Thursday, December 30, 2010

Life is not always perfect

As 2010 ends, I can't help reflect. One moment it was January 2009, and then I blinked.
Life and death is part of every day life, which is emphasized in this profession. I couldn't count how many people I have seen take their last breath, how many febrile seizing children have been handed to me, nor the countless heartbroken families that have been told that their loved one is critical. however, with the death and sorrow that comes into the emergency room, life, relief, and joy walk out those doors. I can count the number of births, 2 girls and 1 boy. I have seen the relief on families faces when the have realized their family is going be okay. At the end of this year, I am thankful that I work were I do. I am bless to work with great doctors, nurses, paramedics, techs, and secretaries, who are always their for each other and our patients.

Friday, July 23, 2010

What not to do or say in the ER

1. As a 1st year resident on a student visa, yell at the nurse when you have no idea what the heck you are talking about. Result will be the nurses taking up a collection for your one way ticket back home and handing it to you in front of your attending, who by the way loves us.

2. Don't say while you are attempting to place an ET Tube, "Damn my tube is huge and her mouth is too small." Result will be the perverted nurse laughing her butt off and everyone in the room catching the giggles.

3. Don't play a practical joke on the charge nurse because it makes you fair game. Result will be your coffee cup dermabonded to the desk.

All kidding aside...

Do remember when you are having a bad day that we are in it together, we have your back as you have ours. If you are new to the ER setting, most of us working in the department have worked together so long that we are family. We have are times that we love to hate each other, but in the end we are there for each other.

Monday, July 19, 2010

There comes a time....

There comes a time when a person must take responsibility for themselves. If they do not then their care takers need to buck up and make responsible choices.

I have a 39 year old male that lived with his mother his entire life. His mother was ill and had him placed in a nursing home 2 months earlier. However, the nursing home had set up independent living for him complete with 24 hour aid to help care for him. Sounds great, but here is the catch.

When he presented to me, he came into the ER on a SWAT teams flat bed truck, he was soaked head to toe with urine, fecal matter, and unknown debris. He had fired his aid 2 days earlier and had no one to care for him, which he was completely bedridden. All of his medical conditions and his current condition was completely due to one modifiable condition. His weight. He came in weighing 894lbs. according to his medical records he has had and average yearly weight gain of 150lbs over the last 4 years. In talking to him, I felt sorry for him. In front of me laid a man that was able to walk, bathe, or even find his penis to urinate all because he was overweight. Earlier this year, he had a trach placed because the weight was causing breathing problems. I wondered how he could have gotten to this point and if he had any medical condition, which caused him to gain weight. There was none, he was overweight by choice. In talking to him, he believed that if he broke the Genesis book record for the heaviest man, then he would become famous and never have to work. So, I would say he had a mental disorder there!!!

Now here is where responsibility for ones self should kick in. Once he started developing medical problems, he should have gone on a diet. Once he was unable to do anything for himself, he should have rethought his idea of being the worlds heaviest man.

Responsibility as the care taker (his mother). If your son is so overweight you have to wipe his butt at the age of 39. Then put him on a diet. Seeing that his mother had to take total care of him, why did she keep feeding him everything that he wanted? He reported that breakfast normal consist of 1lb bacon, 6 sausages, pancakes and a dozen eggs... does anyone see the problem here I wanted to say to his family. Now back to the live in aid. He fired he because she made the diet that the doctor had ordered. He instructed her to leave the phone by the bed, his wallet by the bed and the front door unlocked. Over the few days that he was without help, he ordered and average of 40 pizzas a day, side order of wings, and bread sticks. He was worried about food and did not care about his toileting needs. The only reason that 911 was called was because the one night he had ordered Chinese, well the delivery guy call 911 due to the condition of the patient and truly believed that someone was dead in the house due to the smell.

What gets better is that he refused medical care when EMS arrived. Police had to be called and adult protective services had to file and emergency order of custody. Then the fun part came. How to get this guy out of his home and to the hospital. It is just sad, but people need a wake up call. After all was said and done, he still insists that he needs to keep to 10,000 calories a day to reach his weight goal.

As a side note, is it really right for tax payer to foot the bill for his selfinflicted medical conditions? He is on SSID, all of his meds are paid for, foodstamps supply him with a portion of his food, medical bills are paid, and he had HUD housing. To me there comes a time that we need to just cut the umblical cord. If he wants this life and he is doing it on purpose, let him. Just let him foot his own bill!

Tuesday, July 13, 2010

ER work note

Patient of the day award goes to this guy. I could not resist putting works into animation. I am just too under paid to pay for it to have real charters or a scene setting:)

Sunday, July 4, 2010

Talking in Tongues

Starting an hep-lock, the guy started saying something, yet I couldn't hear him. So, asked him to repeat himself. His wife jumped in and said he was praying. Now, I couldn't understand what the heck he was saying. Instead of just letting it lay, I asked what language is he specking. You think I would have learned by now not to ask people anything anymore. His wife became highly upset, yelled that she wanted another nurse and the supervisor. Well, I am the supervisor, and explained that, but she wanted someone else who could recognize the holy spirit talking through them. Apparently, he was speaking in tongues and I was the antichrist.

Nurse asked me, "where is the prostate in a women?" No shit are you serious I asked, it just slipped, but come on!!!