Sunday, July 26, 2009

Heart Health in Action

After explaining atherosclerosis, cardiovascular fitness, weight management and the importance of maintaining a diet low in cholesterol to my old country non-English speaking relatives, my sister and I scurried out of the door like rabid dogs as soon as we heard the siren song of the ice-cream truck and returned with ginourmous cones of ice-cream that probably had 2 days worth of calories. Our display of unrestrained gluttony was met with sharp disapproval as ice-cream melted onto the carpet. We’re soooo smooth.

Saturday, July 25, 2009

When Your Timing Sucks

Lately I’ve been getting patients who suddenly remember all of their outstanding medical concerns AFTER they’ve been seen and discharged! Last night, three of my patients started causing a ruckus over needing various scripts* to tide them over until they were able to see their family doctor. I fail to understand why they would not ask the doctor about their medication concerns when the doctor is actually seeing them rather than sauntering up to the nursing station 30 minutes after being discharged and then casually asking for scripts from the ward clerk or the nurse. I do not enjoy having to needlessly argue with a patient especially when I’m juggling a full area because the patient thought, ‘hell I’m here, might as well take care of ALL of my inane errands’. I’m also pretty sure that our docs don’t like being confronted with an eager pen holding patient who they thought was long gone asking for a script. I realize that sometimes patients forget to mention things to the doc because the entire department seems to be rushing, but it’s called an EMERGENCY department, not the WALK-IN clinic.

*Not narcotics – those are a completely different issue!

Friday, July 24, 2009

Highly Personal Shit

Location – ER waiting room
Time – 0327

Me: Hi there, how can I help you?
Patient: Yeah, yeah, I’m going through some highly personal SHIT.
Me: Meaning?
Patient: Yeah I need some Percocet and Ativan for my highly personal shit.
Me: Have a seat.

Best triaging I’ve ever done while getting an unofficial orientation to the area!

Saturday, July 18, 2009

High School Hospital

I was one of those people who didn’t enjoy high school. I didn’t hate it either, but I saw it as a stepping stone towards something greater. I certainly didn’t enjoy the petty backstabbing, clique forming, ass kissing groups that smiled at your face while their lackeys stabbed you in the back. Leaving high school was great because I was finally free of the aforementioned people. But they were quickly replaced by another set. In university, they wanted to rip off your academic accomplishments. In the workplace, they want to strip you of your professional accomplishments. But no matter what stage of life they’re in, they all have one thing in common – they’re all a bunch of vindictive bitches who know how to ‘work the system’. They can be mean, and they’re often stupid, but they get in touch with the higher ups (some of whom couldn’t give two shits about what’s actually going on in their units so long as the right paperwork is done) and so, they can make your work life HELL! Mean cliques can be especially dangerous when they’re led by stupid people.

Sadly, two of my very good friends (and highly competent nurses) are in trouble because of such slithering snakes holding nursing licenses. Without giving too much information away, the first friend got called into her manager’s office because he has allegedly been providing consistently unsafe patient care. Never mind that none of his patients have ever complained against him or have suffered any adverse outcomes but because the manager is chummy-chummy with the snake, all of his charts are going through review. I’m sure he’s going to come out of this unscathed but it’s extremely unfortunate that so much time and effort is being wasted on trying to look for something that doesn’t exist. The icing on the cake - when I was orienting, this nurse told me "basically it doesn't matter what kind of insulin you give - they're all the same!"

The second friend was also called into her manager’s office for violating “patient confidentiality”. Over dinner. During her days off. What did she have the misfortune of uttering out loud? “Some days I hate work [name of hospital] because I’m sick of dealing with demanding people who have their heads stuck up their asses”. Ummm, isn’t irritation with oblivious demanding masses almost a prerequisite for working with the public? Some manager-ish person who was sitting nearby and heard her called her into her office to discuss the “image of the workplace she’s projecting when she’s not working”. We quietly talked about how certain TYPES of patients (did NOT mention specific names/cases) drive us mental and how we deal with their crap. Apparently we’re not supposed to talk to our friends or our close support systems – we have to talk to hospital employed specialists. I would much rather rant and bitch to my closest friends get it done with and then go on with my bloody day rather than speak to a stranger! What I still fail to understand is HOW patient confidentiality was compromised considering no specifics were mentioned – no names, no specific cases, no ages, no locations. Because of some gremlin trying to cozy up to higher management, my friend is stuck dealing with idiotic management on several levels.

Right now I’m furious on behalf of my friends and any nurse who has had to deal with obnoxious backstabbing bullshit because it can easily happen to any of us. My naivety led me to believe that a nurse’s first priority would be to provide the best possible care to patients, not to keep a bunch of vindictive people with the mentality and intelligence of high school punks happy.

Friday, July 10, 2009

Public Transit Hissy Fit

After any shift (especially night shifts), I throw on a jacket over my scrubs* and hurry home to my shower, kitchen and lavender-vanilla scented bed (I love Downy). While I’m rushing home, I like to decompress by getting lost in my own world while surrounding myself with a giant bubble of silence. So imagine my irritation on a sunny morning I’m completely zonked out of my mind, I’m approached by a seemingly normal looking guy who looks directly at me and then loudly asks, “Excuse me miss, are you a nurse or a doctor?” Having just gone through a break-less shift liberally peppered with loud obnoxious alarms and patients screeching every two minutes, I ignored him and started to pray that he was addressing the other scrub-clad people on the train. Nope. He was talking to me. Once again, he very loudly asked me,

“Are you a doctor? A nurse?”

This time, I took a perfunctory look around the train to a) make sure that there wasn’t some dire catastrophe about to unfold and b) catch another scrubbie’s gaze and maybe get rescued from the asshattery of the buffoon standing in front me. Once again, my hopes were crushed.
I reasoned that he’d eventually tire himself out and since he did not look to be in any distress (clearly his ABCs were intact), I could go on ignoring him for another couple of minutes before getting home. Yet again, his unrelenting questioning did not cease.

“Miss, I need to ask you a few questions! Are you a nurse or a doctor? Where do you work miss? I NEED to ask you some questions!”

This was pushing it too far! I can normally get away with my standard “No speakie English” line and have public transit folk leave me alone but this guy was clearly not going to buy that. As the train hurtled towards my stop, his questioning became louder and more persistent. He then inched towards me (in the off chance that I did not hear him the first several times) and very loudly repeated himself again, this time trying to reassure himself that I was a nurse. Unable to contain my rage at having my decompression time and post shift latte sipping interrupted so rudely and without any justifiable reason, I snapped. Oh boy did I ever snap. While he was firing off the next round of questions, I screamed,

“Just leave me the f**k alone! I don’t wanna f***ing talk you jackass!”

Normally, I would have tried to cover my crimson face in a newspaper and quickly get off at the next stop to avoid strangers’ stares, but that morning, I felt a wormy self-righteousness in screaming back at this guy and keeping my seat. He was of course stunned and quickly sinked back into his seat. I’m sure I did not do the image of nursing any favours with my little outburst, but did it ever feel good. When I told my coworkers about this, some of them were high-fiving me for telling him off while others were aghast at how I handled at the situation. The latter group felt that I should have politely but firmly told him to seek medical attention from his family doctor or at a hospital.

So what should I have done? Should I accept the congratulatory high-fives or should I have handled the situation with more grace and dignity while keeping my ‘nurse’ face on?

*Changing out of them is not always an option because I would much rather catch the train on time than hang around work for another hour especially on weekend mornings. I am not safe to drive after a night shift.

Sunday, July 5, 2009

Even if it is a Quiet Night...

…The wierdos still come out in packs.

Exhibit 1
30 something year old woman comes in presenting with palpitations and diaphoresis. When I get her into her room, she tells me that she thinks someone at a party tried to get her to OD on cocaine at a party two nights ago. I then asked what brought her in to the ER on this particular night. I almost wish I hadn’t because then I wouldn’t have to hear her say that she kept on taking crystal meth at home to prevent withdrawal. *headdesk*

Exhibit 2
50 something year old man presents with midsternal chest pain radiating to his axilla. He got the standard chest pain workup and then asked for the “Jewish Bible, the Christian Bible, the Quran and the Ramayana and Mahabaratha”. Unable to provide him with those texts in the middle of the night, I asked him why he needed them so urgently. He replied that since he’s been a “lying, cheating, whoring, filthy sonovabitch who’s screwed chicks from every religion, nationality and race”, he might as well repent to all the gods before he “kicks the crapper” since no one can tell for sure who “reigns supreme beyond the clouds”. I ran a drug screen on him. Came back positive for marijuana and benzos. Nonetheless, I believe that his request implied some measure of remorse for his past actions, selfish though his motives may have been.

Exhibit 3
40 something year old woman comes in with halitosis that would make a decaying zombie shrink back in disgust comes in for, surprise surprise, dental pain! I put on an N-95 and ask her to open her mouth. Two of her molars are missing. The void left by her missing teeth was filled with puce yellow pus. She said her pain just started “a couple of hours ago”. Right. She tried prayer and crystals to heal herself when her teeth first fell out. I must have hidden my frustration quite well because she gave me a shiny crystal for being a “sweetie pie”. The crystal hangs in the nursing lounge with a set of sharp white teeth attached to it!

It was a quiet night because for almost 3 hours I had no patients – I saw 6 patients in total that night. Good times indeed!

Wednesday, July 1, 2009

Happy Birthday Canada

Happy Canada Day! Enjoy the wonderful weather, a break in the middle of the week, a good bbq, some Ceasars and fireworks :D