Ok, we'll take him....

So the law that went into effect last September to help prosecute meth manufacturers has caught it's first big fish.

Well, not really a big fish. Kind of a little fish. Well, actually, a plankton in the world of meth dealing.

Yesterday William Fousse was convicted of purchasing 29 grams of Sudafed in a 30 day period.

There was no evidence that Fousse made methamphetamine or turned the medication over to others for its production, said Assistant U.S. Attorney Douglas E. Gregory.

Way to go, guys. That'll help fight the war on drugs. I can already tell the difference.

Shoot them both.

Woman has boyfriend.

Woman has baby.

Paternity test shows baby isn't boyfriend's.

Boyfriend allegedly begins abusing baby.

Woman continues to leave baby with boyfriend even though

Shortly after the paternity test results were known, she said she began noticing bruising on the baby's face, arms, legs and chest. She said her son began having nightmares, and that he seemed afraid of Mr. Knight.

Boyfriend kills baby.

How is she not at fault, too?

My favorite joke of all time

No, it's not PC. Deal.
**************

A woman walks into the downtown welfare office, trailed by 15 kids.

"Wow," the social worker exclaims, "are they all yours???"

"Yep, they’re all mine," the flustered momma sighs, having heard that question a thousand times before.

She says, "Sit down, Leroy." All the children rush to find seats.

"Well," says the social worker, "then you must be here to sign up. I'll need all of your children's names."

"This ’un’s my oldest – he’s Leroy."
"OK, and who's next?"
"Well, this ‘un, he’s Leroy, too."

The social worker raises an eyebrow but continues. One by one, through the oldest four, all boys, all named Leroy. Then she is introduced to the eldest girl, named Leighroy!

"All right," says the caseworker. "I'm seeing a pattern here. Are they all named Leroy?"

Their Momma replied, "Well, yeah; it makes it easier. When it’s time to git ‘em out of bed and ready for school, I yell, 'Leroy! Time to git up!' An’ when it's time for dinner, I jus’ yell 'Leroy! Time for dinner!' an' they all comes a-runnin.' An' if I need to stop the kid who's runnin’ into the street, I jus’ yell 'Leroy! Stop!' and all of them stop. It's the smartest idea I ever had, namin’ ‘em all Leroy."

The social worker thinks this over for a bit, then wrinkles her forehead and says tentatively, "But what if you just want one kid to come, and not the whole bunch?"

"Oh, that's easy. I call ‘em by their last name."

I am All-Powerful.

I have cured PMS.

Next, World Peace.

Change of Shift

Change of Shift is up over at NursingLink- Beth from PixelRN did a great job, so go check it out!

Indicator Lights

This is what I need.

In the middle of my forehead, there will be three LED lights. One green, one yellow, one red. They will light up according to my response to what you are saying.

Now, to put it simply, Green means go, Yellow means go, with caution, Red means stop.

Sound familiar? It should. It's really a simple concept. Now, let's try a few examples.

"Hey MonkeyGirl, did you see the game last night? (Green) I swear, there is nothing better than when the Patriots lose. (Green) How've your Chiefs been doing? (Yellow) Don't worry, it's a rebuilding year. (Green) At least you're not a Raiders fan." (Green)

"Hey MG, did you watch Grey's Anatomy last night?(Yellow) Why not? I love that show. That and ER." (Yellow) You should really watch them!" (Red)

"Hey MG, your hair looks cute tonight. (Green) Did you get it cut? (Green) You know, you should go to the salon I go to. (Yellow) You could get these cool, trendy highlights put in, and they could give you a really expensive-looking haircut that would only double the time it takes you to get ready for work. (Yellow) No, their prices are really not that bad. I get my bikini wax done there, too. (Red) Have you ever heard of a Sphinx?" (RED, Dammit, RED!)

"Hey MG, what are you doing on Friday night? (Green) You should go out with us. (Green) We're going to go to dinner at Benihana. (Green) Then we're going to go dancing at The Trendy Club. (Yellow) Drunk Slut, Total Kootch, and Crazy Bitch are going, too. (Yellow) We just need to find a Designated Driver." (Red)

"Nurse, NURSE!" (Yellow) Could you ask the doctor if I can have some more pain medicine for my non-fractured, non-swollen, perfectly-normal-looking, ankle?" (Red)

"Can you help me? (Green) I need to go to the bathroom. (Green) No, I can't get up, my fibromyalgia is hurting my 300 lb body too much. (Yellow) Oh, no, I couldn't use a bedside commode, either. (Yellow) I need a bedpan. (Red) I think I might need to have a bowel movement. " (RED,RED,RED)

"MG, can you work for me on *insert day here*? " (Green)
"MG, do you want to work an extra shift on *insert day here*?" (Yellow)
"MG, can you stay over for 4 hours? They're short on day shift." (Red)

You get the idea. Whenever they come up with the technology, I'm going to be first in line.

When I am Queen of the World

1.You will have an ET tube and an IV placed in triage.

2. There will be no family allowed at the bedside unless you are dying.

3. There will be a Lortab dispenser in the waiting room to recoup some of the money we lose on Medicaid patients.

4. Aerosolized Ativan will be dispensed via the air vents q 2 hours PRN.

5. There will be a Valium salt lick at the nurses' station for emergent WTF's when dealing with JCAHO or new policies created by paper nurses.

6. Nurses will be issued Tasers.

7. Reproductive organs will require activation by a chip. The chip will not be activated unless you have a job and a brain, and have passed parenting classes (thanks, DamnLemming).

8. Fibromyalgia will not be treated with narcotics. Ever.

9. You are allowed two ER visits a month. That's it.

10. All social, er, I mean, diagnostic intubations on mean and nasty people will be done with succs only (thanks 911Doc).

Life Lessons

1. Don't beat up old men.

2. You can't pick your parents.

3. Medical school is actually a pre-requisite for surgery.

4. Pants are not worth $54 million.

5. Apparently, you can eat too many hot dogs.

I hate teeth.

Not just Meth Mouth. I hate all things tooth related. I have anxiety attacks when I go to the dentist. If a patient comes in with a tooth that got knocked out by Sumdood, I gross out. Foot-long full thickness lac to the forearm? No biggie. Loose/missing tooth? Near syncope.

So imagine my husband's glee right now, because the 5-year-old is popping out teeth faster than a drug seeker pops out excuses for narcs. He discusses it with her in great detail, and I'm pretty sure that he's told her that any time one falls out to bring it to me.

So last night she woke me out of a dead sleep in the middle of the night (yes, I do get to sleep at night, occasionally), and handed me .... a tooth. In my hand. Touched it.

Almost screamed like a girl. Passed it on to husband. His problem to deal with. Not mine. Ew.

Sex and Heart Blocks for Dummies

In a fit of pure genius, Ambulance Driver has demystified the inner workings of the heart with the help of Sidney Sinus Node and Virginia Ventricle.

I think my cats have Chronic Fatigue Syndrome

I'm really worried about them. They seem to be sleeping a lot.

.

So I looked up the symptoms of Chronic Fatigue Syndrome, and I'm pretty sure that's what's wrong. After all, the Internet says so. And everybody knows the Internet is always right!

.

This is what I found on The Chronic Fatigue Syndrome of America website (who by the way, boast 20 years of making CFS History):

********************

Symptoms:

.

Weakness and exhaustion, lasting more than 24 hours, following mental or physical activity

All they do is sleep. I find them at the top of the stairs, sleeping, as if just climbing the stairs has exhausted them so much that they have to nap. After we play "Chase the Laser Light" for a few minutes, they always have to lay down (though I'm not sure if it's the mental or physical activity that does them in).

.

Unrefreshing sleep

They must be getting unrefreshing sleep. They sleep 23 hours a day. How refreshing can it be if it takes 23 hours to do it?

.

Substantial impairment of short-term memory or concentration

I feed them, and then 5 minutes later they're begging for food again. As if they've totally forgotten I already fed them. When the 5-year-old chases them, they run for a little bit, but then they let her catch them. As if they've forgotten why they're running.

.

Muscle pain, or pain in the joints, without swelling or redness

Sometimes they move really slow, and they always grunt in pain whenever they jump down off the countertop or the bed. I ask them if they're hurting, but they never answer. Perhaps they've forgotten.

.

Headaches of a new type, pattern or severity

Sometimes, when they're sleeping, they bury their heads under their paws, as if the very light is hurting them. Sometimes they sleep under the bed in the darkened room, away from any noise that might hurt their tender kitty heads.

.

Tender armpit and/or neck lymph nodes

When the 5-year-old carries them around with her arm under their armpits, and their feet dangling toward the ground, they always struggle to get away. I think it's because their little armpit lymph nodes are sore.

.

Sore throat

Sometimes, when they've meowed a lot, they sound a little hoarse. Like they have little kitty sore throats.

********************

.

It's really hard to tell, since there are no actual signs of this disease, only symptoms. Hmmm, that sounds like another disease I've heard of.... Oh My God, what if they have fibromyalgia, too? Pain, Fatigue, Sleep Problems, Impaired Memory and Concentration, Headaches, Restless Leg Syndrome (their little paws are always twitching when they're trying to sleep)......

.

Help! Does anyone know a Fibromyalgia/Chronic Fatigue Syndrome vet? I need to get them hooked up with a PMD, or else they'll start showing up in my ER on the ambulance, looking for narcotics! Do you have any idea how embarrassing that would be?

Good Vs. Evil

In the beginning, God created the Heavens and the Earth and populated the Earth with broccoli, cauliflower and spinach, green and yellow and red vegetables of all kinds, so Man and Woman would live long and healthy lives.

Then using God's great gifts, Satan created Ben and Jerry's Ice Cream and Krispy Kreme Donuts. And Satan said, "You want chocolate with that?" And Man said, "Yes!" and Woman said, "and as long as you're at it, add some sprinkles." And they gained 10 pounds. And Satan smiled.

And God created the healthful yogurt that Woman might keep the figure that Man found so fair. And Satan brought forth white flour from the wheat, and sugar from the cane and combined them. And Woman went from size 6 to size 14.

So God said, "Try my fresh green salad." And Satan presented Thousand-Island Dressing, buttery croutons and garlic toast on the side. And Man and Woman unfastened their belts following the repast.

God then said, "I have sent you heart healthy vegetables and olive oil in which to cook them." And Satan brought forth deep fried fish and chicken-fried steak so big it needed its own platter. And Man gained more weight and his cholesterol went through the roof.

God then created a light, fluffy white cake, named it "Angel Food Cake," and said, "It is good." Satan then created chocolate cake and named it "Devil's Food."

God then brought forth running shoes so that His children might lose those extra pounds. And Satan gave cable TV with a remote control so Man would not have to toil changing the channels. And Man and Woman laughed and cried before the flickering blue light and gained pounds.

Then God brought forth the potato, naturally low in fat and brimming with nutrition. And Satan peeled off the healthful skin and sliced the starchy center into chips and deep-fried them. And Man gained pounds.

God then gave lean beef so that Man might consume fewer calories and still satisfy his appetite. And Satan created McDonald's and its 99-cent double cheeseburger. Then said, "You want fries with that?" And Man replied, "Yes! And super size them!" And Satan said, "It is good." And Man went into cardiac arrest.

God sighed and created quadruple bypass surgery.

Then Satan created HMOs.

.

Happy Birthday to my Mommy

Things My Mommy Taught Me:

My mommy taught me that helping people might not be easy, or convenient, but it's still the right thing to do. (She neglected to mention that most of the people that you help will be largely unappreciative. I had to learn that on my own. I also learned how nice it is when someone does appreciate you.)

My mommy taught me that I don't have to like stupid people, but I do have to be polite to them. (Until they start cussing at me. Then I can give them "The Look" and ignore them.)

My mommy taught me that there are many opinions. I don't have to accept yours. I just have to accept that you have as much right to it as I have to mine. (She originally tried to teach me that I wasn't always right, but she failed miserably. So she amended that lesson.)

My mommy taught me that I am special. (She didn't teach me that I'm more special-er than everyone else. I picked that up on my own.)

My mommy taught me that talking back and not doing what I was told could be dangerous to the health of my behind. Consequently, my butt grew padding to protect itself, and I learned to do what I was told. (I still talk back, though.)

My mommy taught me that if you're going to take the time to do something, you might as well do it right the first time. (Which turned me into a rabid perfectionist. With borderline OCD.)

My mommy taught me that it was OK to stand up for your beliefs. (And then put up with me as my beliefs changed on a daily basis.)

My mommy taught me how to love someone even when they break your heart. (She didn't, however, warn me how hard it would be.)

My mommy taught me that homemade food is the best. (Especially homemade chocolate chip cookies.)

My mommy taught me not to spend more than I make. (Thanks to her I have an excellent credit score and complete paranoia about said score.)

My mommy taught me so many things. And I learned all by myself how lucky I was to have her for my mommy.

Happy Birthday, Mommy. I love you.

A Matter of Perspective

Tonight we had an Amish man and his son who were driving their buggy and were hit by a car that came up behind them too quickly to stop. It ended up swerving to try and miss them, and sideswiping them instead. Both of them got tossed out. Both of them had numerous abrasions and lacerations. Mr. Amish had a broken neck. (He was neurologically intact, thank God.) Both of them were obviously in tremendous pain. Both of them continuously refused pain meds.

Mr. Amish got shipped to the Neuro Hospital in the Big City. His response the last time I asked him if he was sure he didn't want any pain meds? "No, it's not that bad. I'll be OK." Mind you, he could barely move his extremities because they hurt so bad. When we rolled him to staple the lac on the back of his head, he was gritting his teeth in pain, but all he said was, "Just go slow. I'll be OK."

Amish Son could barely move, he was so sore. He had an 8 cm lac on the back of his head. He didn't even want pain meds to go. He said he had to get up early tomorrow to milk the cows and pick the produce for their stand, and he "didn't want to be fuzzy".

While I cleaned her husband's bloody head a bit, Mrs. Amish and I talked about fresh vegetables, people who drive too fast, and cows. She told me where their produce stand is. It's right down the road from where I live. I told her I'd come by.

On their way out the door to the ambulance, Mr. Amish said, "Be sure to come by and see us!" Mrs. Amish added, "But wait for a day or two. He'll probably be down for the count for a day or two."

And that, ladies and gentlemen, is the difference between our normal clientele and people that truly work for a living.

Fun and Games in the ER

Angry Nurse has some great ideas for ER based games and such. I'm going to propose some of them to my nurse manager. Purely because I want to see her reaction, of course....

To the First-Born Go the Smarts

Higher IQ determined by birth order, not genetics, study contends

MonkeySiblings, eat your hearts out.

It should be a law

If you weigh over 300 pounds, I don't care how hot it is, you do not have the right to play in the water fountain in a public park in nothing but short-shorts and a white t-shirt.

My eyes are still burning.

I'm Lucky.

I don't know anyone that is currently serving in Iraq. I do, however, know a lot of people who know someone who is serving in Iraq.

I'm lucky that I don't have to deal with the worry of having a loved one over there. But I really only have a bystander's knowledge of what happens over there. (Translation: whatever spin the media is putting on it today.) So I really appreciate first person viewpoints from people that are actually over there risking their asses, not just making decisions from nice conference rooms.

I appreciate very much the freedom that I have to do whatever the Hell I want. And I appreciate the people that are defending that freedom.

Anyhoo, one of our soldiers that is a friend of a friend has a blog, and he only writes once or twice a week, but it's a great read. So go check it out. And leave him a shout-out and tell him how much his being there means to you.

(The funniest stuff is here, here, and here. But you really should read the other stuff, too.)

And be nice. I didn't ask him if I could invade his privacy. Please don't make me regret it.

Do you think they died happy?

I'm not sure what to make of this. Perhaps they should have chosen a safer roof.......

I think I'm demented.

At least I know it runs in my family.

My sister sent me a link to an essay entitled "I Like Monkeys". I'm assuming that it was written by this guy who also has a blog written in some other language. (I don't know what ANY of his posts are saying.)

I thought the monkey thing was hysterical. I don't know why. I laughed all the way through it.

So I'm sharing it. You're welcome.

This one's for GruntDoc

Ok, maybe they're not talking about Priuses (Prii?) specifically, but still....

"Little Pipsqueak"

There are two schools of thought about drug-seekers in my ER. Half of us think that we should give them nothing so that they'll go away. The other half think that we should give them whatever they want so that they'll go away.

Both want pretty much the same thing. For the drug-seekers to go away.

There is an inherent problem with both schools. It's called the "yo-yo effect". If you give them their drugs, they come back for more. If you don't give them their drugs, they come back and try again with a different story. Either way, they come back.

It's a classic "damned if you do, damned if you don't" scenario.

One of our docs that belongs to the "damned if you do" school was on the other night. He started out one of our regular "mysterious 10/10 abd pain that gets much worse when you're in the room" patients with a Morphine/Phenergan cocktail. Now, everybody knows that you can't go straight to the morphine. You have to start off small and build up, because whatever you give them at first will not work. No matter what it is.

Consequently, when I asked her how the medicine was helping her pain, (in my "caring" voice), the dose that would have knocked me on my ass for a week was "barely touching it".

She said, "I wish the doctors would just listen to me. I know what will work. The only doctor around here that will listen is Dr. Jones (another "damned if you do" school member). Why can't Dr. Smith just pull my chart and see what Dr. Jones did last time? It's all there. I just need some Dilaudid. That's the only thing that works."

As an aside: Every time someone tells me that Dilaudid is the only thing that works, I have a moment that I want to say, "Then what the Hell are you going to do if you ever have any real pain that you need us to take away?"

Anyhoo, I went back up to the nurses' station and told Dr. Smith that he isn't as good as Dr. Jones, because Dr. Jones is the only doctor working here that is smart enough to figure out that Dilaudid is all that works on poor Mrs. Need-a-Fix's pain.

His response?

"Give me her chart. There's no way I'm going to let that Little Pipsqueak out-dilaude me!"

Mrs. Need-a-Fix now thinks that Dr. Smith is the best doctor in our ER.

Ah. Office politics with narcotics. Gotta love it.

A Moment of Silence

You can't quantify tragedy. But pray for those directly impacted by it today.

Grand Rounds

Grand Rounds is up over at Codeblog: Go check it out!

It's not hot.

We had thunderstorms all day yesterday, and all night last night.

There's more forecast for all day today, and all night tonight.

The Home Weather Station on the wall in my TV room says the humidity outside is 80%.

I'm drowning just breathing.

My husband just opened all of the windows in the house because "it's not hot" and he wants to "let in some fresh air".

My forearms are sticking to the desk as I'm typing.

I fully understand the phrase "But it's a dry heat" more right now, this very second, than I ever have before, or may ever again.

Oh, Dear Lord.

The Queen of Crayzee, self-proclaimed "Advocate of Nurses", and general, all-around PITA, has now got a post up called "Protecting Yourself From Bad Nurses and Physicians".

She says, among other things,

"Nurses enjoy and exploit one of the highest ratings of public trust."

and

"They are interested in their paychecks, in exerting their power over people, and in serving their own interests."

According to the quotes she has chosen from other blogs, she is no longer supporting the nurses. N=1 is now supporting the drug seekers, drunks, prescription forgers, and in general, the people who are causing a lot of the problems in our healthcare system.

I suppose she says it best in the comments section of her "Naw, just kidding, I wasn't really going away" post:

"I’m all out of interest in supporting or promoting nurses or nursing. "

Thank God. As has been previously stated by one of the real nurses, "We don't want you."

PS: N=1, please stop linking me. I don't want to read your stupid blog. But if you keep linking me, I have to go see what you're saying about me. Can't we just break up? I'm really not that into you anymore. You're just not my type. You'll find someone new, someone who appreciates you for who you are. I'm just not that someone. I'm sorry that it had to end. But you have to stop calling. My mom's worried we'll have to change our phone number....... Oh wait, that was the boyfriend in high school. Sorry. The crayzees get mixed up in my mind sometimes.

But Ma, everyone's doing it...

I've had fun reading this meme that's circulating lately, but I wasn't going to do it until my best friend from high school e-mailed it too me, too. Since she never asks me for anything.......

1. WERE YOU NAMED AFTER ANYONE?
Nope.
2. WHEN WAS THE LAST TIME YOU CRIED?
I don’t remember. If I cry, run. It means I’m furious.
3. DO YOU LIKE YOUR HANDWRITING ?
Nope.
4. WHAT IS YOUR FAVORITE LUNCH MEAT?
Peanut Butter and Jelly.
5. DO YOU HAVE KIDS?
A 5-year-old stepdaughter. My uterus is for decorative purposes only.
6. IF YOU WERE ANOTHER PERSON WOULD YOU BE FRIENDS WITH YOU?
Yes. I would not, however, be enemies with me.
7. DO YOU USE SARCASM A LOT?
Sarcasm is just one of the useful tools in my bitch arsenal.
8. DO YOU STILL HAVE YOUR TONSILS?
Yup.
9. WOULD YOU BUNGEE JUMP?
Nope.
10. WHAT IS YOUR FAVORITE CEREAL?
Fruity Pebbles. I can eat a whole box in one sitting. That’s why I don’t buy them.
11. DO YOU UNTIE YOUR SHOES WHEN YOU TAKE THEM OFF?
No. Shoelaces are decorative. They should be tied loosely enough to allow the easy ingress/egress of my foot into and out of the shoe they are decorating.
12. DO YOU THINK YOU ARE STRONG?
Yup.
13. WHAT IS YOUR FAVORITE ICE CREAM?
Any variation of Chocolate, Brownies and Fudge.
14. WHAT IS THE FIRST THING YOU NOTICE ABOUT PEOPLE?
Whether or not they are whining at me to do something for them.
15. RED OR PINK?
Red. Pink is a color invented by the devil to torment me.
16. WHAT IS YOUR LEAST FAVORITE THING ABOUT YOURSELF?
My lack of motivation. I’d be rich and retired if I had any motivation at all. Anyone want to come vacuum my living room?
17. WHO DO YOU MISS THE MOST?
H.T.
18. DO YOU WANT EVERYONE TO SEND THIS BACK TO YOU?
Whatever. I rarely lose sleep over what other people do.
19. WHAT COLOR PANTS AND SHOES ARE YOU WEARING?
Green scrubs and Crocs.
20. WHAT WAS THE LAST THING YOU ATE?
Steak and shrimp shish kebobs.
21. WHAT ARE YOU LISTENING TO RIGHT NOW?
A waiting room full of people whining “Can you tell me when I get to go back?”
22. IF YOU WHERE A CRAYON, WHAT COLOR WOULD YOU BE?
Blue. Not Cornflower, Not Cerulean, Not Aquamarine, Not Indigo, Not Denim, Not Sky, Midnight, Turquoise, Navy, Pacific, or Robin’s Egg Blue. Just Blue. What the hell is Crayola thinking?
23. FAVORITE SMELLS?
Fresh cut alfalfa, fresh baked apple pie, the smell of an imminent downpour.
24. WHO WAS THE LAST PERSON YOU TALKED TO ON THE PHONE?
Some dumbass who wanted to know if she should bring her sick kid in to the ER. I don’t know. Why don’t you put the phone up against the part that hurts so I can hear it. Hmmm. That sounds serious. You better bring him in.
25. DO YOU LIKE THE PERSON WHO SENT THIS TO YOU?
Yup. She’s the only person from high school that I’m still in contact with. Literally.
26. FAVORITE SPORTS TO WATCH?
Football is the best, but I’ll watch anything but NASCAR. NASCAR isn’t a sport. And arena football isn’t really football.
27. HAIR COLOR?
Clairol Hydrience #34
28. EYE COLOR?
Blue.
29. DO YOU WEAR CONTACTS?
Nope. Too lazy.
30. FAVORITE FOOD?
Bacon Cheeseburger. Loaded. And a Guinness.
31. SCARY MOVIES OR HAPPY ENDINGS?
Bombs and guns matter. Scary don't matter. Endings don't matter.
32. LAST MOVIE YOU WATCHED?
The Departed. The ending sucked.
33. WHAT COLOR SHIRT ARE YOU WEARING?
Green scrub top.
34. SUMMER OR WINTER?
Winter. I hate the sun.
35. HUGS OR KISSES?
Hugs.
36. FAVORITE DESSERT?
Chocolate Soufflé with Grand Marnier Sauce.
37. WHAT BOOK ARE YOU READING NOW?
A Meeting at Corvallis by S.M. Stirling
38. WHAT IS ON YOUR MOUSE PAD?
A cool gel pad thingie.
39. WHAT DID YOU WATCH ON T. V. LAST NIGHT?
Tiger Woods playing golf. It’s fascinating. I couldn’t turn it off.
40. FAVORITE SOUND?
Thunder.
41. ROLLING STONES OR BEATLES?
Metallica.
42. WHAT IS THE FARTHEST YOU HAVE BEEN FROM HOME/HERE)?
I’ve never been anywhere good.
43. DO YOU HAVE A SPECIAL TALENT?
The ability to piss off anyone. Anyone.
44. WHERE WERE YOU BORN?
The Republic of California

There. More information than you ever wanted or needed to know about me. Now leave me alone.

Happy Father's Day

This is how life looked from the cockpit of my daddy's airplane. We would go fly for hours, just him and me.

I have never been so happy since.

I love you Daddy.

Quote of the Night

From the sweet little old lady with the nastiest UTI I have seen in a long time (forget pus- she had something resembling soupy KFC Mashed Potatoes in her bladder), after listening for 2 hours to the drunks and psychos and generally unpleasant not-sick freaks:

"It's like a torture chamber down here, honey. How do you do it?"

Sometimes I wonder that myself.

Public Service Announcement

If your mailbox is 20 feet from your house, and you pull up in your car to said mailbox, facing the wrong way on the street, blocking traffic, to get your mail, before pulling into your garage-

You are lazy.

Free Babysitting at Applebees!

What, you're not supposed to give your toddler margaritas?

And mama says they offered her free stuff, but she's not going back. (Wouldn't look right for the lawsuit, you know....)

And just in case you don't have any tequila, how about some horse?

Poo+epiphany= poopiphany

A LOL came in from the nursing home tonight, with a complaint of N/V/D x 2 days. Skin and bones little thing with a PEG-tube. We got the IV and labs, gave her some Zofran, and did a CYA EKG. Then, of course, she needed a catheter.

So I got all geared up for the puddle of poo that is the geester diarrhea diaper. I pulled back the sheets, peeled back the plastic tabs (cheap, generic geester diapers suck!), opened it up, and was met by......

BABY POO!

If I'd thought about it, I would have remembered that the stuff they put through those PEG-tubes is just the geester version of baby formula. So it makes geester baby poo. I had forgotten. (Or maybe I've blocked out all my nursing home memories.)

And she was so little, we just lifted her butt up like a big baby.

And what did she say to all this? "I'm so cold, but my pee is so hot!" I swear. I think she had a touch of dementia.

OK, maybe it's not an epiphany. But it is funny.

Dinosaurs on the Ark?

There's an article in The Economist about a museum that opened last month in Petersburg, KY. It's called the Creation Museum, and it's a $27 million attempt to merge creation with evolution into a bizarre combination of science and religion.

Articles from Yahoo! News and the New York Times describe high-tech dioramas that have dinosaurs in the Garden of Eden, and even on Noah's Ark.

Here's my favorite quote, from Economist.com:

The museum says that, if Noah took two of every animal on his ark, he must have had dinosaurs. Could dinosaurs have fit into a boat only 300 cubits (about 135m) long? “It is likely that God brought young adults. Being smaller, they would be easier to care for.”

.

Yeah. Every animal on earth, and now little bitty dinosaurs, too. Sure. That's how it happened.

*sigh*

And reality rears its ugly head......

This is God Speaking......

...and he is telling you, in very literal terms, that your religion/cult/whatever, is retarded.

Perhaps you should listen to Him.

Wake Up Call

Edith Isabel Rodriguez

1964-2007

************************

Attention Drug Seekers:

If you cry wolf often enough,

we won't believe you when you need us.
************************************

It's tragic that she died. It's scary that it could happen at any reasonably busy ER. It's horrible that we'll never know the truth.

.

We have patients that push the limits of status dramaticus every day. We try to take them seriously every time, just in case. But sometimes, it's just too busy. We've all taken care of someone that sat in the lobby longer than they should have, for reasons beyond our control. It's just the way it is.

.

Someday, when we're perfect, mistakes won't happen. We'll magically be able to separate the drug seekers from the really sick people. Even if they are one and the same.

.

But we're only human. Cut us some slack. And leave the poor 911 operators alone.

_________________

EDIT: If you want to read the Coroner's Report, go here. (Thanks, Babs.)

***********************************

ADDITIONAL EDIT 6/19/07: Anyone coming here from Universal Health; welcome. To see why N=1 hates me, go here. If you think N=1 is crayzee, too, make sure to check out the summary of last week's fun. Welcome back N=1. Every crowd needs a crayzee.

**********************

ANOTHER ADDITIONAL EDIT 6/25/07: Anyone coming here from Universal Health this time; welcome. Yes, she's crayzee. Yes, she's obsessed with me. I can't help it. It's my cheekbones. They turn her on. I wish she'd leave me alone.

My head almost exploded last night.

It all started when I went to Generic Nurse K's blog and read this post about false dichotomies. Of course, then I had to go read the post she was going nuts over.

Now, I don't read the Universal Health Blog. The uncomplicated reason is that it's got too many columns and links and clutter and it hurts my ADHD brain. It's just not visually appealing. I don't want to have to work so hard to be entertained/informed, etc. The other reason is that this N=1 person bores me. If I don't either laugh at what you write or agree with what you write, I don't waste my time with you. I would expect the same of anyone visiting my blog.

Besides.

You have to break up the eloquent verbosity with some strategically placed spaces.

Like so.

Otherwise my brain goes into "scan" mode, and I skip 3/4 of what you have to say. I'm just sayin'. (That's why girlvet intimidates me. She can make me read an entire page with no spaces, and I read the whole thing. How does she DO that?)

Anyhoo. While I was on the previously-mentioned rant-inducing site, I figured that I would look through a few posts, you know, just in case I had made an error *gasp* in judgement. (Hey, I've been wrong before. Once, I think.) And I came upon this post about nurses and doctors and why can't we all just get along. Which led to posts by Signout, another by N=1, and one by Midwife With a Knife.

After at least an hour of painful reading (because I was determined to stick it out to the very freakin' end), I came to my own conclusion.

This person with the pseudonym N=1 is, as Scalpel puts it, C-R-A-Y-Z-E-E. And not just regular crazy. Angry crazy. And not just angry crazy. Angry crazy with a huge sense of entitlement.

When I read a physician blog, I read it as just that. A physician blogging. When I read a med student blog, I read it as just that. A med student. Someone who is going to be a physician.

You know, a physician. That guy (or gal), who went to 7-10 freakin' years of medical school. Compare that to 2 years for an ADN. Or 3 if you've got a BSN. Last time I checked, 2 did not equal 10. All of the associated monetary costs of school and subsequent pay after school are not equal. The decision-making requirements and responsibility for those decisions are not equal.

Therefore. Nurses. and. Physicians. Are. Not. Equals.

The people may be equals. An MD isn't any more important as a person than the guy working behind the counter at McDonalds. But nobody ever died because they didn't get a hamburger. And McDonalds workers don't need malpractice insurance. (Though they should. Yuck!)

So if I read a physician's blog and they put the nurses in their own section in the blogroll, I think, "Hey, they've got nurses on their blogroll. Cool!" Not, "Hey, why are the nurses segregated on the blogroll? Bastard!"

If I read a physician's blog and they say nice things about what a nurse has done, I think,"Hey, they noticed how hard we work. Cool!" Not, "Hey what about how smart I am? Bastard!"

If I read a med student's blog and they don't *gasp* mention the nurses in every post, I think, "Damn. Sucks to be them. They work hard. Glad I decided not to go to medical school." Not, "Why aren't they talking about me? Bastard!"

And if I don't like what someone has to say on their very own blog that they started, write, and maintain, I just don't read it. I don't attack them in the comments, and I sure the hell don't come back and make a huge pain in the ass of myself. It's their damn blog!

So I was already wanting to beat this N=1 person about the head with a crowbar, when I clicked on the "About" tab and read this.

"I continue to hold nursing licensure in one state, but I no longer practice clinically, no longer teach, and no longer work as an employee within the healthcare industry. As one who never found a niche in the system, I find blogging to be a platform for free-er thinking - and for the risks and advantages that the forum provides."

Translation: I sucked as a nurse, and I'm no longer a nurse, but I'm going to continue to call myself a nurse and throw Molotov Cocktails at people from behind my cloak of anonymity.

That's even lower than a politician. At least they're not anonymous.

Jeez. Go away, you freak.

PS: N=1, if you grace us with your presence, you only get one comment. I'll delete any more than that. I will not allow you to take over my comments section with your diatribes.

Thank you, that is all.

Change of Shift

Mother Jones, RN, over at Nurse Ratched's Place has done a fantastic job on Change of Shift. Go check it out!

Financial Decisions

So my husband called me tonight to tell me he has worked out a plan. He's figured out the hows and wheres of investing a little extra money so that we can retire before we get to Wal-Mart Greeter age. Our master plan includes a cabin, on 50 acres, off the grid, in the middle of nowhere. (Find me there, you drug-seeking twits!)

That wasn't the surprising part. The surprising part was what he's willing to give up for the initial investment into the account.

For those of you non-gun nuts out there, (which I'm assuming is most of you), this is a Cooper Arms Model 22 Phoenix in 6.5 x 284.

He's had the money earmarked for this baby (and has talked about nothing but), for months.

And now he says he'd rather wait a while, and put the money towards something more useful. Like retirement.

I'm worried. This could be considered a significant Change in Mental Status. Perhaps he's having a stroke.

Bigger worry; if we do put the money in this account/fund/whatever, am I going to have to listen to him whine about it for the next year?

Don't wanna blog today.

But I'm glad you stopped by. So go watch this over at 10/10. It made me laugh. And come back tomorrow. I'll try to think of something entertaining by then.

Dilbert Calls It

Filed under: WTF?

A certain Angry Med Student from across the Pond has said that I spend way too much time on MSNBC. He's right.

That being said, today I found this article about the latest candidate for "Worst Mother in the World".

Now, I was horrified by the fact that this poor kid weighs less than half what the average weight for his age is. I was very bothered by the fact that he was filthy and nasty. But this was the most disturbing part of the story:

"The woman has nine children ranging in age from 2 to 23 and is pregnant."

There are some people that sterilization should just be mandatory for.

I thought you quit smoking!

We have a patient, who shall be called Flo, that we all hate. Actually, hate is too strong of a word. We all dislike her. She is very exasperating. To the point that Pillow Therapy has been requested of the Docs as a Standing Order.

Flo exists in just about every ER in the country. She's the COPD-er that comes in three times a week for SOB, will not quit smoking, will not take care of herself, and ends up being admitted every 5 or 6 trips because she's either got pneumonia again (or still), or else her sats are just too low to justify d/c-ing her home.

One of the medics does a dead-on impersonation of Flo. Dead-on to the point that we look around for her if we hear him. She has a very memorable redneck-smoker-hillbilly-with-a-basement-IQ voice.

One of our RNs came in with a bad gallbladder on a night that she happened to be arrested in the ER for an outstanding warrant. (Hell, if I'd known she had outstanding warrants, I'd've called PD to come get her 3 visits ago!) He said that the sight of Flo leaving the ER in handcuffs made the cholecystectomy worth it. I'm not sure I disagree.

The last time Flo was admitted (last week), she didn't do her usual set-down-the-neb-treatment-and-go-out-and-smoke routine. We figured that she must be really sick if she didn't disrupt her nebs to go smoke. She always goes out at least 2-3 times, usually after each neb. It's like a shot of Albuterol with a Nicotine chaser. We try to catch her, but it's just too busy, and stupidity alone doesn't qualify you for a patient sitter. (Thank God. If it did, we'd have to have 100 patient sitters.)

I mentioned this peculiarity to the nurse who had triaged her, and she said, "Oh, Flo said that she quit smoking."

After I picked myself up of the floor, I thought to myself, "Self, keep an eye on her. She's figured out how to tell us what we want to hear. That means she's evolving. Evolution has previously passed her by. This could be dangerous." (Self didn't reply. I'm weird, not schizophrenic.)

Sure enough, 3 hours later, she still hadn't gone outside. And she was being admitted. Creepy.

We took her upstairs (I say we, but I really mean somebody else that I suckered into doing it for me) and the night went on as usual.

Until 2 hours later when I walked by a previously empty room and Flo was sitting on the bed with a breathing treatment. What the.........?

My frantic rush into the nurses' station scared the Hell outta everyone, that, and the fact that I was babbling words like "Flo" and "twin" and "clone" and "aaaaaaaaahhhhhh".

Turns out that Flo had been out of cigarettes. Her brother brought her some, so she signed out AMA to go smoke. She hadn't had one for almost 5 hours, after all. And since she was actually pretty sick this time, she had to come back in for a breathing treatment. Go figure.

Her response to the "I thought you said you quit smoking!" comment she was hit with by the triage nurse? "I lied, sweetie. I'm sorry."

She really is a nice person. I just hate her. Oh well. At least I got to meet her brother. He looks just like her, only his beard is a little fuller than hers is. Sounds just like her, too. The last thing he said as he walked out the door was, "You better pay me back for those cigarettes as soon as you get out."

Ah. Redneck hillbillies. Gotta love 'em.

Redneck Pot of Gold

Got this from a friend of mine....

I wonder if they carry Lawdog's Two Beers there?

Blast From the Past

Guess what I had for dessert last night.......

I haven't eaten Pistachio Ice Cream for at least 15 years. Probably longer. MMMMMMMM.

The best non-chocolate ice-cream on Earth. Well, except Pumpkin. Or Eggnog. But you can only find those at the end of the year.

Job Security

Perhaps my job is not so secure as I'd like to think. Think about how many nurses (and other staff) will have to relocate after this happens.

Granted, I don't work in the ghetto of a large metropolitan city, but still, this is a frightening view of things to come.

Sumdood was here

Last night in our ER, the average BAL was at least 3 times the average IQ. I am not exaggerating. I wish I was.

At 0300, we had 6 patients in the ER. The only one that was not an intoxicated SPAK (Status Post Ass Kicking) was a 15 month old with a fever.

The guy on bed 6 and the guy on bed 7 with multiple facial injuries were sure that the guy on bed 10 was the guy who beat them up.

The guy on bed 10 had a boxer's fracture that he maintained he got when he fell on his hand after some particularly vigorous dancing at the local club.

Said local club was indeed the one where bed 6 and bed 7 were assaulted.

Prior to seeing the patient on bed 10, bed 6 & bed 7 had stated that "Sumdood" beat them up.

Ergo, we had Sumdood in our ER last night. And he had been busy. I hope his hand injury doesn't put him out of commission for too long.

Ah, the Good Old Days

I paid $2.93/gallon for gas yesterday, and I didn't even blink. Until I thought about it. When I was in high school, I paid a buck a gallon and that was way too much. Now I'm complacently paying 3 bucks a gallon. And I'm so glad that I don't live here anymore....

Just a nurse

Once upon a time, there was a little Monkey. She was very smart, and MamaMonkey had great plans for her future. She did very well in school, got great scores on her SAT and ACT, and had a full ride scholarship to a well-respected university. MamaMonkey was excited at the prospect of a MonkeyDoctor. But the little Monkey didn't have any desire whatsoever to go college. She didn't have the attention span or the motivation. So she declined the scholarship, accepted a manager position at the local fast food joint, and moved out of the family abode, much to the dismay of the MonkeyParents.

Over the next dozen years, the little Monkey grew up. She left the fast food industry and entered the medical industry. She worked as a CNA, first in a nursing home, and then on the floor in the hospital. She worked as an EMT, and then went to paramedic school. She decided that she wanted to be a flight medic. But she wanted to get some experience, first. So she worked on the bus and in the ER.

But life tends to interfere with best laid plans. Things happened. Plans changed. And the little Monkey (who wasn't so little anymore) ended up working as a tech in an ER at the edge of nowhere. She didn't want to be a firefighter chick, and private ambulance pay sucked. She decided to go to nursing school, because after all, it wasn't that much different than what she was doing now, and the pay was better.

Fast forward a few more years. MamaMonkey has never given up trying to talk MonkeyGirl into going to medical school. "Why would you want to be just a nurse? You could be so much more!" MamaMonkey's not the only one on MonkeyGirl's back. A certain ER Physician has also climbed on the bandwagon, and is pushing for her to do something more. If she won't go to med school, she at least needs to go to PA School. She's wasting herself on nursing. Here's what I say to that.

If I'm just a nurse, I'm at the bedside when Mr. Denial has his big ol' freakin' MI. I can start the line, push the meds, and bust up the clot in his heart that wants to kill him.

If I'm just a nurse, I'm right in the thick of things when the kid with epiglottitis needs the tube and the line and the drugs.

If I'm just a nurse, I'm taking care of Mrs. Sweetness when she has her CVA, and I can take the time to explain to her family all of the big words that the doctor just used.

If I'm just a nurse, I'm there to clean all the lacerations and abrasions on the MVA victim who narrowly escaped with her life after the drunk driver hit her head on. I'm there to hold her hand when the cops tell her that her husband who was airlifted from the scene might not make it.

If I'm just a nurse, I hold in my hand the power of the narcotic analgesic. Some deserve to be touched by this power, some do not. It is not for me to decide, or judge. It is, however, wise to not call me a f-ing bitch if you want me to bestow the power of the narcotic analgesic upon you.

If I'm just a nurse, I can take special care of Mr. Neglected, the 80 year-old man whose family doesn't have time for him. I can clean him up, feed him dinner, and make him comfortable while we wait for his useless son to come pick him up. Likewise for Mr. Homeless. But he doesn't have a son to come get him. He'll just be back out on the street in the morning.

All of this, if I'm just a nurse.

Superior Court Judge Michael T. Sauer, you're my HERO!

'Nuff said.

Men in the news

A 66 year-old man trapped under a tree amputated his own leg below the knee with a pocketknife. I'm half his age and I think I would've just laid there until I died.

Conversely, a 41 year-old man drowned in a sewer drain when he got stuck while trying to retrieve a lost cell phone. That's a Darwin award candidate, is it not?

And a 27 year-old man narrowly escaped serious injury when the family he attempted to rob at gunpoint disarmed him and beat the hell out of him with various implements on hand. Note that both the robb-er and the robb-ee were treated for bites. Talk about a cat fight- did they pull hair, too?

Something in the air

In an effort to keep the HIPAA dogs at bay, I have kept my geographical location super-secret. However, I will tell you that I am somewhere in the Land of Humidity. That narrows it down a bit, but not much, as humidity is a plague upon many of us throughout the year.

When I got to work tonight, the weather was beautiful. Not too hot, not too cool, very little moisture in the air. About 2200, I walked outside into a wall of humidity. It was one of those, "Where the hell did all the oxygen go?" moments. So I wasn't at all surprised when shortly thereafter, EMS started bringing in the SOBs. No, not the jerks. The Shortness of Breaths. The jerks are always here.

Within a matter of a couple of hours, we had 2 people on vents, 2 people on Bi-Pap, and you could hear the hiss of the neb treatments all through the ER. Every respiratory therapist in the building was hanging out in the ER. It felt like every COPD/asthma patient in the city was either here or on their way here.

But that wasn't the most bizarre thing. The most bizarre thing is that the drug seekers stayed away. The "clinic" patients weren't rude and demanding. The only crazy guy was a mushroom ingestion that was *gasp* hallucinating.

Apparently, there are occasions when you can walk the "don't really need to be here" patients past 4 people with machines breathing for them, and then surround them by the hiss of oxygen, and they will realize that their minor BS complaints are just that. BS.

Hmm. Who woulda thunk it?

The Problem with Blogging....

...is that it requires a computer. And every time I turn on my computer, I have to read about Paris @%$#& Hilton.

If it's not an article about her controversial early release, it's one about her going back to jail.

And hey, guess what? Her prison jumpsuit is for sale on Ebay, just in case you cared.

But I have to admit, this did make me smile. Annoyed the hell out of me because it's probably not far off, even though it's supposed to be a joke, but nonetheless, made me smile.

*Tee-Hee*

Does it make me a bad person if this makes me laugh?

My Feet

Our hospital just instilled a policy that Crocs are off limits because the holes are an infection control issue.

I have had every body fluid on earth hit my shoes. They have never, not once, made it to my feet. I wear white socks. I would know. Even betadine and charcoal. If those substances don't make it through, the barrier is impermeable, as far as I'm concerned.

And how are mesh tennis shoes, that absorb and redistribute said body fluids, any safer?

Anyway, being the good Monkey that I am, I went out and bought some new shoes. They were made of the same stuff, just no holes. They were Dickies, for crying out loud! I figured I'd be OK.

I can't feel my big toe on my right foot.

Apparently the new shoes are compressing a nerve somewhere, or something. (I'm just guessing. It could be an arch thing. Dammit, Jim, I'm a Monkey, not a podiatrist!)

I'm going back to the Crocs. Addendum to said policy states that we can wear OR booties over them.

There's Something Wrong With This Picture

She's 99 years old. She's about 5 feet tall, and can't weigh more than 90 pounds. She lives alone and takes care of herself. Her medical history and medications are almost nonexistant. She hasn't been to the hospital since she had pneumonia in 1994. (That was 13 years ago, for those of you who are not mathematically inclined.)

She fell getting out of the bathtub tonight. She has an obviously shortened and rotated left leg. EMS said they could hear her screaming in pain from the front porch. The had to give her narcotics to move her, but they were concerned with how well she could handle the drugs. It took almost nothing to knock her out.

When we got her, she was wrapped in pillows and straps on the backboard, in as much of a position of comfort as they could get her. She was mostly unconscious, but she'd wake up and scream in pain, grabbing at her leg, every few minutes. Then she'd go back out.

It was horrible. There was nothing we could do. She was hypotensive, and when she went out, her sats dropped to 94% even with the supplemental O2. More pain meds could kill her. There was no way to position her to get her comfortable. We stood there looking at each other helplessly. All of us knew that she will probably die from this, either quickly, in surgery, or slowly, in the nursing home. It was sobering, to say the least.

And then, from the next bed, came a whiny voice. "Can't you make her be quiet? My head is killing me." One of our chronic "I have a migraine and nothing but Demerol and Dilaudid will make it go away" patients was being her usual impossible self. I have never wished for a Taser as much in my whole life as I did at that moment.

Thankfully, I don't have a hot tub.

Fever Dog found an obituary for Monkey Girl.

I hate hot tubs, I don't cry, I don't know anything about any buried treasures, and I have 3 cats.

Of course, if someone wouldn't let me out of the hot tub until I told them where the buried treasure was, I might cry, and then my SVT might kick in, and then I might die, and there would be no location revealed for the buried treasure I know nothing about. And my cats would ALL miss me.

How Much is a Housewife Worth?

My sister is a stay at home mom with 3 kids under 5. My mom was a stay at home mom until we were all in school. Both of them periodically send me stuff about what housewives should make for a salary, but it changes with every article.

I am happy to inform you that there is now an accurate quantification of the worth of a housewife.

Tycoon’s ex-wife awarded $184M in Ill. divorce

Granted, she's not your typical housewife. But I think that she earned her money.

"The couple married in 1975 in Kiev, Ukraine, then part of the Soviet Union. They arrived in the United States in 1976 with only four suitcases and $500 in cash, according to court records. In 1980, they moved from Detroit to Chicago, where Michael Polsky found success in the energy business."

It's not like she was a 26 year-old blonde bimbette who was only married to him for 2 years. They were married for 30 years. My parents have been married for 35 this year. Hear that, mom? You're worth almost 200 million bucks! Stick it out, MonkeySister! Your day will come.

MonkeyGirl Defined

Courtesy of AD (who, by the way, is a person of questionable sanity who starts their own cult)

MonkeyGirl -- [noun]: A person who is constantly high 'How" will you be defined in the dictionary?' at QuizGalaxy.com

At least I'm a noun. I'm not sure I'd like being an adjective.

What She Said.

In response to the idiots that we are surrounded by: Babs has spoken. I've been trying to come up with a post like this for a week now. I'll just delete my draft and link hers. It's exponentially better than anything I could have come up with. Go read it. Now.

Did something change?

OK. I admit it. I am addicted to House. I Tivo it every week. I have since the first episode. As with all medical shows, there were some minor inconsistencies, but nothing too bad. Until the season finale. (Which I just watched, because, well, I have Tivo.)

Main character patient died. Heart stopped. 3 hours of CPR ensued. Yes, 3 hours. Then, and only then, patient was placed on a heart/lung bypass machine, which was eventually turned off, and patient miraculously returned to life. Not vegetable life. Oh, no. Talking, smiling, totally fine life. After 3 hours of CPR. My beef isn't with the heart/lung bypass and then return to life scenario. It's with the 3 hours of CPR. Who the hell does 3 hours of CPR? We don't even do 3 hours of CPR on a kid that codes in front of us. 1 hour, of course. 90 minutes, maybe. But 3 hours?

And even if the miracle described above had happened, she'd be cabbage. Not talking, fine, totally normal, cute Hispanic chick. She'd be bloated, intubated, 10 different drips running, cabbage.

Bye-bye House. You have gone the way of ER. I have no time for soap operas. It was nice knowing you.

Living Artwork

Is there anything in the world that is quite such a lovely phenomenon as the incredible wicking white cotton granny panty? Into what other material on earth can you insert a small ball of semi-solid stool, add 1-2 episodes of urinary incontinence, percolate 8-12 hours, and achieve such a lovely expanding field of brown?

And if the living artwork that is the Granny Panty isn't visually stimulating enough, there is always the smell. The eye-watering olfactory sting of aged ammonia, with the underlying bitterness of nutrient-free Little Old Lady Dung.

Yes, honey, there is something wrong with Grandma. It's called
D-E-M-E-N-T-I-A. It's the reason Grandma was walking around downtown in said pair of panties and nothing else. Perhaps you and your daddy should start looking into assisted living facilities.

****I appear to be obsessed with poo this week. Sorry.

More Night Shift Fitness

If you are contemplating a new exercise program, and you need a jump start, may I recommend the "Intestinal Virus While Working 4 Night Shifts"? I lost 10 lbs this weekend!

• Those women out there, try it during your period. The cramps all blend in together.
• Berry Rain Gatorade tastes better coming up than Fruit Punch X-Factor Gatorade.
• Calories don't count if you puke them back up.
• Chocolate does not, in fact, cure everything, Sadly, it makes some things worse.
• The pizza at the nurses' station at 2 am will not smell the least bit appetizing. Quite the opposite, in fact. It will, however, permeate the entire ER.
• The 20th person to utter the words,"Why are you so crabby today?" will be subject to the f-word. Repeatedly. In the form of a noun, verb, adverb and adjective all in one sentence.
• There will be three times as many ambulance patients and admissions, requiring three times as much running around, resulting in an exponential amount of exhaustion.
• The bathroom will always be the farthest distance away from where you are when you need it.
• The patients that are not nearly as sick as you will require the greatest amount of care.
• When, at 0330, there are 6 patients left, and 4 RNs and a tech are sitting at the nurses' station discussing bikini waxes, and you tell the charge nurse that you are going home now, her response will be, "But I don't have a triage nurse!" Like I care? Get one of the bikini waxers to do it.

Some random facts

This is my 100th post.

As of yesterday, Sitemeter says 10,000 people have come to see me.

That's an average of about 350 a day. (Though I'm at least 10 of those. My sister is another 5.)

People spend an average of almost 4:00 minutes each time they're here.

Technorati says that 76 people have linked to me. I've found a few more that Technorati has missed.

I've been doing this for a little bit over a month.

Since I started blogging, 3 doc blogs that I read on a daily basis have disappeared under duress. One came back. A couple more are getting paranoid. I can't blame them.

I'm guest-hosting Change of Shift next month. *yikes*

My mommy thinks I have a potty mouth. She has no idea. I have a "Mommy" button next to the spellcheck in order to replace a suitable amount of bad words with kosher versions so that she'll read my blog.

The only thing that made me smile last night at work (besides LeBron James) was the gentleman who stepped right inside the door of the completely full lobby and said, (in "deaf little old man" volume) "I can't take a piss and it's killing me. I need a tube in my penis, NOW!"

Have a nice day.

LeBron James is a God, Part 2

Tim Duncan, you're going down.......

The Rules

If it requires the ambulance team and entire truck of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.

When you present to the triage nurse, do not tell him/her that your doctor called ahead. If you survey our waiting area, probably 50% of the people waiting said the same thing and the other 50% use the ER as their regular doctor.

Never start out by saying, "I was searching the Internet....."

When asked how much you weigh, please do not give the deer in the headlights look, and tell us you really don't know. It's a simple question, simple answer.

Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.

If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a pussy and treated like one. Enjoy the waiting area with your family.

One complaint/ailment per visit, please.

Just because you came in on an ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.

If you have one of these four, go to your own doctor in the morning: a migraine, the flu, a stomach virus, or a stuffy nose.

Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now and so I sure as hell don't know when you're getting a room.

We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.

If your mother is a patient and we ask her a question, let her answer it.

If your child has a fever, you had damn well better give it Tylenol before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?

If you are well enough to complain about the wait, you are well enough to go home.

Do not utter the words "It is in my chart." I don't have your chart, and I don't have the time to call and get it. Just tell me.

We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you.

Do not lie to us. If you lie about one thing, we will assume you are lying about everything. You don't want that.

If you have diabetes and do not control it, you are committing slow suicide.

If you are a female between 16 and 42 and your last period was between 28-35 days ago, and you are here for abdominal pain and vaginal bleeding, guess what? You got your period. Again.

Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to get around seven people in the event that you are really sick.

Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.

If you want something, be nice. I will go out of my way to piss off rude people.

Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or shot. We don't consider a kidney stone sick. Painful, yes. Sick, no.

At any given time, one nurse has four patients. One doctor has up to 15. There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. Don't be the whiner.

Please. If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate asshole. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.

If you can bitch about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.

Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonalds, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets and the lights dimmed, go to the Ramada.

If you have any sort of stomach pain and you ask for something to eat, you are not sick.

Do not talk shit about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.

If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.

Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?

Please don't bring in a show and tell. If you have to fish it out of the toilet, it's really not necessary to bring it in. We will take your word. If you did fish something out of the toilet, you may not use my pen.

***No, I didn't make these up. Somebody much funnier than I did. No, I don't know who it was. But if it was you, let me know, and I will happily give you credit.

Yuck.

Number of men observed entering the men's restroom in the ER lobby between 0100 and 0500: 14

Number of times the toilet flushed: 13

Number of times the faucet was turned on: 2

And people wonder why I obsessively wash my hands, even out front. No, I don't want the pen back. Just throw it away. Thanks.

But WHY did he hit her?

Recently, a woman came in by EMS after her boyfriend beat her up. According to her friend, this had happened before, "but never this bad."

One of the nurses was very concerned for this girl. He spent quite a bit of time in the room with her trying to explain to her that she needed to get out of this situation before her boyfriend injured her very seriously, or even killed her.

About 20 minutes later, he came out of the room, sat down at the nurses' station and put his head in his hands. I walked over to find out how it had gone.

He looked up at me with tortured eyes. "I'm a horrible person," he said. I asked why, and he said, "After 20 minutes with this girl, I wanted to hit her, too! She wouldn't shut up, she just kept yapping away, he was probably just trying to get her to shut up!"

Probably true, since he hit her in the mouth.

Now, I don't think men as a rule should be hitting women. But I do think that there are exceptions to every rule. Apparently she was one of them.