Welcome to Weird Nursing Tales

Year Of Awesome Continues....

2012-01-22T09:12:00.000-05:00

Sometimes when you're on a roll, good things just keep happening.

Last week I was asked to speak at a local Community College's Nurse Pinning Ceremony come May.
As you might remember, I was asked to do this honor at my daughter's Pinning last year.

I guess I could just re-hash last year's speech, but that's just lazy, so I'll put a new one together using some elements of last year's speech.

Annnnd.....

Our Hospital CNO has asked me to write an article for the Hospital Nursing newsletter about my daughter, JoJo.
She is a 4th generation RN at our facility.

If the rest of this year is like the month of January, I may have to buy a lottery ticket.

Yep, That, Too

2012-01-20T05:58:00.000-05:00

Tex: Mr. Constipation, your Doctor has asked me to give you a suppository.

Mr. C: Oh, alright, I hate these things.

Patient rolls on his side as I prepare his suppository

Tex: You're going to feel some pressure.

Mr. C: The hell I am. I'm gonna feel your finger up my ass!

I Resemble That Remark....

2012-01-16T09:21:00.000-05:00

So this year is the Year of Tex.
After last years debacle and subsequent fallout, I have decided that this year, it will be about me.
A little side trip to Charleston last week, next month I plan to head to the beach for a long weekend, or maybe fly out to Vegas.
This year, it's about attitude, I refuse to be down, and nothing will keep me down.

Which brings me to work.

I often get asked (as most people are), "How are you, Tex?"
I respond, "Awesome, ask anyone. 'Hey, how's Tex?' and their answer is, 'Awesome!'"
It's become a bit of a running joke.

So yesterday, a friend sends me this via Facebook:

Yep, that's me.

Charleston Was A Nice Respite

2012-01-09T05:58:00.000-05:00

What Are Friends For?

2012-01-03T08:09:00.000-05:00

Okay, so here it is, a WHOLE two days after New Year's, and your friends and family notice you haven't quite awaken from the festivities?

Yeah, an entire quart of tequila, even the cheap stuff, will put you in a drunken stupor, but TWO days?

By the time they tried to wake you, still in bed, your face in a puddle of vomit, your urine-soaked party clothes disheveled around you, well, you weren't doing too well.

EMS brought you in, intubated: unresponsive, renal failure, dehydration, aspiration pneumonia and your blood alcohol still over 400.

You'll live....for a while.
But the damage is done, and it can't be undone, not this time.
I guess that party really was to die for.

Twenty-five years old with two small children.
I wonder what mom will say when they ask, "How did daddy die?"

Heavy Man

2011-12-27T08:33:00.000-05:00

Eight bed Intensive Care Unit*

Patient #1 600 pounds
Patient #2 420 pounds
Patient #3 280 pounds (but a double amputee)

All on ventilators, all total-cares, all full codes.

Joy.

*It took all four nurses to turn patient #1

Working On A Another Christmas Day

2011-12-24T09:42:00.000-05:00

A Redeux: My First Time Doing CPR

2011-12-18T09:43:00.000-05:00

As mentioned in an earlier post, student nurses seem to gravitate towards me when they visit us for clinicals. One on occasion, we had code blue coming in. I told my two student minions to stand in the back of the room, watch, experience, learn. The code was called pretty quick (You can cure a little dead, sometimes mostly dead, but never just-plain-dead). The students were encouraged to try practicing some CPR. Both refused, the chicken shits. It's not like you're gonna hurt the guy.

Well, that encounter brought to mind the first time I ever did CPR. It was 1982, my first year in RT school, and just two days after I started working as an OJT (On-The-Job Trainee) in Respiratory.
An elderly man was brought into our little 3-room ED via POV by family. There was some big party at the patient's residence. It involved all the necessities of a good time: family, booze and in this particular case...fried chicken. Anyway, Gramps had a little too much of the booze and chicken, and aspirated a chicken bone.
So the family drives up to the ED entrance, Gramps in the back, looking mighty blue. We hauled him out the car into a wheelchair and took him straight back. We worked the code for a good 40 minutes, but to avail. The man was just-plain-dead.(Technically, and honestly, I stood back trying not to wet myself. It was my first honest-to-goodness code, and I was but a child of 22.)
Once it was called, the ED Tech asked me to jump in and do some compressions. My response was both classic and stupid:

"What if his heart starts up?"

After the ED Tech stopped laughing, he assured me that short of some kind of celestial intervention, that wouldn't happen. That, and that my CPR technique sucked. He took the time to show me hand placement, compression technique and how to count out the compressions. To this day, I appreciate it. Somethings you never forget, despite the passage of more than two decades.
Oh yeah, and the patient, he stayed just-plain-dead.

Complaint Of The Day vs WTF!

2011-12-17T09:42:00.000-05:00

22 year old female*: Nausea and vomiting/"I think I'm pregnant"

Gravida 13
Para 2

*I thought she must be selling it cheap, but then when I saw her and I realized she's giving it away

Complaint Of The Day

2011-12-12T06:49:00.002-05:00

25 year old female: I burnt my mouth eating pizza.

Things That Make You Go 'WTF!'

2011-12-07T08:32:00.000-05:00

So EMS brings in a lady from the local National SuperStore. This person had been sitting in one of those motorized shopping carts reserved for the physically disabled, morbidly obese and lazy patrons (she fell into the two latter categories) in the pharmacy area. She was unconscious and unarousable.
While attempting to extricate her from said motorized shopping cart, the pharmacy staff was questioned. Her name, address and various personal information was ascertained. It was also determined she had been waiting for her narcotic refill.

'lightbulb'

She was loaded in the rig, a line was placed, oxygen administered, care given.

Then came the Narcan.

By the time she came to me, she was a bit upset, as you may imagine. And it didn't take long for her to sign out AMA.
Because she was 'disabled', our staff was considerate enough to put her in a wheelchair and wheel her out* to her son's car.
Her son was patiently waiting in the ER drive (he was snorting something), and told his Mom not to worry, he had 'some medicine to help her feel better.'

Don't you just get all warm and fuzzy inside knowing a son's love for his momma?

*just get her the hell out of here!

Rim Shot Part Deux

2011-11-28T14:31:00.000-05:00

Tex to Stoma Nurse:

"I hear you give a hole lotta lovin'."

Subtle Threats Don't Work Either....You Know

2011-11-26T08:05:00.000-05:00

So a patient comes into the ED requesting 'something be done' for the pain in his arm.
You know, the pain he's had for 9 years.
You know, the pain he usually sees Dr. FamousName at Real Hospital in the Big City.
You know, that place is closed over the Thanksgiving weekend?!

Here's some Naprosyn.

MyArmHurts: You know*, my Mom died in this Hospital.
Tex: I'm sorry to here that.
MyArmHurts: You know, it was on the news.
Tex: (Ignoring patient) Sign right here and you you can be on your way.
MyArmHurts: You know, I have a lawyer.
Tex (still ignoring patient) Have a nice weekend.

* He said 'You know' at the beginning of every sentence.

Rim Shot

2011-11-21T06:08:00.000-05:00

Tex: So how long have you been married?
Patient: Sixty years!
Tex: Wow! And to the same woman.
Patient: No, she's changed, she's changed a lot.

How To Get In Trouble...

2011-11-10T09:55:00.000-05:00

When 2/3s of your Facebook 'friends' are co-workers, posting about a generic 'patient' will get you laughs and likes, and even a few comments, such as; "I had one of those last week!"

Chuckles all around.

Until Administration sticks their nosey faces into it.

I posted the following status last week,

"I gave my patient a toothbrush, because a teethbrush would have been redundant."

Then I got an e-mail saying even though there was no identifying subject matter in the post (except for the one tooth, I guess), it could violate HIPAA, and I should delete the status immediately.

Do you have any idea how many single-toothed people live in North Carolina?

'Anything You Can Do....

2011-11-05T07:38:00.000-04:00

... I can do better. I can do anything better than you.'

So goes the song, and apparently the family dynamics I dealt with last week.

EMS called, saying they were bringing in 50ish lady who had overdosed on several medications, including Prozac, Lamictal, Xanax and Geodon. (Getting a picture on this persons medical history, are we?)

The story was the patient was depressed because of her beloved pet's death. This must have been one hell of a dog, because the patient's daughter called to tell Mom how upset she was and how she was planning to kill herself.
"Hell no!", says Mom, "I'll kill myself first!"

And the winner is......(drum roll)......

That pesky 'Will To Live'!

Dialing It Down

2011-10-24T18:46:00.000-04:00

Okay, I admit it.
I get excited about my job. Not, excited like, "Oh, my gawd!"
More like, "Hells, yeah! I love this!"
Heck, I get excited when I discharge patients. I get the feeling I've had some small part in making that person's life better.
So when I was working Cardiac Step-Down the other day, well, let's just say I was happy that one of my patients was scheduled for discharge later in the day.
Unfortunately, when the Cardiologist came to see the patient, he changed his mind, much to the patient's wife's chagrin.
"That nurse has been acting like my husband was supposed to go home, and now you tell us no?"

The Doc caught up with me at the desk and laughed it off.
"Hey, Cheerful, Mr. NotReadyForDischarge's wife said you're too happy."

I did apologize to the patient and his wife.
Her response?
"You have a nice bedside manner, but you need to dial it down a notch."

I've been doing this for almost 20 years, I don't think I can...or want to!

Um, Is That A Stethoscope, Or Are You Just Happy To See Me

2011-10-18T08:51:00.000-04:00

After almost thirty years of direct patient care, the last nineteen as an RN, I can truthfully say, the worst family members are the ones with a medical background.
The more extensive, the worse.
I cared for a very sweet, demented 90 year old patient recently, who was admitted after a rather bad fall.
(Doesn't gravity drag down LOLs?)
Her daughter decided to help take care of her mother.
She slept in the room.
Ate all her meals there.
Bathed and changed in the bathroom.
What a refreshing scene, the dedicated daughter. Putting her life on hold for her mother!

Did I mention said offspring was an RN...over thirty years, or so she says.
The daughter dressed in scrubs everyday.
Had a name badge on from employee, boldly displaying the RN behind her name.
She even wore a stethoscope around her neck, which I found strange, since her position at her place of employment was 'educator'.
That wasn't bad enough...she discontinued her mother's IV because it 'didn't look good', then offered to restart it.
She insisted on lab work, specific IV fluids, fiddled with the IV pump to adjust the rate, stated the doctor's had 'messed up all of mamma's meds', ad nauseum.

I know what you're thinking..."Report her to the Board of Nursing!"
I thought about it, but momma was discharged home in the care of her daughter.
Let the Home Health Nurses, Physical Therapists and CNAs deal with her.
I'm sure the daughter will find their expertise less than adequate, and the daughter can do it by herself.

Maybe the stethoscope will come in handy.

I Resemble That Remark

2011-10-07T09:05:00.000-04:00

The bane of Float Nurse existence is the ability to just up and get reassigned to another part of the Hospital at the drop of a hat.
When this happens, it is necessary to give a quick, concise report and move your ass to another Unit.
This happened last week, and as always, I thanked the folks I'd been working with for their assistance.

Tex: Hey, UnitClerk, thanks for your help. See ya next time.

UC: See ya, Tex. Thanks for working with us.

RN I've Never Seen Before: Hey, you're Tex?

Tex: Yeah. Do I know you?

RN INSB: No, but I heard of you. I work across town at Hospital's Infusion and Wound Center. I've heard the patient's, their families, even the Doctor's talk about you. They say your a great Nurse.

Tex: Thanks. I guess you thought I'd be taller.

Take A Mulligan

2011-09-29T19:27:00.001-04:00

Being Hispanic and working in the south, I get a lot of questions regarding my heritage.
Most people simply ask where I'm from, while other circumvent that question by simply saying, "Y'all ain't from around here, 'er ya?"
But recently a patient asked if I was any good at golf.
"I don't golf, why do you ask?"
His reply, "Well, y'all got such a nice tan."

I Hope It Never Goes Away

2011-09-23T02:12:00.005-04:00

Tex: So how was your first day off orientation?

JoJo: Dad, I was so nervous. You know, my stomach was turning flips.

Tex: I know what you mean, I get that every day as I walk from the parking lot into the building.

JoJo: You mean it never goes away!!??

It's All About The RIF

2011-09-20T09:11:00.000-04:00

Reduction In Force.

That's what my Hospital called it when it fired about 4% of the staff.
The Administration said it was due to Medicare/Medicaid (e.g. The Government) being late with payments.
The same RIF happened in two other facilities in the immediate area.

At the same time, my Hospital hired upwards of 20 new nurses, including my daughter.
Don't get me wrong, I thrilled my daughter got a job where I work, and I'm thrilled I survived the RIF, but somehow it doesn't compute.

Who was let go?
Staff that was either near retirement age, had been with the Hospital for a long time (one was employed there for over 40 years), LPNs, those staff who complained a lot or were chronically late to work or called in sick too often.
There were, of course, non-nursing staff let go as well. I deemed those positions, for the most part, unessential.
Like clip board carriers, redundant suits and people I never heard of.

Administration needs to call it what it is: culling the herd.

Shoot 'Em Up

2011-09-09T09:50:00.007-04:00

It's bad enough that people will crush up their pain meds and try to inject them intervenously, but it's worse when you catch them doing it....
with the pain pills you just gave them...
in the pill cup they left on their bedside table...
using the water in their water pitcher...
using gauze the lab left on their arm from this morning's blood stick as a filter...
with the empty syringe you threw in the garbage....
and the PICC line that was put in yesterday....

Kudos for the thought process, Bro, but the Doc just d/c'd all narcotic meds.

How To Use The Pain Scale

2011-09-06T09:00:00.002-04:00

Update....

2011-09-05T09:50:00.000-04:00

Wow, no post for over a month.

Let's see what's been happening:

I'm no longer married.
Why?
You know, all those posts on all those blogs about crackheads?
You'll never guess.

Now I know why all that overtime I was working wasn't making a big dent.

A Re-Post: Trauma Queen

2011-08-02T08:12:00.000-04:00

Stupid People.......

2011-07-12T08:35:00.001-04:00

...are driving under the influence...enjoy your time at the GrayBar Hotel.

...are inhaling 'not for consumption' Atomic Blast...enjoy your SOB, nausea and vomiting.

...are snorting bath salts...enjoy your paranoia, at least until we intubate.

...are not heeding their doctor's advice about their diabetes, enjoy your dialysis.

...are stupid.

A Re-Post: Tangled Up In Poo

2011-07-06T10:04:00.000-04:00

Hospital: A Re-Post

2011-07-02T12:02:00.003-04:00

Working In Triage- A Repost

2011-06-28T07:19:00.002-04:00

No Threat Goes Unpunished....

2011-06-21T08:39:00.000-04:00

Your Mama is sick.
Very sick
Fifty years of hard living, drinking, smoking...abusing her body like there was no tomorrow has taken its toll.
Now there is no tomorrow.
And all the king's horses and all the king's men can't fix it.
Neither can the Doctor.
So telling him he will be "sweatin' in his own blood" if he doesn't save Mama is only gonna get you one thing.
An escort out the door by the local LEOs and barred from Hospital property.

And away from your Mama's bedside where your Father needed you most...on Father's Day.

Remembering Dad On Father's Day (Repost)

2011-06-19T06:00:00.000-04:00

I was 11 years old and playing Little League for the first time.
My Dad had played a little semi-pro ball and although he never made it off the local sandlots, he had high expectations for his only son.
He would be disappointed because his son sucked at sports.
But back then there was still hope.
My Dad had been preparing me for Organized Baseball by teaching me the finer points of the sport:
Bunting
Choking up on the bat
Covering first
Backing up the pitcher

He should of concentrated on catching and 'not throwing like a girl'.

My excuse for not catching well was because he had me using an old glove, and I do mean old. The thing looked like was used in the 1940s, just barely larger than a man's hand, and it fit me like the proverbial catcher's mitt.

As he drove me to my first official practice, me sitting in the front seat of that Oldsmobile with that horrible baseball glove in my lap, I was terrified to disappoint him (I would), but even more so, I was embarrassed by that glove..and he knew it.
He parked the car in that gravel parking lot. I got out of the car and started making my way toward the practice field. As I did he called me back.
He reached under the seat and pulled out a brand new Wilson outfielder's baseball glove!
I gave him a hug, thanked him and ran to the field.
My Dad gave me many things during his life, but that glove always meant the most.

I still have that glove, some 40 or so years later. It's beat up, the leather ties cracking and some broken, my name in marker still visible on the thumb.
And I still can't catch worth a shit.

Threat By Peripheral Smear

2011-06-18T06:03:00.000-04:00

Pt: Tell the doctor he better give me something for pain or I'll call my brother!

Tex: Is your brother a lawyer or something?

Pt: No, he's a Clinical Pathologist!

But Was It Prescription Or OTC?

2011-06-16T08:07:00.000-04:00

Chief Complaint Of The Day

2011-06-13T06:15:00.000-04:00

Past ER Visit History:
10/10: GSW Abdomen
01/11: GSW Left Thigh
03/11: GSW Right Arm

c/o: Paranoid

Hello...Hello, Again

2011-05-30T08:34:00.000-04:00

Like most ED Docs, ours work in various EDs in the region, so it isn't unusual for them to see the same patients in different EDs.
Last week, one of our Docs came out of a patient room laughing.
Apparently, the patient he had just seen had threatened to sue him just the day before at a neighboring ED because the Doc wouldn't refill his pain med script.
He told us the patient looked at him, got a quizzical look on his face, and asked if the Doc had a brother.

He didn't get his script.

An Dey Over Watered De Plants, Too

2011-05-28T05:57:00.000-04:00

When confronted by the ER Doctor when her 4 month old child's urine drug screen came back positive for cocaine:

"Some ones broke in to my house an gave my baby cocaine!"

A Conversation Yesterday:

2011-05-27T05:39:00.001-04:00

Dr. F: Hey Tex, did the alcoholic lady mention she also smokes weed?
Me : Yeah. I guess when she can't have Bud Lites, she lights buds.

Damn, I crack me up!!!

For Dr. Grumpy

2011-05-24T07:06:00.002-04:00

I Guess The Stress Is Getting To Them

2011-05-18T05:53:00.000-04:00

....and they just can't stand the strain....

2011-05-07T06:04:00.000-04:00

The full context of the Speech I gave at my Daughter's Pinning Ceremony:

Good Evening.

My name is Tex and I’m a Nurse.

“I’m a Nurse.”

That’s a pretty powerful statement. And it comes with a lot of responsibility.

Last year’s Gallup Poll listed Nurses as the most trusted profession in the United States….for the 11^th year in a row.

That means Nurses ranked above Doctors.

Above Teachers.

Above Police Officers.

Even above the clergy.

Wow.

I graduated from this program back in 1992 and have been working as a Registered Nurse at Westernish North Carolina Medical Center pretty much since then. Before that, I worked as a Respiratory Therapist for 10 years. That’s 29 years of direct patient care. Almost two thirds of my life dedicated to helping the sick feel better.

My only regret is that I didn’t have the drive, the fortitude, to further my education. So, I don’t have any fancy degrees and I don’t have a bunch of letters behind my name.

But those 29 years have given me wisdom, given me experience and given me a passion that a bunch letters can’t.

And it’s that experience, wisdom and passion that I’d like to pass on to you, the next generation.

I’ve seen a lot of Nursing students file through the Hospital. Every year a new bunch. And every year I look forward to seeing those Students.

I enjoy teaching them.

I enjoy working with them.

I want to instill in them the same love for Nursing that I have.

I want the next generation of Nurses to be great!

I like to use this little analogy, especially with the first year Students:

A carpenter is making shelves. He measures the piece of wood, he cuts and he hangs the shelf.

If he happens to measure wrong, takes a short-cut, loses focus and cuts the piece of wood, even just a little short, it won’t fit. He has to throw that piece of wood in the scrap pile and start over.

Nurses do not get that luxury, if you screw up, someone can get hurt…or worse.

Scared yet?

Because you should be.

So if it’s so scary, so wrought with responsibility, then why choose Nursing?

I’m pretty sure I’ve asked that question to those Students that I’ve met.

And I get a lot of answers.

The most common one being, “I want to help people.”

Or, “I care about people.”

Or, “As a sick child, the Nurses in the Hospital inspired me.”

Or “My Mom’s a Nurse.”

Or “My Dad’s a Nurse.”

Whatever the reason, you put in that application, you took your pre-requisites.

You waited for that letter.

And you got in.

Then the fun started.

Remember that first day in Clinicals?

There you were.

You had on that crisp, clean new uniform.

Little bandage scissors that barely cut paper tucked in your pocket.

New stethoscope slung around your neck, feeling all nursey.

Standing in twos or threes, like little, lost puppies, but ready to save the world.

But Clinicals weren’t what you thought they’d be, were they?

Reading charts.

Copying down patient histories.

Studying disease processes.

Trying to figure out what the labs meant.

Asking the Nurse, “what’s the difference between an MRI and an MRA?”

Writing and memorizing drug cards.

And care plans!

Hey, I had to do Care Plans, too.
The writing.
The research. And this was before everybody had internet, you had to use books.
And the time.

I don’t know about you, but sometimes I’d write them about myself.

‘Activity intolerance related to lack of sleep.’

‘Sleep pattern disturbance related to stress.’
‘Impaired home maintenance management related to Nursing School.’

Let me tell you a little something about Care Plans, now that you don’t have to do them anymore.

Care Plans equal Critical Thinking.

And Critical Thinking is not an option.

Here it is, almost 20 years later, and I'm still doing Nursing Diagnosis and I'm still doing Care Plans.
Every shift, for every patient. In. My. Head.

But it’s not enough to know the intervention and rationale behind Nursing Diagnosis.

It’s not enough to memorize the names of drugs and their side-effects.

It’s not enough to know the difference between ischemia and angina.

Nurses treat people. And it’s how you treat people that will define you as a Nurse.

In 1993 I lost my father to cancer. Before he passed away, he was in the Hospital in Texas and I couldn’t be with him. He was 2,000 miles away. We had planned a trip to see him, but I was worried if I’d get there in time, so I called him. Often.

And I worried if the Nursing staff was treating him well.

Because when you work in a Hospital, you see that not all Nurses are the same.

Most are caring, compassionate, but some aren’t.

Some walk and talk like they’re better than everyone else, and some, well, some you wonder why they even bother.

So I worried.

But my Dad told me this, and I will never, ever forget it. He said, “Son, don’t worry about me. The Nurses, they’re my angels. And they treat me like I was their own father.”

And that, ladies and gentlemen, is what defines me as a Nurse.

If you treat your patient the way you would want the most precious person in your life to be treated, I guarantee you will never go wrong.

And let me tell you.

People will remember how they’re treated.

My wife, Texette and I can’t go anywhere without running into someone who remembers me.

About four, five years ago, I was at a local dealership looking to buy a car. This lady walks up to me and says, “I know you, you were my Nurse. You took care of me after I had open heart surgery, I was in the ICU.”

I looked at her, but her face didn’t ring a bell.

“I’m sorry, I don’t recognize you. When was your surgery?”

“I’m Mrs. Jones; you took care of me 14 years ago.”

Fourteen years.

But not all encounters are quite as rewarding.

On one trip to Wal-Mart, Texette, and I were waiting in line to pay for our groceries. There was a lady standing beside Texette, and she kept peaking around her, looking at me.

Finally, she catches my eye and says, “You’re Tex. You were my husband’s Nurse.”

To be polite, I asked, “How’s he doing?”

She turns toward her husband, who was down one of the nearby aisles and started yelling, “Hey, Ray. Come here. Your Nurse, he’s at the Wal-Mart.”

We don’t shop at that Wal-Mart anymore.

Thing is, though, you don’t get to choose your patients.

You may not like them.

You may not approve of their lifestyle choices.

You may disagree with their political views.

You may oppose their religious convictions or their lack of them.

Heck, you may not like them because they’re a Duke fan but when you walk into that room, you treat them with respect, you treat them equally and you treat them well.

And if they are a Duke fan, you flash your Carolina keychain at them.

But before you become Nurses, there is just one more thing left for you to do.

The National Council Licensure Examination.

The NCLEX.

Also know in many nightmares as The Boards.

I know you are all worried about it, but let me ease your nerves.

That seat you’re in, that uniform you have on, the pin and the lamp you will receive tonight.

Nobody is giving those to you.

You earned it.

The hardest part of your journey is finished. You spent the last two years studying, working and stressing to get here…tonight.

Rest assured, the knowledge you have gained is sufficient. Let me be the one to ensure you, you will pass your boards, you will make us, your family, your friends, all the more prouder.

And once you’ve passed, and you will, you’ll get that first Nursing job.

And when you do, find a Mentor, a good one.

Because the Nurse you become will be heavily influenced by those whose guidance you seek.

My influences were Donna and April.

They were my Mentors.

Donna had organizational skills like none I have ever seen. Not then and not since. She could finish up report by 7:15, assess 5 patients, including vital signs and give 2 baths before breakfast.

And she never sat down, never stopped moving.

April was a patient advocate and she never gave in. I don’t know if the Doctors loved her or hated her, but they certainly respected her.

And she never sat down, never stopped moving.

I only hope I am half the Nurse these ladies are.

Now then, I’d like to finish up by giving you just a little more advice, some guidelines.

Rules, as it were.

These aren’t all the rules, just a few to get you started.

Tex’s Rules of Nursing, rule number one….

Don’t kill nobody.

Every other rule directly or indirectly, will always come back to Rule Number One.

The others:

Never pass up the opportunity to see a procedure.

Learning never ends.

Ask questions.

More importantly, know when you must ask questions.

If you still don’t understand, ask more questions.

Don’t think you know more than you do. You don’t.

The only thing worse than a nurse that doesn’t know anything, is a nurse who thinks they know everything.

Wash your hands.

Not everyone can be fixed.

Patients will unexpectedly get sicker for reasons completely unrelated to the quality of your care. Don’t take it personally.

In the event of an emergency, the first pulse you check should be your own.

Stay focused.

Don’t forget your ABCs. Airway. Breathing. Circulation.

Basic nursing comes first.

Bed baths are an essential skill even for RNs

Wash your hands.

Trust your gut. Ignore it at your own risk.

If you feel something isn’t right, it probably isn’t.

Your most recent assessment is the most important assessment.

Assess the patient, not the machine.

Eat.

Breathe.

Pee.

Wash your hands.

Talk to your patients, not above them and certainly, not at them.

Listen. Carefully. To colleagues. To Patients. To Family.

Wear gloves.

Five rights. (Or is it 6, maybe even 10) Three checks. Always. No exceptions. Ever. Amen.

If you’re giving more than two of anything — tablets, capsules, vials — you’re may be giving too much. Double check the order.

Wash your hands.

Don’t bring an attitude to work, bring chocolate. Or donuts. Or chocolate donuts.

If your colleague is drowning, throw them a line.

Help if asked.

Ask for help.

Teamwork.

Housekeepers. Nursing Assistants. Food Service. Unit Secretaries. They are your best friends. They are your equals. Treat them as such.

Specialize in a skill. Be that go-to nurse for hard IV starts.

Veins don’t roll.

Take no guff from no one.

Wash your hands.

Advocate. For your patients. For your profession. For yourself.

Thank you for inviting me here tonight.

Westernish North Carolina Community College Nursing Class of 2011, welcome to the family.

Nurses 'Day

2011-05-06T15:24:00.001-04:00

What a very special Nurses' Day.
Yesterday, I was part of the celebration at my Daughter's Pinning: I stood at that pulpit and spoke directly to her (while a church full of 500 looked on), stood by her side as her mother place the Pin on her uniform, and I handed her her Lamp.
To say I am proud is an understatement.
To say I didn't shed a tear would be a lie.
I love you, JoJo.

Tattoo You

2011-03-19T06:02:00.001-04:00

You're almost eighty.
You would think vanity would have long ago faded...but nooooo.
Getting your eyebrows tattooed on was a bad idea.
How bad?
You got so upset with the finished product, so worked up that your new brows resembled a couple of pieces of electrical tape on your forehead...
That you had an MI.

Your best bet would be to grow a mustache, grab a cigar and host "You Bet Your Life"

And That's Why My Car Wasn't Running

2011-03-16T06:02:00.000-04:00

Tis life in the NC Boonies.....

Another Excerpt From My Speech

2011-03-13T11:09:00.000-04:00

I found these 'rules for new grads' on several websites, mostly from Those Emergency Blues.

If you have any more I might add, please let me know.

Thanks!

Rules for the new Nurse:

Do no harm

Find a mentor

Never pass up the opportunity to see a procedure

Learning never ends.

Learn something new every day.

Ask questions.

More importantly, know when you must ask questions.
If you still don’t understand, ask more questions.

Don’t think you know more than you do. You don’t.

You’re going to make mistakes. Learn from them.

Don’t guess. Know.

The only thing worse than a nurse that doesn’t know anything, is a nurse who thinks they know everything.
Be skeptical

Pay attention when a patient complains of imminent death.

In the event of an emergency, the first pulse you check should be your own.
Not everyone can be fixed.

Patients will unexpectedly get sicker for reasons completely unrelated to the quality of your

care. Don’t take it personally.

Remember your ABCs. Airway. Breathing. Circulation.

Trust your gut. Ignore it at your own risk.

Your most recent assessment is the most important assessment.

Assess the patient, not the machine.
Walk before running. Basic nursing comes first.

Bed baths are an essential skill even for RNs
Chart.

Then, chart some more.

Eat.
Pee
Breathe, but mostly, pee.
Wash your hands. Often

Talk to your patients, not above them and certainly, not at them
Five rights. Three checks. Always. Forever. No exceptions. Ever. Amen.

If you’re giving more than two of anything — tablets, capsules, vials — you’re may be giving too much. Double check the order.
Listen. Carefully. To colleagues. To Patients. To Family.
If you’re going to bring anything, bring chocolate.
If your colleague is drowning, throw them a line

Ask for help.

Teamwork.

Housekeepers. Nursing Assistants. Food Service. Unit secretaries. They are your best friends. They are your equals. Treat them as such.
Specialize in a skill. Be that go-to nurse for hard IV starts.

Veins don’t roll.

Take no guff from no one.
Advocate. For your patients. For your profession. For yourself.

Things That Are Doing 'It'

2011-03-08T07:36:00.000-05:00

Because of Hospital over-crowding, my wife was admitted to the Pediatrics unit during her Hospital stay. The room was nice: roomy, extra bed, and a rocking chair.
It also had 'colorful' wallpaper with cartoon characters.
Unfortunately, the cartoons were, well, inappropriate:

Looks like Mr. Raccoon is getting fresh with the Moose

Meanwhile, Ms. Bunny is copping a feel from Mr. Snowman

How Rude!

2011-03-05T12:49:00.000-05:00

As mentioned in my previous post, my wife's Doctor visit became an ER visit.
Well, the ER visit became an admission to the Hospital.
Being the dutiful spouse, I called in for the next few days, so I could be at my wife's bedside to offer support and be her personal gopher (go for water, go for ice, go for another blanket, etc.).
Despite my marital loyality, the employees of my Hospital still assume I belong to them.
In a two day period I had:
The Supervisor come to my wife's room to ask if I would be working the next day
A Nurse from an adjacent Unit come to my wife's room and ask if I had time to start an IV for her
A Unit secretary call my wife's room to ask if I might to work a half shift
The answer to each of these were a resounding "NO!".

Incidently, my wife was sleeping each time.

Giving Free Advice

2011-03-03T09:13:00.000-05:00

We all do it. Give advice to family,friends, even strangers.
"Hey, you a Nurse? Does this look infected?"
Of course, the answer, if you've played this game enough, is always, "Yes!"

Well, last week my wife called me while I was working to let me know her Doctor visit had evolved into an ED visit.
I notified the powers that be, punched out and joined her in the crowded ER waiting room.
Sure enough, a 'colorful' character tapped my shoulder, "Dude, you a Doctor?"
He pulled a very dirty pill from his pocket, held it between his thumb and finger, "This a Vicodin?"
Using the standard answer, I said, "Yes."
Heck, for I knew it was Biaxin.

Still Working On My Speech...

2011-03-01T06:08:00.000-05:00

Sorry about the lack of posts, but life here at the Tex House has been a little busy.
I'm still tweaking my speech and thought I could get some more input from my readers. The comments from my last post were great!
Thank you all!
Here is the opening I'm working on:

Good evening.

My name is Tex and I’m a Nurse.

That’s a pretty powerful statement. And it comes with a lot of responsibility.

Last year’s Gallup Poll listed Nurses as the most trusted profession for the 11^th year in a row.

Nurses ranked above Doctors.

Above Teachers.

Above Police Officers.

Even above the clergy.

Wow.

Powerful stuff.

I have seen many Nursing students file through the Hospital. Every year, a new bunch. And every year I look forward to seeing those Students because I enjoy teaching them. I enjoy working with them. I want to instill in them the same passion for Nursing that I have.

I want the next generation of Nurses to be great!

I graduated from this program back in 1992 and have been working as a Registered Nurse at Westernish North Carolina Hospital pretty much since then. Before that, I worked as a Respiratory Therapist for 10 years. That’s almost 30 years of direct patient care. Almost two thirds of my life dedicated to helping the sick feel better.

I don’t have any fancy degrees and I don’t have a bunch of letters behind my name.

But those 30 years have given me wisdom, experience and a passion that a fancy degree and a bunch letters can’t.

And it’s that experience, wisdom and passion that I’d like to pass on to the next generation.

Any suggestions would be greatly appreciated.

Thanks

An Honor....

2011-02-19T06:19:00.000-05:00

As mentioned previously here, my daughter JoJo is in Nursing School. She will be graduating this May.
Last week she informed me that her class, by majority vote, has asked me to speak at their Pinning Ceremony.
Quite the honor.
So I've been dabbling with the speech, trying to set the tone.
Here is an excerpt:

It isn’t enough to know the intervention and rationale behind a Nursing Diagnosis. It isn’t enough to memorize the names of drugs and their side-effects. It isn’t enough to know the difference between ischemia and angina. Nurses treat people. And it’s how you treat people that will define you as a Nurse.

In 1993 I lost my father to cancer. When he was in the Hospital, I couldn’t be with him. He was 2,000 miles away. A trip had been planned to see him, but I was worried if I’d get there in time, so I called him often.
And I worried if the Nursing staff was treating him well. He told me, “Don’t worry son, the Nurses are my angels. They treat me like I was their father.”
And that is what defines me as a Nurse. If you treat your patient the way you would want the most precious person in your life to be treated, then you will never go wrong.

It's a process, I've never given a speech before....

I Wanna Be An ER Nurse

2011-02-16T05:43:00.001-05:00

This is for my daughter, JoJo, who graduates Nursing School in May. She wants to be an ER Nurse.

Do You Have What It Takes?

2011-02-08T07:44:00.000-05:00

People die.
The sooner new nurses understand that, the better off they'll be.
There is nothing written that says you're going to save everyone's life.
Sorry.
Ain't gonna happen.
I know, it was a messy code, most codes are. The man was fat, had had an MI and strained too hard on the throne.
Trying to get his 300 pound body out of the bathroom and onto the bed (because the ED doctor couldn't intubate on the floor) was, in hindsight, comedic. And a tragedy.
But calling in 'sick' your next 3 shifts?

Grow a pair.
Or this profession will eat you alive.

Dr. Google, Paging Dr. Google...

2011-02-03T08:22:00.000-05:00

Here we go again...
One of the Hospitalist where I work was 'fired' the other day.
'Fired' by the family because a family member disagreed with the course of treatment the patient was on.

This one particular family member had googled the patient's diagnosis, and out of the literally thousands of websites offering information, read the one which most contradicted the plan of care.

The internet has a plethora of information, and this family member could not be convinced that some of that information could be misleading.

Incidentally, the family member is what people 'in these here parts' would call "Country".
In other words, an idiot with a laptop.

Learning IVs

2011-02-01T06:07:00.000-05:00

The Answer Is: "Polish Brain Tumor"

2011-01-27T09:34:00.000-05:00

The question is: "What do you call a pimple on your ass?"
Yeah, I know; old, stupid and racist joke.
But what happens when that pimple on your ass nearly kills you?

While floating in the ICU, I cared for a relatively young patient on a ventilator and pressors.
The story goes, the patient had a pimple on their ass.
The patient's spouse popped it (gross!), and both forgot about it for a few days.
Evidently, it festered, and got infected.
She saw her family Doctor, who didn't appreciate just how much worse it had gotten.
Or maybe he didn't like large infected butt cheeks.
In either case, it abcessed, got septic, the patient coded and now is trached, PEGged and missing the entire left buttock and most of the left groin.

Shoulda used Clearasil.

HIPAA My Ass!

2011-01-23T09:24:00.002-05:00

The patient was a very popular student in High School.
Star athlete.
BMOC.
And he was attacked in his own home and left for dead.
His parents didn't want a lot visitors, they felt he needed time to recover, family to support him and especially, keep him out of harm's way.
You see, the attacker was out on bond.
So they invoked their right to opt out on the hospital directory.
That means, should anyone call, try to visit, send well wishes...anything, the Hospital will simply reply that no one with that name was a patient.

Unfortunately, the girlfriend felt differently, enjoyed the added attention and let more than one person at school know which room he was in.

So started the avalanche.

Attempts to hold back the deluge were unsuccessful.

Luckily, he was discharged after a relatively short stay, his injuries minor.

But I wonder if.....

Retaphin

2011-01-14T08:31:00.000-05:00

A Little Knowledge Is.....

2011-01-13T02:59:00.000-05:00

Yes, I know your brother is restless and anxious, a bad, itchy rash will do that.
I just gave him a little Ativan, along with some Vistaril, just give it time to work.
Oh really, you used to volunteer at theRescue Squad in the backwoods, out-in-the-boonies, Jed Clampetisque county you're from?
And you recommend Versed?
Um, that's a conscious sedation drug, we don't arbitrarily give to patients with an itchy rash, but thanks for the opinion.

Said At The Nurse's Desk

2011-01-11T04:54:00.000-05:00

Charge Nurse: Hey, Tex, how's it hangin'?

Tex: Depends which side the StatLock is on.

So Much For That

2011-01-09T04:12:00.002-05:00

My Hospital has initiated a "Bonus Shift" program that pays an additional $100.00 per extra shift worked. This is above any overtime earned.
Since I routinely work extra shifts, I figured, "Hey, more for me!"
The extra cash is bundled into '3s', for every 3 extra shifts, you get $300.00.
I had 10 extra shifts = $900.00. A nice chunk of change.
There are stipulations to the program, one being if you have 1 absence (defined as one day of work missed or two tardies) within the 6 week schedule, you forfeit all bonuses.

Guess who had his kidney stones the last week of the schedule?

Best ED Complaint Of The Day

2011-01-07T02:48:00.001-05:00

Ate candy with maggots in it.

Analogy Me

2011-01-05T04:43:00.000-05:00

Tex to Doc regarding reversal of hyponatremia in 93 year old female:
Tex: Hey Doc, looks like you cured her.

Doc: Yeah, but she still looks like shit.

Tex: Just because you fix a flat on an old car doesn't mean it's going to run better.

Worse Than USING The Call Light

2011-01-03T04:48:00.000-05:00

As any Nurse will tell you, whomever invented the Nurse Call Light should rot in hell.
Me, I don't mind the call light, it's the person pushing it that bothers me.
But there is the alternative....
The family that doesn't use the call light.
I had just such a family yesterday.
Forget the call light, we'll just go to the desk every time we need something for Mawmaw.
And come they did.
At least 3-4 times an hour.
And it was for piddly crap:
Can we raise the head of her bed?
Is it OK if we touch her? (no, really)
My cousin's next door neighbor's gardener wants you to explain hyponatremia for him.
Then an hour later: Can you explain hyponatremia for the gardener's wife.

I explained hyponatremia at least 4 times to various family members, once while a grandson googled it on his Droid.

Winter Storm 2010

2010-12-31T01:49:00.000-05:00

This area of North Carolina is notorious for it's residents freaking out at the mere mention of snow. Well, the day after Christmas was no exception, what with a good 7 inches of snow on the ground.
So a notable percentage of the Hospital staff called in because of the weather, which for those of us that make arrangements to get to work, you know, really piss us off!
I worked the ED that particular day, and the place was packed.
So I wonder?
How is it ED patients can drive to the Hospital, but employees can't?

Are You Kidding Me!?

2010-12-29T03:45:00.000-05:00

I worked a rare shift in the ED and the following call came over the EMS radio:
"En route Code Blue, 101 year old female. Intubated, CPR in progress...."

We 'slow coded' her, and let nature take it course.

Braggart

2010-12-27T02:32:00.000-05:00

Patient: I'm a hard stick. Only one person has ever gotten my IV the first time.
Patient's Spouse: That's right. They always end up calling someone to put the IV in.

Tex-after putting the IV in on the first try: Just so you know, I'm the one they call.

I missed twice on the next patient.

Merry Christmas

2010-12-24T09:08:00.000-05:00

GirlVet over at Madness ruminates about the Traditional Hospital Christmas Gift. That post prompted this one:
Our Hospital, for the third year in a row, gave employees the choice of a ham or a turkey.
These were decent sized, my turkey weighed in at about 8 pounds.
Unfortunately, I dislike both baked ham as well as turkey. My wife and I decided instead to help a needy family, whom we met through a mutual friend.
My wife went to the local market and purchased the makings of a nice Christmas meal and took the turkey and trimmings to the family.
My daughter JoJo, who didn't want a Christmas present, had me go with her to the local Rape Crisis Center to make a donation. The Crisis Center gave us each a Wal-Mart bag with a list of clothing needed for rape victims stapled to the bag.
She and I then spent a wonderful 90 minutes in a crowded Wal-Mart purchasing clothing for someone in need.
JoJo then asked what I wanted for Christmas. I simply told her, "You just gave it to me."

ED Christmas Carol: Working Christmas

2010-12-22T01:58:00.003-05:00

ED Christmas Carol: Working On Another Christmas Day

2010-12-21T01:18:00.002-05:00

ED Christmas Carol: It's The Most Miserable Time Of The Year

2010-12-20T01:56:00.004-05:00

ED Christmas Carol: Do You See What I See

2010-12-18T03:53:00.002-05:00

First Time For Everything!

2010-12-16T10:49:00.001-05:00

So I just got back from the ED at my facility.
Apparently, I am the proud owner of not one, not two, but THREE renal calculi.

The twins, Rosetta and Sharon Stone each reside in a kidney, while the third, Oliver Stone, is attempting to exit my left ureter and take a swim in my bladder.

I've never had kidney stones.

They suck.
Hard!

ED Christmas Carol: Freddie The Frequent Flier

2010-12-16T04:00:00.002-05:00

ED Christmas Carol: 'Tis The Season

2010-12-14T04:40:00.000-05:00

Well, it's that time of year, again. So to help 'celebrate' the season, I'll be posting some Christmas Carols - Tex Style!
I'll post some favorites (my favorites, maybe not yours) from last year, plus a few new ones.

Thanks, I Enjoyed That....

2010-12-10T03:53:00.001-05:00

Listen, when your patient suddenly has a change in condition, call the family.
I don't care if it's two in the afternoon or two in the morning.
Just do it.
Thanks to you, I got a major reaming from two physicians, and three family members.
Yes, I know, you called the doctors, but when they found out the family wasn't, well.....

So, just so you know, I'm enjoying the new orifice.
I plan on using it to crap on you.

"It Hurts Right Here"

2010-12-07T08:31:00.000-05:00

"Pancreatits is painful, yes I understand."
"No, eating will only aggravate the pain and lengthen the recovery process."
"Yes, you have pain medication ordered."
"No, I won't call the doctor to give you Dilaudid for the 'hunger pains'."

Day For The Ages

2010-12-02T02:49:00.001-05:00

People at work often ask me, as a Float Nurse, where is my favorite place to work.
The answer:

The ED.

Why?

Because it's like a box of chocolates...you never know what you gonna get.

This past week, while working in the ED, I had, in adjoining rooms, two beautiful patients: one was 11 days old, the other 101 years old.

That's the ED.

The Reason For Gowns

2010-11-30T02:06:00.002-05:00

#1 Health Care is about time management. If you come in with a complaint of belly pain, what makes you think putting the gown on over your clothes is going to help the Doctor examine you quicker?

#2 Health Care is messy. If you like your clothes, but hate bodily fluids on them, then don't bitch about the speck of blood on your favorite blouse/shirt.

#4 Health Care is about accessibility. Er, can't get to that, with all that fabric in the way.

#3 Health Care is humbling. Just get the hell naked, we promise to laugh after you leave.

PeptoBismol

2010-11-28T02:17:00.000-05:00

On the level of stupid that is "I Didn't Know I Was Pregnant", I cared for a young lady who came in with the complaint of 'nausea and vomiting for 2 weeks'.
She wondered if the PeptoBismol she was taking could be the reason she hadn't had her period for two months.

Um, no.
The cause is a little more obvious.

The Nurse Inside Of Me

2010-11-24T04:35:00.000-05:00

My daughter, JoJo, has just one more semester until she finishes Nursing School.
This song is for her.
My only regret?
That I couldn't sing it better.

"Vaginarrhoids?"

2010-11-22T04:18:00.001-05:00

While getting report on a very elderly patient, the night shift nurse was telling me about the patients hemorrhoids, describing them as swollen, ecchymotic and somewhat excoriated.
During my assessment, I was examining said swollen tissue. I saw the patient did have hemorrhoids, but the swollen area looked more like the patient's labia.
When the physician arrived, I explained what I saw to her and helped turn the patient so she might see for herself.
After we left the patient bedside I asked what it was. The Doctor wasn't entirely sure.
"They look like vaginal hemorrhoids," she said.

"Vaginarrhoids?"

She laughed so hard, a booger came out her nose.

"Excuse Me, But Do You Have The Time...?'

2010-11-19T00:47:00.000-05:00

I took my Mother-in-Law to see a new doctor.

I guess he collects clocks from drug reps.

Just so you know, the reason none have the same time is because none of them were running.

New Layout

2010-11-16T09:16:00.002-05:00

Even homeless people change their underwear once in a while.
Well, the ones that wear underwear.

Dust In The Wind

2010-11-15T01:17:00.000-05:00

Look, you got some dust in your eye while cleaning some shelfs.
We understand, it's uncomfortable.
But after checking your eye sight and for corneal abrasions, that's all it is...uncomfortable.
Now, get the hell out because it's not uncomfortable enough to warrant narcotic pain relievers.

No, really.
Get out!

Seriously, leave!

Call security.

Damn, dude!

Call PD.

Okay, room's empty.

Next.

ED Sing-a-Long: Bambulance

2010-11-10T06:18:00.002-05:00

"Snort,snort"

2010-11-08T05:45:00.002-05:00

A lesson: Never assume your patient has taken their medication.

Sure, he put them in his mouth, he took a drink of water and 'gulped'.
Loudly.
Too, loudly.

What he really did was cheek the Percocet he so desperately said he needed.
He then took it out and crushed it on his bedside table and began snorting it with his drinking straw.
He also accidentally hit his call light button in his little recreational frenzy.

That's when I walked in.

Needless to say, he was 'cured' and discharged that day.
No, he didn't get a script for Percocets.

History Lesson

2010-11-05T01:04:00.000-04:00

The Hospital I work at will be celebrating it's 100 year anniversary next year, so there's been some recent hullabaloo going around.
I recently cared for a 93 year patient with pneumonia who remembers coming to the Hospital for an appendectomy when she was only 8.
The Hospital is named for the Doctor that cared for her.
This lady is sharp!
She remembers minute details of her stay, but what surprised me the most was when she mentioned she was hospitalized for nearly a month.
"Did you have some sort of complication?, I asked.
"No, I guess that was a normal stay back then."

Incidentally, she told me the man was her Doctor from that time until he died, a total of 45 years.

ED Sing-a-Long: I Don't Want You Comin' Here (And Wastin' All My Time)

2010-11-01T01:25:00.002-04:00

"What You All're Doin' Ain't Working"

2010-10-29T04:07:00.000-04:00

It never ceases to amaze me what people expect from medical care.
Here is this 63 year old man.
He's had two heart attacks.
One by-pass surgery, as well as subsequent PCI; once a native vessel, another time an SVG.

And here he is again with his third MI in 6 years.

The family is upset with the Cardiologist because 'Papa is sick, again!'
Well, 'Papa' still smokes 2 packs a day, weighs better than 285 pounds and eats greasy southern cooking 4 meals a day.
Don't get me started on his diabetes, either.

Maybe if we got him off his ass, off his disability, and away from the TV, he just might get better.

2010-10-28T10:16:00.002-04:00

Little Red Corvette

2010-10-26T01:19:00.001-04:00

I cared for an elderly lady, 91 years old, recently. The poor thing took a tumble and broke her hip.
She was a sweet, sweet lady, but lived in her own little world. She could recount her name and birth date, but nothing else, not even the year she was born.
She had been residing in an assisted living center, but would require much more at discharge, so she was booked to go to Rehab/Nursing Home instead.
Prior to her discharge, the lady's daughter was visiting and gathering up belongings to take to the NH.
The daughter was talking to her mom when I came to get some paper work signed.
The patient was concerned about her car.
"She has a car?" I asked.
"Oh yes, a little red sports car. A Dodge Avenger."
"That's a pretty recent vintage, when did she stop driving?"
"Last year."

"Daddy Ain't Eatin'"

2010-10-24T05:46:00.000-04:00

The call went out to EMS for "Daddy ain't eatin'."
Upon arrival, the crew found an elderly man in a recliner, emaciated, grits running out of one corner of his mouth from the family's attempts to feed.

He was also dead.

As in 'door nail'.

And cold.

As in 'witch's teat'.

The grits, however, were still warm.

Stupid Comes In Many Forms

2010-10-22T02:27:00.001-04:00

Just because it's 'only a baby snake', doesn't mean it thats it's a good idea to chase it around your backyard.

In flip-flops.

Trying to step on its head.

Dumbass.

.

ED Sing-a-Long: Drug Seeker's Rhapsody

2010-10-20T05:02:00.000-04:00

Electricity: A Theory

2010-10-17T02:51:00.000-04:00

My community celebrated October like most communities, but since mine was founded by German immigrants, it celebrated with a bit more gusto.

So, as you can imagine, the ED got its share of beer-swelling revelers.

One young man was so 'reveled', he had to be tased by the local boys in blue and brought to the ED.
This young man was so infused with Oktoberfestitis, that despite having the taser prongs in his chest, the police officer at his side, and one wrist handcuffed to the rail, he still grabbed the ED Doctor's arm.
Of course, the cop tased him.

But herein lies our the basis for our theory:
The ED Doctor didn't feel a thing.

Fact: Electric current will flow through a conductor.
Fact: The human body will conduct electricity.
Problem: Electric current did not flow.

Theorem: Due to lack of significant synaptic function essential to neuronal function within the brain of said reveler, electrical current was absorbed within the presynaptic neuron, therefore
limiting electrical current, hence the ED Doctor didn't feel a thing.

Sex Education #3

2010-10-15T02:22:00.001-04:00

An expectant mother, whose membrane ruptured at 20 weeks, and is expected to remain on bed rest in order to protect her unborn child, should not be caught in the bathroom with the her boyfriend copulating.

On three separate occasions.
Standing.
Having unprotected sex.

Sex Education #2

2010-10-11T08:41:00.000-04:00

I recently worked on a Unit that had a patient admitted with pneumonia. The patient also had vaginal discharge diagnosed as a MRSA infection.
One of the staff wondered out loud how someone could get MRSA 'down there'.
I postulated, "Poor hand washing?"
Another said, "Well, since we colonize MRSA in the nares....."

Sex Education #1

2010-10-08T02:31:00.004-04:00

This story was relayed to me by a staff Hospitalist. He swears it happened to him while in medical school.

I was interviewing a patient in the ER for admission and while getting his history the patient said he had once had 'gonorrhea of the lungs'.
I had never heard of such a thing, so I started asking around and no one had ever heard of it either. My attending recommended questioning the patient about it.
I asked the patient, "Exactly, what is it the doctor told you had?"
The patient said, "The doctor said I had claps lung."

From Bad To Badder To Baddest

2010-10-05T06:05:00.000-04:00

Bad: Showing up to your pre-op appointment drunk.
Badder: Hitting two cars in the parking lot, because you drove yourself.
Baddest: Getting drunk on post-op day 1 with the booze your husband sneaked into your room.

"I Was Only Trying To Help"

2010-10-01T05:59:00.000-04:00

I know your family member is in severe pain, and I'm trying to control it with the medications her doctor has ordered.
We have to be careful, her pulmonary status is chronic, but unstable.
Too much pain medication and she stops breathing.
So giving her the OxyIR you carry around for your own chronic pain isn't a good idea.

That's why she coded and is now in the ICU.

Welcome to Weird Nursing Tales

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Yep, That, Too

I Resemble That Remark....

Charleston Was A Nice Respite

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Heavy Man

Working On A Another Christmas Day

A Redeux: My First Time Doing CPR

Complaint Of The Day vs WTF!

Complaint Of The Day

Things That Make You Go 'WTF!'

*Rim Shot* Part Deux

Subtle Threats Don't Work Either....You Know

*Rim Shot*

How To Get In Trouble...

'Anything You Can Do....

Dialing It Down

Um, Is That A Stethoscope, Or Are You Just Happy To See Me

I Resemble That Remark

Take A Mulligan

I Hope It Never Goes Away

It's All About The RIF

Shoot 'Em Up

How To Use The Pain Scale

Update....

A Re-Post: Trauma Queen

Stupid People.......

A Re-Post: Tangled Up In Poo

Hospital: A Re-Post

Working In Triage- A Repost

No Threat Goes Unpunished....

Remembering Dad On Father's Day (Repost)

Threat By Peripheral Smear

But Was It Prescription Or OTC?

Chief Complaint Of The Day

Hello...Hello, Again

An Dey Over Watered De Plants, Too

A Conversation Yesterday:

For Dr. Grumpy

I Guess The Stress Is Getting To Them

Nurses 'Day

Tattoo You

And That's Why My Car Wasn't Running

Another Excerpt From My Speech

Things That Are Doing 'It'

How Rude!

Giving Free Advice

Still Working On My Speech...

An Honor....

I Wanna Be An ER Nurse

Do You Have What It Takes?

Dr. Google, Paging Dr. Google...

Learning IVs

The Answer Is: "Polish Brain Tumor"

HIPAA My Ass!

Retaphin

A Little Knowledge Is.....

Said At The Nurse's Desk

So Much For That

Best ED Complaint Of The Day

Analogy Me

Worse Than USING The Call Light

Winter Storm 2010

Are You Kidding Me!?

Braggart

Merry Christmas

ED Christmas Carol: Working Christmas

ED Christmas Carol: Working On Another Christmas Day

ED Christmas Carol: It's The Most Miserable Time Of The Year

ED Christmas Carol: Do You See What I See

First Time For Everything!

ED Christmas Carol: Freddie The Frequent Flier

ED Christmas Carol: 'Tis The Season

Thanks, I Enjoyed That....

"It Hurts Right Here"

Day For The Ages

The Reason For Gowns

PeptoBismol

The Nurse Inside Of Me

Rim Shot Part Deux

Rim Shot