Monday, October 27, 2008

How often do you change your socks?

This guy comes running into the front of the ER hollering, "My girlfriend's having a seizure! Help me!"

So the triage nurse and tech grab a wheelchair and head out to get her.

When they get to the car, they find a 250+ lb 20-something young woman having the worst fake seizure EVER.

The triage nurse tells her to knock it off and get into the chair.

She does.

While pushing her through the waiting room to triage, she starts up again.

Since the lobby is full of suckers medically uneducated patients, the triage nurse calls us for a bed and wheels her back to the back, in an effort to keep her from flopping onto the floor in the lobby (the next step in the "get attention by faking a seizure" algorithm.)

We meet her in the room and apply our mad assessment skillz, noting the lack of urine in the crotch of the jeans, the lack of blood in the mouth, as well as the really bad fake seizure going on, and plan our immediate interventions accordingly.

I head to the cabinet that holds the STAT 16 Fr Punitive Foley Catheter, and Nurse Tinkerbell heads for the cabinet that holds the STAT 16g Punitive IV Catheter.

It's called a "16 Squared", and it's the first line treatment for ODs and fake seizures.

Meanwhile the triage nurse is telling her to knock it off and get into the bed.

Which she does.

Now, the ER nurses out there will tell you that this story is pretty much scripted from this point on. It usually involves the aforementioned 16 Squared, a dead normal prolactin level, a lengthy story about how her boyfriend doesn't love her anymore, a whole lot of drama, and either a discharge home or a Mental Health consult.

That alone is not worth a blog post.

What happened next, however, is.

While the triage nurse was getting her vitals, and Tinkerbell was trying to find a vein buried in the massive rolls of subcutaneous tissue on her arm, I was trying to peel the size 20 jeans off the size 28 ass. (I try not to cut off the clothes of the patients that I know will be leaving, because then I have to find something else for them to wear home. Not easy to do in my ER.)

Once the jeans finally came off, it was time for the underwear removal. Thankfully, it wasn't a thong.

But when I pulled down her panties, I discovered the answer to an age-old question: "What does a redneck girl use when she runs out of panty liners?" The answer: "A sock."

Once upon a time this sock was a plain, white athletic sock.

No more.

Now it was an interesting shade of yellowish-green that falls somewhere in between asparagus and inch worm.

Now, I'm not positive why she was using the sock, but I'm pretty sure it's because a regular panty liner would have dissolved.

The smell was like a cross between athlete's foot and crotch rot. Sort of a Crotchlete's Foot, if you will.

Which begs the question: Do you treat it with Monistat? Or *bam* tough-actin' Tinactin?

48 comments:

KiKi said...

My nose is on fire.
Guess that what happens when Diet Pepsi sprays out of it.

P.S.
**vomit**

Working Girl said...

my goodness. we don't get a lot of fake seizures, but when we get them they're good. We had a former field medic faking seizures with an oscar worthy commitment to detail. She got to take up the last ICU bed in the hospital for 3 days having her bad ass fake seizures. It really was something to see. She didn't have a sock in her panties tho she did have a baby in her uterus!

marcia said...

Gag. She came in for attention for a fake seizure, and never mentioned a disgusting vaginal discharge? I think that would be really high on my list of things to get treated (assuming I could survive the embarrassment).

Why do ODs get the Punative 16-gauge IV?

Anonymous said...

Absolutely and completely nasty. I guess if one wants to be a bit more sadistic, send them out the door with a script for ER flagyl, if they like to drink booze, they won't for a a bit, not unless they want to get pretty sick. Of course then you might have her coming in again with another complaint because she can't drink while on the med and for 72 hours after stopping the med, disulfram reactions and such.

M said...

I just threw up a little in my mouth.

Chapati said...

Ewww!

NurseExec said...

When I was in nursing school, I worked in our local ER as an EMT/Tech. One of our ER physicians had this thing about feet. We had to bag the feet of any homeless person, because she literally would vomit at smelly feet. I remember one homeless person who had green feet, I swear. I had to bag them in garbage bags, and she still came out of the room and threw up. She would have never made it in the room you describe. Uggghhh.

MonkeyGirl said...

Marcia: ODs get the punitive 16g because if they're a real OD, they might need it, and if they're just looking for attention, it makes me feel better. I hate ODs. Use a gun, already.

Karin, RN said...

socks, huh, they must me cotton

yogini ninja mama said...

OMG. amazing. LMAO!

ERP said...

Rowwwwwlllllfffff! (the sound of me puking)

Teresa said...

What M Said - excuse me while I go watch TV to get THAT image out of my mind.

Phorun Medipoxy said...

Ew. Last time I read your blog over my lunch. Ew. Ew. Ew.

Matt M said...

Her boyfriend doesn't love her any more? Could there be a connection between his affection and the condition of her cooter?

It sounds like those Lysol ads of 70 years ago. Get her some Lysol.

my-rt-life said...

Haha, that's pretty damn sick.

The only thing that compares to is when I was working at a nursing home as a CNA and I lifted a pt's breast to clean underneath it, only to find a dead roach.

reflectoscope said...

After reading that, all I can think is... whatever you get paid, it isn't enough.

EE said...

Oh. My. Gosh.

This is the funniest thing I've read all day.

Derek Elwell said...

GAH!

cheezyrn said...

Wow, I've actually seen something like this at the end of a tooo looong shift and I didn't even laugh. I need to work with you.
Then I wouldn't get so cranky.
Thanks for seeing the humor in this "crayzee" world......

Mama Mia said...

OMG, That actually made me a bit queasy! wow!

Sarah (pointypen.com) said...

I'm torn between laughing and really, really wishing that I hadn't read that.

marcia said...

Did she keep the sock?

Felix Kasza said...

Dear Monkeygirl:

Your stories brighten my day! More gross-outs, please?

Dear Marcia:

Are you a nurse, too? :-)

Nurse K said...

I liked the unapologetic links x 2 to the CRAYOLA website. Silly.

marcia said...

I can't find my glasses, but it looks like your name might be Felix? And it kind of looks like you might me talking to me...

No, I'm just a medical junkie. I finished all the pre-reqs and got accepted to nursing school, then had an unfortunate nursing home intership that changed my mind.

...if that was some name other than Marcia, then never mind. :)

girlvet said...

Regarding the first part of your post about the algorhythm - I think you are on to something there - we need algorhythms for this kind of patients and all the punitive interventions. We could develop a class around it....Advanced Fake ER patient support.

Jamie said...

Well, the dinner that I just cooked is no longer necessary. Thanks for the weight loss help! :)

HaloKitty said...

Oh I threw a bit of my pea soup up. Thanks. lol

That's just naaaaaasty.

ERnursey said...

well I'm an idiot, I just left the comment for this post on the last post. Sorry :(

Joeymom said...

A size 28 at only 250 pounds? What was she, 5'2"? *'m* not even a 28, and I'm a frickin' land whale.

911DOC said...

oh mg,
this is a monumental post for your neologism... 'Crotchlete's Foot'. applause from the peanut gallery.

Tex said...

MonkeyGirl, how disappointed I am....only a 2 16s???


Although an Ewald is perferred, where's the 16 fr. NG?

16 CUBED, my dear!

Michele in Michigan said...

oh. my god. ROFLMAO

I can only IMAGINE that stench.

I worked with a 1st year OB/GYN resident who, as he was up close raking through a pregnant patient's pubes for lice, said "I feel like I'm on a safari hunt." It was funny, but I wanted to smack him on the back of his head because he said it out LOUD.

I HATE that green cloud that emanates when you pull the covers off of some women. Clean that shit, already!

Odo-Ban works wonders for killing all sorts of stench. Too bad they don't make a douche :)

Canuck Med Student said...

AMAZING post. Welcome to my RSS feed.

Anonymous said...

my GOD you write funny stuff! people are so nasty. jesus.

catherine said...

Ugh, I didn't know whether to laugh or vomit.

scalpel said...

I nominate this for ER Blog Post of the Year.

Lynn Price said...

How do I unread this? I will never look upon a white pair of socks fondly again.

EE said...

I second scalpel's nomination.

Julie said...

i'm with reflectoscope ... eeewwww

Meghan said...

Oh my god, I haven't laughed out loud at a blog post in a long time. That was hilarious. I also got a good laugh about girl vet's comment. They should teach it at our yearly mandatories- "Fake ER patients, and how best to make them wish they never came in" Probably doesn't work though- the only time I've ever put an EWALD in, the girl was wide awake and seemed to enjoy the attention. She swallowed it like a champ!

Ash said...

I am entertained, a wee bit disturbed, and a skosh nauseous. I am SO bookmarking this blog.

Purple Stinky Onion said...

OMG! That is So Funny! Haven't you learn to breathe in and out of your mouth yet? Though I don't think I would want my breath to smell like that!!!

Best posting yet!

Purple

Anonymous said...

omg, vile.. people never cease to amaze me!

on the fakers of seizures: i used to have a very matter of fact senior, and was once with him on a ward with a famed pseudofitter - she was also massive and tended to stage fits for maximal attention at visiting hours, and would always be partially naked but would be conscious and cooperative throughout - so she started up one day, and of course a concerned visitor came to fetch staff-
i took a student with me as i thought he should see a fake fit -and our lovely senior came with us - as we briefly assessed airway etc of our half naked behemoth, etc he stood beside the curtain with his arms folded and then grabbed a passing staff nurse - "x," he said "youve got to see this! - she looks completely disgusting!"
- and the patient sat straight up and screamed "you cant say that about me!"
he just walked off! i always wish i had his style...

Elaine said...

Yes, I knew about alcohol and flagyl (mouth abscess), but nobody told me about the 72 hours after finishing the course.............

thecatsmeow said...

OMG...I laughed so hard reading this that I almost wet my pants! Kinda makes me glad I'm just a medical records person & don't get the delightful sights, sounds, and smells of patient contact...got a strong stomach, but a sensitive nose.
This is one kick-ass post! Sometimes the gross-out makes for total hilarity. Sad commentary on the patient, however.

Katie Bee RN said...

Sounds like the Trichymonis fairy paid her a visit.

O.M.G. said...

how have i missed nurse/medical blogs?? this is the first one i've come across in my recently started blog journey. how refreshing! there are enough mom blogs and sassy single girl blogs. this is the best! loved the comments too!
i'll be back!