Deliverance

So I finally got the hell outta town. Packed up the jeep and the dog, kissed the cop and hit the road. There is a commercial for satellite tv that talks about always playing the perfect song for the situation. I can't say always here, but as I drove through podunk USA the radio piped up with 'If You're Going Through Hell....' and then when I turned off the paved road it turned into 'A Country Boy Can Survive'. SO... the cabin on the river turned out to be a double wide.... with a nest of pissed off hornets that chased Maddux and I back into the jeep. We waited there for my sister who had the keys.

All in all it wasn't a bad trip... no cell service, no shower curtain, no cable or computer. Just my family and the dogs. We put in the river at 1030 Sat morning and floated downstream for about 3-4 hours. That water was FUCKING COLD. I chose the inner tube vs the kayak and now have bruises on my ass from it hitting the rocks.

I left at noon yesterday with every intention of coming up with a decent excuse to call in last night. I was still itching to call in and get some well-needed sleep. I made it onto the interstate and was kicking ass in cruise control when everything came to a grinding stop... and stayed that way for an hour and a half. Obviously was an accident, but didn't realize how bad until one of these babies buzzed us.....

This is NOT the real aircraft..... it was orange and blue... but ut was this style. This is an EC 135, similar to what they fly from my hospital. The helicopter that landed I think was from the next trauma center over. I'm a dork... I know that, but I LOVE these things. I can't wait to get a flight job. Anyway, as it was landing I called work and told them I had no idea how long I was going to be on the side of the highway. The CC working actually gave me some shit about why I couldn't get in by 11. At this point it was 245pm, I was still 2 hours out and showed no sign of moving. The do was so good, peed on the guardrail, drank his water and didn't try to eat the stupid people who were walking up and down the roadway.

Finally got home at 530 and was eating dinner when my mom called. Her OLD Jeep was overheated at the exit where the accident was hours before. UGH... the cop and I got in the car and drove back up and over the mountain to get her. They fixed the jeep and I held onto the old cocker spaniel praying that he wouldn't die on me. Work had the never to call me at 930 to see if I could make it in by 11. Grrrrr..... not the time or place. I can't even play hooky and enjoy it!!!

So am home, still tired, but have too much shit to do before I go back in to work tonight. Have to get ready to go to Buffett this week... and then DC afterwards. I don't know that I can do any more time in the car yet. My butt still hurts.

Playing Hooky

I had every intention of calling out last night. I was OVER work. Needed a mental health day in the sun. Maybe road trip to the beach for dinner, have some wine on the porch with the new fire pit. RIIIIGGGGHHHTTT... Didn't happen. The cop got home after I did and saw that the alarm was set for 2pm (I have to call before 5 if I call in) so he changed it to 515. So when I woke up it was too late to call in. SHIT!!!

So I carried my tired ass back to the ER. Was in the trauma room... again. I can honestly say that I (almost) didn't do a damn thing. I had a nice guy wreck his car because he was upset his girl was cheating on him. He had a head bleed and free fluid in his belly. The only other trauma I had was not a brain surgeon. He was leaving the store and '2 dudes' came up and tried to rob him. He told the dudes that they would have to shoot them... so they did! What a moron. He went to the OR shortly thereafter.

The highlight of my night was a phone call that I picked up at 630. It was a psych patient calling from the next city over. She was in the locked psych unit in the hospital there. She wanted a boot for her broken foot since she wasn't allowed to have her crutches or a wheelchair. She was very slurred and manic on the phone. I asked her to get the nurse and she gave me the phone number instead. I was bored so I called back. The nurse answered the phone, I gave her the patient's name and what she was telling me. The nurse's answer "we are taking her phone away from her right now." I laughed my ass off!!!

Off for 3 days, gonna sleep, go to the mountains with my family, float in a tube with the dog and drink wine. Sounds like a plan to me.

Shut Up!!

I have said this over and over and over. Don't fucking drink and drive. I am so tired of this shit. There is a national group called the Red Hats. Several of our nurses are members. You have to be over 50 to be 'part of the club.' They go out, have dinner, movies... whatever old women do on their nights off. I'm thinking that last night the Red Hats must have sponsored a kegger and not given rides home. Between 7pm and 1130pm I had about 12 traumas. The majority of them were women over 50 drunk as shit who hit stationary objects (jersey walls, trees, parked cars). Let me just tell you... old women are a pain in my ass!!! They want this and that done, you can't move them too fast, they want you to come introduce yourself everytime you walk near their bedside and they want EVERYONE called to know where they are. Let me tell you.... when I don't have 50 billion traumas coming in back to back I am a bit more accommodating.... but last night I was lucky to just keep my peeps straight. They are also professionals with the 'Nurse, Nuuuurse, NUURRRRSSSSEEE' screech. But they won't tell you what they want... they want you to 'come here.'

Little did they know that my smiling face was there giving them the finger and pointing the finger gun at my head and softly saying 'shut up, just shut the fuck up!' The one thing I can say is that none of them puked. Thank GOD!

You know what pissed me off?!?! As busy as we were I could not get the CC to put us on diversion. The patients kept on coming, and so did the traumas. It got to the point that I couldn't move trauma patients out because there were no beds..... but there were still traumas coming. (including a GSW to the shoulder who I had to make wait in the hallway) I thought we were on diversion and asked for all but multi-system trauma diversion. The CC said that the Doctors didn't feel like we needed to go on diversion. ARRRUUUGGGHHHH!!!

I get to risk my license for these fuckers who are making $200,000 a year easy and don't want to miss out on the extra per pt billing they get to do by going on diversion. I guess they figure that its just the nurse's ass on the line if something goes wrong with these people. If something gets missed or the patients charting doesn't meet standard of care. Ummm.. yeah, thats one of the reasons that I am not staying full time. The CC's response??? 'If you can't take the heat...' My response...'look motherfucker (obviously I was pissed at this point) I HAVE taken the heat, and am the only nurse you can get to come in here on nights like this. I worked too damn hard for my license to have some cocky son of a bitch in a white coat dictate to me what is and is not safe nursing care. Now put us on fucking diversion before I walk out of here and leave you on your own!' Not the most tactful response, but it got my point across. I got diversion, and a thank you from the CC at the end of the night.

I'm thinking of calling in sick tonight.... as the cop so brilliantly put it, if they don't care about me doing more that turning over the trauma room, then why should I care if they are short another nurse tonight.... god knows I need a mental health day!

The problem with that... I feel bad about calling in when I AM sick, I very rarely call in sick or not. UGH.... I hate integrity sometimes!

Go Cubs Go!!!!

I've been a bit slack over the past few days. Haven't been getting the sleep I need... and it doesn't help that the cop has started snoring like a mother fucker. Everyone down here has that nasty sinus thing, so I buy the breathe right strips and try to get to bed before him!!!

An update, my nasty sexual assault case from the other day has a good ending. The restaurant and the police were able to pull up security tapes, get the logo off this guy's shirt (dumbass was wearing a work shirt) and tracked him through his job. He was found with the victims car in Philly. They are waiting to extradite him now. I CAN'T WAIT to get that subpoena!!! This guy is gonna get decades in jail!!!

So Friday night was very very green. Steady busy with no letting up. We were joking that I was running my own ICU down there. I sent one to MRICU (medical respiratory), one to CICU (cardiac ) and one to NSICU (neuro science.... my future home). This last guy was fucked up. Did cocaine, had himself a big ole head bleed. Family took him to some community hospital where they scanned his head and belly. Not just a big bleed (ventricles AND brainstem) but a AAA (abdominal aortic aneurysm... BAD). What a was to go out. We were humming that Clapton song 'Cocaine' all night.

So I've mentioned that night shifters are a little on the mischievous side. One of our medics brought in his new favorite toy. It was a remote controlled fart machine. You put the speaker near someone... in a box of gloves, your back pocket, somewhere good....back off and start hitting the button. People really do freak out, esp when you blame them for the noise. We did it to cops, medics, patients, staff....it was too fucking funny. We take the laughs when we can get 'em.



Road trip yesterday was to DC. Family outing to the Nats/Cubs game at RFK. We got some dirty looks from the DC crowd (hey, its not my fault the Nats suck). We sat with my grandparents aunts/uncle behind him plate... but under the cover so we couldn't see shit. Not that there was much to miss. I love my Cubbies, but they were stinking up the place yesterday. The beer was good, the hot dogs were not. The highlight of my day was the whole stadium of Cubs fans (myself included) singing 'Lets Go Cubbies' and getting booed. So the experience left something to be desired. Made me miss Wrigley and the 'Go Cubs Go' at the 7th inning stretch.


The traffic was terrible, but no big surprise. Anyone know why the hell DC, N. VA and Maryland drivers STOP on the highway at every exit ramp??? I'm sure we'll get another chance to find out when we are back up there in a couple of weeks for Buffett.

As I mentioned earlier, I'm going to be leaving the ED in the end of August for the NSICU. I will still work in the ED hourly... Probably about 12-24 hours a week. Thats going to be my wedding/Honeymoon money. The move is strictly career oriented. I want to be a flight nurse, and must have ICU experience to do so. The reason I chose neuro was because the group is smart, works together and all in all is the best atmosphere to learn in. Plus the nurse manager is a rock star.... nice, friendly and used to work night shift. What can I say.... she gets me. The only downside DUM DA DUM...... is that Lurch is doing the same thing. Ugh..... he makes me nuts. Fortunately, he will work days and probably weekends only per his admission. So I could see him about every third weekend. We'll see how that goes.

Back in trauma tomorrow.....the flight MD saw me the other night in there. Told me later that I was 'in my element' Nice compliment.

Sexual Monkey

One thing I love about my job is that it is never the same. I never know what kind of patients I will take care of or who I will meet. I meet and frequently take care of folks from all walks of life. Homeless guys, rich folks, politicians you name it. A few notables...

The guy from the corner... I see him on the way to work. Sleeps on the air vent.
The governor and his children (daughter is diabetic).
chief and assistant chief of police
the doc our burn center is named after (dying)
the parents of a childhood friend (horrible MVA)
grammy award winning r&b singer (drunk, high, flipped a hummer)
NASCAR driver with a head bleed (Hit the wall)
owner of a downtown gay club (drunk, fell)
owners of the 'BIG' family jewelry store (granny fdgb)
the drunk who calls me 'Boo' (drunk, faking seizures
multiple state troopers (one died... I still have nightmares)
Tire carrier for yet another NASCAR driver (mva)
many many fellow staff members

Its weird... everyone ends up in the trauma center at some time or another. Its just a matter of when.

Last night we had a few gems. I was waiting in triage for a trauma to get called in (I got a heads up) and took a call. 19 year old male, on LSD trying to get into a bar... minus his clothes. What can I say, its been hot down here. When the cops got there he was licking the pavement. Brought to us flat on the belly, still naked, screaming. Heart rate was 160's, he got 140mg of IV valium. (to put in perspective.... 10mg IV would make me sleep for about 8 hours) As he was yelling he declared that he is "the sexual monkey." He also told the cop holding him down must have a hairy ass and a big cock. His momma is going to so proud.

His female counterpart was there also. Snorted over a gram of cocaine and then rolled in her own poo. Yum-O!

I finished up my night with one of the most awful sexual assaults that I have seen in a long while. Legally I'm not going to discuss any details. I know I'm going to court for this one. We have forensic nurses who can collect evidence from these victims. I also have to go to court very often for the legal blood alcohol draws that I do. I don't love it... but its nice to slam dunk these fuckers from time to time.

Rude

People treat medical personnel pretty badly. To get yelled at, cursed, hit, kicked, spit on and (in some cases) chased is not uncommon. Fortunately, I run pretty fast. What bothers me is the attitudes that patients and family members throw at us without even thinking. They are pissed because they have to wait to get seen, but as soon as they get in the back, they want to know when they get to leave. If they don't get what they want (tests, narcs to take home, admitted, not admitted) then they act like assholes. The trick is to stay professional, but not to take any shit. I only get nasty when I really have to. Yes, I have been snippy, but there are certain populations that I don't take shit from and don't kiss ass for. Drunks and folks under arrest are the top 2.

For the most park I try to be nice. I have found that you get farther with people that way. In my day to day life I really only get pissed when people drive like they have their ass on their shoulders.

Soooo..... Saturday morning the cop and I got up early to have breakfast and go to Kroger. Armed with my list and determined not to spend too much we grabbed a front row spot and entered the empty store. After a bit too long in the wine aisle we moved on. There was a middle aged woman who was keeping pace with us. Unfortunately, she was a bit ahead of us and parked her cart in the middle of the aisle as we shopped. We didn't make it very far. The cop was farther along than I, and I was looking at something dumb.... when this woman approached me. She said (in her very prim voice) "I just wanted to tell you, you didn't have to be so rude."


HUH?!?!?!? I know I said 'I don't know what you are talking about' but the cop said I didn't get much out after that. I stood there with a stunned look on my face unable to say anything. The cop, fortunately, wasn't blessed my tied tongue and asked this bitch what her problem was. She was very aggressive and in my face, until he started giving her hell back. Then she backed down. We never did figure out what I did that was so rude.... she left the store shortly after.

I just wanted to kick her ass!!! I deal with this shit all the time at work, but I am living my life keeping to myself and this (I didn't use the 'C' word, but the cop did) as the audacity to say that to me? What the fuck? I'm not going to dwell, but I guess I still don't get it.

So the inside joke is "Am I just being rude?"

Have spent the night playing on the computer planning the honeymoon. Trying to decide between a cruise, one of the Sandals resorts or something else. Budget is around $5-6000. Any suggestions???

I have my mom's dog with me for the (long) weekend. He's the oldest cocker spaniel I have ever seen. It's like babysitting a little old, neurotic man. He keeps scratching his butt on my sofa and howls when I leave the room. I just hope he doesn't die before mom gets home!

Whatever you do.... DON'T BE RUDE!!!!

Amateur

I picked up the room at midnight. Whats scary? We had an extra nurse for four hours. The charge nurse 'Elvis' left me in my zone, and then had the 2 extra nurses floating with nobody assigned to the trauma room. Sooo... when the trauma light went off.. Elvis decided to sent my happy ass in. Drunk beaner.... either 1) was assaulted (his story) 2) he was hit by a car (bystander said that) or 3) fell off a bridge (the police officer's story. His alcohol was waaaaayyyy low. I was embarrassed for him.

The amateur of the night award goes to the chick who came in at 1am. She was unrestrained passenger in a head on collision. Went to cut her clothes off... dress, green and yellow hot pants, green and yellow tied up shirt, white thongs and pasties shaped like flowers. Now I have pulled piercings out of everywhere you can think of, but have never had to remove pasties before. Especially not flower shaped ones.

When the cops arrived I was able to get the real story from them. She works at a computer graphics company and is married. He husband was (as the cop says) 'Click Click 10-31.' AKA under arrest for dui. Apparently, they were at amateur night at the local strip club. Homegirl won the grand prize. (hubby must have had the $$$ cuz she only had $13 on her... and NO it was not in her g-string) OMAA!!!!

Strippers are funny. We get them at the hospital from time to time. I had one once who was doing her thing upside down on the pole and fell off. She arrived backboarded with her arm sticking straight out. (dislocated shoulder) I have also seen some NASTY broken ankles from those shoes. We were trying to decided if fake boobs hurt when you lay on top of them, like on your stomach. I don't know anyone with fakies so can't ask.

I know nursing doesn't pay great, but I think I'll stick to my crocs and scrubs instead of flower shaped pasties and stripper shoes!

Dead

This is my last night and I get 2 whole days off. 4/4 always sucks. I told people not to expect much from me besides being a warm body. It seems that again, the gods and fate have laughed at me.

Had 3 people die in the department tonight.... the first was a cardiac arrest from a nursing home. The squad actually got the man back. I was surprised. The used the geezer squeezer and some drugs and fuck if it didn't work. Unfortunately, while 9pm wasn't the man's "time" it turns out that his time was about an hour later. Oh well... it happens.

So I was helping out, trying to avoid checking the trauma room yet when my light went off and the phone rang at the same time. Thats not good. I told the triage nurse to hang on while I got a piece of paper. She said "hun, just get ready... 37 yo male GSW to the belly, got the call from dispatch." Hot damn we were dancing over that one. GSW's to the belly are great because we don't have to do a lot. We get labs, X-rays and a quick exam and then they are off to the OR to (as my CC said) "move the bowels." LOL, they actually run the bowel (look at every inch for injury) but its the same thought.

So when the squad rounded the corner with a breathing tube and a patient that looked like shit we were not real happy. They guy had a through and through to the belly alright.... but was not exactly with a pulse. My exact words to the special forces medic (they train here) was "oh fuck, they are gonna crack his chest" YUPPPERS..... thats what happened. The bullet must have hit some major vessel in the abd because the heart was empty. We worked like dogs on this guy. 5 units of blood and all kinds of other fun stuff, but never got much back. He died at about 2am.

Finally, as we were calling the GSW a sids patient came in. Sudden Infant Death Syndrome is pretty sad to deal with. This kid was 4 months old and was sleeping in the same bed with mom. I don't know how long she was down before they found her. The squad brought her in anyway.... kids, cops and ems peeps pretty much get worked regardless of whats wrong. Even if we can't fix it we will try. So mom was able to watch as we worked her... this is a new trend in medicine. Its called family presence. I am all for it... it the appropriate situation. It gives some closure to the family and (if its for a procedure) comforts the patient.

So my room is not quiet and beautiful and I am off for the next 2 nights. Whoo-hoo!!! I'm gonna sleep today!

Don't sleep in the bed with your infant. Over a year is ok... before that please please please don't give in and do it!

Money and Guns

Apparently things have been rough for teenagers these days. In the past couple we have had some horrible accidents. Yesterday there was a kid who was running from the police with a friend. The car lost control, rolled multiple times and the driver was ejected and impacted the pavement with his face. The passenger was DRT. The driver was flown in and will probably be taken off of life support when his family arrives from Florida.

When I got in there was a little girl (16) who lost control when driving and hit a tree. She as a brainstem bleed and will probably die in the next few days. Her family was a bit Jerry Springer. Mom, Dad and stepmom, all arguing in the hall outside of the CT scanner.

I was sitting next to one of the docs... he is NUTS (like the devil with a medical degree) watching a cop with a drunk. This bitch was driving drunk and hit a tree. Her 5 year old daughter was in the back. The cop charged her with DUI and child endangerment. She kept trying to get up and go to the bathroom with her purse. The officer finally stopped her, and took her purse (she was trying to keep it from him) when he looked in it he pulled out a loaded pistol. (It looked like a .22) The doc and I looked at each other with the 'oh shit' look. Ummm.... I don't even want to think about how bad things could have been!!

We actually take weapons off of patients frequently.... Especially in the trauma room. We have found them in pockets, underwear, under do rags in purses you name it. What upsets me is that we have been asking for metal detectors for years and they still won't get them. Its going to take someone getting shot to fix that... OH!!! nevermind, we have already had a psych patient shoot a security guard. Umm, maybe we need to have someone get killed first.

Had a husband and wife involved in an accident. The fought at the club, took it to the car (both drunk as hell) got to physically fighting and he punched her face, she bit his finger, they went off the road and hit some parked cars. The best park was when they started ratting each other out to the police. They were in beds 1 and 3... and started screaming at each other across the room. It was so damn funny. My CC finally had to tell them to shut the hell up.

Finally, right before shift change we had another drunk driver. This dickhead was driving along, and hit a PARKED DUMP TRUCK. How the hell do you hit a parked dump truck? You can't exactly say it jumped in front of you. We were going through his pockets and hit the motherload. 2 bricks of cash... 100's, 50's and 20's. Nine 100 dollar bills, nine 50 dollar bills and over one hundred 20's. This guy had enough cash to pay my mortgage, and go on a trip to Hawaii via Vegas and LA. We have decided that he was self employed in the pharmaceutical distribution business. (AKA drug dealer). Must be nice to deal drugs and get all that tax exempt cash... However I like my health plan a little too much to drop it all now!!!

Make your kids wear their seatbelts too, and actually punish them when they get in trouble. PLEASE! Limits and year round school could be a good thing!

July

So I had a great day yesterday. I can't stand going to those big 4th of July things that they have around here, the people make me so nuts. So instead of trying to get to the beach and share a 4x4 area of sand with 50,000 of my closest friends we took his father's boat out. We did the same last year. They shoot fireworks out over the water... its beautiful. So we spent the day on the water dodging jetskiers and those HUGE Donzi boats that are going 60mph. Too much sun, but otherwise had a great time. We even saw a couple of bald eagles nesting. Very cool.

I must warn all of you who care, about July. You never, ever want to end up in a teaching hospital in July. All of the medical students graduate at the end of May, and the residents finish their programs in the end of June. July 1 should be blacked out of all calendars. This is the day that we get new interns. Interns are folks that have graduated medical school, take the first of many board exams and are now pleased to take care of your health care needs. Basically, they don't know their elbow from their asshole and require a large amount of hand holding and direction. They either come to the nurses for everything (help me help me) or treat the nurses like we are morons. The latter get their asses handed to them and quickly change their tune.

I make a point never ever to work the first few days of July. It helps that my birthday is the 2nd. I've had about a week off... Enjoyed my birthday and have been working on getting my house clean. Not too exciting, but enough to keep me happy. Before I run I must say thank you to Drs Steinbrunner, Finan, Quinn, Ward, and Ines. These are all of our residents who are (Or were) in the military. All but 1 were sent to Iraq after graduation. We are SO proud of you all!!!

Clumsy

Did I ever mention that I am extremely clumsy? It would be hard to believe as I was a dancer in my younger years. 16 years of ballet, jazz tap and pointe. I really loved it. Did great on stage too. However, offstage I can hardly walk in a straight line. I fall down ALL the time. I tripped over a stretcher in the ER about 2 years ago and fell on my outstretched hand. POP, broke a bone in my wrist. Cast for 6 weeks and light duty. Didn't stop me from gloving up (one S and one XL glove) to help crack a chest.

Well, was walking out to the jeep to help carry groceries in and tripped over the landscape timber. Actually, my story is going to be that massive moles burrowing underground caused the timber to get bumped up about 4 inches and thats why I tripped. Unless someone has a better story.... anyway, I broke my freaking toe!

I'm an ER nurse and I know better than to go in for this. The ER is busy enough and doesn't need my bullshit. Here's what would happen.....X-Ray... yup its broken. Buddy tape the thing to the one next to it. Take my NSAIDS, ice, elevate and no contact sports or chasing psych patients for a while. Damn that fucker hurts though!

HAPPY BIRTHDAY

TO ME!!! Yes, its my birthday. Actually its more like it was yesterday...(so today should be great too!). My cop was so funny. He had all of my presents but couldn't wait to give them to me. His *big* present for me was a silver chain with a St Michael's badge on it. Unless you have a loved one who in law enforcement (or you are yourself) its hard to explain how much that means. Yesterday we went shopping (sales sales sales) and then my friend K invited us to the pool. I think we freaked some soccer moms out with our poolside conversation. Oh well... they can get over it. Shit happens... as they say.

After we got slightly crispy around the edges (ok, I look like Rudolph) we went to dinner with one of my sisters and some people from work. Great italian restaurant, the kind of place you would expect to see Sinatra in the corner. They play great music too. So had a great martini and just enjoyed having most of my peeps there.

Not sure what the cop has planned for today. I woke up early and am watching CMT and looking at the gorgeous roses he got me. (again, couldn't wait til today to give them) I must say, I have my family, friends, my cop, a great job and a dog that wakes me with his snoring. I really can't ask for much more. I've told people, I'm very lucky.... but I know that and don't take it for granted.

Oh Crap!! I forgot to mention... yesterday we were almost in 2 accidents and the cop got in a fight (off duty!) We were on the way to the pool and grandpa in a big ass gold caddie ran a red light and made a left turn right in front of us. (I doubt the jeep would have fared well against a Cadillac). Same trip, some beaner (thank you Carlos Mencia) ran a stop sign in front of us. By then the cop was about ready to chase him down and cuff him himself!

So when I was getting ready for dinner the cop was at Target and had to help security wrestle a shoplifter! Apparently homes was trying to walk out with CD's, toner cartridges and who knows what else. He told security he had a gun. (but then my cop did too) After a struggle they got him cuffed. Later the cop told me he wanted to put the gun to the asshole's head and say 'Don't move motherfucker or I'll put 13 rounds in your head!' Ummm... not exactly the phone call I was looking to get!!! He ended up bleeding from both knees, elbow and toes. (he was wearing shorts and flip flops... not exactly city-issued uniform!)

ok, I'm going to go wake up the cop and convince him to take me to breakfast. Shouldn't be hard. :)

Appreciate what you have guys. It can be gone in a flash... I see it all the time