A Nurse With Attitude

Where Dark Cynical Humor, Nursing Issues, and Politics Seem to Merge

Archive for the month “October, 2012”

I’m going home!

This morning, the cardiac crew came in to give me the full assessment.  Well, first the intern came in at around 4am. Then around 5am the resident came in with a few medical students came in to do an assessment. They all had to get a full story (independently) so that they could compare notes when they eventually made rounds.  Around 6am they all came in with the cardiac attending.  They asked questions and talked among themselves and occasionally ask me a question. A student would ask something about my history or what medications I was taking, all the while listening to my chest or back.  They would take turns listening to a particular side or spot on my chest.  After being the object of their underling study, The attending eventually said that I was ready to go home. They all took turns looking one more time at my groin cath site and pressing on it until it became even more tender.  Then they all left to continue their rounds on the rest of the patients.  Eventually a med student and a resident came in to give me discharge instructions.  I only half listened as I was anxious to depart, and as a nurse, I was sure that I already knew what I was suppose to do.  They said something like I couldn’t drive for a week or couldn’t have sex for three days, blah, blah … I’m not sure, I figured I couldn’t have sex while driving and let it go at that.  Needless to say, my wife was taking detailed notes. Because she was going to make sure that these intern ramblings, no matter how senseless, were going to return to haunt me for quite some time.

The “cardiac rehab” person and the pharmacist, and several other people who I failed to remember.  (keep in mind that I haven’t had caffeine in several days, my ADD was in full bloom)  They all paraded through my room as I was getting my stuff together to tell me their own versions of “discharge instructions”.  I called for breakfast to pass the time and to dull the ache in my stomach.  I asked for some coffee and some toast and jelly.  The lady on the other end of the phone said, “now Mr. Taylor, you’re a diabetic, you can’t have jelly…”  I was stupefied,  “hey, it’s my heart not my pancreas.  I’m not a diabetic”  the lady insisted saying that was “the orders.”  So I ordered eggs, bacon, and pancakes with sugar free syrup.  The cardiac guys came in, they were horrified that I  was eating bacon and eggs.  I said, “hey, who said cardiac, the cafeteria claims I’m on a diabetic diet!”   The physician apparently made corrections before my coffee arrived as all I got was decaf Sanka.  It was muddy water in a cup.  Oh well, I’m heading home in a bit anyhow.

Everyone makes mistakes. It’s only human.  It’s natural.  It’s just that some are more serious than others.  I’ll write more on this later. In the meantime, I gotta get home, get a real nap and then some real food.  I’ll keep you updated. Signing out for today.  JT

Life is not a journey to the grave with the intention of arriving safely in a pretty and well preserved body, But rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming,  “WOW—-WHAT—-A RIDE!!!”

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Nurse turns Patient

  Hey folks, I’ve gotten a passel of e-mails. I’m sorry for not writing as much.  I was at work the other day and got this funny feeling…. then a lot of nausea.  I laid down in one of the PACU stretchers and about 30 minutes the feeling got better.  The nausea persisted and the overall sick feeling stayed.  Now, a little bit of medical knowledge can be really good or really bad.  I know that I’ve ranted about this with patients on several occasions, but you never think about it when it’s happening to you.  Back when I was an ER nurse, there was a test that we gave patients to quickly decide if their pain was cardiac pain or just some vague abdominal pain.  We would mix some Novocain and Maalox and give it to them.  If their pain suddenly disappeared, they were OK and sent home.  If it didn’t, then it was cardiac and called for a workup.  I thought, hey, I’m at work, I’ll take the mixture.  It did nothing…. Oh crap.  So, the next thing I did was to run an EKG on myself.  After it ran, it said “normal sinus rhythm.”… hey cool!  I thought.  By now the pain was fading away.   I’ll just head back to my room and go to work and no one will know the difference.  I was clearly in denial as to the potential hazard.  “Maybe it’s too much coffee, or just an arterial spasm, or a strained muscle from digging in the yard…” I thought,  as I was heading back to the room.  Needless to say, I finished the caseload for that room, but the nausea and achy feeling persisted.  I got home and called promptly my physician for an appointment and checkup.  I had to move a heavy table to the back of my truck.  As soon as I lifted the table, the pain returned.  Except this time it was several times worse.  I became faint and weak.  Still thinking that it cold possibly, very remotely be some sort of cardiac problem,  I chewed an aspirin tablet to thin the blood and laid down to rest.  It seemed like moments later (actually in real time, about 20 minutes).  The pain faded.  I forgot everything and crawled into bed.  My wife was becoming upset. She kept saying that I “didn’t look well.”  I told her that I was really tired and needed sleep.  She reluctantly agreed.   I just couldn’t make myself believe that I had a cardiac problem.  Heck, I have no history. I don’t smoke.   Neither my mom or dad had had heart problems. I run at least two miles at least twice a week… most of the time more often.

The next morning, I woke up and asked my wife what she wanted for breakfast. She said “Oatmeal.”  I climbed out of bed and walked to get my sweat pants on and suddenly my nausea and dizziness returned. Except this time the chest pain was the worst ever.  Now, I couldn’t make up any excuses.  “Pain  without exertion” was clearly symptoms of unstable angina and I knew I was having a heart attack.  My wife said, “you look pale and kinda funny again… are you OK?”   I could barely speak, I said, “no… lets go to the hospital.”  She flew into “go-mode” and we were off.   Heading out the door, I chewed another aspirin.  Thinking how I hated the patients that brought everything with them, including their pockets full of valuables, suitcase, jewelry and nonsense, I left the house wearing only an old  t-shirt and sweat pants carrying only my insurance card.

On arrival, my pain had diminished a lot, but not all together.  I got out and my wife parked the car. I went in and said that I was having chest pain.  A team of nurses,  techs and well, a bunch of other people ran out to wheel  me back to the room to do an EKG and draw blood and a flurry of other stuff.  They gave me a nitroglycerine tablet and it burned as it dissolved in my mouth.  Minutes later, I felt much better. No pain, weakness, or nausea. I was ready to dance.   Unfortunately, they had me on strict bed rest.    A little later, the cardiologist came in and said that he wanted to do an angiograms and shoot some dye into my heart to see where the clot was.  “Hey, that involves surgery… and needles… I feel great now.  How about you give me some of those little burning pills and let me loose.”    My wife glared daggers at me and I reluctantly agreed to the angio.

I’ve been a nurse for 27 years and I’ve never been a patient but once… and it was a minor procedure where I went home that same day.  Never a stay and sleep and eat at the hospital kind of stay!

Well, the angio went well and I an now fixed.  I bought a stent and an several angioplasty balloons for this party.  Now I’m sitting the night away in the ICU hooked to all sorts of monitors.  I have to lay still with my right leg perfectly straight to not kink off the area that the catheter went in.

My wife was kind enough to bring me my lap-top computer so that I could still toil the night away and write to my blog and work up some stuff from actual  work work while I  convolese.

The good news is that I’m a real bono fide VIP.  All of the ICU nurses know me from when I actually worked the ICU and they are all wanting to talk “old nursing stories.”  I’m getting some new writing material!

 

I’ll tell you more, later.  It looks like I’m gonna have plenty of spare time.

I don’t understand socialism

I’m a libertarian living in the socialist republic of Oregon.  Just the other day, I was grumbling about a bill in Congress that would impose fines on eating  establishments  who served  obese people.  The complaint was that the state pays for a large portion of the health care of citizens under the Oregon Health Plan.  And we all know that obese people have higher health costs.  They are more prone to diabetes, vascular disease, and infection, just to name a few.  It is the same reason that is used to justify the laws requiring motorcycle helmets and seatbelts in cars.  After all, if one exercises his liberty to ride without a helmet and eventually becomes a vegetable, society has to bear the expense of taking care of him.  The fact that obese people  become ill, or a cyclist who scrambles his brains is not a  problem of liberty.  It’s a problem of socialism where one person is forced to take care of another.  If that person is to have any personal responsibility at all, he would have some sort of insurance.  If he choose to forgo his insurance and choose to not wear a helmet, then he should be forced to suffer the consequences.  If more people were to deal with their decisions, and even better, if the public were to see what I see on a regular basis, and forced to witness the consequences of other’s bad decisions, then we would have more people actually thinking about what they are doing.  It’s like the circus performer doing the death defying stunt with a safety net.  It’s not really death defying unless you remove the net.  Once the net is gone, that performer has to think a lot harder about the consequences of his actions and the real risks of the stunt.  He may even think a lot harder about it after he sees his friend  fall, not die,  but becomes permanently  crippled in the event.

I attended fourth grade in  a rural schoolhouse with a wood burning heater.  That thing was really hot.  We played around that stove,  like kids do.  We didn’t recognize or even care that that stove was incredibly hot.  That is, until someone slipped and touched it.  They suffered a burn and thus learned, not only how hot the stove was, but forever more  to stay way away from that hot stove.  All of us kids, who once played near the stove, saw the kid with the burned arm.  Because of our witnessing of this incident and having a desire to not suffer the same injury, we all learned too.  Because of the nanny-state always being the safety net, this kind of learned “cause and effect”  is totally absent in modern America.

But because we as Americans choose to sit back and let someone take care of us, we are losing our freedoms.  There is always strings attached to the money… no matter where it comes from, nothing is ever free.   When the government takes up the responsibility of paying for our health care, then the government will forcibly add safety measures to reduce that health care cost.  They will forcibly implement things to make all people be safe and therefore reduce their cost burden of care.

I for one, am not willing to let go of the freedom to gain a small bit of security in reduced cost in health care.

 

Unhappy Muslims

  THE MUSLIMS ARE NOT HAPPY!

They’re not happy in Gaza ..They’re not happy in Egypt…They’re not happy in Libya.. They’re not happy in Morocco.. They’re not happy in Iran.. They’re not happy in Iraq.. They’re not happy in Yemen.. They’re not happy in Afghanistan.. They’re not happy in Pakistan.. They’re not happy in Syria.. They’re not happy in Lebanon.

SO, WHERE ARE THEY HAPPY?

They’re happy in Australia… They’re happy in Canada… They’re happy in England… They’re happy in France… They’re happy in Italy… They’re happy in Germany… They’re happy in Sweden… They’re happy in the USA… They’re happy in Norway… They’re happy in Holland… They’re happy in Denmark.

Basically, they’re happy in every country that is not Muslim and unhappy in every country that is!

AND WHO DO THEY BLAME?

Not Islam. Not their leadership. Not themselves.

THEY BLAME THE COUNTRIES THEY ARE HAPPY IN!

AND THEN;  They want to change those countries to be like….

THE COUNTRY THEY CAME FROM WHERE THEY WERE UNHAPPY! Excuse me, but I can’t help wondering…

How damn dumb can you get?

 

A Halloween Tale

  Yep, it’s October and Halloween is around the corner.  I like telling scary stories… especially when they actually happened to me.   For some strange reason, scary stories tend to help strengthen my own faith.  In my job, I don’t see that many miracles like in the day of Moses, but I feel that as long as there are evil and bad things happening there is a devil.  And if there is evidence of Satan, then there must be a God to protect us and give us hope.  Here’s a true story.

Have anyone of you seen the 1990 movie “Ghost?” It starred Demi Moore, Patrick Swayze, and Whoopi Goldberg.  Well, in  that movie, there were these little demons that swarmed the soul of the bad guy and drug him off to hell.  This is the way I envision the happening of bad people when they pass… and I’ll tell you why.

I was taking care of these two patients in the ICU. One was possibly a good guy and the other was obviously a bad guy.  Mr. Good was a bartender and at closing time. Mr. Bad came in with a gun saying, “gimmie your money or I’ll kill you.”  Mr. Good said, “here, take it…  just don’t shoot, I have a wife and two kids, a dog, a sick mother that I gotta support, please don’t hurt me.”  Mr. Bad took the money and said, “too bad,  I’m gonna kill you anyhow, but I’m gonna do it slow.”  Then he proceeded to shoot him in the knees, legs and abdomen to produce the greatest amount of pain.  Mr. Good, seeing that his end was near, reached under the counter, feeling for the .44 magnum he kept there. He got his hand on the pistol and blindly fired one shot just before he lost consciousness.  That single shot went up through the bar and hit Mr. Bad.  The bullet, dragging with it,  wood and fiberglass splinters from the bar as it tore through Mr. Bad’s liver, spleen, pancreas and kidney before exiting.  Mr. Bad was in serious trouble.

Sitting in the ICU, I didn’t know the story. I admitted Mr. Good and talked with him about his issues.  General surgery did a bowel resection and he was stable. Ortho team was consulted a little later for his leg fractures.  A little later, Mr. Bad was admitted from surgery.  I put Mr. Bad in the ICU bed right next to Mr. Good. Mr. Good recognized Mr. Bad and complained bitterly. I told him that Mr. Bad was unconscious from the medications. He was very sick and probably wouldn’t last the night. He calmed down and told me the story of how he was injured by the unusually bad Mr. Bad.

Now, working in New  Orleans, the majority of the people are incredibly superstitious.  The belief in Voodoo, witchcraft and demons run rampant.  I obviously didn’t believe in any of it, but as a torment, I would pretend to do spells and call demons to get the natives all riled up.  It was simply late night entertainment, and I thought it was hilarious.   One night, I got some official Gre-Gre dust from “Madam Laveau’s House of Voodoo.”  I took some “silver coins” and put them in a can and shook the can making a lot of noise while mumbling a “special chant” and sprinkling the dust around the bed of Mr. Bad.

The supposed purpose of “Gre-Gre” is to keep away demons.  They say, “no bad spirit can cross the line.”  Pure hogwash, but it was incredibly fun to play with.  I put on a big show and two of the CNA’s on the bath team saw me and ran away yelling, “lawzy be, he’s  a-calling a haint!”  They never came back.  I didn’t care, I bathed my own patients  anyhow.

Mr. Bad was incredibly sick and getting worse rapidly.  I was counting the minutes until shift change.  I was pouring in the blood products and I had him on Epinephrine and Levophed drips and he was still sinking.   Incredibly, after I put down the Gre-Gre dust, he began to improve!  Over the course of several hours, I gradually lowered his blood pressure drugs and his ventilator settings.  His hemicrit was steady. I rejoiced, now confident that Mr. Bad was quite possibly  going to survive the shift.  Although his urine was still cola colored from the high dose pressors, he was actually looking a lot better.  Soon the day shift nurse came in to get report. I explained the history and course of events through the night and his plan of treatment.  (I omitted the part about the Gre-Gre dust).   She was satisfied and I left to change out of my scrubs.  As I walked by, I saw the day shift housekeeping crew coming in. I had totally forgotten about the Gre-Gre dust. Even if I had remembered, I wouldn’t have said anything because it was only a joke in the first place and had no effect what so ever…. or did it?    The housekeeping crew started cleaning and mopping the floor.  I went into the changing room to get out of my stinky scrubs.  Because I was eager to go, it took me all of  three minutes to get changed into street clothing and gather my belongings.  When I emerged from the changing room, Mr. Bad was in full code status with the code team doing CPR, injecting drugs and the works.  I glanced at the monitor and he was flat-line… dead as a door nail.  I guess once the housekeeping crew throughly cleaned the floors, the demons had finally been allowed access to  their prize.

And I never, ever messed with Gre-Gre, or anything else like that ever again.

ICU Revisited

  Today I had lunch with one of the old PACU nurses that I worked with many years ago.  We reminisced over the life and times, back in the day, when we both worked the ICU.  She had given me report a little earlier on a patient that had multiple problems … cardiomyopathy, A-fib, diabetes, vascular disease, pancratitis, previous spinal fusion, total joint in shoulder and knee, chronic pain… otherwise basically healthy.  I laughed, “just the kind of patient we need to be doing an elective procedure, in an out-patient setting.”  She said, “Hey, it wasn’t ordered, but I got an EKG just because… I ain’t having anyone die on my watch.”  I laughed again saying,  “just like the old days,  when each and every hour when we took our  vital, charted, tallied up our urine output and IV drips, etc, we’d  chant,  ‘just five more hours,’  or however  many was left till the end of the shift.”  She laughed again.  “Yea, those were the days.”

Hey, this reminds me of another story.  I’ll tell you about it tomorrow.

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