April, 2006 Archive

April 14, 2006, 6:34 am

I Am A Scrubbing Bubble in the Toilet Bowl of Life

Oh man, is it a full moon or something?

I only did eight hours tonight but I’m beginning to think I work at Hell Community Hospital.

My patients were all wonderful. It’s not them. They all had a sense of humor and were a pleasure to care for.

And I work in THE best ER in the San Francisco area, so it isn’t the job.

It is the intensity of the illnesses, the number of patients who are seriously sick – every single patient I had tonight was admitted.

Honestly, I should have had a warning when

  • The unit was full when I walked in
  • I passed an ambulance on my way in the door and
  • My colleague-who-is-working-on-her-PhD nearly flew out the door. She had graciously offered to work the first four hours of what should have been a twelve hour shift for me and those four hours nearly did her in.

The next eight were no better. For the second time in a week I had no breaks. Not one.

Okay,I lied.

30 minutes before my shift ended I shoved two cold pieces of pizza into my mouth.

No break? What was I thinking.

We pulled it off without going on ambulance diversion and that is quite a source of pride for our ED docs. To tell you the truth, it makes me feel good, too.

Ambulance diversion has its place, but 99% of the patients we get are walk-in patients, even the sickest ones, and when an ambulance is en route with a Code 3 patient (life threatening, red lights and siren) we have to take them anyway.

So while it is psychologically a relief, it really doesn’t help anything in the long run.

We are one of the hosptials with the least amount of ambulance diversion.

We’re good.

Ya know, sometimes ya just gotta give props to yourselves.

hhhhhhhhhhhhhhhhhh

I loved the title of this post. Made me laugh.Too bad I couldn’t think of a topic to go with it.Sometimes I crack myself up….

hhhhhhhhhhhhhhhhhh
Note to self: you can’t read the syringe if you are wearing crappy, non-progressive contact lenses.Since Etomidate is a general anesthetic used in rapid sequence intubations, this is “bad”.In these situations it is best to hand the medication to your colleague who is not visually impaired.

I redeemed myself by reading the Succinylcholine vial all by myself.

hhhhhhhhhhhhhhhhhh

Okay, so I walk into Lenscrafters to get my spontaneously combusted frames replaced.No I must tell you that up until my haircut three weeks ago I had a “John Denver” thing going.I wore wire-rimmed glasses and my hair had grown so much that it framed my face with my bangs hitting the top of the glasses.

Now when a woman looks in the mirror and sees John Denver, it is time for a make-over.

So… I go get a major freakin’ cool haircut, so very 2006. But I still have the wire glasses. That’s okay, they’re only six months old.

Then they break. So I walk into Lenscrafters and, to my delight, discover I had purchased replacement insurance that would give me a new pair at 50% off.

Screw these wire frames, I thought. I’m goin’ designer frames….so I went for the frames they had to unlock. That’s how cool these frames were.

But unfortunately it has been so difficult to cut my prescription into the lenses, they had to send them to THE BIG LAB.

So, instead of “about an hour”, it’s more like “about two days”

You see I have…..the big A.

Yes, it’s true. I’m not ashamed. I have….astigmatism.

The bane of my life.

The reason so many beautiful vision options were closed to me over the years.

But I will not give in!

Astigmatism be damned, you will not keep me from my Versace frames!

I will have those frames if they have to get Donatella Versace herself to cut the lenses.

So, if you are ever in the San Francisco Bay Area and you see a nurse with a totally cool haircut and Versace frames, that would be me!

Oh, do stop and say hello, I won’t look down on you from my Versace frames!By the way, did I mention my new frames were Versace?

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April 13, 2006, 4:24 pm

BECAUSE I ABSOLUTELY, POSITIVELY HAVE TO SAY SOMETHING OR I’LL BURST

UPDATE: THIS IS WHAT HAPPENS WHEN YOU POST WHEN YOU ARE TOTALLY TICKED OFF. IT SEEMS THAT THE PHOTO BELOW IS ACTUALLY A FAKE, SOMEHOW USING PHOTOSHOP TO PUT MOHAMMED IN THE SCENE AS IT IS SHOWN. THAT IS WHY MOHAMMED LOOKS LIKE A SOUTH PARK CHARACTER AND NOT A FAMILY GUY CHARACTER. I DON’T KNOW ENOUGH TO EXPLAIN THE INTRICACIES OF PHOTOSHOP, SO I CAN’T BE SPECIFIC. AND SO…..ALTHOUGH THE PHOTO MAY BE A FAKE, THE OPINIONS AND COMMENTS BELOW THE PHOTO STILL STAND. THANKS FOR PUTTING UP WITH MY RARE FORAY INTO THE POLITICAL ARENA…..

Ladies and gentleman, this is a screenshot of what Comedy Central refused to air last night so as not to offend Muslim sensibilities. Mohammed hands the helmet to Family Guy, mutters “jihad…jihad..” and walks off.

Score another round for the terrorists.

I feel like buying a T-shirt with Mohammed on it saying: No free speech for YOU!

And yes, I have been offended by some South Park episodes and I exercise my right to put my finger on the remote and turn it off.

Thank you for indulging me on this post. If anyone is offended I am truly sorry on a personal level, but in this country, especially at this time, this censorship is unacceptable.

Free Speech. What an amazing concept!

(I now return you to your regular Emergiblog.)

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April 11, 2006, 10:42 pm

It Was the Best of Times, It Was the Worst of Times

Greatest hygienic handicap?

At least as your daughter’s doctor views it?.

Hey, at least the doctor is a woman here, which was probably unusual for the times.

The poor, poor patient who is experiencing her…uh…monthy “visitor”. She looks just beside herself with period-ness.

I wish I had the luxury of flopping in a chair. The more likely scenario is that I’d be in your face because you moved my chart 5 millimeters to the right.

I guess before the advent of Kotex, women had to use “makeshift, unsanitary” items for their hygenic issues.

Come to think of it, what DID they use?

You know, I don’t think I want to know the answer to that after all.

All I can say is that the day Stayfree invented the adhesive strip should be a national holiday.

And don’t even get me started on the efficacy of “wings”. I might have to pop open a bottle of champagne.

(Oh, and the author of this “article” is Ellen J. Bruckland, Registered Nurse. Remember the name. We will be meeting her a few more times….)


Last night was a bitch.

I’ve had root canals that were less painful.

It started out bad.

The department was full to the brim, people were in the waiting room, our tech went home sick at 2200 and two hospitals in the county were on ambulance diversion. Okay, business as usual…..

…. but then my glasses broke. Not the nice break that can be fixed with a tiny screw at the earpiece. The frame itself actually broke in the middle of nowhere. It was like my glasses had osteoporosis and spotaneously fractured, with the lens falling out. Now realize, I am as blind as you can be without needing a cane. So here were my options:

  • Function for eight hours with my glasses held together with plastic tape that covered
    50% of my left visual field, making me look like an extra in “Revenge of the Nerds”, needing only a pocket protector to complete the look.
  • Wear my prescription sunglasses all night, bathing the ER in a brown tint and making me look like an extra from “Miami Vice” or someone with a chronic migraine, which, by 0800, would have been an appropriate diagnosis.
  • Call my loving husband of 26 years and ask him to run my contacts down to me, allowing me to at least hear report and allow the PM shift to leave on time.
  • Run home and back going 80 mph down the freeway to retrieve my contacts myself, with only 3/4 vision, in the dark, having one co-worker go overtime one hour and ten minutes while I made the trip (I have the timing down to the second). Oh, and by the way, the contacts are not progressives so while I can read the monitor a mile away, I will be charting in an absolute blur, not to mention starting IVs by sticking the angiocath into the depths of the bluish haze running up a forearm.

I chose option number four because hubby would not participate in option number three.

(I am pretty sure that is grounds for divorce in California, but I’ve invested too much time in the marriage and anyway, I kicked his ass when I got home. It will be a cold day in hell before I get him ibuprofen or Sudafed the next time he’s sick. Sorry honey, this nurse is off duty! But I digress…..)

So I run breathlessly back into the unit with my contacts in, my vision worse but my looks enhanced by the absence of frames and high-five my colleagues who are breathlessly running out the door they are so happy to escape.

And for the next eight hours I am running. No breaks. No lunch. No food. No coffee.

Just Diet Pepsi (my addiction always gets fed) and I barely got in a third of that.

For six of those hours, I took care of a patient who had chronic pain exacerbated by a fall earlier in the day.

We are talking agony here, folks. Serious pain. 50/10 on the pain scale. Just the slightest movement set off additional spasms.

Because of various other problems discovered in addition to the pain issue, this patient was a 1:1 for almost my entire shift. The emanations of pain that came from her room were heartwrenching. A family member was present, knowledgable regarding their relative’s health issues and an absolute saint in the bargain.

I developed an even deeper respect for my sole co-worker that night, an RN who remembers when she would have 14 patients and would cover the LVN’s 14 patients on the floors.

She makes me look like a baby nurse.

She took every other patient that came in that night after our 0330 nurse left. Believe me, they didn’t stop coming just because one nurse was busy.

And they were sick, no clinic stuff last night.

Just as we were ready to transfer my patient, the family member expressed concern over a possible need for some respiratory medications and the ER doc added an additional medication for pain, which I gave at that time, so the patient remained with me for another half an hour.

And then it happened.

We were able to stabilize my patient and by the time the patient left the unit, they were smiling and comfortable. They were telling jokes!

We had found the medication combo that stopped the overwhelming aspects of the pain.

The metabolic issue would be addressed after admission, but for now the pain was minimal. I told the patient that it was worth the additional half hour in the ER just to see her looking so good after so much suffering.

I needed to see that.

Maybe it is a selfish thing, but I felt like all the ministrations, medications, repositionings, revitalizing and compassion had made a difference.

I was overtime, finishing the shift with a zombie-like numbness. I checked the glucometer. I ordered the drugs – all night shift duties – while my colleague finished her charting and as I left, the day shift began dealing with the five patients that arrived between 0800 and 0810.

I drove home, took the ibuprofen and valium that I take for the back spasms and body aches that I never seem to feel while I’m working and fell into a sleep so deep my husband woke me up at 1800.

I never even heard the phone when my daughter called for me to pick her up after track practice, so I guess I gotta give the hubby a few props for picking her up when it was my turn to do so….


Tonight, during “American Idol”, the contestants were singing songs written by Queen (and I hope you all voted for Taylor!)

I thought Freddie Mercury was a doll and I cried when he died in 1991, but I was never really “into” Queen as a group.

Until tonight.

Maybe it’s my frame of mind, but I heard lyrics that reached out and grabbed me by the soul.

I don’t want to sound like a drama queen here (no pun intended), but one song hit me in particular, especially considering the day I had just finished. The song is called “The Show Must Go On”, written by Queen and sung, of course, by Freddie Mercury:

“Inside my heart is breaking
My make-up may be flaking
But my smile still stays on…….
The show must go on
The show must go on
I’ll face it with a grin
I’m never giving in
On – with the show –
I’ll top the bill, I’ll overkill
I have to find the will to carry on
On with the –
On with the show –
The show must go on…”

Or these lyrics from “Somebody to Love”, again written by Queen, that describe so vividly what it felt like to be going through burn out a few years ago:

“Got no feel, I got no rhythm
I just keep losing my beat
I’m ok, I’m alright
Ain’t gonna face no defeat
I just gotta get out of this prison cell
Someday I’m gonna be free, lord!”

I’ll stop here. I don’t want to get too self-indulgent. I just can’t figure out how this closet rock-and-roll groupie didn’t “discover” this band long ago. I just downloaded “Queen’s Greatest Hits I and II” from iTunes.

After all, who couldn’t love a group who paid tribute to “Fat Bottomed Girls” loooong before Sir Mix-a-Lot came along with his “I like big butts and I cannot lie!” rap.

Now if you will excuse me, I have about 20 years of rock-and-roll catching up to do…..

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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