Adventures in Fall Photography

These lovely pictures were taken by my awesomely talented sister (ie: little bear) in various places on my way to work. She was using her bf's camera (who is also uber talented but I don't have his work so it can't be posted - yet). I love fall!

Had Edgar Allan Poe Been an Emerg Nurse…

The Drunkard

Once upon a midnight dreary, while my back ached, weak and weary,
Over many a quaint and curious patient at the triage door.
While I nodded, nearly napping, suddenly there came a tapping,
As of someone rudely rapping, rapping at my triage door.
"'Tis no drunkard," I muttered, "tapping at my triage door--
A well man and nothing more."

Ah, distinctly I remember the bloody night before November,
And each and every staff member had brought a patient to the floor.
Eagerly I wished the morrow, vainly I had sought to borrow,
From my books of assessments thorough –to avoid the cookies from days of yore
And drink my latte from so long before.

But the stinkin’ sad uncertain shuffling of a drunkard’s gait that’s struggling
Thrilled me – filled me with supreme annoyance, never felt before.
So that now to still the beating of my heart, I stood repeating
“Tis no drunkard entreating entrance at my triage door –
Some late UTI-er entreating entrance at my triage door;
This is it, give toradol galore”.

Towards the patient I finally headed, hope for sleep completely shredded,
“What,” barked I, “please don’t have a complaint I’ll deplore,
But the fact is I was napping and so intently you were tapping,
And so rudely you came slurring, ranting at my triage door”.
And without regard or thinking, he barfed upon my triage door,
Chunky vomit and lots more.

Then, of course, the air grew denser, thanks to the obscene Spencer,
A man now pickled, whose foot-falls dragged in the department’s floor.
“Wretch,” I cried, “why did God bring thee – by the devil he hath sent thee
Respite – respite and valium please for thy abnormal CIWA score
Why, oh why this loud decree of your drunken presence on my door?!”
Screamed the drunkard, “I barfed some more”.

"Spencer!" said I, "this stench is evil!--Spencer this is the needle’s bevel,
Whether taxi sent, or whether ill-fate tossed thee here ashore,
Desolate, yet all undaunted, in this department un-enchanted,
In this hallway by Horror haunted--tell me truly, I implore--
Is there--is there calm from gravol?--tell me--tell me, I implore!"
Quoth the drunkard, "I need lots more."

"Spencer!" said I, “more upheavals? - Spencer still, if man or devil!
By the score of twenty and eleven – by the valium we both adore –
Tell this nurse with sorrow laden, who to call? Perhaps thy maiden?
Please, oh please, I beg thee, use the bucket on the floor.”
Quoth the drunkard, "Nevermore."

"Be that word our sign of parting, man or fiend!" I shrieked, upstarting.
"Get thee out of the department and save my night from being abhorred!
Leave no chunks of vomit as a token for my tolerance thou hast broken!
Leave here with this train token! – Quit the bed and leave the main floor!
Take thy stench as you depart, and take thy form from out the door!”
The drunkard started to loudly snore.

And the drunkard, unremitting, still is snoring, still is snoring
On the pallid stretcher mere inches from the door;
And his socks have all the seeming of a mould that is steaming
And the lamp-light o’er him streaming throws his shadow on the floor;
And my break retreating into shadows that was planned for four,
Shall be taken – nevermore!


Have a spooooky halloween!

Rethinking Professions

Recently, I was working fast track and I brought in a patient who needed a script for ramipril and atenolol because she forgot her meds in another province. Being surprised that a) the script refill wasn’t for narcotics or benzos and b) she was prepared to wait for a while with a copy of the Massey Lectures, I tried to get her seen quickly but since we were expecting EMS to bring a patient with a CTAS of 1*, I just ended up chatting with her for a while. We started to talk about job security and how nursing seems like a very safe profession since there are always sick people who need attention (tell that to the half baked suits that think firing nurses is the best step towards achieving fiscal goals). I told her that I was considering applying for a part time/casual position at one of the local clinics so I can get rid of my student loans a bit faster. She disagreed with my choice and told me that I ought to consider becoming an escort! After recovering from nearly obstructing my airway with my latte, I had to tell her that as much as I would like to cease worrying about money, I can honestly say that nowhere in my psyche have I ever considered escorting (is that the proper verb?) as a potential means to achieving that end. Apparently I have the ‘right personality and look’ – I suppose telling Mr. Drunky McDrunkington that he’s wearing a hospital gown because he pissed his pants numerous times while wearing my ‘I’m too bloated and tired to care wtf I look like scrubs’ is the escorting look du jour. Since I’m in a rather forgiving and jovial mood (I got New Year’s off!), I’ll just pretend that she was trying to complement me in her own bizarre way but when all is said and done, I’m rather offended and the entire discussion just left me with a sour feeling in the pit of my stomach.


*CTAS (Canadian Triage and Acuity Scale) 1 is an honest to goodness emergency - if you're ever in an ER and hear people scrambling about saying CTAS 1, it means that a patient who's about to start knock knock knockin' on heaven's door is going to be coming in shortly and you will have to wait until said pateint is either stabilized or is transferred to the Eternal Care Unit.

Letting it All Out – While Retaining Everything

Old MD Girl’s post about how one should maintain their composure and appear zen-like while interacting with patients at all times is inspiring this particular rant. I got a memo stating that admin is starting mandatory once a month round table discussions aimed at airing out the nursing staff’s frustrations or concerns. There’s some crap written about how those discussions can have the potential to positively benefit the entire staff because concerns can be dealt with as they come along. There’s also some other crap about how reflecting on our practice with staff at varying skill levels can improve our overall practice. My personal (ill-articulated) thought - suck it! I do not want to give up my precious break to sit awkwardly in front of some suits to talk about how much I hate the smell of C. diff in the morning. Nor do I want to talk about how irrationally angry I get when my latte doesn’t have the right proportion of espresso and milk because I’m nagging the barista to hurry up so I can make it to a meeting to talk about my ‘feelings’. I can understand the need for debriefing sessions after a particularly memorable or horrendous event but being forced to go every month to these ‘vent out your feelings sessions’ when I do just fine venting over great food with my friends is simply cruel. Not only that, the entire concept seems redundant to me because up until now, I thought monthly staff meetings and providing proof of competent practice to the provincial licensing body were for the very same purpose. No matter how stressed I am, I can guaran-damn-tee that I would find peace and quiet much more relaxing than having to restrain myself with politically correct language in front of power suited chumps.

Tasteful Fixtures

I want this in my bathroom for Halloween! Also tempted to put it up discreetly in the ER’s shower room and await the inevitable meeting with admin about the utter lack of professionalism that would follow!

Found via Gizmodo

Status Dramaticus

From my highly un-researched, completely anecdotal experience, ER nurses are generally thought of as ‘tough as nails’, ‘bitches’, ‘know-it-alls’ but rarely are we acknowledged as overly emotional cry babies who can’t keep their shit together. However, I have the great fortune (note sarcasm) of working alongside such a nurse. Every call bell, every new patient brought to her when it’s ‘busy’ and every patient/doctor/nurse/lab tech/porter who’s being a jerk to her brings her close to tears and for some reason, I up having to clean up the resultant mess because she’s too busy wailing (complete with snot and tears) in the bathroom. When I’m off work, I love shooting the proverbial shit with her, but when we are working together, I feel myself cringe because I know I will be running off my feet no matter how organized I keep my area. Not being a completely insensitive dunce, I tried to ask her if anything has been bothering her lately but her excuse for her outbursts is that she is just a very emotionally expressive person and that she feels that it’s better to let everything out rather than keeping frustration bottled up. Fair enough. Except when she’s busy sobbing, someone else has to pick up the slack that she creates. Lately that lucky person has been me and I’m getting just a little annoyed. I get it – nursing can be tough. There are always setbacks and jerks that must be dealt with but there has to be a point in which one has to put on their game face and start paddling through shit creek. Breaking down into a blubbering sobbing mess at every hiccup doesn’t help in anything except erode others’ confidence in a nurse’s ability to function well under pressure – and it’s not very professional either.

Whiny Cry Babies or Warning – Rant Ahead

I don’t know what’s in the local water supply but lately I’ve been inundated with patients who are a) obstructed in the small bowel and b) prone to throwing screaming fits of agony when I have to put in an IV and get blood work done. I would imagine that having your doody machine tied up in knots or bunged up to the point of needing surgical intervention would hurt a hell of a lot more than a puny needle collecting minuscule amounts of blood. All friggin’ day I get to hear bitching and screaming about how 25 gauge needles are instruments of superb and exquisite torture. And that was before GI and Gen Surg wanted 18F NG tubes shoved into tiny nares. Also, why, WHY would someone eat a giant pork souvlaki meal after having a confirmed obstruction and being told in no uncertain terms that eating is strictly off limits? Guess who gets to provide barf buckets to those degenerates? Honestly, some days, people really suck! Rant over. Now to head off to bed and dream of something better than small bowel obstructions.