Yuck

    WARNING: If you are thinking about eating anytime soon, read this blog once the food has settled. If you enjoy eating either mayo or spaghetti, I suggest neglecting this blog entry entirely. Here we go. 

In nursing school, we learn that we ought to be nurses who engage in "compassionate care." Unfortunately, some patients are too rude and disgusting for this to become a reality. Take my middle-aged heroin addict patient for an example. The man keeps demanding that we give him candy. A relative of his hands him a Snickers bar. He begins to eat it, but hates the peanuts in it so he SPITS THEM OUT ON HIS LINENS. To make matters worse, this man only chose to communicate with me through loud and piggish grunting. He was a disgusting human being, and I thereafter referred to him by the acronym H.L.P.O.S - huge loser piece of shit. 

     In another incident, we had a homeless patient whose clothes smelled worse than anything I could possibly describe in words. He yelled out expletives to our nurses that would probably not even be allowed on H.B.O. or the most hardcore of porn scenes. At the end of his tirade, he squatted down on the floor, and went #2 right in the middle of his room. He then pointed to a staff member, laughed, and yelled "Merry Christmas." Despite getting a relatively high salary, this is why nurses still complain of being underpaid. 

    My most interesting patient case to date came yesterday morning. A young man fell into a tar pit, and his entire body was covered in black tar. In order to get it off of him, we all had to get a huge container of mayo and spread it all over his body. As we did this, the young man screamed at the top of his lungs. We then took dry towels and scrubbed off as much tar as we could. We couldn't get it all, and so he was transferred to the burn intensive care unit. This was a very serious case, and a patient a month earlier had died from the same kind of incident. 

      A lot of the nurses were talking afterwards, and said they could never eat mayo again after smelling it on tar and seeing it spread all over someone's body like that. It was one of the most eerie and disturbing things I've seen in my life. Another nurse said it wasn't too bad. She said one time a lady was throwing up so much, that long spaghetti strands starting falling out of her nose. Out of respect for my loyal readers, I will end it right there. 

     I'm almost finished with my experience and am so grateful for the skills my nurse has taught me. I will never forget 6 words of advice she gave me as I was struggling to put in a male catheter. 

    "Grab it like you own it"

         Thanks for reading. 

      - Tommy

     

     

Sundowners

     Alas, I have completed my 100th hour in the E.R. The last 24 have been full of fun and excitement. Let me share it with you. 

 

      On Friday, I took care of a patient with Sundown syndrome. These people get increasingly more confused as the day progresses, culminating in the most absurd and preposterous statements shortly after the sun goes down (hence the name). In a nutshell, this is what happened: 

  Before the sun went down - I interviewed patient. Patient discussed diagnosis, her family, and commented that I would make a good nurse someday. The conversation was functional, logical, and pleasant. 

  After the sun went down - Pt informs me that General Electric makes every single telephone pole in the United States. Pt longs for the days when during lunch hour, she would let herself loose on the concrete dance floor. Pt loves September, and is so happy that it is finally fall outside. Pt concludes conversation with me saying, "You are going to make a great surgeon one day."

    Moving on. Here are two notable patients I've had in the last two days. 

  Hacksaw Hank - Fell in his garage and landed on a hacksaw. Lot of blood and work to do, but discharge teaching was easy: Don't keep hacksaws on your floor. Goodbye. 

 The Kidney Guy - Guy comes in with kidney pain. CT scan, urine-analysis to rule out kidney stones. Nurse comforts him by declaring that passing a stone is like giving birth. Lucky for him it never happened. He was discharged A.O.K.

    In addition to those guys, I've seen liver failure, asthma attacks, chest pains, eye injuries, hypothermia and seizures. The list goes on and on. 

    As far as my skills go, I've learned a hell of a lot lately. I now start IVs, get lab work drawn, interview patients and chart without any supervision what so ever. I've even catheterized a male and female patient by myself, and got to insert an OG tube when a patient was on the cart about to code. I've come a long way. Last semester I didn't know how to change a diaper. 

   As always, thanks very much for following my blog. I appreciate your loyal readership. You all deserve a gold star. 

    

   

  

   

  

 

  

   

      

       

       

     

  

3 Kinds of Patients

    I noticed something about the E.R. There are 3 kinds of patients. I shall list them off for you. 

 Patient # 1 - The Baby 

       These patients have zero tolerance for pain. When you take their blood pressure, they scream as if you just chopped their head off with a power tool. The sight of a needle makes their face go like this. They complain about any symptom they have and exaggerate it to the point where it sounds fatal. Example: a young lady had flu-like symptoms and suddenly panicked and caused up a stir when she said her back was getting really warm. That'll happen when you have a fever mam. You're not about to spontaneously combust. 

   Patient # 2 - The Psych Patient 

          These patients will tell you they are Louis the XIV's grandson and that they just came back from the Vancouver Olympics winning a gold medal for Team Latvia. They are often very needy and love to ask the staff for any favor at any given moment. They get hostile, impatient, and incredibly hard to deal with. They are often a risk to you, themselves and others. The staff often has trouble looking past their actions and understanding they are truly ill and need our help. It is actually kind of tragic. 

   Patient # 3 - The True Patient 

       The people have serious concerns and deserve our beds in the E.R. Nonetheless, they probably account for 15% of the beds on any given day. 

 Here is a brief and rather unorganized synopsis of my day: Patient tried to kill himself with steak knife. Cut huge gash in wrist and stabbed himself all over the chest. Heard voices that told him to do so. Another patient is a cocaine addict who wasted our bed just to get free food and water. Doctor wanted her gone and complained he was forced to practice "defensive medicine" by not being able to discharge her. I did two IVs totally on my own with no help, learned how to do a blood transfusion, gave many meds, and further honed my interviewing skills. Great day!

 Drum roll........

 Lesson of the day: Wanna cut waste in our healthcare system? When you have a f**@ING cold, don't go to the E.R. 

  Thanks for reading. 

 

- Tommy 

   

     

Somber Sunday

   My first blog ridiculed the common perception that E.Rs are full of death and drama. Today I stand corrected. 

    My Sunday shift made the show E.R look like an episode of the Golden Girls.* It started off with a psych patient falling out of bed and screaming. This often tends to happen when people who are unable to walk try to anyway. 

    At around 11:00 AM, I am interviewing a patient. In the midst of my interview, a young woman walks in carrying her 4 year-old daughter and says "Please help my daughter, she is having trouble breathing." We quickly plop her daughter onto the bed, ask our old patient to go elsewhere, and we begin to try and rescue the little girl's airway. 

   

     Soon an entire team rushes in to help this girl out. They have me bag the girl, while countless nurses try to find IV lines and push medications to jump start her heart. Mom is outside crying and vomiting. The scene gets more chaotic as more and more people rush in to help. The girl's heart rate jumps to 200, and soon after it stops completely. CPR is begun, people are getting more frantic. 

    After 20 minutes of CPR Mom comes around and glances in. A female doctor puts her arm around Mom and says, "I don't think your daughter is going to make it." Mom collapses to the ground and screams at the top of her lungs. It was probably one of the worst scenes I have encountered in my entire life. 

       The trauma did not end there. Later on, a young guy came in after being hit in the head from a sporting injury. Unfortunately, he was hit in the part of the brain that controls his breathing. I don't know what came of him. I really hope he was revived.

 

       On the bright side, a doctor bought us all pizza....

  - Tommy

* The Golden Girls is a good show

E.R. BLOG 2

   

      People have very different ideas of what the word "emergency" means. Some come in hardly breathing. Others come in with bloody and broken jaws. Others walk in flicking their noses, as to displace a bugger that is about to make them sneeze. These are the patients nurses tend to have contempt for. 

    When meeting a patient, it is first important to ask them a set of questions involving their chief complaint. Seasoned nurses are experts at this. Nursing students are not. Here is a real-life example of that: 

Patient: I got this chest pain. It hurts so bad. 

  

Seasoned Nurse: What area of your chest hurts? Is it crushing, aching, or a sharp pain? How would you rate it? Does it radiate to other body parts or is it localized to your chest? 

Patient: I got chest pain. It hurts so bad. 

Tommy: Oh yeah? Where? Man I'm sorry. 

    Although a slight fabrication, my interview was about as effective as that. I am learning though, and in 130 hours from now, I will have this down. Moving along, I'd like to talk about some patient cases and what I've learned from them. 

Patient # 1  - Bites his fingernails. Bites the nail bed off, exposing him to infection. He gets infection. Swollen, puss-filled finger. Had to be drained. I'll stop. 

Patient # 2 - Cold. Sore throat. Convinced himself he couldn't swallow anything. For some reason this compelled him to spit up all the saliva within him. Hence a bucket of saliva by his bed. I'll stop. 

  Most other patients came in with chest pain, probably the most common of all chief complaints in the E.R. These are true emergencies, and so even the smallest amount of ridicule directed at them is unwarranted. They deserve our beds. 

  My favorite patient was a young woman who suffers from liver failure. Her skin was very yellow and her bone structure was akin to a skeleton. She could hardly stand without the help of me and my nurse holding her in place. She bruised so easily, that even pressing down on her skin for a handshake would likely turn it purple a few hours later. 

 Despite her utter right to be in low spirits and even a grouch, this patient was one of the sweetest ladies I've ever had. She was so soft spoken and polite, always complimenting me or the staff about something even though the focus should have been solely on herself. 

She loved Jeopardy, and so told me to come back at 3:30 when it aired, to play it with her. At 3:30 I looked at my watch, informed my nurse I was leaving, and walked in for the show! We both did quite well. She nailed the pop culture and the kitchen gadget categories, I nailed the state flags. I had a great time keeping her company.  

   Patients like that remind me exactly why I am pursuing this degree. 

 Thanks for reading. 

- Tommy

   

Day One

    Welcome to my ER BLOG! My goal is simple: to expose what E.R. life is like, and even share some medical knowledge with you. Enjoy! But first, read the disclaimer at the bottom of the page.

   Right as I step on the unit, I see 5 nurses sprinting down the hallway with oxygen masks. A few doctors are sprinting behind them with IV poles, tracheotomy tubes, and countless syringes stuffed in their pockets. Blood is splattered all over their clothing, and all I can hear are the words, "CODE BLUE. CODE BLUE. ROOM 710. CODE BLUE." The secretary was sobbing. The janitor stood helpless with a mop as he looked on in horror. All hell broke loose until I finally witness what had happened: A man's head fell off. 

  Okay, if you are expecting this blog to be as exciting as what you see on ER, House, or Grays Anatomy (all stupid shows except for ER and House), then you have come to the wrong place. That story was not true, but if you bought it at first, it simply highlights the prejudice you have about an E.R. My blog will work to erase that prejudice. 

    Day one was rather slow. I saw a false pregnancy, appendicitis, a stomach virus, high blood pressure, a lot of hypoxia, and way too many STDs before lunch break. None were serious cases, although if all in one patient, it would probably be a little serious. 

    The most remarkable patient was a 268 year old Native American dwarf (HIPPA can be fun see?) who came in thinking she was pregnant. The test was ordered and she was negative. Despite having serious symptoms of potentially fatal diseases, the patient refused any further treatment. She left AMA (against medical advice). Leaving AMA involves signing a bunch of papers and having the nurse basically say "when you drop dead, it ain't our fault." Case closed. I wish her well. 

    

Medical advice of the day: THE BRAT DIET. What is this? 

When you have the flu and are nauseous with diarrhea and a weak appetite, remember BRAT. 

Bananas 

Rice

Applesauce 

Toast 

  These foods are good for several reasons. One, they help solidify your poop because they are sticky and tend to absorb a lot of fluid. Also, they are bland and easy to eat, even when you feel like your stomach is about to explode. Personally I find the thought of eating rice when sick to be grotesque. That R needs a changing. Any ideas? Raisins? Ramon Soup? A ribeye? 

   This is the very beginning of a long, 160-hour journey (and hopefully a career) in emergency nursing blogs. Thank you for reading today. I appreciate your time. 

- Nurse Tommy

 

****As to comply with HIPPA (patient confidentiality rules) all names and ages of patients will be intentionally distorted.