!!! Think it is going to be a while before they let up on me.
Saturday, January 2, 2010
New Year's Resolutions
Every year, I hear about people making their New Year Resolutions. However, they are mostly things that people do not want to do. I on the other hand use this time to check a few things off of my bucket list. Why do I have a bucket list many ask me. Well I have Ehlers-Danlos syndrome (EDS), plus I am human. I know that I am not immortal and will die... eventually. Also, with the EDS, I have so much metal and plastic in my body that my children tease me and tell me that they will just take me to the recycling plant when I die, which should cover my funeral expenses... Any way, I do not want to live my life afraid of being in pain or broken. Truth is, I am always in pain and about once a month, I am dislocated or have broken something. So why should I live my life discouraged and crippled?
First.... Last years bucket list
1. Get out of a wheel chair and relearn to walk.... Was in wheel chair for 4 months, Was out on 2/10/2009.... Done (The rehab and learning how to walk again was tricky, but I got it done!
2.Walk in the Walk For life 10k..... done on 4/2/2009
3. Hike 50 trails..... Trail number 50 completed 11/1/2009
4. Cliff jump 100ft.... Done, many times over the fourth of July weekend, what a blast, only cost me a dislocated shoulder
Now this year, money and joints permitting....
1. Tandem Skydive.... the jump and fall should be a piece of cake, the landing might be a little tricky.
2. Hike another 50 trails.... advance from medium to hard
3. Learn to play tennis.... with my physical limitations, friend has suggest playing doubles with me in front... we see how it goes, but I want to play in one competition match.
4. Go to Alaska and watch the whales, not so sure on cost, but going to give it one heck of a try!!!
4. See if I can give my orthopedic a heart attack when he asks about my bucket list (smile)... last year he threatened to disown me
Happy New Year to all of you, and I hope you have atleast one thing that you want to do on your list. Life is short!!!
New Years Day as a SANE
First, let me say a few things...
If you are sexually assaulted it is not your fault, even if you are drunk, stoned, or doing something that you really should not be doing. Someone that assaults another is a predator. On New years Eve I worked a 8 hour shift in the ER, which I did 4 RAPE kits. After work I did another 3 Kits prior to calling it a night and handing off the next 3 exams to another nurse. On the New Years day, I did another 2 kits in the ER and 4 more kits as a SANE. What all of these have in common is that the person was drunk and/or stoned, passed out and alone. They woke up with someone on top of them raping them. Yes, I get paid VERY well to do the kits as a SANE, but please put me out of a job.
Now, with that said.....
Use some common sense if you plan on getting so drunk or stoned that you don't remember who you are.
1. Use a buddy system, If a bunch of you are going out drinking, have one person there who is going to remain sober. This person can help steer you away from dangers situations.
2. Always carry a condom. Believe it or not, a predator will put one on most of the time if there is one available. No judge or jury will ever say you had consensual sex with someone if you are the one who had the condom. They will just think you where using your brain. Also, the condom is a great collection device for DNA, most the time the predator leaves it behind.
3. If your are assaulted, don't shower, wash, brush your teeth, eat, change clothes, no matter how much you want to. If you have to urinate and can't wait, go ahead, but don't wipe. I am a forensic nurse, I collect the DNA, if you wash and shower, I will have a harder time finding evidence. This is the evidence that links the victim to the predator. With out evidence, it is a he said, she said situation that could go either way.
Remember, my job is to collect the evidence. I don't judge what you do, have done, or planning to do. I need to know the truth. I am your advocate in the court room and out of it. If you hide the truth from me, I can't come to your defense because all of my testimony will be based on false information.
If you are sexually assaulted it is not your fault, even if you are drunk, stoned, or doing something that you really should not be doing. Someone that assaults another is a predator. On New years Eve I worked a 8 hour shift in the ER, which I did 4 RAPE kits. After work I did another 3 Kits prior to calling it a night and handing off the next 3 exams to another nurse. On the New Years day, I did another 2 kits in the ER and 4 more kits as a SANE. What all of these have in common is that the person was drunk and/or stoned, passed out and alone. They woke up with someone on top of them raping them. Yes, I get paid VERY well to do the kits as a SANE, but please put me out of a job.
Now, with that said.....
Use some common sense if you plan on getting so drunk or stoned that you don't remember who you are.
1. Use a buddy system, If a bunch of you are going out drinking, have one person there who is going to remain sober. This person can help steer you away from dangers situations.
2. Always carry a condom. Believe it or not, a predator will put one on most of the time if there is one available. No judge or jury will ever say you had consensual sex with someone if you are the one who had the condom. They will just think you where using your brain. Also, the condom is a great collection device for DNA, most the time the predator leaves it behind.
3. If your are assaulted, don't shower, wash, brush your teeth, eat, change clothes, no matter how much you want to. If you have to urinate and can't wait, go ahead, but don't wipe. I am a forensic nurse, I collect the DNA, if you wash and shower, I will have a harder time finding evidence. This is the evidence that links the victim to the predator. With out evidence, it is a he said, she said situation that could go either way.
Remember, my job is to collect the evidence. I don't judge what you do, have done, or planning to do. I need to know the truth. I am your advocate in the court room and out of it. If you hide the truth from me, I can't come to your defense because all of my testimony will be based on false information.
Subscribe to:
Posts (Atom)
Posts
