The Nurseweek article on nurse blogs is out. Thanks to Geena, who posted the link over at Code Blog, and without whom I would've remained ignorant.
We're STAAAAAAHHHHS!
Wednesday, August 31, 2005
*sigh*
Everybody I know in NOLA got out okay, 'cept one friend had to leave her horse stabled about 45 miles north of the city. I woke up this morning to hear an interview with a man whose biggest worry was the three cats he and his wife had to leave behind when they evacuated. *That's* a buzzkill.
*sigh*
My easiest patient yesterday was the one with blood pressure problems, sugars that ranged from 21 (0700) to 538 (1730), a half-inch thick clot the size of the palm of my hand covering her incision line (the order read: "Shampoo patient's hair and remove clot covering incision." Three hours of H2O2 later, I'd gotten an inch square chipped off), a crazy husband, as in paranoid schizophrenic not on meds, and incontinence of bladder and bowels (the order read: "Do not diaper patient." I guess they were worried about skin breakdown?).
Then there was the guy with the leaking scalp incision who kept throwing PVCs on the monitor. For non-medical types, the heart has its own electrical system, independent of the rest of the body. Sometimes the ventricles (the big chambers at the bottom of the heart) will Contract Prematurely, leading to Premature Ventricular Contraction, or PVC. This is a bad thing if it happens more than, oh, eight times in a row. Like the heart will get its electrical signals all flummoxed and, well, have to be shocked.
I showed the EKG tracing to the PA, who was unconcerned. The damn thing looked like a test strip you'd get on the NCLEX, but PA-Man just shrugged and said he was aware of it.
So I parked the code cart outside that patient's door.
Add in two lumbar drains, a post-angiography patient who kept leaking, and Doctor Asshat, who yelled at me for something that I had nothing to do with, and you have a typical day. Oh. I forgot about the 410-pound patient with the shoulder scope who needed pain medicine every hour.
It got bad enough that, as Dr. Asshat revved up in his bitching, I slapped my hand flat on the chart he was writing in, leaned forward, and hissed "I am trying to make your job easier. Do not bitch at me about policies that I did not write."
It's nice to be considered the Go-To Girl when people are having crises. Even when I'm working sick and putting out only about 80% of my usual effort, that's still better than a lot of people's 100%. Really. Still, it's *not* so nice to be such a go-to girl that I end up with six complex patients when other nurses are carrying three. Especially when two of them are Dr. Asshat's and the third belongs to a resident who's unwilling to write the orders necessary to get things done.
Chef Boy asked last night "Again, why are you doing this? Wouldn't you rather be in a lab somewhere?"
Sometimes I would. It's not the patients that get me; it's the doctors.
*sigh*
My easiest patient yesterday was the one with blood pressure problems, sugars that ranged from 21 (0700) to 538 (1730), a half-inch thick clot the size of the palm of my hand covering her incision line (the order read: "Shampoo patient's hair and remove clot covering incision." Three hours of H2O2 later, I'd gotten an inch square chipped off), a crazy husband, as in paranoid schizophrenic not on meds, and incontinence of bladder and bowels (the order read: "Do not diaper patient." I guess they were worried about skin breakdown?).
Then there was the guy with the leaking scalp incision who kept throwing PVCs on the monitor. For non-medical types, the heart has its own electrical system, independent of the rest of the body. Sometimes the ventricles (the big chambers at the bottom of the heart) will Contract Prematurely, leading to Premature Ventricular Contraction, or PVC. This is a bad thing if it happens more than, oh, eight times in a row. Like the heart will get its electrical signals all flummoxed and, well, have to be shocked.
I showed the EKG tracing to the PA, who was unconcerned. The damn thing looked like a test strip you'd get on the NCLEX, but PA-Man just shrugged and said he was aware of it.
So I parked the code cart outside that patient's door.
Add in two lumbar drains, a post-angiography patient who kept leaking, and Doctor Asshat, who yelled at me for something that I had nothing to do with, and you have a typical day. Oh. I forgot about the 410-pound patient with the shoulder scope who needed pain medicine every hour.
It got bad enough that, as Dr. Asshat revved up in his bitching, I slapped my hand flat on the chart he was writing in, leaned forward, and hissed "I am trying to make your job easier. Do not bitch at me about policies that I did not write."
It's nice to be considered the Go-To Girl when people are having crises. Even when I'm working sick and putting out only about 80% of my usual effort, that's still better than a lot of people's 100%. Really. Still, it's *not* so nice to be such a go-to girl that I end up with six complex patients when other nurses are carrying three. Especially when two of them are Dr. Asshat's and the third belongs to a resident who's unwilling to write the orders necessary to get things done.
Chef Boy asked last night "Again, why are you doing this? Wouldn't you rather be in a lab somewhere?"
Sometimes I would. It's not the patients that get me; it's the doctors.
Saturday, August 27, 2005
Overloaded
Check this out:
Incredible cuteness during daylight hours
I would've posted the link to the one that comes from the National Zoo's website, but the traffic is too heavy for their servers to handle.
I have become a certified Panda Cam addict. Just now I'm watching Mama take a nap as Baby stretches and plays with his wee little paddy paws aaaaawww off in a corner skreeeeeek isn't he the CUTEST THING???
*koff*
Sometimes he makes noises like "rrrraaaar" or "urk" or "squeeee" and sometimes he barks. When his mother grooms him you can hear her slurpy tongue and his urks of protest.
Excuse me. I have to go pound my head on the desk now.
Incredible cuteness during daylight hours
I would've posted the link to the one that comes from the National Zoo's website, but the traffic is too heavy for their servers to handle.
I have become a certified Panda Cam addict. Just now I'm watching Mama take a nap as Baby stretches and plays with his wee little paddy paws aaaaawww off in a corner skreeeeeek isn't he the CUTEST THING???
*koff*
Sometimes he makes noises like "rrrraaaar" or "urk" or "squeeee" and sometimes he barks. When his mother grooms him you can hear her slurpy tongue and his urks of protest.
Excuse me. I have to go pound my head on the desk now.
Nightmare
Carrie, the wound care nurse, took me aside before she saw my patient. "You'll need to give her a couple of milligrams of morphine before I change her dressings," she said.
A couple of milligrams of morphine for a patient so light and emaciated I could lift her clear of the bed by myself? I raised an eyebrow and Carrie nodded.
I helped turn the patient, then moved to the other side of the bed so I could take a look at her decubiti while Carrie changed her dressings.
There were four spots where the soft yellowish white of bone showed through. Her buttocks were degloved of skin, as were her upper thighs. She was so thin that we could see the outline of her hip joints through the skin that had long since ceased to hang off her body. When someone is starved long enough, that flaccid look of quick weight loss disappears.
Her nephew, a twitchy guy with a constant sniffle and long sleeves even in August, had been caring for her for five years. According to the other nieces and nephews, he didn't feed her often enough or take care to clean her up more than once a month. I don't remember why she ended up with us, or even what her diagnosis was, but he'd come along with her and spent all of his time in her room, sitting on the couch.
Later that day, after the pain of the dressing changes had worn off, I helped bathe her. And noticed old burns, about the size of a cigar end. And old scars, from God only knows what, on her arms and lower legs. And bruises. Of course, she'd bruise from the slightest touch, but still....
So I called Adult Protective Services. I told them what I'd seen and got transferred to a geriatric nurse case-manager, who'd actually know what I was talking about. She agreed that it was time somebody checked out the living conditions this woman and her nephew had and told me they'd send somebody out in a week, after my patient had been discharged and had headed home.
A month later the patient was back. This time she ended up on a different floor for what was basically in-house hospice care. She died less than twenty-four hours after being admitted. The cause of death on the medical examiner's certificate was listed as heart failure. The examiner noted that the patient was emaciated and that her alimentary canal was completely empty, and postulated that an electrolyte imbalance brought on by dehydration and starvation had stopped her heart.
The APS people were nice enough to contact me a few days later and tell me that they'd found no evidence, on a home visit, of abuse or neglect. The nephew had told them that his aunt was sleeping and was not to be disturbed, so they interviewed him alone.
They told me to contact them if I had any further concerns and gave me a case number. I thanked them, then suggested that they concentrate their efforts on the clients who were still alive.
Her family had known about this for five years. She was in our hospital the first time for two weeks. I was the one who called APS, two days before her discharge.
This is the sort of thing nurses have nightmares about.
A couple of milligrams of morphine for a patient so light and emaciated I could lift her clear of the bed by myself? I raised an eyebrow and Carrie nodded.
I helped turn the patient, then moved to the other side of the bed so I could take a look at her decubiti while Carrie changed her dressings.
There were four spots where the soft yellowish white of bone showed through. Her buttocks were degloved of skin, as were her upper thighs. She was so thin that we could see the outline of her hip joints through the skin that had long since ceased to hang off her body. When someone is starved long enough, that flaccid look of quick weight loss disappears.
Her nephew, a twitchy guy with a constant sniffle and long sleeves even in August, had been caring for her for five years. According to the other nieces and nephews, he didn't feed her often enough or take care to clean her up more than once a month. I don't remember why she ended up with us, or even what her diagnosis was, but he'd come along with her and spent all of his time in her room, sitting on the couch.
Later that day, after the pain of the dressing changes had worn off, I helped bathe her. And noticed old burns, about the size of a cigar end. And old scars, from God only knows what, on her arms and lower legs. And bruises. Of course, she'd bruise from the slightest touch, but still....
So I called Adult Protective Services. I told them what I'd seen and got transferred to a geriatric nurse case-manager, who'd actually know what I was talking about. She agreed that it was time somebody checked out the living conditions this woman and her nephew had and told me they'd send somebody out in a week, after my patient had been discharged and had headed home.
A month later the patient was back. This time she ended up on a different floor for what was basically in-house hospice care. She died less than twenty-four hours after being admitted. The cause of death on the medical examiner's certificate was listed as heart failure. The examiner noted that the patient was emaciated and that her alimentary canal was completely empty, and postulated that an electrolyte imbalance brought on by dehydration and starvation had stopped her heart.
The APS people were nice enough to contact me a few days later and tell me that they'd found no evidence, on a home visit, of abuse or neglect. The nephew had told them that his aunt was sleeping and was not to be disturbed, so they interviewed him alone.
They told me to contact them if I had any further concerns and gave me a case number. I thanked them, then suggested that they concentrate their efforts on the clients who were still alive.
Her family had known about this for five years. She was in our hospital the first time for two weeks. I was the one who called APS, two days before her discharge.
This is the sort of thing nurses have nightmares about.
Friday, August 26, 2005
And the Stepford Award goes to....
Me.
Damn.
I won the monthly Just Doin' My Job, Ma'am award at work this month.
Every month the hospital management picks three Mini-Stepfords and a Maxi-Stepford to honor with gift certificates (Minis) and big honking taxfree checks (Maxi).
I'm one of the Minis this month. Strangely. My pal Carolita, the only other nurse who's worked at an abortion clinic and knows what it's like to have people pull guns on you, said (when somebody told her I'd won the award), "No, really. Where'd she get the balloons?"
My response to being told that I needed to be in the conference room at 1500 to receive the Mini-Step award was short, profane, and angry. Angry because I didn't want to have to farm my patients off on other overloaded nurses on an already-busy day for half an hour, profane because that's how I am ("You're shittin' me, right?"), and short because I had a patient asking for Dilaudid every hour on the hour without fail and it was five to the hour.
I told the manager that nominated me that I would tell the world that the reason I was nominated was because I had dirty pictures of her squirrelled away. You should've seen her face when the director of nursing asked me if I knew why I'd won. Heh.
But really, all I'm doin' is my job. If a patient doesn't get a tray at dinner and his nurse is busy, *anybody* would go and get that person a tray. If another nurse is busy and their patient needs morphine, *anybody* on my floor would help out. We do what needs to be done without regard for whose patients are whose.
Pretty damned sad, ain't it, when you get an award for doing your job.
Damn.
I won the monthly Just Doin' My Job, Ma'am award at work this month.
Every month the hospital management picks three Mini-Stepfords and a Maxi-Stepford to honor with gift certificates (Minis) and big honking taxfree checks (Maxi).
I'm one of the Minis this month. Strangely. My pal Carolita, the only other nurse who's worked at an abortion clinic and knows what it's like to have people pull guns on you, said (when somebody told her I'd won the award), "No, really. Where'd she get the balloons?"
My response to being told that I needed to be in the conference room at 1500 to receive the Mini-Step award was short, profane, and angry. Angry because I didn't want to have to farm my patients off on other overloaded nurses on an already-busy day for half an hour, profane because that's how I am ("You're shittin' me, right?"), and short because I had a patient asking for Dilaudid every hour on the hour without fail and it was five to the hour.
I told the manager that nominated me that I would tell the world that the reason I was nominated was because I had dirty pictures of her squirrelled away. You should've seen her face when the director of nursing asked me if I knew why I'd won. Heh.
But really, all I'm doin' is my job. If a patient doesn't get a tray at dinner and his nurse is busy, *anybody* would go and get that person a tray. If another nurse is busy and their patient needs morphine, *anybody* on my floor would help out. We do what needs to be done without regard for whose patients are whose.
Pretty damned sad, ain't it, when you get an award for doing your job.
Tuesday, August 23, 2005
Wahooooo!
A relatively new person on the blog scene is a NEUROLOGIST!
To paraphrase, "I'm trying to figure out if I'm a neurologist because I'm strange, or if I'm strange because I'm a neurologist."
It doesn't matter, honey. We'll still love you either way.
Information is Free
To paraphrase, "I'm trying to figure out if I'm a neurologist because I'm strange, or if I'm strange because I'm a neurologist."
It doesn't matter, honey. We'll still love you either way.
Information is Free
There ain't nothin' like a DRAAAAIIINNNN....
Sunday afternoon. I thought I'd have a few minutes to chart, having just opened my patient's lumbar drain. It takes thirty minutes to drain ten cc's on her, to I figured I'd just hop down to the station, enter a few orders, and hang out for twenty minutes or so.
Then the call bell rang.
"I have the worst headache ever" said the voice on the other end. "Worst headache ever" is a klaxon to a neuro nurse; it usually means something like a hemorrhage or herniation. And it was my patient who was complaining.
So off I trotted to see what the problem was. I found her sitting up in bed, at about a forty-five degree angle, with her hands pressed to her forehead.
Her lumbar drain was still open.
Now, then. A lumbar drain is a small, flexible, hollow catheter connected to a measuring device and a collection bag. You'd get one if you had a cerebrospinal fluid leak from somewhere in the whole brain/spinal cord complex. Basically, the premise is this: if you have a leak up high, we take some of the fluid off down low, so as to reduce the overall fluid pressure and allow the leak to close up.
Unfortunately, gravity is not your friend with these devices. The patient with a lumbar drain must remain flat and quiet while the drain is open, lest too much CSF drain out and remove the cushion that your brain depends on to stay in place.
My patient had gotten out of bed, walked to the bathroom and peed, then come back and sat up in bed. In ten minutes she'd drained five times what she normally would drain in a half-hour.
It was the first time she'd forgotten about the drain being open and I can guarantee that it'll be the last.
So I closed the drain, flattened out her bed, upped her IV fluids, and handed her the soda on the table. "Drink this," I said, "the caffeine will help." As soon as I had shot her up with some morphine I called the resident to let her know what had happened.
An hour later, when the headache had subsided, the patient asked me why it had been so bad. What could I say?
"Your brain was trying to migrate down into your chest" was the only reasonable way of putting it.
Then the call bell rang.
"I have the worst headache ever" said the voice on the other end. "Worst headache ever" is a klaxon to a neuro nurse; it usually means something like a hemorrhage or herniation. And it was my patient who was complaining.
So off I trotted to see what the problem was. I found her sitting up in bed, at about a forty-five degree angle, with her hands pressed to her forehead.
Her lumbar drain was still open.
Now, then. A lumbar drain is a small, flexible, hollow catheter connected to a measuring device and a collection bag. You'd get one if you had a cerebrospinal fluid leak from somewhere in the whole brain/spinal cord complex. Basically, the premise is this: if you have a leak up high, we take some of the fluid off down low, so as to reduce the overall fluid pressure and allow the leak to close up.
Unfortunately, gravity is not your friend with these devices. The patient with a lumbar drain must remain flat and quiet while the drain is open, lest too much CSF drain out and remove the cushion that your brain depends on to stay in place.
My patient had gotten out of bed, walked to the bathroom and peed, then come back and sat up in bed. In ten minutes she'd drained five times what she normally would drain in a half-hour.
It was the first time she'd forgotten about the drain being open and I can guarantee that it'll be the last.
So I closed the drain, flattened out her bed, upped her IV fluids, and handed her the soda on the table. "Drink this," I said, "the caffeine will help." As soon as I had shot her up with some morphine I called the resident to let her know what had happened.
An hour later, when the headache had subsided, the patient asked me why it had been so bad. What could I say?
"Your brain was trying to migrate down into your chest" was the only reasonable way of putting it.
Monday, August 22, 2005
Links o' the morning!
Several this morning, two of which I'm shamelessly stealing from HypnoKitten:
Eric135
He's a nurse, of course, of course.
March of the Platypi (Last Blog Standing)
Another male nurse, this one in the ER.
Both of these guys have much better stories than I do. *sigh*
Special Sauce
Who has posted here occasionally in the past. Again, much better stories than I have. Dammit. What is it with you people??
Sure Thing, Babs
She's on vacation at the moment. Go back and read the archives anyhow.
And finally, an old favorite, reposted here simply because I laugh out loud every single effing time I read it:
Dogblog
Eric135
He's a nurse, of course, of course.
March of the Platypi (Last Blog Standing)
Another male nurse, this one in the ER.
Both of these guys have much better stories than I do. *sigh*
Special Sauce
Who has posted here occasionally in the past. Again, much better stories than I have. Dammit. What is it with you people??
Sure Thing, Babs
She's on vacation at the moment. Go back and read the archives anyhow.
And finally, an old favorite, reposted here simply because I laugh out loud every single effing time I read it:
Dogblog
Saturday, August 20, 2005
Which reminds me...
In the Tom Swift and Nancy Drew books I've been devouring lately, there're all sorts of references to "trained" nurses. As in, a *trained* nurse puts a chair beside the bed in the hospital for Tom Swift, then smiles at him with her "even, white teeth".
I've got to assume two things from this: that the mention of *training* meant something to people in pre-1950's America, perhaps that "trained nurse" differentiated a person from a sort of "sitter" or "companion", and second, that the state of dentistry and orthodontia must've been so bad that even, white teeth rated a mention of their own.
Goodness. What a sentence.
Or maybe there were packs, nay herds, of untrained nurses darkening the plains of the American west before 1930. The solitary, laconic nurse-herders drove them from the desolate deserts to Chicago, where, with the help of starch and a horsewhip, they were transformed into Trained Nurses.
I kinda like that second theory.
I've got to assume two things from this: that the mention of *training* meant something to people in pre-1950's America, perhaps that "trained nurse" differentiated a person from a sort of "sitter" or "companion", and second, that the state of dentistry and orthodontia must've been so bad that even, white teeth rated a mention of their own.
Goodness. What a sentence.
Or maybe there were packs, nay herds, of untrained nurses darkening the plains of the American west before 1930. The solitary, laconic nurse-herders drove them from the desolate deserts to Chicago, where, with the help of starch and a horsewhip, they were transformed into Trained Nurses.
I kinda like that second theory.
Musings
On Food
You can add anything to eggs. Today it was sausage, tomatoes, pepper cheese, and onion, served with guacamole and fresh tortillas.
Poutine may be the most perfect food ever invented. I wish I could remember the name of the place we went in Montreal (no, it wasn't Frites Alors), but my brain was suffering from too many Cheval Blanc blanche, and I could barely remember anything outside the poutine. I know I was there, though--Magda and Joey have pictures.
On Fashion
It sucks when a cheap and well-reviewed makeup line is sold exclusively at Wal-Mart in the US. Rimmel is supposed to stay put, not smear, be incredibly inexpensive, and not cause breakouts. But I can't shop at Wal-Mart. I just can't.
And how come Old Navy clothing is sized so strangely? I can't wear a 12 in most of their pants and shorts, but a 14 falls off my body as soon as I button the waist. And I wear an eight or ten in their skirts. Whassup with that?
On Fine Literature
I've gotten Chef Boy interested in the original Tom Swift series of books. We read interesting passages to one another out loud and comment on the dialects spoken by the "darkies" (yes, the term is actually used and was acceptable at the time) and the Irish cooks (all named Bridget). Although Tom's a nice guy, in my mind, he still doesn't compare to Frank Merriwell, student leader and officer at Fardale Academy. Why, in two chapters, Frank saved a person from a burning house, then a person from torture, then a sinking ship, then another person from *another* burning house! All this and offensive ethnic characters from such far places as Vermont, too!
All Tom ever does is thrash Andy Foger, the red-haired, squinty-eyed bully, and invent stuff.
In all seriousness, there's a lesson to be learned from comparing such books as the Frank Merriwell series (first published in 1899 or 1900) and Tom Swift (the books I have date from 1910-1911) and the Nancy Drew series of the late 1920's and early 1930's. Nancy Drew books contain all the offensive racial and religious stereotyping of the others, but thankfully skip the offensive gender stereotypes. Even Bess, the wimpy one of the Bess/George/Nancy triad, isn't such a pantywaist as she is in the yellow-backed 1950's rewrites.
On Nursing
I go back to work tomorrow after an unprecedented four days off. I hope I remember where the brain is.
You can add anything to eggs. Today it was sausage, tomatoes, pepper cheese, and onion, served with guacamole and fresh tortillas.
Poutine may be the most perfect food ever invented. I wish I could remember the name of the place we went in Montreal (no, it wasn't Frites Alors), but my brain was suffering from too many Cheval Blanc blanche, and I could barely remember anything outside the poutine. I know I was there, though--Magda and Joey have pictures.
On Fashion
It sucks when a cheap and well-reviewed makeup line is sold exclusively at Wal-Mart in the US. Rimmel is supposed to stay put, not smear, be incredibly inexpensive, and not cause breakouts. But I can't shop at Wal-Mart. I just can't.
And how come Old Navy clothing is sized so strangely? I can't wear a 12 in most of their pants and shorts, but a 14 falls off my body as soon as I button the waist. And I wear an eight or ten in their skirts. Whassup with that?
On Fine Literature
I've gotten Chef Boy interested in the original Tom Swift series of books. We read interesting passages to one another out loud and comment on the dialects spoken by the "darkies" (yes, the term is actually used and was acceptable at the time) and the Irish cooks (all named Bridget). Although Tom's a nice guy, in my mind, he still doesn't compare to Frank Merriwell, student leader and officer at Fardale Academy. Why, in two chapters, Frank saved a person from a burning house, then a person from torture, then a sinking ship, then another person from *another* burning house! All this and offensive ethnic characters from such far places as Vermont, too!
All Tom ever does is thrash Andy Foger, the red-haired, squinty-eyed bully, and invent stuff.
In all seriousness, there's a lesson to be learned from comparing such books as the Frank Merriwell series (first published in 1899 or 1900) and Tom Swift (the books I have date from 1910-1911) and the Nancy Drew series of the late 1920's and early 1930's. Nancy Drew books contain all the offensive racial and religious stereotyping of the others, but thankfully skip the offensive gender stereotypes. Even Bess, the wimpy one of the Bess/George/Nancy triad, isn't such a pantywaist as she is in the yellow-backed 1950's rewrites.
On Nursing
I go back to work tomorrow after an unprecedented four days off. I hope I remember where the brain is.
Thursday, August 18, 2005
What do geckos eat?
I ask this because I found a pink gecko in my bathroom today.
Pink didn't strike me as being the first color choice of your average gecko, so I slapped on the glasses and took a good look at him/her. Little cloverleaf paddy-paws, check. Big bulgy eyes, check. Black-ringed tail, check. Two inches from nose to tip of said tail, check.
But pink?
It seems healthy and active. I'm afraid to catch it, because it looks so delicate. Besides, don't geckos' tails come off if you try to grab them? And couldn't I break a leg or some ribs or something?
So in the bathroom it stays. I'll put a plant in there later to give it some cover from the Evil Cat Who Eats All Small Creatures, and it already has plenty of water. I figure if I can keep it alive for a few more days, it might climb up onto a wall or some flat surface where I can trap it under a glass and then take it outside.
Sure is a cute little guy. I think I saw it flicking around the corner of the cabinet about two weeks ago--at the time, I wasn't sure whether it was a scorpion (unusual this far East, especially three stories up) or a lizard. I'm glad he's a lizard. A pink scorpion would've seriously screwed up my worldview.
Pink didn't strike me as being the first color choice of your average gecko, so I slapped on the glasses and took a good look at him/her. Little cloverleaf paddy-paws, check. Big bulgy eyes, check. Black-ringed tail, check. Two inches from nose to tip of said tail, check.
But pink?
It seems healthy and active. I'm afraid to catch it, because it looks so delicate. Besides, don't geckos' tails come off if you try to grab them? And couldn't I break a leg or some ribs or something?
So in the bathroom it stays. I'll put a plant in there later to give it some cover from the Evil Cat Who Eats All Small Creatures, and it already has plenty of water. I figure if I can keep it alive for a few more days, it might climb up onto a wall or some flat surface where I can trap it under a glass and then take it outside.
Sure is a cute little guy. I think I saw it flicking around the corner of the cabinet about two weeks ago--at the time, I wasn't sure whether it was a scorpion (unusual this far East, especially three stories up) or a lizard. I'm glad he's a lizard. A pink scorpion would've seriously screwed up my worldview.
Wednesday, August 17, 2005
How Half the World Doth Conspire Against Me!*
It was a long week this week. Even though I got an unexpected day off, even though the patients were fairly easy. Only a few seizures, one stat CT, one no-code death.
"I won't take that patient" announced Joe. "She's bleeding. I can't stand the smell of menstrual blood."
"I won't start a Foley on her." said James. "I don't start Foleys on women."
"I don't understand why the charge gave me a fifth patient." said Vincent. "I already had four patients."
Joseph, you don't get to choose. James, I've started Foleys on your female patients for three years straight, now. Vinny, it might be because you're standing around, chatting up the internal med residents, rather than doing your charting. The charge must think you're not busy, if you can yap at blondes in the middle of the morning.
Besides, Vinny, I was carrying six people at that point. Don't bitch.
I don't know if it's PMS, or just me, or some weird concantenation of the moon and the planet Saturn, but I have NOT gotten along with the guys I work with this week. Usually, with the women, it's a short, quick, ugly bitchfest. They start it, I finish it. (I don't do the passive-aggressive thing; it annoys me.) But with the guys I work with, it goes on and on and on and on....
Case in point: I got waved off today because we were overstaffed. Male Charge Nurse says, when he calls me, "Hang around, because I might need you later." (Note: he does this every single time, to every single nurse.)
Me: "No. I am not getting paid to be on call. You either call me in now, or you call me off now. There will be none of this 'Jo, I want you to drive thirty miles through unforgiving traffic to save me from having to take a patient myself.'"
Him: "Well, I can't tell if I'll need you."
Me: "Every other charge nurse can tell. I'm going to turn off my phone and start drinking now. Have a nice day."
Or this, from an online magazine for male nurses: the female respondent to the post points out, quite reasonably, that her brother asks her for help in computer problems....then she gets accused of flaming other posters.
Guys, I love working with you. I'm thankful for your muscle when I need to move a 300-lb patient. I'm proud of your diagnostic skills and thrilled when you're able to get an emotionally traumatized patient to open up. I like having the perspective of men on the floor. I like being able to trade assignments when it turns out that the middle-aged, middle-eastern man I've been assigned to won't allow a woman to examine him. If I can't personhandle a traction setup off the end of a bed, you'll be the first ones I call to unscrew things.
But please. I don't make you bathe the stinky fifty-year-old homeless guys that come in, because I "don't do" stink. I start Foley catheters on men and women both. And I don't chat up the residents. To put it bluntly, I've carried two and three patients when I've charged, and six and seven when I haven't.
Don't make me kill you, boys.
*To be fair, this seems to be a problem only at my facility. The men I work with are whiny, a condition not seen in most male nurses. Which leads me to ask, What UP With That, Dawg?
"I won't take that patient" announced Joe. "She's bleeding. I can't stand the smell of menstrual blood."
"I won't start a Foley on her." said James. "I don't start Foleys on women."
"I don't understand why the charge gave me a fifth patient." said Vincent. "I already had four patients."
Joseph, you don't get to choose. James, I've started Foleys on your female patients for three years straight, now. Vinny, it might be because you're standing around, chatting up the internal med residents, rather than doing your charting. The charge must think you're not busy, if you can yap at blondes in the middle of the morning.
Besides, Vinny, I was carrying six people at that point. Don't bitch.
I don't know if it's PMS, or just me, or some weird concantenation of the moon and the planet Saturn, but I have NOT gotten along with the guys I work with this week. Usually, with the women, it's a short, quick, ugly bitchfest. They start it, I finish it. (I don't do the passive-aggressive thing; it annoys me.) But with the guys I work with, it goes on and on and on and on....
Case in point: I got waved off today because we were overstaffed. Male Charge Nurse says, when he calls me, "Hang around, because I might need you later." (Note: he does this every single time, to every single nurse.)
Me: "No. I am not getting paid to be on call. You either call me in now, or you call me off now. There will be none of this 'Jo, I want you to drive thirty miles through unforgiving traffic to save me from having to take a patient myself.'"
Him: "Well, I can't tell if I'll need you."
Me: "Every other charge nurse can tell. I'm going to turn off my phone and start drinking now. Have a nice day."
Or this, from an online magazine for male nurses: the female respondent to the post points out, quite reasonably, that her brother asks her for help in computer problems....then she gets accused of flaming other posters.
Guys, I love working with you. I'm thankful for your muscle when I need to move a 300-lb patient. I'm proud of your diagnostic skills and thrilled when you're able to get an emotionally traumatized patient to open up. I like having the perspective of men on the floor. I like being able to trade assignments when it turns out that the middle-aged, middle-eastern man I've been assigned to won't allow a woman to examine him. If I can't personhandle a traction setup off the end of a bed, you'll be the first ones I call to unscrew things.
But please. I don't make you bathe the stinky fifty-year-old homeless guys that come in, because I "don't do" stink. I start Foley catheters on men and women both. And I don't chat up the residents. To put it bluntly, I've carried two and three patients when I've charged, and six and seven when I haven't.
Don't make me kill you, boys.
*To be fair, this seems to be a problem only at my facility. The men I work with are whiny, a condition not seen in most male nurses. Which leads me to ask, What UP With That, Dawg?
Sunday, August 14, 2005
So here's a question....
You get up early on Sunday morning and put on a pair of linen pants and a dark blue t-shirt.
You hop in the car and head to the local Schwankola Organic Grocery, where there are dozens of things you've never heard of and some things you're a bit scared of.
You load up the cart with magenta peaches larger than your two fists, monster fruit, apples from New Zealand, raspberries, sesame sticks, coffee, little miniature baguettes, stinky cheeses from the four corners of the earth, some Danish butter you love, and a flaxseed cereal that looks like sawdust but tastes like Heaven.
Then you head past the small island where olives and capers and pickled goods of every sort are kept. You pause briefly, admiring the colors of the vegetables.
A man with a heavy Italian accent and the unlikely name of Henry spots you. He offers you various olives to taste, and a debate starts about the relative merits of dry-salt and brined curing. You walk away with a half-pound of tiny, wrinkled, intensely-flavored black olives and a mouthful of pits from your samples.
What do you do with the pits???
You hop in the car and head to the local Schwankola Organic Grocery, where there are dozens of things you've never heard of and some things you're a bit scared of.
You load up the cart with magenta peaches larger than your two fists, monster fruit, apples from New Zealand, raspberries, sesame sticks, coffee, little miniature baguettes, stinky cheeses from the four corners of the earth, some Danish butter you love, and a flaxseed cereal that looks like sawdust but tastes like Heaven.
Then you head past the small island where olives and capers and pickled goods of every sort are kept. You pause briefly, admiring the colors of the vegetables.
A man with a heavy Italian accent and the unlikely name of Henry spots you. He offers you various olives to taste, and a debate starts about the relative merits of dry-salt and brined curing. You walk away with a half-pound of tiny, wrinkled, intensely-flavored black olives and a mouthful of pits from your samples.
What do you do with the pits???
I think that's enough imagination for one day, thanks.
So, yesterday, I saw "Big Fish" and read "Life of Pi".
In the same day.
Strangely, I don't remember dreaming.
I think I'll do nice, boring things today, like grocery shopping.
In the same day.
Strangely, I don't remember dreaming.
I think I'll do nice, boring things today, like grocery shopping.
Saturday, August 13, 2005
No, Mom, I didn't forget.
I promised Mom I'd post the gazpacho recipe I've hoarded for years, then promptly forgot to do so. Here, then, with no further ado:
Extremely Lazy Gazpacho
Peel four vine-ripened tomatoes. Toss them into a blender.
Blend until relatively smooth.
Chop up one or two peeled and seeded cucumbers (depending on size), a red bell pepper, and a clove of garlic. Add some red onion if you'd like.
Salt and pepper the vegetables well. Pour the tomato puree over them.
(I'm assuming that you'll put them in a bowl, not just dump liquid tomatoes all over the counter.)
Add olive oil, balsamic vinegar, lime juice, and dried thyme or fresh basil to taste.
This will keep for three days, no more, in a Tupper in the fridge.
Further Catch-Up
I've discovered what's wrong with the healthcare industry, at least in part. We have two prn (as-needed) nurses working for us right now. Both have regular jobs as long-term travelling nurses. They both get paid about twenty-three bucks an hour to work with us--that's our going rate.
James makes $45 an hour as a traveller, plus he gets a $1400 monthly housing allowance, tax-free. His company matches his retirement contribution up to ten percent of his paycheck.
Cathy makes $55 an hour, no housing allowance, as a traveller. Her insurance is completely paid for and covers both her and her husband. Her prescription benefit is ten bucks for generics, fifteen for brand-name drugs.
Both of them have worked at the *same hospitals* for the last eighteen months as travel nurses. In other words, the hospitals have been paying God-Only-Knows how much to the agencies that employ James and Cathy to have them work there, rather than expending the time and energy necessary to find their own, permanent, slightly cheaper nurses.
If it didn't mean working for a hospital that had its head up its ass, I'd be a traveller in a second. Well, that and strike-breaking. I don't like the idea of scabbing.
Girly Product Reviews
Been a while since I've done this, and I have four new things that will never leave my medicine cabinet.
Giovanni Cosmetics Wham Jam in Mint. Also sold under the name Whammo! Mint:
It comes in a six-ounce jar, has the consistency of Dippity-Do, and smells of mint. Strongly. You can use it as a shampoo and soap, to shave with, as a foot soak, whatever you'd normally use soap or shampoo for. It's wonderful stuff.
Unlike most multi-purpose soaps, it doesn't leave weird sticky goo all over your hair or body. It's not drying, and it's not as intense as undiluted Dr. Bronner's.
Neutrogena Instant Nail Enhancer
Eeeh. Whatever. It's nice, I guess, for when you're not working, as it tends to fade away after three or four handwashings. The pros are these: it really does dry instantly, it's not nail polish but it leaves your nails looking buffed and pretty, and it doesn't require chemicals to remove.
Just don't put it on too thick or you'll end up with weird booger-like things where it wears off.
ProLinc Cuticle Away Cuticle Remover
This is the strontium-90 of cuticle removers. If you have nasty cuticles from overexposure to chlorhexidine scrubs, this is the stuff for you. One caveat: follow the instructions to the letter, or it'll eat your nails right off. But you do, if you follow the instructions, end up with nicely manicured hands. It even makes Chef Boy's hands look good after a week of cooking and working on his car.
Neutrogena Deep Clean Face Cloths
Supposedly you can control the amount of exfoliation you get with these suckers, but I've not discovered how, yet.
The little washcloths come in a plastic box, thirty to a box, which seems to me to be an excessive amount of packaging. You could, however, use the box later to make a mini-first-aid kit or to carry a salad to work.
One side of the cloth is excellent for removing major facial landscape markers like your nose or lips. The other doesn't do much. They're impregnated with Deep Clean, a salicylic-acid cleanser that foams when you wet the cloth.
I'm using them to scrub my hands and feet and finding them fine for the purpose. I probably couldn't use them daily on my face without ending up like the Terrible Trivium from The Phantom Tollbooth: no face at all.
Mrs. Malaprop In The HOUSE!!
Three things from yesterday:
A nurse who wrote report on one of my patients jotted down that the patient had a "double loomin" subclavian line.
Another nurse, giving me verbal report on a patient, mentioned that the patient was in for an "exasperation" of multiple sclerosis.
A third nurse showed the deepest recesses of her psyche by saying that a MUGA scan was meant to show the "ejaculation fraction" of the heart.
Of course, I was the one who walked into a patient's room with a syringe of morphine in hand and cheerfully announced, "Here's your marijuana!"
Extremely Lazy Gazpacho
Peel four vine-ripened tomatoes. Toss them into a blender.
Blend until relatively smooth.
Chop up one or two peeled and seeded cucumbers (depending on size), a red bell pepper, and a clove of garlic. Add some red onion if you'd like.
Salt and pepper the vegetables well. Pour the tomato puree over them.
(I'm assuming that you'll put them in a bowl, not just dump liquid tomatoes all over the counter.)
Add olive oil, balsamic vinegar, lime juice, and dried thyme or fresh basil to taste.
This will keep for three days, no more, in a Tupper in the fridge.
Further Catch-Up
I've discovered what's wrong with the healthcare industry, at least in part. We have two prn (as-needed) nurses working for us right now. Both have regular jobs as long-term travelling nurses. They both get paid about twenty-three bucks an hour to work with us--that's our going rate.
James makes $45 an hour as a traveller, plus he gets a $1400 monthly housing allowance, tax-free. His company matches his retirement contribution up to ten percent of his paycheck.
Cathy makes $55 an hour, no housing allowance, as a traveller. Her insurance is completely paid for and covers both her and her husband. Her prescription benefit is ten bucks for generics, fifteen for brand-name drugs.
Both of them have worked at the *same hospitals* for the last eighteen months as travel nurses. In other words, the hospitals have been paying God-Only-Knows how much to the agencies that employ James and Cathy to have them work there, rather than expending the time and energy necessary to find their own, permanent, slightly cheaper nurses.
If it didn't mean working for a hospital that had its head up its ass, I'd be a traveller in a second. Well, that and strike-breaking. I don't like the idea of scabbing.
Girly Product Reviews
Been a while since I've done this, and I have four new things that will never leave my medicine cabinet.
Giovanni Cosmetics Wham Jam in Mint. Also sold under the name Whammo! Mint:
It comes in a six-ounce jar, has the consistency of Dippity-Do, and smells of mint. Strongly. You can use it as a shampoo and soap, to shave with, as a foot soak, whatever you'd normally use soap or shampoo for. It's wonderful stuff.
Unlike most multi-purpose soaps, it doesn't leave weird sticky goo all over your hair or body. It's not drying, and it's not as intense as undiluted Dr. Bronner's.
Neutrogena Instant Nail Enhancer
Eeeh. Whatever. It's nice, I guess, for when you're not working, as it tends to fade away after three or four handwashings. The pros are these: it really does dry instantly, it's not nail polish but it leaves your nails looking buffed and pretty, and it doesn't require chemicals to remove.
Just don't put it on too thick or you'll end up with weird booger-like things where it wears off.
ProLinc Cuticle Away Cuticle Remover
This is the strontium-90 of cuticle removers. If you have nasty cuticles from overexposure to chlorhexidine scrubs, this is the stuff for you. One caveat: follow the instructions to the letter, or it'll eat your nails right off. But you do, if you follow the instructions, end up with nicely manicured hands. It even makes Chef Boy's hands look good after a week of cooking and working on his car.
Neutrogena Deep Clean Face Cloths
Supposedly you can control the amount of exfoliation you get with these suckers, but I've not discovered how, yet.
The little washcloths come in a plastic box, thirty to a box, which seems to me to be an excessive amount of packaging. You could, however, use the box later to make a mini-first-aid kit or to carry a salad to work.
One side of the cloth is excellent for removing major facial landscape markers like your nose or lips. The other doesn't do much. They're impregnated with Deep Clean, a salicylic-acid cleanser that foams when you wet the cloth.
I'm using them to scrub my hands and feet and finding them fine for the purpose. I probably couldn't use them daily on my face without ending up like the Terrible Trivium from The Phantom Tollbooth: no face at all.
Mrs. Malaprop In The HOUSE!!
Three things from yesterday:
A nurse who wrote report on one of my patients jotted down that the patient had a "double loomin" subclavian line.
Another nurse, giving me verbal report on a patient, mentioned that the patient was in for an "exasperation" of multiple sclerosis.
A third nurse showed the deepest recesses of her psyche by saying that a MUGA scan was meant to show the "ejaculation fraction" of the heart.
Of course, I was the one who walked into a patient's room with a syringe of morphine in hand and cheerfully announced, "Here's your marijuana!"
Thursday, August 04, 2005
Who thinks this shit up, anyway?
No, this is--for once--not about management.
It's about those damned catalogs. You know the ones I mean: they sell cute, springy, witty scrubs and adorable dingle-dangles from which to hang your name tag, and lanyards with the Cause Du Jour printed on them, and so on.
Let me tell you what I do not need. I do not need microfiber scrubs with the look and feel of silk, especially not when they're leopard-print or tiger-striped. Unless there's some branch of nursing that involves no contact whatsoever with bodily fluids, and in which tacky is a good thing, *nobody* needs those.
I do not need genuine gemstone pins that remind me to allow miracles, keep hope alive, live strong, that I'm "special" (yeah, short-bus speshul), that we're all supporting a cure, or that I've parked my car on the third level in section C. Actually, come to think of it, that last might be useful.
I do not need cute plush animals to hang from my stethoscope and hold my name badge. That's just a bad idea all 'round.
I do not need totebags that tell others that I heart nursing, that nurses rock, that nursing is my bag, or that nurses care. I don't, we do occasionally, it's not, and we frankly could, but less.
I do not need shoes that have "just a little bit" of heel. Especially not when they're clog-style with a backstrap. I am here to keep my patients alive, not look fashionable and catch a doctor. Or look fashionable and turn an ankle, which is much more likely to happen.
Needless to say, I do not need anything with kittens or puppies on it. Take it away.
Nor do I need hipster, flare-leg, or capri (!!!)-cut scrub pants.
I don't need a "genuine acrylic" (huh?) stethoscope with a magnified smiley-face under the head. I don't get how those things are supposed to work. They'd make good weapons.
Dora the Explorer, Sponge Bob, and Scooby scrubs are not for me. I understand that those in Pediatrics might find a use for 'em, but is the ratio of Peds nurses so large that we really need four pages of the damned things?
Nor are seasonally-themed prints. Again, some folks like 'em. I'll keep my sushi-print tops, thanks.
I'll tell you what I *DO* need, kiddies: Decent shoes that don't cost $200 a pop and actually fit my crippled, bunioned Size Nines. Scrubs that I can wash on boil and dry on broil without having the elastic shrink on the pants so that I'm cut in half. I need jackets without knit cuffs--ones that end just at the hip and swing freely, so that they look a bit more like a blazer and less like a lump of dough. I need another stethoscope and a fifty-percent discount on the Hickey neuroscience text.
And a massage and a pedicure and maybe a personal trainer. If you can find me a nursing catalog that offers those, I'm in.
It's about those damned catalogs. You know the ones I mean: they sell cute, springy, witty scrubs and adorable dingle-dangles from which to hang your name tag, and lanyards with the Cause Du Jour printed on them, and so on.
Let me tell you what I do not need. I do not need microfiber scrubs with the look and feel of silk, especially not when they're leopard-print or tiger-striped. Unless there's some branch of nursing that involves no contact whatsoever with bodily fluids, and in which tacky is a good thing, *nobody* needs those.
I do not need genuine gemstone pins that remind me to allow miracles, keep hope alive, live strong, that I'm "special" (yeah, short-bus speshul), that we're all supporting a cure, or that I've parked my car on the third level in section C. Actually, come to think of it, that last might be useful.
I do not need cute plush animals to hang from my stethoscope and hold my name badge. That's just a bad idea all 'round.
I do not need totebags that tell others that I heart nursing, that nurses rock, that nursing is my bag, or that nurses care. I don't, we do occasionally, it's not, and we frankly could, but less.
I do not need shoes that have "just a little bit" of heel. Especially not when they're clog-style with a backstrap. I am here to keep my patients alive, not look fashionable and catch a doctor. Or look fashionable and turn an ankle, which is much more likely to happen.
Needless to say, I do not need anything with kittens or puppies on it. Take it away.
Nor do I need hipster, flare-leg, or capri (!!!)-cut scrub pants.
I don't need a "genuine acrylic" (huh?) stethoscope with a magnified smiley-face under the head. I don't get how those things are supposed to work. They'd make good weapons.
Dora the Explorer, Sponge Bob, and Scooby scrubs are not for me. I understand that those in Pediatrics might find a use for 'em, but is the ratio of Peds nurses so large that we really need four pages of the damned things?
Nor are seasonally-themed prints. Again, some folks like 'em. I'll keep my sushi-print tops, thanks.
I'll tell you what I *DO* need, kiddies: Decent shoes that don't cost $200 a pop and actually fit my crippled, bunioned Size Nines. Scrubs that I can wash on boil and dry on broil without having the elastic shrink on the pants so that I'm cut in half. I need jackets without knit cuffs--ones that end just at the hip and swing freely, so that they look a bit more like a blazer and less like a lump of dough. I need another stethoscope and a fifty-percent discount on the Hickey neuroscience text.
And a massage and a pedicure and maybe a personal trainer. If you can find me a nursing catalog that offers those, I'm in.
Monday, August 01, 2005
"Great Scott!" I cried, springing from my chair
...."I've been reading too much Conan Doyle!"
Holmes, released from his burden of inactivity at last, turned his gleaming eyes upon me. I could see the subtle signs of excitement that, to a casual observer, might appear inconsequential. "Calm yourself, Jo," he replied, "It is a certainty that, after such a trial as you yourself endured last night, you would overindulge in the flowery prose of such an author. However, now is the time to action! The game is afoot!"
Grasping my revolver, I hurried to the door in Holmes' wake. My eyes lit upon the bed that Mrs. Hudson had made up in his absence.
"If you don't mind, Holmes, I'll just lie down here and have a little toes-up."
Holmes, released from his burden of inactivity at last, turned his gleaming eyes upon me. I could see the subtle signs of excitement that, to a casual observer, might appear inconsequential. "Calm yourself, Jo," he replied, "It is a certainty that, after such a trial as you yourself endured last night, you would overindulge in the flowery prose of such an author. However, now is the time to action! The game is afoot!"
Grasping my revolver, I hurried to the door in Holmes' wake. My eyes lit upon the bed that Mrs. Hudson had made up in his absence.
"If you don't mind, Holmes, I'll just lie down here and have a little toes-up."
Isn't it ironic, don't'cha think?
The neuroscience nurse got what was probably only the second migraine of her life last night.
I think I might've had one about three, or maybe ten, years ago. I actually called Beloved Sister, who gets them fairly frequently, to describe the symptoms and make sure I wasn't overreacting.
Though it's hard to overreact when your head feels like one half of it might just pop off at any moment.
What an interesting sensation that is. The trouble with knowing about things like headaches is that you tend to catalog what's going on in your body and your reactions to things as you're lying there hoping that maybe you'll die. It's a fun hobby, but not one I want to practice more often.
Now I'm feeling very logy. I think that's from the two Dramamine tablets I took in desperation, trying to kill the nausea and get to sleep. There's not a headache any more; rather, there's the sensation that a headache will start at any moment. And my head feels like a large porcelain bowling ball balanced on the end of my neck. And colors are very bright, still.
Hildegarde von Bingen was lucky. At least *she* got heavenly visions and snatches of music with *her* migraines. All I got was this lousy post.
I think I might've had one about three, or maybe ten, years ago. I actually called Beloved Sister, who gets them fairly frequently, to describe the symptoms and make sure I wasn't overreacting.
Though it's hard to overreact when your head feels like one half of it might just pop off at any moment.
What an interesting sensation that is. The trouble with knowing about things like headaches is that you tend to catalog what's going on in your body and your reactions to things as you're lying there hoping that maybe you'll die. It's a fun hobby, but not one I want to practice more often.
Now I'm feeling very logy. I think that's from the two Dramamine tablets I took in desperation, trying to kill the nausea and get to sleep. There's not a headache any more; rather, there's the sensation that a headache will start at any moment. And my head feels like a large porcelain bowling ball balanced on the end of my neck. And colors are very bright, still.
Hildegarde von Bingen was lucky. At least *she* got heavenly visions and snatches of music with *her* migraines. All I got was this lousy post.