PS: You're a moron.

Part I

Dr X: "Why hasn't the Argle-Bargle T380A test been run on my patient yet?"

Nurse Jo: "Because it's a timed test that has to be done by the lab. It can't be drawn through a central line."

Dr. X: "Why haven't you drawn it yet?"

NJ: "Because...it's...timed. As in, it shouldn't be drawn until a...specific time."

Dr. X, growing upset: "But you could draw it right now! Out of the central line!"

NJ: "No. I can't. It can't be drawn through a central line. The heparin lock we use will screw up the test results, and besides, it's a timed test. It's not due to be drawn until 1630."

Dr. X: (incoherent ranting about incompetence of nursing staff.)

NJ: (finds herself on the opposite end of the hall, unsure of how that bruise got on her forehead. Oh, wait. It was Head-Meet-Wall again.)

Part II

Dr. Y: "Why did you change my patient from calcium gluconate to a calcium citrate and magnesium supplement?"

Nurse Jo: "Because that's our protocol for people who have had gastric bypass surgery."

Dr. Y: "But this patient didn't have a gastric bypass! She had a parathyroidectomy!"

Nurse Jo: "Yes, I know. However, the patient's history shows that she had a bypass six years ago, and her blood calcium levels have been low enough to warrant IV repletion. Therefore, according to protocol, we changed her over to citrate and mag, and her calcium levels have come up."

Dr. Y: "Are you a doctor? I didn't write that order!"

NJ: "It's the standard hospital nutritional protocol for patients who have had bypass surgery. Here it is on the computer (clicks twice)."

Dr. Y: "I didn't write that order! You had no right to change that patient's medication!"

NJ: "Her calcium has been stable at 9.2 for three days, after being between 2 and 3.5 for the proceeding week. Is there a problem?"

Part III

Dr. Z: "Why didn't you replete this patient's magnesium and transfuse blood?"

Nurse Jo, looking worried: "Because I didn't see an order for it."

Dr. Z: "Her hemoglobin is ten! TEN!! Why didn't you transfuse her??"

NJ: "Um... ... ...because her hemoglobin is ten. And has been ten for the last four days. And her magnesium is 2.0 and has been for the last four days."

Dr. Z: "But I always transfuse patients with a hemoglobin less than twelve!"

NJ, taking chart in hand: "See this preprinted sheet? You filled out this preprinted sheet. It says right here that if hemoglobin is less than nine or crit is less than 25, we transfuse. It says we replete magnesium for mag levels of less than 1.7. Her crit and hemoglobin and mag have all been above those levels for four. days."

Dr. Z: "But that's not how I do it!"

NJ: Considers banging head on desk, then decides that the bruise that's already there is enough, and wonders why on EARTH the new docs in rotation aren't briefed on our protocols.

Live, from the dusty plains of Central Texas, it's Head Nurse!

I had no idea my eyes slant downward like that.

Product Reviews: This Shit? Right Here? Is The Bomb. Edition.

This product review is brought to you by Sierra Nevada Torpedo Extra IPA. It's a good, solid, tasty IPA without too much bitterness. 

Product Review: This Shit? Right Here? Is The Bomb.

I read a review on Beauty Wonkette of diptyque's Huiles Precieuses (that's Precious Oils for you non-Francophones) that was positively pornographic and decided I had to try the stuff for myself. After all, I reasoned, I'd just broken up with my boyfriend; what better time to try a body oil that inspired one-handed typing on the part of the reviewer?

People, take note: I bought both the body wash (more on that in a second) and the body oil, and I have to say: Even Though It Cost Me As Much As Two Weeks' Worth Of Groceries, Both Are Worth Every Penny.

The body oil comes in a small glass bottle with its own eyedropper. That, I think, is so that you don't immediately compare the size of the bottle with the price that you paid for it and foam at the mouth. The benefit of the eyedropper becomes apparent once you start using the stuff--two drops of this oil will not only moisturize both of your arms (it absorbs insanely quickly) but will send you into herbal-scented reveries and make you forget where you are.

I'm not kidding. I got out of the shower after using the body wash and put the body oil on and was shocked to find myself still in my small bathroom with the vaguely grotty bathmat and cat hair everywhere.

It smells like...well, it's hard to describe. It's sweet, like irises. It's also spicy with sandalwood and vaguely musky, and there's a sharp note that I think might come from rosemary or rue. Once it's been on your skin for a few minutes, it smells powdery and flowery, but there's still that deep bass note of wood and musk that warns passers-by that this is some Serious Shit Goin' On. A little goes a long, long way.

Plus, you know, it absorbs fast and moisturizes. I even put some on my hair.

Now, as to the shower gel: you know those little shops in Paris or Montreal or Chicago that are full of herbs and fresh fruit? The ones where a little wizened granny presides over glass jars full of God-knows-what, and the smell of the place stays on your skin, but in a good way, for hours? Mix that with the smell of yarrow and dried cattails and my paternal grandmother's house and you have the body wash. It's complex, but it's not overbearing. 

And, again, a little goes a long way. I used, no shit, about a quarter teaspoon of the stuff on a maguey-leaf washcloth and had plenty of suds left over. The whole time I was washing the citronella and grass clippings and sweat off my skin, I was laughing. It smelled that good, and it left me that clean, but without being dried-out and itchy.

The body oil is $78 for 4.25 ounces. The body wash is $46 for just short of 7 ounces. Believe me when I say that these, given how little you have to use to get what you want, are actually a really good value. I can see the body wash lasting longer than my super-duper-sized bottles of store-brand Dove. I mean, seriously: the body wash has a top on it that allows you to dispense four microns of the stuff at a time, and that's about all you need. I used less than nine drops of the body oil *all over*, including my hair.

Still, I plan to save these both for very special occasions. Men of Texas, be warned: my shower routine is no longer taking prisoners.

Fuck passion.

Oh, for cryin' out loud.

Some well-meaning person told me yesterday, after I excoriated him for using a toothbrush on an incision, that I must have a real passion for my work.

No. I do not have a passion for my work. I have a commitment to it, and a love for it, and I felt like a fish finally in water for the first time in my finny life when I got to nursing school, but I do not. Have. A passion. For nursing. I have a deep, consuming dislike of people who scrub incision lines with toothbrushes, though.*

I certainly do not have a passion for people who use the word "passion" as a positive term.

"Passion" is like "artistic". People who are artistic tend not to show up for work on time. They tend to be a little ADD. They tend to freak out and need a certain level of excitement in their lives that normal people can't tolerate. In short, they're drama queens. "Passionate" people are the same way: try to live a normal life with one of 'em and you'll find yourself on the receiving end of invented crises and tearful midnight phone calls as they attempt to keep things off-balance enough to make themselves happy.

A patient's wife told me the other day, as I was tranferring him to the ICU with a raging case of bacterial meningitis, that he had ignored two cerebrospinal fluid leaks following surgery because, you know, he's an artist. He has a mind above such things, don't'cha know. He had apparently ignored the clear, yellowish fluid running out of his nose in favor of demolishing old car parts, or whatever the hell it is he does for art, until the headache and nuchal rigidity got to be so bad that he couldn't stand up. The pus leaking from his incision should've been the first clue, but oh, you know these artistic, passionate people--he felt he simply had to finish chopsawing that radiator to get his Vision out into the world.

My ex-husband told me, after he and my best friend had started screwing like rabbits, that he'd done it because he missed the Passion in our Relationship. Uh...dude. Passion, with a few exceptions, does not last for fifteen damn years. If you're lucky, you can build a good, strong, solid, deep-rooted something that outlasts passion and over-reaches it. You were not lucky. You were, in fact, a drama queen asshole, which is pretty much what I told him after I finished laughing. 

See? Passion bad. Workhorse good. Boredom positive. Excitement debatable. Butterflies early, good; butterflies late, a sign of needing to up your Xanax.

I am sick and tired of artists and passionate people. Give me a good, strong, not-too-brilliant workhorse of a surgeon any day rather than the passionate, artistic guy with a gift who tells patients to shut up when he's talking and is prone to fits of the sulks. Give me the uninspired, hardworking nurse who shows up on time, doesn't miss details, and gives a decent report rather than the one who feels drawn by some Higher Shiny Cosmic Power to the field. The ones who are so very drawn to this marvelous, wonderful, fulfilling thing are the same ones who either end up in management, fucking things up for the rest of us, or who go back to accounting or truck-driving or whatever it was that they could actually pay attention to and be good at.

Give me a nice, good, workhorse of a boyfriend, while you're at it. I don't care if he bradys down into the 50's when he's relaxed; it'd be a nice change from constant tachycardia. If he spends days silent, punctuated by the occasional grunt, so much the better. Keep your Jack Russell terriers and your people in search of something all-consuming; I want somebody dull and reliable and not prone to causing crises for the sake of excitement.

Which is why I love my dog. Max is passionate about one thing only: bully sticks. Even then, he won't bite my fingers taking one from me, or stay out in the yard with one when it's raining. He's my new benchmark for sensible behavior.

*And while I'm bitching, what is it with you people scrubbing your incision lines with a damn toothbrush? Doesn't common sense tell you that that is a bad idea of the first order? Don't you think about things before you do them? What posessed you to...oh, wait. I'm getting back into excoriation mode. Sorry.

A correction

My Brother In Beer* has informed me that I'm a dope. 

He put it much more nicely than that, but in response to my post about Boulevard's pale ale not being what I really wanted, he basically said, "You dope, Belgian-y is what we *do*, duh."

So, I take it all back. If you want a well-balanced, not-for-the-hophead PA, go for Boulevard's Double-Wide. It'll get you where you need to go.

If you're still a hophead, try Brooklyn Brewery's East India Pale Ale. That, too, will work fine.

*Dear man, I love you like I love my own gallbladder, but your hair is cut much, much too short. You look like a Midwesterner.

In Which Jo Goes to the Opthamologist and Gets All Steampunk On Your Ass....

...and reviews a beer. A really mediocre beer. A sex-in-a-canoe beer. In a word, Dundee: Avoid.

*** *** *** *** ***

So I went to the eye doc today. This is a fraught event for many reasons, least of which being that, when my eyes get dilated, they *stay* dilated for 24 hours or more. I was dreading the dilation and the feeling of being totally bat-blind while in public and then of having no close vision while at work in the morning. (And no, I don't know why my eyes stay dilated. I stayed stoned for 72 hours the only time I tried smoking weed, and I can't tolerate narcotics. Must be something inside.)

Technology, thankfully, has caught up with us bat-blind people. My doc has this new thing called an OPTO-MAP (ACQUIRING TARGET: RANGING: HIYA BABY) that requires no dilation to read a 200-degree map of your retina. It takes about thirty seconds and totally rocks out: there's a bright green light that blinds you for a brief moment, and then look! it's your photogenic retinas on the computer screen!

I must say that I have very cute retinas. My optic nerve is darling, as well.

Anyway. The ratio of my optic disc to optic nerve is five-point-nine when it ought to be five or less, but it's the same in both eyes and hasn't changed lately, so I've not got glaucoma. Yet. Likewise, my vessels aren't tortuous, and that little freckle in my left eye disappears with different color screens, so it's not melanoma. I was absolutely certain that missing an eye appointment last year would land me in the "horrible incurable eye disease we'd better just take that out right now hold still" camp, so this is good news.

However, my eyes are still bad. As in, really bad.

As in, the lenses for my new glasses (which I have not replaced in a decade at least) cost somewhere north of shocking and somewhere south of a mortgage payment.

It's bad news when the therapeutic optometrist who's in charge of fitting you with glasses ixnays all your choices for frames on the grounds that they would be too large. Not because you would look matronly, but because your vision would be impaired with the type of lenses you need.

So I have itty-bitty constipated librarian glasses with a mustard-yellow and turtle-green Pucci print on the frames, and horrifyingly expensive toric prismed carbon-fiber super-thin technologically magnificent lenses that will do everything but my laundry for a good three to four years.

Which means that they'll only cost me between one-and-a-half and two bills a year to wear.

*sigh*

You will be pleased to hear that Practical Nurse Jo refused the thick-templed glasses, the glasses with jewels on the sides, and even an adorable pair of frames with orange-red miniature rhinestones on them which rocked her world, just so she could look professional in case she has to wear glasses at work.

Pictures forthcoming. On my old cruddy digital camera, as I now have no money to buy a new one.

*sigh*

Musings, product review, odds & ends

If only all I needed to stop mouth-breathing was a Perfect Breather, I would have much better days at work. If you treat nurses as though they are morons, they will act moronic. 

Thankfully, the moron-baiting is not on my unit, but on another unit I floated to for the first time a couple of weeks ago. Jo's Second Law of Nursing has been revised to read: The number of exclamation points ending a sentence that states the obvious is inversely proportional to the perceived intelligence of those reading the sentence. In other words, if you have laminated posters up all over your unit that say things like "EVERYONE must pitch in to keep the break room clean!!!!!!!" then it's obvious you're treating your employees like morons.

Seven exclamation points? They don't grow on pepper plants, you know.

On second look, that dude reminds me of Hannibal Lecter. 

*** *** *** *** *** ***

In other news, I'm replaying the following over and over in order to deal with moronicity:

and, especially:

(Fiddly embedding fixed, I think. And isn't it funny how, even when you haven't heard a song in TWENTY YEARS, you can still remember every damn word?)

Yeah, I'm a bug for the '80's. Even though--and this might shock those of you who know me in the meatworld--I have never seen Pretty In Pink or Sixteen Candles. I prefer Some Kind of Wonderful over The Breakfast Club, though. Crazy romantic, that's me.

*** *** *** *** *** ***

Flying Dog's Double Dog Pale Ale: almost as good as Great Divide Brewery's Fresh Hop.

*** *** *** *** *** ***

Max went to the vet today. He's lost 15 pounds in six months, and I hadn't noticed. I'm a bad puppy mama. Anyway, his kidneys seem fine, and the vet didn't notice any weirdness in his belly, so the general consensus is that he's simply not being fed enough (hanging head in shame). He got FIVE cups of food today and is walking around slowly, belly rounded out, looking quite complacent.

I think, since Strider left, that he's running around more (well, duh, since he's not afraid of being attacked) and is generally happier and is therefore burning more calories. So he's getting more food until such time as I can make some satin balls for him (no comments from the peanut gallery, plz.) and give him EGGS.

*** *** *** *** ***

Good God. Double Dog has 11.5% alcohol. No wonder I feel so cheerful after a half of one. And to think, five years ago Delirium Tremens and Nocturne were too strong for me.

*** *** *** *** ***

I read Coraline and The Graveyard Book this week while I was off. Coraline is easily the most frightening book I've ever read--even surpassing Stephen King--and The Graveyard Book is one of the best. It's right up there with The Phantom Tollbooth. I read it once and I plan to start it again tonight; that's the highest recommendation I can give a book.

*** *** *** *** ***

Do any of you fine readers do Sculpey or Fimo clay work? If so, or if you know somebody that does, I have a commission for you. I've got a project involving frogs that has to be done by the middle of April. Email me at the link to the right.

*** *** *** *** ***

I leave you with this: