Unbelievable!!!

52 year old female, c/0 left sided weakness last known well time yesterday at 1600. Brought into ER by family today because she became unresponsive. Family reported that yesterday her left side went limp. So why did family not bring her in earlier, like on first onset????? Well family was in town to celebrate thanksgiving on wednesday. Since everyone went home this morning, thought waiting a bit would be best. Long story short. woman is dead, who could have had TPA because family did not want to ruin their holiday. Now, family is threatening to sue us because we did not give TPA when she first presented to us....... this afternoon

Been a Few Days

My hospitals in the middle of this big buy out. Now, we are doing mandatory 16 hour shifts, reg at the beside, and still short. I don't see much in the way of all of the promised changes with the buy out. Same sit, just another boss. Main things I care about.
1. do I still have a job....... yes
2. Will I get a raise..... damn it.... nope, in fact we still are on a pay freeze
3. What will happen to all my vacation time?..... doesn't matter, I used it all a long time ago

Now,what I find funny, just got a notice that I am up for wage review and to make sure that I have all of my education and shot records up to date and turned back in, or I will not get my raise..... LMAO, what is the purpose of the review????? Am I missing something???? We have been on a pay freeze for 4 years, which means that I have not gotten a raise and will not get on for a long time. Freaking morons

Silly

I just had to giggle at this one:

Guy comes in with his wife. she had a laceration that needed to be sutured. He was all into looking at the wound, without a problem. The minute he saw the small needle that was going to be used to numb her, he passed out cold. He hit the ground, smacked his head, and was now in the need of stitches. Instead of his wife showing any concern, she just says he always does this when he sees a needle. Now, what I don't understand is:
If the sight of a needle makes you pass out, why are you watching us stitch your wife????
If you know that you husband is going to collapse when we pull out the needle, why not warn us? why not suggest that he sits down? why the hell have him in your room?

Translation

Dr. Hates women: always thinks it is funny when a women is charge instead of one of the guys, and calls the charge phone at least once an hour.
Today he questioned why the nurse pulled a Foley out without his order and he wanted them to be written up

Me: No, I am not writing them up, I told them to pull it, It was clogged, from nursing home with debris and green discharge, nursing home notes reported last changed 3 months ago, client had 900 ml of fluid in bladder per bedside bladder scanner. Here is the form, you can write me up!

His response: none
2 hours later received call from director about me being written up for ordering diagnostic lab without order. Dr. hates women neglected to list which test was done
Me: answered with written nursing protocol signed by medical director
What I should not have done was run protocol through language scanner for his native tongue(Arabic) and posted it on his locker... opps...bad nurse

I wonder how he would respond to this posted on his locker????


تقبيل الكاحل بلدي تبين بمقبض الأمريكية

You Did What????

What is it with people this month? I have had way to many objects where they should never be. 2am seems to be the magic time that I get the foreign bodies shove only god knows where. This morning was no different.
Pt came in c/o abd pain x 2 days. Fever, n/v, but was constipated and refused to give me any other details. He wanted a male doc only and he stressed this point over and over again. I have been doing this long enough to know that it is related to 2 things. He has a blockage or something shoved where it should be. Well he was out of luck, the only docs on where both female. Pt did not fess up to anything and lab work showed that he was septic. After coming out of his room, I noticed that the doc was staring at the x rays with her head cocked to the side, a look of puzzlement on her face. Anytime a doc gets this look, you have to just go see for yourself because it is something odd. The cause of this pt's pain and vomiting was indeed a blockage. 16inches worth of wooden broom handle had been inserted and broken off. Pt ended up going to surgery, going to ICU, and having his bowel redirected. The only story we got out of the guy.... He fell while sweeping and was to embarrassed to come in. I can't wait to see that surgical report.

How to REALLY tick me off

I have three pet peeves, and everyone that works with me knows them by heart, or at least I thought so. That was until the nurse that only works two days a week decided to make me want to snatch her by the back of the head by violating every single one of them.

1. Help your coworkers. I don't want to hear that it is not your room! If the rack is full, the waiting room is standing room only, I have patients lined up in strechers down the hall, waiting room is standing room only, and your patients are taking care of, please get off of you ass and help discharge. There is no I in emergency nursing, or any position in the emergency room, for that matter. Working in the ER is a team sport. That is the only way we can get everything and keep everything flowing. Especially, when I convince our docs to help discharge, you should not be sitting there goofing off.

2. Wipe a butt, place a Foley, wheel out patients, when the techs are getting their butts kicked Just because you are a RN, does not mean that you can not do personal care. As far as I am concerned, RN means that you can do EVERYTHING from CNA to RN. And if you talk down to my staff, I swear, that I will give you the next patient that has to have Kayexalate while convincing the Doc that they do not need a rectal tube!

3. Finally, but one of the most important.... the diet cherry limeade from sonic that EMS and Docs always bring me in is ... MINE, so keep your lazy, grubby, nursitis hands off. That is my crack of choice, if I don't get it one of my multiple personalities will come out and make your life hell!

The Items Nurses Take From Patients

After having my butt kicked by an 90 year old, maybe 89lb dementia patient today, which ended in me with bites, scratches, and tetanus shot and her in hard restraints. I found it humorous at what items that I end up taking form patients over the last few months.

Today, after a few bites from the above patient, I took her dentures. Now, she could only gum people.

After a homicidal/ suicidal pysc patient attempted to run away for the 3rd time, I took his artificial leg. Now, he could only hop away, which he attempted, but he was easier to catch.

I have taken a cane from a women that was attempting to hit my poor doc with it.

A bucket of snakes from some guy who was bitten catching snakes. Apparently, he was not the best snake charmer in this neck of the woods

Finally,the patients favorite, but my worst... a 10in vibrator from a patient with a lower GI bleed, who was c/o pain, but still attempting to use it.... Hmmm, wonder how he got the bleed!!!

Same Man, Two Calls & One Visit

First Call
Me: Hello XXXX ER, MLee, RN can I help you?
Them: I was there last night, sick and all, in bad pain
Me: Okay, what can I help you with
Them: I cant read what it says on the drug pad
Me: The prescriptions you can't read? Did you get them filled?
Them: Naw, didn't want to fill them unless it was some good shit, you know to take care of bad pain
Me: Give me you name and SSN, I will look you up and let you know what meds they wrote you
Them: Name and SSN
Me:He wrote for naproxen for pain
Them: Never had that, it any good?
Me: Yup, it is great for back pain

Second Call
Me: Hello XXXX ER, MLee, RN can I help you?
Them: Ya man, just talking to some chic, the bitch told me that the drugs the doc gave me were good
Me: Yes, That chic was me, Naproxen is a good pain reliever for chronic low back pain
Them: naw, it is just Aleve, I am allergic to Aleve, Cant the doc wright me something else? I'm in bad pain
Me: sorry, but our doctors are unable to write you anything stronger unless they see you because the doctor that saw you is not here at this time.

Visit
Pt came in with c/p low back pain x 2 years, stated he was in bad pain and that bitch (me) lied to him about Aleve being good.
Doctor saw pt,went through every one of his allergies and informed him of a new pain medication that he was not allergic to. I discharged him with a Celebrex script, he flipped me the bird and said told ya I get something good..... I can't wait till he sees the cost of the script

What is so frustrating is that this pt, along with many others abuse the ER for pain medications. When they do not get what they want, they keep showing up. I am sure that he will show up again and again. Hopefully, he will not get what he wants, less than two weeks ago, I took care of him for OD on prescription meds.

Mayo Stands

I thought to myself, how hard could it really be to put together a few Mayo stands. Hell I have directions and tools. Well, 3 hours later, I finally get the damn things together... Would have helped if the instructions were in English. or if I knew what the freak an Allen wench was!!

Husband + Nail Gun = ER

Was not really sure of where to post this one, my ER blog, or my home blog because it fits into both.

The other day I was just out puttering around with odd and end chores when I heard my husband scream. He was repairing part of the chicken coop, so that is the direction I headed thinking my god what happened, is he okay, and all the other wonderful things that run through a persons head when they think that someone they love is hurt. I find him yelling and screaming, yet I can't figure out why. Then I saw it, he had nailed his hand to the chicken coop. Once he calmed down, I was unable to keep a straight face. He was stuck and there was noway to get him unstuck without cutting the board that he was nailed to. I am positive that it was painful, but come on it was pretty funny,. what made it even funnier was that it was my husband. After taking him to the ER with board, nail and all, my poor hubby had to endure my friends and coworkers. Even the ER doc was unable to keep a straight face. His words to my husband, "if it was anyone else i would not tease ya, but that was not the smartest thing you have ever done."
Just for the record, that is not my husbands x-ray.
He is fine with no real damage, but pride
The chicken coop has been patched

Fetish with the ER.... WTF

Okay, I understand wanting to spice things up a bit. I have no problem with being adventurous, but checking into the ER just to get your rocks off is insane.

Apparently, a older man was going along for the ride with a much younger women. We have seen her before, all the ER's know her a little too well. She is the patient that complains of abdominal pain and vaginal conditions while requesting not to have anyone in the room with the doctor during her pelvic exams. She has a fetish for gyno beds and anything, male or female in a lab coat. Well, today was her day. She checked in for a headache, which shocked us because it meant no pelvic exam. However, she had a friend with her. I had to go and do the nursing assessment on her. As I walked into her room, I heard the shuffle of pants being pulled up. There she was buck naked, kneeling on the floor in front of this "friend", with a smirk on her face. He looked mortified, she just crawled over to me and stated, "I have always wanted to play with you" My first reaction, which I had to suppress, was to snatch her by the head and drag her out of the ER. However, I just walked out. The guy took off, security called the cops. After arresting her for lewd behavior and three other offenses, my poor ER doc still had to treat her for the headache prior to them taking her to jail. He gave her 1 gram of Tylenol

What I am wondering....
1. WTF would make her think anyone in the ER would allow her to touch us with a 10 foot pole?

2. WTF is would make her want to have sex in the ER?

3. Why was she completely naked to give a man head?

4. What is it with some people and the pelvic beds?

Long Day

Some days are just long days. Unfortunately, there are more and more days where we work shorthanded. People seem to be sicker every day, and to complicate the situation, more people seem to use the emergency room as their personal doctor’s office. Today was just one of those very long days. We see these days written in the body language of the doctors and nurses that are exiting the hospital. Head down, shoulders slumped, and exhaustion in their eyes. Today, I believe that I went through almost every emotion possible before I did the long walk to my truck with the day written all over my body.

Dread hit within minutes of clocking in and realizing that four of the nine nurses scheduled had called out with flu like symptoms. This means that not only will we be short today, but for at least a week.

Ah, shit hit after someone that had no real reason to, went asystole.

Anger spread when I hit the code button and no one responded because the secretary was bull shitting on the phone with her new boyfriend.

Sadness hit when a mother came running in with a 4 week old that was blue and lifeless.

Humor snuck in when I decided that it was the perfect time to payback a doctor for handing me a snake a few months ago. I slipped a glass eye into his coffee, what a shriek he made, as he went to sip and realized something was looking back at him. Revenge is great.

Homicidal thoughts kicked in when a patient had the balls to say, “I am going to just stand here and cough in your face so you get the flu, unless you get the doctor in here right now.”

Embarrassment struck when I realized that I had a handprint on my butt from the powered later gloves. (The handprint was my own, for the record)
Gratefulness hit around 1500 when one of my doctors thought to bring me some food because I had not eaten yet.

Relief and accomplishment kicked in when I got a tube a tough patient.

Joy finally kicked in when I saw my relief come walking through the EMS doors.

Basically.... It was a long day, but for all of the crap, I still enjoyed it. I am just feeling a little exhausted and beaten down right now.

Kids

There are so many crazy, insane, idiotic, and sad events that happen in the ER. However, every so often, there are those that make me smile, cry, laugh, or just think how lucky I am a to work where I do. Here are a few:

A 5 year old is brought into the ER, just yelling and screaming, complains of everything under the sun from belly ache to fever. Her parents are frantic because they have no clue what is wrong with their precious little child. Once I walked into the room and sat down to talk with her and get her to calm down a bit, she leaned over to me and asked if I could keep a secret. The horrible thoughts of what this child was going to tell were running through my head. She than produced a very small turtle out of her pocket and said I think he is hurt because he won't move. You have to fix him!!! Her big blue eyes full of tears just broke my heart. After looking at the turtle, I got a wash basin and place him in it. I explained to the child that he was just scared and was hiding. After a few minutes, he poked his head out and looked around. The little girl was so excited that she gave me the biggest hug I have ever had. She walked out with wash basin and a very alive turtle a happy camper.

While in triage, a little boy came in with classical symptoms of the influenza, plus a possible ear infection. I provide him with a mask and tried to explain that he needed to wear it so other people did not get what he had. After I put it on him, I looked away for just a minute, when I turned back around he had the mask over his ear. Trying not to laugh, I attempted to adjust the mask for him. He very logically stated," cough ain't bad, sneeze ain't bad, body hurting ain't that bad, but no one wants me to give them this ear!!!"

Common Experimental Drugs Country Folks Use

A friend of mine lives and works in NY. We talk every night about the type of patients that we see and what our locale trends are. She has never experience theses type of drug users, so this is for my city slicker friend.

It was just after lunch time, when five School students began showing classic symptoms that come after ingesting jimson weed. They began to have hallucinations, a lot of vomiting and wild-eyed looks...One of the children was so delirious, had to be restrained to get on the gurney to be put in the ambulance. When you ingest jimson weed seeds, a little will get you pretty high and too much will get you sick, or kill you. Another dosage or so, they would probably be dead, so it is very dangerous. Jimson weed, most commonly found in fertile fields, gardens and barn lots, can cause serious health complications, including rapid heartbeat, high fever, convulsions, blindness, coma, and death.

Shrooms are another natural drug that bored country kids go scouring the local farmer's field for. Had one teen come in after drinking his special tea completely tripped out. Apparently he was having a bad trip and everyone's eyes were leaking their color. Normally we just place them in a room and let them trip until the drug wears off, but some that are having bad trips we sedate.

Peyote users are one of my favorite to see coming strolling through the EMS doors. No matter how bad of a day a person has, one conversation with someone on their peyote trip will make you giggle and look at life in a new light. Many people think that it is the flower of this cactus, and become sick from attempting to gain a high form the flower. The peyote tea is made from the crown, which causes very vivid hallucinations that last about 12 hours. The main problem we see when someone comes in is n/v. However, we have had to help support a persons blood pressure before.

Yup, He is Deader than a Door Nail

Okay here I am enjoying a impromptu day off. Playing on computer, stuffing face with as much chocolate as possible, hanging out under the covers when my phone starts ringing. Dang, thought I had shut it off! Well the neighbour was calling because she had found her dear old gramps laying in bed not breathing. Estimated EMS for this area is 45 minutes to an hour. For the record I have 5 neighbors within a 30 mile radius, all who are very old. Anyway, my truck was stuck in the mud, which meant I had to ride down or walk down. I opted to ride down without the saddle, which I am paying for now. I get there and the family is performing CPR on this very OLD man.Just looking at the guy, anyone could tell he had been dead for awhile. His wife comes up to me and says, " I told them he was deader than a door nail, they just won't listen." I reached down, attempted to lift his arm, which he was in full rigor and I could only say, "yup, he is deader than a door nail." I am thinking that I might want to try and think prior to speaking. Man, life was better under my covers with the chocolate.

Crack heads of the day

Why would administration decide that all ER nurses have a in-service on defibrillators? All of us are ACLS, PALS, TNCC, CEN, and are in at-least 1 situation a day that we use the dang thing. What, they don't they think that we would know how to turn it on by now? Not only did they have us do the in-service, but they sent someone down from education who had to read out of a book in front of us, how to use it.... Only a crack head would come up with that idea

Who had the brilliant idea that the trauma room floors should be stripped and waxed during one of the busiest times of the shift? And, that they would do all the trauma rooms at the same time? Only a crack head

Who would write up a ER nurse for starting a IV and giving epi and atropine to a patient who was in cardiac arrest without a doctors order? Only a crack head float nurse would, who had no business being in my ER!!!

Who would think that sending 14 student nurses to the ER to train when there are only 8 ER nurses on duty would be a great idea because we were short handed? And, they had the thought that we would appreciate the extra help when they were in their 1st semester? Only a crack head would.

Lesson learned today, administration is using way to much crack!!!

Big John

I just love some of my patients. I have been taking care of one patient that is schizophrenic for about 10 years now. He doesn't like many people, but for some reason he has decided that I am a "good egg," and is just a little protective of those he likes. Now, to put him into perspective.

I will call him Big John, who is 270lbs of pure muscle and 6ft 9ins tall. He has a imaginary friend that I will call Harry. Big John becomes very violent because Harry tells him to kill everyone that is around him due to them wanting to kill Big John. Now, Big John knows that Harry is wrong and comes in before Harry can take complete control of him. Harry can only take complete control when he is all of the way out of the floor. Now the only reason why Harry thinks that I am okay, is because I kicked someone out of the room one day years ago that was yelling at Big John. So, I am safe, as Big John says, but I am always careful.

Now back to my story: Big john came in and was completely homicidal today. He would not let anyone around him, but me. I was very leery, because anything could always change the mind of a

schizophrenic. Anyway, we were trying to get another patient that was on PCP into one of the locked rooms that was next to Big John's locked room. The patient got loose of us and I was just in the wrong place at the wrong time (my fault). I ended up knocked on my butt. Well Big John saw this and thought that the other patient was going to hurt me. He broke down his door and knocked the other patient out cold. By this time we have police, techs, security all in this area, which Big John trusts none of them. He thought I was hurt and before I could say a word to calm him down, he just picked me up like a sack of potatoes and laid me down on a stretcher. I was scared to death to move. He sat down and yelled for one of our doctors to come and fix his friend.

Vomit

There are many reasons why people vomit, but there are always the few that just leave you shaking your head.

1. Pregnant patient states,
"every morning when I get up, I get sick and vomit all over the place, it goes away after an hour or so then it comes back the next day."

2. Patients says, "dude, can't you give me something for this vomiting and headache? I had one hell of a party last night and have plans tonight, I can't go out with a hangover."

3. A known drug seeker reports that his vomiting is killing him and he needs some pain medicine now for his life threatening pain. This has not been the first time this patient has requested pain meds for this complaint, so doctor tells me to tell that patient that he is not getting anything till we see some vomit. Patient says hold on and proceeds to shove his fingers down is throat.

4. 16 year old male came in violently vomiting. Come to find out he did not want to go to school so he ingested some good old fashion ipecac.