Iceberg

Spent Sunday night down in the ER. These days I seem to be orienting all kinds of new people. Not sure what this is all about. So we have this lady who has asthma and is short of breath. The sheets are up to her chin and she looks like an overweight but perfectly well proportioned person... Until you pulled the sheets back. HOLY SHIT!!! Elaphantitis of the legs. Her legs were bigger around than both myself and the girl I was orienting, they had the texture of leather(like a new football) and had ulcers all over. GROSS! Can you imagine the smell??? Or do you just not want to? Ugh is all I have to say... and yes, I was in the stinky smelly Green ER.

We also had a man, dressed as a woman (drag queen, transvestite? not transsexual.... shit I get them all confused) who had a anal fistula. Someone piped up... "how did that happen?' Ummmmm.... welll, the bee and the bee meet and really like each other.

Another thing about the Er is that it can be a modified version of Springer... just without Springer. Very nice middle aged mother of 5 comes in thinking she was a UTI (urinary tract infection). We do a pelvic exam since that is part of the work up. Ummm.... no UTI. STD instead. We were a little perplexed until she said that her husband worked out of town a lot. She was very upset when we told her what it really was.

First of 3 in the ICU tonight. I'm hoping that thanksgiving up there isn't like in the ER. The gun and knife club has its first holiday meeting Thursday night and that never bodes well for us!

Proud

Don't know if there are any Bagdad ER fans out there. I mentioned a while back that one of our former ER residents was on CNN while working in an Army trauma center. Well it turns out that he was also on an episode of Bagdad ER on HBO this past week. He is home now, but it sounds like he did an amazing job. Dave will be back at my hospital after the first of the year to do a guest lecture. I'm looking forward to seeing him.

stuff

Let me just say... having a day off is a good thing. I was so physically and emotionally wiped when I left work Friday morning. I had the Evil One again... who was must better behaved. I also had the 26 year old quad that I have mentioned before. They have really gotten him cleaned up and he is such a cutie! Sad sad case though. He and I have been buddies since he got to the ICU so it wasn't a big adjustment. He just breaks my heart.... he tries so hard to do everything he needs to do to get better and get out of here. I have not seen this kind of determination in many patients. The girls have decided that we are going to keep him "pretty" while he is with us.... I think he just enjoys the attention and feeling a little normal again. Let me say though.... DON'T DRINK AND DRIVE!!! This guy is 26 and will be in a chair for the rest of his life. I swear, its not worth it!

So at 11 I had my boys and was having a good night. Then Lurch had to go home... not even going to ask why. So I got his patient. So I was tripled. That sucks my ass. I'm the newest person here and now I have three patients. The charge nurse and another girl had one each! Grrrrrrr... I made it through but was late getting home for all the extra paperwork.

Ran around the grocery store this morning. Those Thanksgiving people are crazy! I swear I almost saw a fight over a frozen turkey. Good thing I didn't need one 'cause I would have kicked ass! I will be working in the ICU Wednesday night and Thursday night. The cop and I are staying at mom's during the day and will be as festive as possible given the circumstances. This was a compromise after how sucky Christmas was last year. The schedule lady came up to me the day that the Christmas schedule came out last year and said "I'm sorry, it was Susie (the nurse manager's) decision. Have I mentioned a million times that I work nights??? Last Christmas I worked 3pm-11pm Christmas Eve and 11am-11pm Christmas Day. For those of you paying attention... I GOT SCREWED! I was soooooo angry. I had no time to spend with either the cop or my family. My saving grace was that we would have an extra nurse from 7-11pm Christmas Day and I *should be* able to go home early. Ummmm..... yeah, she called in. New to the dept and the bitch called in. I was in tears. So this year I am taking the 23-26 off no questions asked.

Back in the ICU tonight and the ER tomorrow..... Whhhhhhoooooooo-Saaaaaaaaa!
(See Bad Boys II)

The Wild One and the Evil One

AKA Grumpy Middle Aged Men

Last night sucked! I was back from a few nights off, so I didn't know any of the patients that were in the ICU. I also had to count narcotics because the hospital is too cheap for a computerized med machine. Hell, even the ER has a Pyxis!

So I landed 2 middle age guys on opposite ends of the ICU. Both were "squirrelly" (all over the place, picking and pulling, out of bed a lot) Not really very safe. One weighed 400+ LBS and was wearing nothing but a pair of boxers that were about 30 sizes too small. Heard them described by one of the nurses as his frontal thongs. Nice mental picture there. Fortunately, the fat rolls kept the boxers from riding up too high. He got combative in the middle of the night. You haven't lived until you've seen a 5ft tall little nurse wrestle a 400LB pt back in bed. FUN FUN FUN. I had to tie him down and sit right next to the bed for most of the night.

My other patient was a VIP. The husband of one of the pathology attendings. She is also one of the state medical examiners. Kind of a big shot. Nice nice woman though. He had a frontal tumor and was a HANDFUL. Smart guy, knew something was wrong but trying to use his smarts to cover the fact that he was wacky! He refused to stay on the monitor, didn't want to be bothered and yelled at the chief of neurosurgery because his light was too far from the bed, his pillow sucked and his bed was too soft. When his wife called for updates she referred to him as the Evil One.

So I was very happy to get home this morning.... was worn slam out. Still not sleeping well. Am off tomorrow and have a ton of stuff to do. 20 bucks says a I sleep all day and don't get to any of them!!!

Thinking...

I was in the ER again last night. Nothing big going on. Was in green and orienting a new hourly nurse. This guy has worked in the burn unit for a while and was just new to our ER. I wasn't too impressed to tell you the truth. He seemed to know his stuff, but kept disappearing. I'm not a babysitter and still had work to do so I just acted like he wasn't there. We'll see how long he sticks around.

I ran into on of my good buddies this morning before I left. I call him SuperMan. He's one of the flight medics for the state police helicopter. This guy is a great medic and a super nice person. He always talks to me about flying and where I am in my goal to be a flight nurse. We talk about calls and he picks my brain to make sure I have my head in the right direction.

There is one thing that is hard for me though. I wouldn't call it jealousy, SuperMan earned his way to where he is and deserves it. It kind of makes me sad to be right there with someone who is doing exactly what I want to do in life. Like being right next to your dream and not be able to touch it. No matter how hard I work, there is nothing out there that can guarantee that I will get a flight job. Realistically, it may always stay just a dream. Don't get me wrong... I'm going to keep plugging away. As I have told SuperMan, its getting a bit frustrating lately.

I have told people that I don't have enough lifetimes to do all the stuff I would love to do. I just feel like all I'm doing in working and not really able to get out there and do it. The cop and I have discussed picking up and moving somewhere completely different. Marathon Key comes up a lot, but (as my reasonable head keeps telling me) we can't really afford to live down there... and where in God's green earth would I have to drive to find a good trauma center... Miami probably.

Ok, all of this is starting to sound a bit like a pipe dream. Can you tell I'm back in the "no sleep" mode? Was so tired I almost didn't make it home and was wide awake at 2pm. What the fuck?!?!?!

Back in the ICU for the next two nights... oh happy day!

Running Away...

...is ALWAYS a good thing!

Spent the weekend with the cop at a little inn at the beach. Its a bit of a drive, but worth it when you get there. We had a soundfront room, jacuzzi and fireplace. Sooo... relaxing. This time of year there are very few people there too, so that was also nice. It was in the high 70's so we took the top off and drove all over. Water was too cold so swim though! (unless you wanted to freeze your nuts off!) Being as busy as we have, it was nice to just get away.

Was back in the Er for a princess last night. (princess= 4 hour shift) We were on diversion, which means no ambulances except for traumas. We don't get to turn away traumas. No beds in the house and patients hanging from every spot you can think of. Plus, they "upgraded" our computer system. "Upgrade" in hospital speak means completely fuck up so bad that nobody (even IT) can make sense of it. So they declared an internal disaster. All the management showed up. This is why I don't work days. Management could fuck up a wet dream. One of the nurse managers took an intubated patient up to the wrong ICU! HAHAHAHA!!!

Was glad to get out of there, even though I was ;ate getting out. Rollover MVA at 2245 with 3 patients in addition to the crazy bitch that tried to commit suicide and damn near cut her arm off! I can't complain. At least she made a decent effort to end it... didn't just scratch with a dull knife!

Tell me this.... 28 year old, racing a new mustang with two17 year olds in the back. His girlfriend just gave birth to a little girl 3 weeks ago. The teenage girls both had condoms in their pockets and ... the grass was mowed. What do you think was going on?!?!?!? As one of the nurses said so tactfully... "you don't mow the grass unless someone is coming over to eat". Ummm.... I must agree. God people are stupid. They must think we are too, cause the dumbass stories always continue!

Sad

Ladies and Gentlemen I am worn the fuck out! Finished about a million shifts in a row, get one day off and then back again. Am running away to the beach on Friday with the cop. That will be a nice break.

We have a kid in the unit now that we are waiting to delcare brain dead. He is 16 and was an unrestrained passenger in a car that was T-boned on his side. Traumatic brain injury. Mom and dad are both medical folks (RN and resp therapy) and are such nice people. They know what is going on and that this is it for him. They want us to do everything we can to allow him to donate his organs. I cannot say how generous that is. Kids like this make great donors because they are still young enough to have great healthy bodies and they help so many people. I can't say enough about this family either..... I don't even have the words.

Teenage classmates of both this kid and another who was in the car (she has a bleed, but will be ok) keep trooping through to see him. I see them crying and hugging each other. Yesterday one of the nurses asked (in the lounge, far far away from the bedside) Do they know this is from not wearing a seatbelt? Or do they just see their sick friend and not realize that this could be prevented? Its sad the whole way around. Wear seatbelts kids..... I can't say that enough.

Of all the traumas we have in the unit right now only 1 was wearing his. He was the only one hurt in his accident.... and that was because of where the car struck the tree. If he hadn't had a seatbelt he would be dead. His dad and brother visit every single day. They say hi to all the staff and shake people's hands. How classy is that?

Its cold as crap and rainy here. If I didn't have to meet a friend for dinner then my ass would still be in bed.

SoapBox

I've been in the ICU over two months now. Although the patients are a bit different than I am used to, the game remains the same. You have NO IDEA how many we have that were either 1) no seatbelt or 2) alcohol related... or in most cases, both.

As an ER nurse there are few things that get to me. I can take care of violent crime victims, HIV/AIDS patients and even sick/dying kids. The kids don't bother me as much (I think) because I don't have any yet. Police/ firefighters and EMS are where my heart is. I worry about those guys.

In the ICU I have found that quads really bother me. We had a young guy in the unit for 6 weeks following a drunk driving accident. He hit a phone pole on a motorcycle and it broke, hitting him in the head and breaking his neck/severing his spinal cord at a high level. He's 30. These people can't even cough without help and will depend on someone else for the rest of their lives. As soon as this one finally was strong enough to get out of the ICU (he will be on a ventilator like Christopher Reeves for the rest of his life) we had another come in. Drunk, no seatbelt..... complete injury at C4. He has a little movement of his arms, but not much. He was so angry when I saw him last. I don't think the reality of his situation had set in yet.

I asked a couple of the more experienced nurses if they ever got used to seeing kids like that. The response.... not really. We do our best for them and hope they do well. Hmmm... I think I like the ER, not knowing what would happen. This is just soooo sad.

Had a great Halloween. We decorated the house and put a dead gangbanger in the front flower beds surrounded by police tape. Tacky, yes but he had lights! Didn't have as many kids as I would have liked, so I spoiled the crap out of the ones who did come to the door. My favorites are always the ones who don't quite get trick-or-treating yet. They have this look that says "why am I at your door in a cow outfit with a plastic pumpkin?" The littlest ones kept trying to get in to see the dog. Poor Maddux was having a breakdown with the doorbell ringing so much.

The cop took my car to work the other evening. We met up and rode to his doctor together and then went home to sleep, figuring we could pick up the car in the morning. Well, yesterday morning we found that my car had been egged in the police precinct parking lot! GRRRRR.... we were both so pissed. I did a police report and spent most of the afternoon getting the egg off. There is a dent and cracked pain from where one had been thrown so hard. The cop is mad because he thinks it could have been one of the other officers. The car wasn't exactly out in the open, and although it is in a not so nice part of town, some thug would have had to cross the lot to get to the car. Lets just say, rollcall tonight is not going to be pretty.

Otherwise things are pretty peaceful here. Cold and rainy.... I have court for a drunk driver tomorrow. He was an asshole so this should be fun!!!!