Tuesday, March 23, 2010

That was just plain weird.

"Get me eight ounces of whole milk. Not skim, not two-percent, but whole milk" the doctor said.

"Okay" I replied, thinking he was running low on calcium.

He gave the milk to the patient to drink, then told me to time out exactly ten minutes. So I did.

Then he went in, interrogated the patient as to whether he'd drunk the milk, interrogated me as to whether it had been exactly ten minutes, and pulled the patient's chest tube.

I have never heard of this before. Whole milk prior to pulling a chest tube? Huh? Does anybody have any clue?

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The flight RN was, as most flight RNs are, long and lean and rather weathered.

"You'll like this one" she told me, with a grin. "She's ninety years old and sharp as a tack. No health problems, no history, no meds at all. Had four kids at home and has never been in the hospital."

"Wow" I said. "That's pretty amazing. Did you guys have any trouble on the flight up?"

"Nope," she said, "Once we let her into the cockpit so she could see how a plane actually flies, everything was very quiet."

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The animal therapy folks came by last night. Normally we don't let Rottweilers in to the ICU, but everybody who's immunocompromised has gone somewhere else, and we have a couple of patients who really need therapy starting NOW.

Rosie the Rottweiler is enormous, calm, kind of drooly, and a leaner. She leeeeaaaans into you in order to get her ears scratched. This is normally not a problem for me, except Rosie weighs more than I used to (somewhere north of 180 lbs) and is persistent.

It's very difficult to give a five a.m. report to a doctor--especially an attending who has a history of being hard to work with--when a nearly-two-hundred-pound dog is leeeeaaaaning on your legs and asking, through subterranean mutterings, to be scratched.

Yes, I work in a children's book.

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Out of the blue came the request: would I be willing to rework Fashion And Beauty Tips For Nurses for wider publication? Never one to turn down a chance at self-aggrandizement, I immediately said yes.

The article should be published shortly in ScrubsMag. They have a website, scrubsmag.com, which is quite informative and rather a lot of fun. It's like Vogue for nurses.

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Max recently saw the "F*CK YOU; I'M AN ANTEATER" Interweb meme and has decided to try to imitate it. I keep reminding him that he's not an anteater, but he won't listen.

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A not-natural-night-person I work with gave me some excellent tips on working nights that I'd like to pass on, as they've helped me regain what little sanity I had.

1. If you have more than two days off, flip the middle days so you're awake when it's light.

2. Spend as much time as possible outside during those days.

3. The day before you go back, take a long nap in the afternoon. Then go to bed early, but set your alarm for midnight or one a.m. Stay up until your regular time, then sleep.

4. Work all your nights in a row if you can possibly manage it. Yes, the third or fourth night sucks, but then you have three or four days off.

5. Do not attempt to flip for a single day, or even two days. That trick (and I quote) never works.

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There is a Scottish Festival coming up in June in Arlington, which is quite a drive from here, but which may be worth it. There's something about piping. And men in skirts.

Seriously: How badass is this? The British took pipes and drums with them into the Falklands.

And Ghurkas. Pipes and drums and Ghurka regiments are, if you know your military history (thanks, Dad!), the most terrifying combination ever.


Jilly said...

It has been a while since I have worked in surgical, but I have a vague memore of patients being given full fat milk to check if they have a chyle leak post-oesophagectomy. We used to routinely give them methyl blue mixed with water prior to chest drain removal to again check for leaks.
Love your blog!

Anonymous said...

re: the chest tube...did the patient have (or was he suspected to have) a chylous effusion? I think whole milk intake would then provoke chyle output from chest tube. (but in 10 min? hmmm). or the doctor was just weird.

Albinoblackbear said...

Chest tube removal plus milk? Huh?

I guess I am more used to seeing them go in than come out but, nay, I have NEVER heard of the two together.

And I totally agree about grouping nights together. The last 2 years when I was working as a travel nurse I *only* did nights so I could avoid the ridiculous turnarounds they expected.

Plus people are always happy when some sucker agrees to do all nights. ;)

Enfermero said...

Milk- it does the body good! *scratches head*

Anonymous said...

Whole milk - The doc may have been checking for chylothorax. It's leaking of lymphatic fluid, and a high fat diet makes it worse. Did the chest tube output look milky?

bobbie said...

I've never heard of the 'milk' trick! Could you contact the Doc and get us an explanation???
Congrats!! on the writing gig!

Abilene Rob said...

Congratulations on having more writing hit the big time. You're awesome.

(My vote is "doctor responding to the very particular wishes of an OCD patient who grew up on a dairy farm.")

Abilene Rob said...

Oh, and you're right that Ghurkas are seriously rad guys.

messymimi said...

Nurses are amazing people, and not appreciated enough. That is especially true for night nurses.

Jo said...

AR: I have a book to lend you on the Ghurkas. One of the stories involves a Ghurka who was imprisoned in China and made his way back to India over a period of two years. His commanding officer asked how on earth he did it, only to be told by the Ghurka, "I had a map, Sir."

It was a map of the London Underground.

Tara said...

I've never heard of using whole milk either.

Penny Mitchell said...

Approximately 25 years ago I was walking through the mall with a friend. I had hiccups blast in out of nowhere, as they are wont to do with me. I get VIOLENT hiccups. They totally trash my vocal folds. Not good.

He said, "I can cure this." He had me sit on a bench. He said, "You need to extend your feet out exact 20 inches." Not having a tape measure handy, he futzed around for a minute or so until he decided he was eyeballing 20 inches exactly right. "Now point your left foot straight out, and your right foot at 45* to it. Have them both pointing right here," he said, as he pointed to a spot on the floor. This was way easier said than done. "No, not there...here. Angle your right heel out some more."

You can see where this is going, I'm sure.

After about four minutes of focusing completely on this inane jackassery, my hiccups were gone. The thing that pisses me off the most is that this will never work on me again. My vocal folds are even more pissed than my brain.

This Magical Hiccup Cure is the FIRST thing that came to mind when reading about the whole milk.