It's a great year in College Football

You don't have to be a Georgia fan to think that's funny.

And I have to say, Tebow looked great flat on his back all 6 times thanks to an early Christmas in the MonkeyHouse. (Think 40" LCD.)

Maybe I'll open a nursing home.

Lovin' on RT!

Top Three Reasons I Love Respiratory Therapists:

1. If we've stuck somebody 10 times trying to get a line and labs, and we've only managed to get the line, and we're all out of veins, RT will come down and do an art stick for the labs. And I usually only have to beg for a minute.

2. RT's have great blogs. Respiratory Therapy 101 is on my "Blogs I Check Every Day" List for a reason. And Respiratory Therapy Cave has a damn funny list of 'olins at the bottom of his blog.

3. If I need to bum a cigarette, it's only as far away as the closest Respiratory Therapist.

Night Shift Fitness: Damn You, Celeste!

I've been on a diet for almost three weeks. Three weeks of starving misery.

M-I-S-E-R-Y.

So I've lost almost 10 lbs. I'm still not sure if it's worth it.

The only thing I have to look forward to is Cheat Day. Cheat Day falls on either Saturday or Sunday, depending on my work schedule. I spend all week planning, revising, re-planning and re-revising my menu for Cheat Day. It gets me through the M-I-S-E-R-Y.

My friend Celeste told me a week and a half ago (right before the first Cheat Day) that I should enjoy my cheat days while I can, because in a few weeks, my body won't be able to handle the food I eat on Cheat Day.

I said, "Nah, I'll be fine. I have a cast iron stomach. I can eat anything."

Saturday night I had a Brownie Sundae while I watched Penn State get their asses handed to them by Ohio State. (Note to Ohio State fans: November 17th. You're going down. Go Blue!)

I was sick as a dog all day Sunday. My stomach felt like it had an alien living (or maybe dying) in it.

Damn you, Celeste!

Sometimes this job just sucks.

When a healthy 33 year old man signs in at 0030, we should not have CPR in progress at 0100.

Yes, sometimes it happens.

And it sucks.

Sorry, no details. I don't have the energy to HIPAA-fy the telling.

Guaranteed to make CrankyProf's blood boil

Some dumbass in Texas paid $100K for a lock of Che Guevara's hair.

My birthday is the anniversary of the day when the psycho finally bit it, you know.

Dilbert

Rice beer wins again

I've never had rice beer.

Apparently, there's nothing better than some home brewed rice beer and a light show.

Unless, of course, you're an elephant.

It's not just about the tasks

Babs said something in a comment thread the other day that I'm going to steal and comment on.

"The majority of my career has been all about what makes people tick. The tasks are only a small part of the real job, no matter how much the current healthcare environment tries to swing the pendulum into the "nurse robot" direction. We have to determine that in order to determine the best way to educate and motivate them, as well as to simply make sense of what we see of people (for our own psychological health) so that we can all keep a handle on it and maintain some semblance of normalcy in everyday life.

Every experienced nurse I know is well-versed in and well-experienced with contact with most anything appearing in the DSM-IV and that sort of psychological assessment of those we come into contact with is just part of the job. You can't effectively and definitively address behavioral and compliance issues, self-destructiveness, and family support issues unless you know what motivates the individual and his/her network as well as what their challenges are. As such, I've got 20 years of behavioral science under my belt.

It's the only way to effect change and bring about results when people are destroying themselves and/or those around them - which often has everything to do with why they're utilizing the system. It's not a detailed diagnostic assessment, but the more familiarity one has with hallmark signs and causative factors, the easier it is to pinpoint behavior patterns that are witnessed and then implement basic therapeutic communication - just little seeds here and there with each contact - in order to gradually bring about that change. The only way we can beat the current crisis is through behavior modification. It's also best for the patient as well as for the system for that to happen."

When I read this, (which I actually had to do two or three times, because it was originally all in one paragraph and my attention span is such that I have to have lots of line breaks or I get confused and start thinking about puppies or some such nonsense), I thought to myself, "Self, this is a woman who actually gives a shit."

Not only does she give a shit, but she actually understands that there are multiple issues at play in our current healthcare crisis. In the political arena, everyone seems to be focused on how to get affordable (or free) healthcare for everyone.

It irritates the hell out of me sometimes to read the opinions of non-medical people that are pro-Universal Healthcare, because the issue isn't simply the availability of said healthcare, it's also the behavior of people who are wasting valuable resources, and the fact that they will continue to do so regardless of which plan is implemented.

But in our current state of burnout and apathy, we go to work every day (at least in my ER we do) and not only expect people to act in a self-destructive manner, but we've actually begun to enable it. After all, it's easier to give the whiny fibromyalgia patient on disability their narcotics 3 times a week than it is to listen to them complain, or better yet, than to get the complaint in writing from administration for not providing "good customer service".

Granted, there seems to be a vast majority of people that are not interested in changing. But like Babs said, we should be more interested in what motivates the individual, as well as find out what their challenges are. It shouldn't just be about giving them their Dilaudid and kicking their whiny asses out the revolving door. There should be a way for us to effect a change, or at least attempt to.

Is that easy with our current staffing issues and patient loads? Hell, no. Sometimes it's not even feasible to get more than a basic assessment done, forget the bells and whistles of "what makes you tick?" But sometimes, we have the time to sit down for a second and learn something about the person we're treating, and possibly educate them and alter their perceptions (and ours).

And it might not make a damn bit of difference to 9 out of the 10 drug seekers you talk to that day. But for that one, you might have, as Babs puts it, "planted a seed". And eventually it might matter.

I don't have any solutions to the healthcare crisis. I don't think that we should be every patient's friend. I don't think that you can care about everyone, or you'll explode. And I don't think that it's worth it to try to "make a difference" all the time, because, well, again with the exploding.

But every once in a while, I think we need to put down the Dilaudid for a second and see if there's something beyond basic skills that we can do for our hardest patients. You know the ones I mean. Not the sick ones. The ones we don't like.

Because even if we accomplish nothing, we're not any worse off than when we started. And we may have actually done something that will make a difference in the long run.

I don't eat at Hardees

But I sure want to. Breakfast has 920 calories and 60 grams of fat.

Dinner has 1,420 calories and 107 grams of fat.

I've been on a diet for 2 weeks. I'm drooling. No really. I'm seriously drooling.

This is all that's missing for the trifecta.

My kind of Meme

I stole this from Addicted to Medblogs-Two. She's also got a funny joke over there that I can't post because it has the word vagina in it. My mommy would beat me if I posted a vagina joke. You can go read it on your own.

Anyhoo-

A Book Reading Meme

1. Open the book you're currently reading to page 133.

2. Read the fourth line on the page.

3. Put the book back where it had been resting.

4. Tell no one of what it was you just did.

5. Think of five friends to tag with this meme.

6. Do not actually tag them. They are busy and have lives.

7. Go about your life as if nothing has happened.

8. Carry the secret of this meme to your grave.

Silver Lining

It's Friday night and there's serious bar time to be spent.

You need a Lortab script for your "spider bite", dental pain, abdominal pain x 2 weeks, fibromyalgia, etc.

The damn ER has a 6+ hour wait.

You don't have a ride home.

What do you do?

Hang out in the smoking area until the meth freak that signed in 5 hours ago comes out with his Lortab script.

Hook up with him and LWBS so you can hit the bar and barter your body for some of his candy.

After all, you can just go back to the ER tomorrow for your script.

PS: Does it creep anyone else out when the regulars hook up in the waiting room while they're waiting to go back?

Senses

First it makes you go blind.

Then it makes you go deaf.

Is getting laid really worth it?

It should be a crime

We have had a massive influx of Nursing Home patients lately that have had G-tubes and DNRs.

The majority of them not only have advanced dementia, but they have various other serious chronic conditions that cause their quality of life to be horrendous. More than one have cried out at regular intervals some variation of "Please let me die," or "I want to die."

It is my opinion that if you cause the absolutely miserable existence of another human being to be unnecessarily prolonged against their will, you should be prosecuted for cruel and unusual punishment and should go to jail.

Change of Shift

Change of Shift is up over at Emergiblog; go check it out!

Name of the Week: Scrabble Edition

Zsaquez.

I swear to God.

Maybe her mama was a fan of Zsa Zsa Gabor or something.

Resurrection

I have good news, and I have bad news.

First the bad news.

The Speaker's back. And Crayzee as ever. With a little bit more of a pathetic tone.

"But I won’t feel terrorized any more. And so this is for me. Finally."

As if nothing she's ever done has been for her.

Apparently, from the timing of her reappearance, the only thing she has to live for is the demise of Nurse K's Blog.

But now the good news....

If she's alive, then I can make fun of her. I tried to get Nurse K to help me out with my new project, The Speaker for Everyone and Everything. But she's laying low for a bit. Something about not wanting to catch a case of frothy trich.

So my good friend and blog fan named Pollyanna is going to collaborate with me. She's trying to lend a positive influence to the endeavor. You be the judge of whether or not it's working.

R.I.P. Crass-Pollination

I headed over to Crass-Pollination for my daily dose of Stage IV Malignant Cynicism, and was shocked and appalled to see that it has been taken private.

Since we all know that Nurse K was strongly against cheesy private blogging, that can only mean one thing.

We'll miss you, Nurse K.

Vacation: In which MonkeyGirl remembers that she hates tourist traps, children and restaurants

I had a big long diatribe typed out detailing everything that happened in the last week, but it was just a bunch of bitching and whining.

It boiled down to this.

1. $120 bucks doesn't guarantee a decent hotel room.

2. Every server at every restaurant we went to sucked. But I still tipped 20%. Just in case they were just having a bad day. All of them. For three days.

3. The more you pay for food, the more you notice when it sucks. And if you have to eat out, your chance of the food sucking increases exponentially.

4. As far as nature is concerned, no matter how beautiful something is, all it takes is a black light and some glow in the dark paint to turn it into a cheesy touristification of something that used to be beautiful. Or colored lights and dramatic music. *sigh* What a waste.

5. No matter how much you wish the opposite to be true, 6 year-old brats will be exactly that.

Why I love my husband

Because he's a die-hard Steelers fan but he bought me this for my birthday anyway.

Quote of the Night

Crazy lady with hysteria-inducing abdominal pain, complete with crocodile tears. Positive Cheetos sign. Wailing like she's traumatically losing body parts (I'm picturing the pruning shears scene from Bound.) Every 5 minutes or so she gets up, runs to the bathroom, flushes the toilet and runs back to her seat.

"I need to talk to the Doctor right away! Something is really wrong with me! I keep throwing up these red stick-like things!"

Chew your food, crazy lady.

Dilbert: Birthday Edition

This is so appropriate, doncha think?

We now pause....

.....for a brief Birthday Break.

Tuesday is my birthday.

I'm going out of town for a few days.

There will be no internet. Well, there may be internet, but I will not be utilizing it.

I'll be back later in the week.

Try to stay out of trouble.

Creepy

I'm at work, so I can't do a screen shot, but I just looked at the details on Sitemeter for visitor #70,000, and get this.

It was someone with an IP address in Forth Worth, Texas, who got to my site by entering "ass monkey girl sex" in some search engine I've never heard of. That's bizarre enough, but wait, it gets better. I happened to look at the "Language" info.... it was Arabic. So I looked at "Visitor's Time", and it was 8:50 am. It's 1:00 in the morning here.

Hey, creepy Saudi dude? You need help.

This one's for AD....

Stanford 24, USC 23

LSU 28, Florida 24

All of you retards that didn't vote LSU #1 last week, how you like them apples, beeyotch?

Beware the mighty unranked Pac-10 teams...... *snicker*
*********************

In other football news: Michigan beat the powerhouse Eastern Michigan, and studly RB Mike Hart had 215 yards. I still think he should be high in the running for the Heisman. But I am a bit biased.

Penn State finally won again. Thank God.

And in the "Picking on My Favorite Blogging ER Docs' Football Teams" Department, Notre Dame finally won, and Georgia got spanked by Tennessee, for crying out loud! (Sorry, Babs. I know they're your team, too. But there's a certain cocky MD that so deserves this loss.....)

*giggle-snort*

When God speaks, Richard Roberts listens

Just in case you are of the opinion that God speaks in confusing, sometimes archaic terms, here is an actual quote from God via Richard Roberts, son of Oral Roberts and head of Oral Roberts University.

"We live in a litigious society. Anyone can get mad and file a lawsuit against another person whether they have a legitimate case or not. This lawsuit ... is about intimidation, blackmail and extortion."

Nothing confusing or archaic about that. It is a bit convenient, though, considering that Roberts is under investigation for misappropriation of University funds.

Bummer. Maybe he should have listened to the part where God said "Thou shalt not steal."

Night Shift Fitness: A Sign From God

I had a patient that was having an active asthma attack in triage, SPO2 87 % on room air and sounded like hell; I could hear him wheezing from across the room. Obviously he went straight back.

The way our ER is set up, it's actually faster sometimes to go back outside and come in the ambulance entrance, which is a double sliding door with keypad access. Said door is a bit schizophrenic, sometimes it opens and closes at will, much to the dismay of the person walking through it.

As I was pushing him through the door, it proceeded to close squarely upon my ass. And it stayed closed for a moment before setting my ass free. This was no loving squeeze, either. I have nice, purple, linear bruises on either side of my ass. Not my hips, my ass.

God has spoken. I need to go on a diet.

"Not all of your patients are dumb..."

There was a fly buzzing around triage tonight. I had been chasing it for hours and was becoming mildly crazy. I made a comment to the tech at the front desk that I hoped it wasn't a tsetse fly.

While the tech looked at me like my hair was on fire, the patient sitting in the seat nearest to where I was chasing the fly said, "Ah, what's a little African Sleeping Sickness between friends?"

I must have duplicated the hair on fire look, because he laughed and said, "Hey, not all your patients are dumb!"

Touche, sir. Touche.

This one's for John

He knew that #11 South Carolina would beat #8 Kentucky.

He's a bit biased. But he was right, nonetheless.

I can't stand Steve Spurrier, but John McElveen is my favorite corny freak.

So Go 'Cocks!

Change of Shift

Change of Shift is up over at Madness: Tales of an Emergency Room Nurse. Girlvet says "Come on down!" Go check it out; it's great!

Tongue in cheek

This would make a SPECTACULAR Home Depot commercial.

And I thought I had a Home Depot addiction.

Observations from my day

Today while I was getting my oil changed (I have to go to the dealer so they can turn off the damn Service light; what a scam), I sat in the "Customer Lounge" and watched CNN for 20 minutes.

To my right was the ugliest woman I have ever seen (and I've seen a lot of ugly women). I ignored her completely until I overheard what she was saying on her cell phone: "Hi, my name is Ugly Jane and I'm Tiffani Rich Bitch's Mary Kay Consultant. She's having a Pampered Piggies Luau (I'm not making this up) on Friday evening at 7 pm, and she'd really like for you to be there. We'll be doing pedicures and makeovers and trying out our new fall colors."

At which point I could not stop looking at her, because if Mary Kay cosmetics can make this woman look good enough to sell Mary Kay to other people, then I need to buy some!

Next I went to Wal-mart to pick up my groceries for the week. When I got up to the check out stands, (of which there are 24) there were 3 open. And one of them was the 20 items or less lane. I actually dug through my cart to see if I could pick out 20 important things and leave the rest. No such luck.

So I got stuck in a line of 6 people with FULL carts waiting to be checked out by the slowest, dumbest woman in the world. (But not the ugliest, I already met her this morning.) For almost 30 minutes, I had the pleasure of listening to the freaks in front of me talk about how they had their feet ionized, and what color their toxins were.

After 10 minutes I was ready to leave the groceries and just order pizza all week. But I stuck it out. And it's a good thing I did, because.......

While waiting in line I picked up two new candy bar variations that I hadn't tried yet. (I know, I was shocked, too). Three Musketeers has a new mint version that is basically what a York peppermint patty wants to be when it grows up. It is fantastic. And Reese's has a new fluffy thing that is basically the peanut butter version of a Three Musketeers bar. Also fantastic. And according to the package, they are good for you (at least that was how I interpreted whatever it was the package said).

So my oil is changed, my fridge is full, I saw the ugliest Mary Kay Consultant on earth, I learned about some freaky feet thing, I was waited on by the slowest, dumbest (but very nice) woman on earth, and I found two new candy bars. Not bad for a day's work.

Note to self...

If I am OJ Simpson, and I am involved in yet another legal dispute, don't have my picture taken by the media while wearing my Rolex, as I owe the Goldman family a lot of money.


Updated note to self.... never mind.

Leg Custody

Some people are just too weird for words.

Synopsis:

So I bought this meat smoker at a garage sale, and when I got it home and opened it, there was a damn leg in it! I freaked out and called the cops, and they came and took it away.

But then I started thinking, "Hey, Halloween is right around the corner. I bet I could get people to pay me money to look at that leg!" So I called the funeral home that the cops took the leg to, and tried to talk them into giving it back to me, since I bought it and all. But they wouldn't, because it wasn't my leg.

So now I'm trying to talk the guy who used to be attached to the leg to let me borrow it for Halloween. Sorta like joint custody. You know?

So does the knee have to be attached for it to be joint custody?

Funny Medical Charting

Found this over at WhiteCoat Rants...

I'll take "Ways to wreck your day for $200, Alex..."

If Only...

UW had hung on to beat USC, then this would have been the best weekend of football ever. At least their ugly win was enough for LSU to take over #1.

As it was, Michigan won, Penn State lost, Kansas City won, and Pittsburgh lost, so MonkeyHusband is sulking and I'm gloating. (Quietly, but gloating nonetheless.)

I wonder if Charlie Weis is getting death threats yet?

And how about that Brett Favre?