Finally

Hooray, I am finally off a run of several 12 hour shifts in a row. My first day, I am in a great mood, plenty of energy, everything is copacetic. Second day, still doing great. Third day, I am caffeinated and still decent to people. About the fourth day, I undergo a change in attitude... it is all I can do not to say the sarcastic and vile things that immediately pop into my mind. About day 5, I am no longer nice... I do the general population a favor by not working 5 in a row.

Rambling, Gambling

As a healthcare professional, I know I should have health insurance. I usually do, but recently I decided I wanted to have my cake and eat it too so I went to part time status from my fulltime teaching position and increased my part time hours in the ER. Shortly after this occured, my hubby changed jobs and this left us without health insurance. I intended to purchase health insurance but life got in the way and I placed this on the back burner...

I would like to point out that I have had health insurance for our whole family for years and years. I have paid thousands of dollars a year to have said health insurance and during that time our whole family remained remarkably healthy. Which I know is a blessing- I'm just saying I've paid my required dues to the system and didn't take back.

Now, in the past month I have had one child ill with mono, my other child broke her wrist playing basketball, and I received an animal bite that was dirty and nasty. Because my one daughter was so healthy, our GP's office felt justified in charging double the fee (*&%*) because she hadn't been seen in 5 years, my other child was seen in the ER, had an ortho dr appt, and I thankfully was seen by my GP in the past 5 years so I was able to pay the usual fee. This of course comes with out of pocket costs for prescriptions and the like.

So all of those dollars spent over the years are now worthless to me and instead I am paying out of pocket. And surprisingly enough, the out of pocket expenses aren't as much as the cost of monthly insurance payments. I guess I should qualify that as "right now". It makes me wonder if I had saved all of those dollars over the years, how many dollars I would have right now. No, forget it. Knowing the amount will only irritate me and hold me back from purchasing the health insurance we need.

Anyways, my venting is complete. I will now do my duty and purchase the required health care.

 

Sexual harrassment

One of the male ER docs I work with has the curse of being incredibly good looking. He is stop-and-look-again Adonis hot and looks very young. I never thought of this as an impediment to working as a health care provider until I realized he is constantly fending off the advances of his female patients. I followed him into each patients room during a shift to see just how bad it was. Each and every female patient he had commented on his youthful appearance and then proceeded to make a pass at him. "You don't look old enough to be a doctor"; " When you fix me up, we could go out for dinner later."

At the end of this long day of female patients, he finally snapped at a lady- "This is not appropriate behavior- I am your doctor. I am here to help you with your illness."

To which the lady responded with a smile, "I can name several ways you can help me..."

So, what do you do about sexual harrassment from your patients?

The Mask

Had a visit from a frequent flyer, Drama Queen, tonight with her usual hulking boyfriend at her side. This couple always reeks of pot smoke and can barely finish a sentence in 5 minutes. They dress like they just stepped out of a costume store with props and all- no particular theme, just costumed. Triaging her is torture...

I try to be patient but I usually end up saying, "So what brought you here today?" while she rambles on about her "medical history" which with each visit sounds more and more like a TV drama they have recorded and played back just prior to walking into the ER and ends with a request to fill a narcotics script.

Today however, is finally different.

I get to practice my blank face. You know the one- you put it on like a mask while desperately trying not to react to what you have just heard.

Drama Queen tells me she had a pseudo-seizure in a very large department store and her boyfriend had to reach into her mouth and hold her tongue so she wouldn't choke on it. And of course no one would help her. I ask the Hulk how long the pseudo-seizure lasted and he replies 5 minutes.

All I can envision is this large mass of a man, high as a kite on THC, standing in the middle of this store with shoppers and families walking by while he attempts to shove his ham-hock like hand down into her mouth while she faintly swoons to the floor in period dress and he in his pirate get-up. For 5 whole minutes.

So, you're a nurse?

I hate this in the ER. Patients, visitors or family members that identify themselves as nurses but really are not. When you tell me that you are a nurse, it leads me to believe you have received a license to practice nursing either as an RN or LPN. I will speak to you in the medical language that nurses, doctors and medical professionals use. If you appear to be confused, I will ask you about your "nursing" experience.

Case in point:
Patient with chief complaint of urinary problems. Young lady tells me that she has had pressure in her bladder like she needs to pee for 2 days, still able to urinate but only small amounts at frequent intervals. Her mother who is at the bedside is cheerily telling me that her daughter works as a nurse and has not been able to make it in to see her family doctor and this keeps getting worse so she had to catheterize the patient at home.

This is a flag to me to ask more questions. Any time a patient has to catheterize themselves at home, it usually indicates that they have other medical problems.

Me: "So how long have you self-cathing at home?"
Patient: "Um, this is the first time we tried it."
Me: ????? "Okay. What medical supplies were you sent home with for cathing?"
Mother: "Oh, we just used a little drinking straw. You know, like the ones you use to stir coffee? But she didn't have much pee come out."
Me to patient: "Your mother cathed you with a coffee stirrer? What type of nurse are you?" *I couldn't help it, it just came out*
Patient: "Oh, well. I really just help the nurses at the nursing home and I've seen them cath patients and figured this would help the pressure."

Holy sweet cream and donuts! Cathed with a coffee stirrer and by her mother no less!

The fun never ends. I have seen many people tell me that they are a nurse when in reality they are a family member who cares for the patient at home with no medical experience, a nursing assistant, a technician, or even in one case a patient's son's baby momma.

Seriously, I worked hard for this licensure. Quit trying to say you are if you are not. That is all.

Anathema

So, it was inevitable. I was handed the charge phone and the temporary position of charge nurse because and I quote "You have the most seniority tonight". I know the charge nurse scheduled for that night called in sick. Bless her, I hope she feels better. But that leaves one doc, two fairly green nurses and myself who was working a midshift that just extended to an overnight shift to hold down the fort. I have no idea why it is thought acceptable to staff exactly half the number of nurses at night when during the day they have a bounty of nurses. But I digress.

One of my greenies said to me as soon as the dreaded charge phone was placeed into my hands, "No worries, it's going to be a good night." Why didst thou curse me? You are in my boat, too. The shit storm that ensued was truly remarkable.

Now, I was never a superstitious person, until I started working in the ER. I have learned there are some things you do not do: Say the Q word, voluntarily work full moons, say aloud that ___________ (fill in the blank with some dreaded problem) never happens, or even predict the status of the upcoming night.

We had 6 chest pains, count them 6, ha ha ha, chest pains show up. All at the same time, through the front door. Of the 6, 2 were cath lab worthy. One was actively trying to die. And this is on top of all of the rest of the tomfoolery that goes along with working an ER.

I was very happy to see the charge nurse for the next shift arrive.

Naïveté

It's 0300 and the ER was starting to wind down from crazy to steady. We had a new young nurse, Suzy Sunshine, RN, with us who was orienting to the night shift in our busy downtown ER. One of our patients was a woman of the night who was assaulted and was being discharged. She was wearing a tube top, a skirt that barely qualified for the job of a belt, and platform heels. After being told by the physician that she was being released, she was eager to leave. Suzy told her it would be just a moment while she got her discharge papers and the woman stated loudly "Y'all need to hurry it up. I gotta get back out there and make some money!" Suzy got her discharge ready and then returned to the nurses' station and said "Where in the world does she work? It's 3 in the morning? There's nothing open around here right now." Laughter in the department ensued. Poor Suzy- we finally quit laughing long enough to explain what the woman did for a living :)  I'm still chuckling about this... 

Of course, I can't say much. I remember the first time I discovered a frequent flyer patient was just using me to obtain pain meds. Then I had a patient that pulled the patient sticker off her prescription for narcotics and told us all to f* off she had money to make- by selling her newly written script.  You lose a little bit of that eager-to-please spirit.