August 25, 2005, 1:12 pm
Oh, my….Google put ads for Vioxx lawyers on the site… not exactly a match with my editorial opinions!
I’m finally getting my cape.
And a cap!
With an itty-bitty uniform and teeny-tiny white open-toed pumps.
I happened to pass by eBay and there were a TON of Barbie nursing outfits (circa 1961) just waiting for a bid.
I didn’t bid, though. I’m smarter than that.
I went right for “Buy It Now!”.
The outfit comes with black-rimmed glasses, presumably because nurses can’t look too glamourous. But Barbie has her pedicure showing with the open toes shoes, and pumps no less.
I have wanted this outfit for approximately 40 years; it’s costing me the equivalent of four real uniforms.
What would we do without eBay?
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There is a virtual bus stop in front of every emergency room and it disgorges its charges at regular intervals.
It runs 24 hours a day.
You can set your watch by its arrival and tell the time by the patients seeking care.
Here is what the night shift might receive….
1:00 am: The Earache Hour
What is it about the nighttime that brings out the worst in ear pain? Kids that were fine at home suddenly wake up screaming in pain. Very disconcerting to the parents, but fortunately easy to treat.
2:00 am: The Croup Hour
Sleepy parents and kids sounding like the seal enclosure at Marine World comprise this block of patients. Usually the child sounds better by the time he gets to the ER. That’s an ER rule, by the way. “All symptoms in children cease upon entering the ER .” Diarrhea since birth, four years ago? Not now. Total lethargy for three weeks? Now the kid needs medication for attention deficit disorder. Acute abdominal pain since breakfast? The kid picks the “smiley face” on the pain scale. The parents are aghast and then embarrasssed for “overreacting” but the staff believes every word. Those of us with kids have been there.
3:00 am: The Alcohol-Induced Head Injury Hour
Brisk bleeding head lacerations attached to intoxicated patients are the hallmark of this hour. They probably fell, they may have been whacked, but every head-injured drunk is a subdural hematoma until proven otherwise; the CT scanner is very busy. The ER rule for this hour is “Nice when drunk, mean when sober.” These patients will urinate half a liter for every ounce of alcohol consumed, while asleep (that’s before they recieve hydration in the department). The problem, as a nurse would put it IF nursing diagnoses were used in real life, “Alteration in level of consciousness secondary to alcohol consumption resulting in alteration in urine output leading to incontinence.” Translation: have a lot of clean linen handy.
4 - 5:30 am: The Wee Hours
Patients are usually few and far between during these hours so the ER nurses study their procedure manuals, work on their certifications and read every nursing journal they can. (That was for the benefit of my manager.) We actually read, crochet, knit, listen to the radio, have that fresh cup of coffee, surf the internet and I have been known to practice my “moonwalking” dance moves (don’t laugh - it’s taken me 22 years to get it right).
By the way, NEVER, EVER, EVER say the word “quiet” when in the emergency room. It’s like dropping the “F-bomb” in church. I just isn’t done. Utter the “Q” word and you will ensure an avalanche of patients the numbers of which have never been seen in this lifetime. The bus driver will have to apply for overtime. The nurses will recoil from you. The doctor will rue the day you were born. Save your breath…..save yourself!
5:30 am: The It’s-Hip-To-Be-Square Hour
Somewhere, someone over the age of 75 is getting up to go to the bathroom and tripping over an area rug. Their hip will take the brunt of the fall and they will join the legions of people with titanium hips. They are scared and in excruciating pain so the “hover mat” is placed on the gurney before they arrive. It’s like floating on a cushion of air and makes transfering from the gurney in xray virtually painless. That, generous medication and the reassurance that a broken hip can be repaired help immensely. Now it’s time to wake up the orthopedist on call. Heck, for that matter it’s time to wake up the ER doctor…..
6:00 am: The Code Hour
Before this hour is over, a patient will arrive Code 3 with severe respiratory distress. Their EKG will be abnormal, their lungs full of fluid, their pasty skin drenched with sweat and the proverbial “elephant” on their chest. The emergency staff will hit that patient with every weapon in their arsenal of life until the patient is stabilized; lungs cleared, breathing restored, blood pressure maintained. The patient goes to the ICU. The staff gets ready to go home, only it will take just a little longer to fall asleep; it takes a while for the adrenalin to subside.
7:00 am: Hey-la, Hey-la, The Day Shift’s Back!
And because I don’t work days, I don’t know their story. I’ll interview a few and see what their day is like and report back from the “frontlines”.
But the PM shift…….now THAT is a whole ‘nother story…..
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August 20, 2005, 1:55 am
Forgive a quick detour from the world of the emergency department. We all know elderly folks who carry a full page, single-spaced computerized list of their medications in their wallet. I’ll never be one of them because there won’t be any drugs. Listening to Hugh Hewitt discuss the Vioxx verdict today cemented my belief that sanity has, indeed, left the jury system
The plaintiff’s win is our collective loss. By awarding one-quarter billion dollars in damages, the Vioxx jury ensured more than the plaintiff’s financial security. They’ve contributed to the increase in drug-related lawsuits that are sure to follow as personal injury firms assess the financial incentive of similar cases. They have helped smother the incentive of research and development departments to develop new medications because of increasing financial vulnerability.
Merck lost the case, but we are the ones who will pay. When you receive your next prescription and you are paying a day’s wage for a two-week supply, remember this verdict. When you are suffering from a health problem and are unable choose a medication pulled off the market because it became too expensive to litigate, remember this verdict. When you are given a diagnosis for which no treatment is available because there has been no research in that area, remember this verdict.
The obscene amount awarded in the recent case against Merck is another nail in the drug companies’ coffin of liability. Until we legislate some form of protection against these unbelievable awards, the personal injury law firms will keep circling drug companies like vultures over an incapacitated animal.
“Remember what the Dormouse said….
Feed your head…….”
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August 16, 2005, 2:22 am
I never knew this game existed until I did a web search for the character! There are actually pristine, unopened Cherry Ames games on eBay.
No, I didn’t buy one. Seventy-five dollars is a wee bit too much to pay, although I did spend that much on a vintage Barbie outfit about ten years ago. Hey, it came with the original shoes and Barbie fans know it’s all about the shoes!
Those who study human behavior should spend a shift in the emergency department. The games played in the ER make the Olympics look like a tetherball tournament. Some of the participants are patients and some are staff. Some are gold-medalists in their specialty and some arrive a few feet short of a full balance beam. Let’s take a look at “The Emergency Olympic Games”:
“The Suck-Up”
Usually the player is suffering from an acute lack of an opiate prescription for chronic pain symptoms with a nebulous origin for which they have not been evaluated by a doctor but they have an appointment with a specialist next week but they ran out of their Vicodin and they just cannot bear it. Said patient is overwhelmingly complimentary to Team Nursing . The targeted nurse is SO much nicer than any other nurse anywhere in the whole world and gee, that other nurse was so rude they wish ALL nurses were just like you! These compliments are dispensed within 3.5 seconds of spotting the nurse, often making said RN feel an acute need for a shower. The player realizes she is out of medal contention when the targeted nurse responds with, “Gee, thanks, but I just came in to get a Betadine swab….”
” Mean Medical Matchup”
This game is closely related to the Suck-Up, utilizing the same team. Player has been evaluated by the ER doctor, who, having the audacity to disbelieve their story, has gone for the gold and verbalized his lack of belief to the patient. Bottom line: no prescription. The patient prepares for this event with the “Which Doctor is On Tonight?” drill, using a telephone to assess the playing field before engaging the opponent.
“Peek-a-Boo Bypass”
This event requires a large team that converges on the patient’s playing field soon after the patients arrival. Anyone can make the Peek-a-Boo team, although it is usually composed of family members and friends of many generations. Upon arrival, Team Nursing announces the event rule: only two members of the Peek-a-Boo team on the field at a time. This is met with a courteous response and extraneous members go to the bench in the waiting room, where the goal is getting back onto the playing field without Team Nursing noticing. This is accomplished by one Peek-a-Boo team member returning to the patient at a time until the bedside number has quadrupled. Stealth and dexterity are assets to this goal. Occasionally Team Security will act as referee.
“The Two Guy Offense”
The preliminaries for this event take place off the Emergency Stadium grounds. The player reports a spontaneous assault by Team Two Guys. The members of this team are always unknown to the patient and the initiation of contact always unprovoked. The goal of Team Patient is to obtain care from Team Medical with minimal disclosure of the playbook. The involvement of Team Police is always declined as so as not to incur a penalty. Team Two Guys apparently has many expansion franchises.
“The Two Beer Defense”
Team Patient enters the arena via Team Paramedic, having received a report of “player down” on the sidelines of a local Team Seven-Eleven. Team Patient arrives supine on a movable gamepiece.Upon arrival in ER Stadium, body fluids are released for assessment by Team Nursing who immediately take defensive positions. Performance-enhancing ETOH is suspected as the characterisic Odor Offense is noted. Team Medical waits for the Designated Cleaners and takes the field. Minimal interaction takes place between the teams for many hours at which point Team Patient verbalizes that he only had “two beers”. Team Medical knows to multiply this number by 58. Team Patient is taken out of the medals race on a credibility technicality.
“The Decible Debate”
Team Patient attempts to propel themselves off the bench and onto the playing field by increasing their verbal intensity. Team Nursing counters with internal auditory blocking mechanisms. The goal: Team Patient enters playing field at appropriate interval. Team Patient rarely medals in this event.
“The Titanic Panic”
Team Patient arrives, usually via Team Paramedic, complaining of numbness, chest pain, shortness of breath and near-syncope occurring at the preliminary event at Home Arena which involved a “Decible Debate” with another member of Team Family. The Peek-a-Boo team arrives to act as cheerleaders for the event. No medal is awarded, as the full cardiac work-up that ensues turns out to be negative. An Acadamy Award nomination, however, would be appropriate.
These are just some of the Emergency Olympic events to which I have a front row seat and perpetual season tickets……
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