Words of Wisdom

Yesterday I was taking care of an otherwise healthy 82 year old man with a nasty FOOSH injury when he said that I looked quite sad. I was actually quite happy except for the fact that I was starving and couldn't stop fantasizing about the ginger beef noodles in my lunch bag the entire time I was getting him prepped for the OR. I guess my hungry face is the same as my sad face which makes sense because when I'm hungry, I'm sad. Since this poor guy had been NPO longer than me, I decided it would be a wise idea to keep my yap shut. Before I had a chance to explain myself, he took my hand in his good hand, looked at me straight in the eye and said with the utmost sincerity, 'sweetheart, the world is large and you're insignificant so do whatever the hell ya want because no one will give two hootin' shits about it tomorrow!' Well said sir, well said!

Really??

Dude gets dared by his friends to try ketamine for the first time and is brought by them sinking in the k-hole. I ask the friends what he took and they look at me most solemnly and seriously and tell me he must have had a bad cup of coffee several hours prior to his arrival. Really? F%$k you! At least save what little dignity you have and tell me the truth! I kicked them out after that because I was feeling annoyed and chocolate deprived.

Epidurals are for Chicks

While working on a paper during the night shift, I got a patient complaining of severe 10/10 back pain. The guy was wearing a brace, grimacing, could barely walk, the works. I did my standard assessment, got him changed into a gown and called the doc over. The doctor ordered some toradol and dilaudid which I proceeded to give to the patient. After I had given him the meds I told him that I would reassess him in about half an hour. In half an hour, he still was not a happy customer because when I came back into his room, he was ranting on about how the doctors just expect everything to be fixed with a pill (at 0230 that pretty much is the only thing that can be done). I asked him what he would like done because he was given some pretty high doses of pain medication to which he replied, “can’t you give me like a needle in my back nerves so I don’t feel anything?” “Like an epidural?” I asked. “Fuck that shit! That shit is for chicks! I don’t want no fucking epidural bullshit! I want a needle to make the pain go away!” He didn’t take too kindly to my explanation nor did he view the IM injection of toradol as a needle to make the pain go away. I went back to working on my paper because that seemed like the only rational thing to do. And the guy walked out of the department without his back brace.

When Nurses Get Sick

Sick Nurse – Guys, I think I’m going to have to throw in the towel and go home. I just threw up again and I’m beginning to spike a fever.

Charge nurse – Sure thing hon. I’ll pull one of the float nurses to cover your area. Feel better soon.

Patient’s family member at nursing station – What kind of nonsense is this? We get sick, we come to the hospital. You get sick, you go home!

Sick Nurse – I prefer bowing to the porcelain gods in my own bathroom.

Miss Maha if You're Nasty

A little old lady with a hip fracture after being catheterized: What does RN stand for?

Me: Registered nurse, ma'am.

LOL: Should be real nasty for what you just did to me.

A Family Business

When asking a patient what he does for a living:

Patient: I’m a dealer yo. My mom’s a dealer. My dad’s a dealer. My sister’s a dealer. My brother’s a dealer. Yo guy, even my motherfucking dog is a dealer.
Me: Foshizzle bro.

*fist bump*

Keeping Kosher

Elderly Jewish patient with a sense of humor who tested positive for H1N1: Is it Kosher for me to suffer from the swine flu?

Me: Sir, almost seven years of schooling and the meager experience that I have as a nurse in this department has not prepared me to answer your question in a satisfactory manner. Would you like some orange juice?

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.

If You Can’t Take the Heat…

Today was a hot, humid and hazy nightmare of a day. It absolutely sucked. I had to forgo my regularly scheduled hot caffeinated beverage for an iced variety, which turned warm within a matter of minutes. Walking to and from the train station promptly transformed me from a bleary eyed nurse to an uncouth sweat drenched bewildered monstrosity. Moisturizer melted. Hair simultaneously frizzed and fell flat. Skin sizzled. It was literally too hot to live – which is just what one of my dingbat patients stated as his chief complaint. He said he had been feeling suicidal lately so he decided to check himself in before he hurt himself. Fair enough. However, my fierce assessment skills revealed his diabolical plan. The air conditioner in his apartment broke down so he figured that he would express suicidal ideation, get placed in a mandatory psychiatric hold in air conditioned quarters for the next several days, while not having to cook, clean and most importantly, not go to work. At first, I was quite impressed with his thought process, but when the caffeine kicked in, I was left feeling like I was punked. What an effin waste of resources. I passed along my newly acquired information to his doc, however, my shift ended before I could witness the (likely) anti-climactic conclusion to the patient’s drama of poorly concocted lies and deceit. Hopefully, he gets placed on the psychiatric hold in a unit that has faulty air conditioning.

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!

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!

Health Teaching Gems

In a recent shift, I met a young man who had a few questions about the transmission and pathology behind influenza. Since it was a quiet lull in my day, I relished the opportunity to flex my teaching muscles and started by asking him to describe what he knew so I could proceed from there. He knew that he should wash his hands and cover his mouth when sneezing or coughing but he did not know how that prevented flu’s spread. The conversation eventually led to me explaining how the virus essentially hijacks cellular machinery to assemble millions of copies that burst out of the cell thereby destroying it. He became slightly confused and in order to clarify the concept, I asked him to imagine an overcrowded place in which people are pushing to get out. Lost deep in thought, he stared at the wall behind me before his eyes lit up and he triumphantly announced, “the virus bursts out of the cell like hookers from a cake!” Flabbergasted at such a crude, yet visually effective analogy, I had no choice but to enthusiastically agree!

Med Error?

Talking to a patient who was particularly hard of hearing today for almost 12 hours has not been good for my voice. However, it was all worth it just for this conversation:

Patient: What pill is this?
Me: This is your Losec.
Patient: Low sex? I’m already old and feeble! Why the hell would I need a pill for that?
Me:* LO-SEC! NOT Low sex! This is for your heartburn!
Patient: Good! I don’t need a pill for low sex!

Good times! I could never have a conversation like this in the corporate world.

*While trying desperately to suppress loud and boisterous laughter

My First Time

“I think I’m joy-gasming”

Overheard when the charge nurse for the day walks into a completely empty department. No one in triage, no one in trauma, no one in resuscitation and no one in fast track. I doubt this will ever happen again. I think the night crew should have gotten a raise just for that night. This has nothing to do with the fact that I was part of that night shift.

Professional Communication

A 50-ish something man comes in with severe alcohol withdrawal, tremors from hell and the highest fever I’ve ever seen. I get him some Tylenol and help him to the bathroom. When I go back to the nursing station, a bewildered doc is looking through the charts and asks me, “where’s the shake n’ bake from exam 5?”

After a moment of silence, I couldn’t help but laugh very loudly at the doc’s very clinical description of the patient! Nursing theorists would be disappointed in me.

What’s in a name?

Ill informed patient: I’m allergic to ibuprofen.
Me: What happens when you take ibuprofen containing medications?
Patient: I get really bad hives and I feel gross.
Me: But you said earlier that you took Motrin for your pain?
Patient: Yeah, Motrin not Ibuprofen. Are you not fucking listening to me?
Me: Motrin IS ibuprofen.
Patient: No its not. I didn’t get hives.
Me: Then perhaps you’re not really allergic to ibuprofen.
Patient: You’re retarded. You’re just a nurse. I AM allergic to ibuprofen so get me some Percocet bitch!
Me: Security!

Moral of the story: If you’re a drug seeker, it would benefit you to know the trade and generic names of your drugs so you don’t look like a bigger jackass than you really are. Oh and I'm not 'just a nurse'. I'm your nurse and I'm not going to 'advocate' to feed your addiction.

Conscious Sedation Chats

Happened while prepping a pt for conscious sedation for an I&D

Doc: Okay dear just relax and think of pleasant thoughts.
Pt: Man I’m thinking I look like Halle Barry! Life is gooooood!
Doc: What’s a halle berry?
Pt: DAYUM doc you one OLD DOOD!
Me and 2 other nurses: Giggle snort chuckle!
Doc: Just push in the stupid fentanyl!
Me: Sure thing – giggle snort chuckle!
Doc: Glares at everyone in the room

Unfortunately named

Dr. Hung for swallowing assessment.

My apologies to Dr. Hung but he provided hours of entertainment for us weary night-shifters! And yes, I'm very immature at 0300.

T.M.I.

Two nurses talking to each other about a dance lesson poster in the staff lounge;
Nurse 1: Did you hear about those dance lessons?
Nurse 2: Yeah I did but my husband won’t go cuz he’s a crappy dancer.
Nurse 1: My husband sucks at dancing as well – the only dancing he’s good at is between the sheets and even then I have to fake the shakes.
Nurse 2: 0_o - You need a new husband.

Boy nurse: I think my little old lady tried to sexually harass me!
Nurse 2: What the hell? How?
Boy nurse: She tried to grope my ass when I turned to hang her antibiotics!
Nurse 2: She is demented though – maybe she was just flailing her arms and one hit you.
Boy nurse: Then why did she wink at me?