It's A Family Affair

I got a transfer from a neighboring hospital to the Telemetry Unit I was working the other day.

The patient had had a heart catheterization and was found to have severe enough disease to require a bypass. (The other hospital does caths, but not interventions)

Ex-Texette works at the 'Other Hospital' in their Cath Lab.

My daughter, JoJo, is doing her clinical rotation on the same Telemetry Unit and was assigned the same patient.

One patient cared for by three members of the same family.

Very cool!

Get Off Your Ass...

I was working on one of our step-down Units recently, a Unit I don't like working because I feel that some of the staff are lazy.

Thanks for proving me right.

As I was getting ready to round on my patients, I heard the distinctive 'beeping' of an IV infusion pump from the opposite side of the Unit. I went ahead and rounded on my peeps.

As I returned to the Nurse's Station, some 15 minutes later, the alarm was still beeping. I decided to check it out, found the room, and corrected the problem (kinked tubing).

I looked at the patient assignment board to see who the nurse was.

There she is, at the Nurse's Desk....on the computer....on Facebook....tending her Farm.

Bitch!

Waste Not, Want Not

Sometimes what appears as a sad case is, well, funny.
I recently cared for what seemed to be a very sad case. A homeless man, who worked a menial position at a large department store, was admitted for possible stroke.
The man, in is early 50's lived in a tent in the wooded area behind the department store. He bathed in the restrooms at his work place, cleaning his clothed in the sink.
Should he need to heed the call of nature while 'home', the nearest tree or bush sufficed.
He spoke intelligently and stated he had attended college 'up north'.
Alcohol had been his downfall, he drank a fifth of vodka every night, not because he was an alcoholic, but to help him sleep. (His 'stroke' was Wernicke-Korsakoff syndrome, secondary to his alcohol consumption.)

And he wasted nothing.

Every little scrap of paper was utilized. He described his abode as a collection of discarded items.
He said he wasted nothing in his tent.

I can think of only one thing that was wasted in his tent.

ED Sing-a-Long: Ballad of the Frequent Flier

Happy Halloween

Happy Halloween, Ortho-Style

Reprise: The Family Doctor

I've had this blog for 2 years now, so I thought I'd put up an early post, just for the hell of it:

When we think of the family doctor, we have images of the mildly-portly, elderly, wise-looking Marcus Welbish MD. Or at least the quack in the Forrest Gump movie, "His legs is strong, but his back is crooked as a politician." Of course in the ED, we recognize the family doctor just as easily.

No, no, not the MD from the family practice across the street, I'm talking about the family member that not only knows more than the ED doctor, but knows about every illness, surgical intervention and medication of every single family member going back 3 generations.

Yes, I am talking about the dreaded Family Doctor, whom henceforth shall be called Dr.Kia (Know-It-All).

Had a lady show up at the registration desk yesterday requesting her spouse be registered immediately:
"He's having a heart attack!"
"Where's your husband?"
"He's on his way, hurry up. We can't waste time with this registration crap!"
"Is he coming in an ambulance?"
"No, he's driving."

That's right, drove himself while having a 'heart attack.'

So he ambles in, we get him registered, much to the ire of Dr. Kia. She plops him in a wheelchair, (Paralysis Point strikes again!) and into a treatment room we go.

I walk into the treatment room as the patient is wheeled in and with the help of the CNA and charge nurse, we quickly place him in a gown, hook up the monitor and get an EKG. Hell, for all we know he might be having an MI (not even close). Meanwhile, Dr. Kia starts writing everything down, VS, names, times. Dr. Kia's PA, the patient's sister, is on her cell phone calling the patient's cardiologist in Durham. That's right, some 250 miles away. The ED doc hasn't even walked in the room and Dr. Kia is already arranging a transfer.

ED doc walks in,
"Hello, I'm Dr. ED. What seems to be the problem?"
"He's having a heart attack. He had the same look when he had his heart attack 3 years ago."
"He 'looks' like he's having a heart attack?"
"Yes, I already consulted his cardiologist in Durham and told him he's having a heart attack. He needs to be transferred ASAP."

Off in a corner of the room, Kia PA is frantically dialing on her cell phone, notifying all near and far of the life and death struggle of their beloved family member.

After initial assessment and the determination that no REAL emergency exist, the doc orders some meds and labs. Dr. Kia is not impressed.

"He's had a nitroglycerin already today. Why are you giving him more? And more aspirin? He takes a baby aspirin every day!"
"I don't know," I said, "I've never done this before."

If that wasn't enough, Dr. Kia questioned us as to why we would give a patient with angina, morphine.

"Doesn't it concern you that you may be masking the pain of his heart attack?"
"No," I said, "That's why we have that TV screen with the squiggly lines connected to him. If he starts having a heart attack, the TV says, 'heart attack in progress'."

It also concerned Dr. Kia why we didn't just go ahead and transfer him NOW.
"We haven't gotten all the lab results back yet," I said, "and besides, Durham hasn't called us with a bed assignment."

"It's a 3 hour drive. They should have a room by the time he gets there."

Incidentally, the patient had been 'looking like he's having a heart attack' for 3 days.

A Different Kind Of Pain

The ED night shift has their own pain scale:

ED Sing-a-Long: Paralysis Point

Paralysis Point:
Every ED has one.

Anal-ogy, Part Deux

Some people's religious beliefs can interfere with even the most basic care. I had that problem last week.

I was caring for an elderly patient whose dutiful wife never left the bedside, having taken residence in the room. I had been told in report that their religious convictions forbade a woman to touch him. Doing so equated to intimate relations, at least in the eyes of the spouse. The patient, well, he was too sick to care.

Attempts to conform to her requests were fruitless: There simply were not sufficient male assistance available, especially on the night shift. Efforts were made, but the spouse made demands beyond the capabilities of the staff.

As it were, I was assigned to his care, simply due to the fact that I have a penis.

At one point during the day, the patient soiled himself. I asked the nurse assistant to, well assist. The spouse forbade it.

I attempted to find help from a fellow penis-gendered employee, but one would not be immediately available, and the spouse wanted her husband cleaned immediately.

The solution: The spouse would turn and hold, I would clean and wipe.

It was during this 'our time' moment that the spouse decided to explain her and her husband's philosophy regarding touch, sex and intimacy.

All the while I was wiping his ass.

I began to wonder if my actions constituted anal sex.

Luckily, the patient let out a large watery stool and the thought was lost.

A Little Goes A Long Way

I had the pleasure of caring for a mid-eighties year old gentleman the other day. He was sitting up in a recliner awaiting his morning dose of slop, when I eyed these mini-bottles on his bedside table:

The bottle on the right is Tequila Rose Java Creme Liqueur (15% alcohol content), the one on the left is Malibu Mango Rum (21% alcohol content). The night nurse had mentioned them and told me she had asked the patient not to drink them, due to the medication he was on.

I asked him where they came from.

"A friend brought them."

I went to pick one of them up...empty. So was the other.

"You drink these?"

"No one said nuthin', and I didn't see no harm."

I think he needs to grab one of those batteries off the bedside table.