June, 2006 Archive

June 27, 2006, 2:32 pm

God Bless T-Mobile, Starbucks and All Who Sail In Grand Rounds

twilightzone

Check out these totally cool dolls!

Surely you recognize them from “The Twilight Zone”?

Season Two?

Episode Six?

First shown on November 11, 1960?

“Eye of the Beholder”?

You meant you don’t know the dialouge…by heart?

You don’t have the entire series on DVD?

Geeze, I really am a dork.

Not because of everything above…

…..because I want those dolls!

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I’m sitting here in a different Starbucks, continuing my boycott of Borders. There is a new one exactly 1.5 miles from my house.

EVERY seat is plush.

Electrical outlets every three feet.

I gasped in ecstacy and ordered my drink.

Uh, excuse me, your T-Mobile isn’t working.

Oh, that won’t be in for a month because we are new.

Oh.

So I took my Venti Iced Non-Fat One Equal Latte and my highly expensive but ethically correct Ethos water (“Helping Children get Clean Water”) and boldly drove where no latte purchaser has gone before.

To another Starbucks.

Where I managed to glare at the previous occupant of this plush chair long enough to make her think I was mentally unbalanced and she left.

Bwahahahahaah.

Oh, and Borders? I have a message for you:

“To the last, I will grapple with thee.”
“From hell’s heart, I stab at thee. For hate’s sake, I spit my last breath at thee.”

Okay, that’s a bit over the top for a boycott of an evil corporate conglomerate in the form of a book store, and it did come from Ricardo Montalban in “The Wrath of Khan”.

What ever did we do before imdb.com?

And did I ever mention just how devastated I was when I found out that wasn’t Ricardo Montalban’s real chest in that movie? I thought he was a stud. Turns out he was a dud.

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Gee, everyone felt so sorry for my little Ativan pill in this post, I felt bad for writing it.

Perhaps I should have chosen a proton-pump inhibitor or the statin-of-the-month.

Ativan has been my friend. Works wonders when you have vestibular neuritis.

That was not medical advice, by the way.

I’m just sayin’….

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Speaking of pseudomonas, this post over at Fat Doctor got me thinking of the time I actually put my nose half an inch from a wound and sniffed. I could smell something even before that and so could the patient’s father.

Everyone else, including the ED doc said they didn’t smell a thing. No one had the cohones to put their nose to the test at the wound site.

In fact, they laughed at me.

Perhaps I have the rare ability to smell pseudomonas before the rest of mankind, and I shared that trait with the patient’s dad.

Unfortunately, I will never know if we were right. That’s the trouble with ER….so often you don’t get the end of the story.

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I am the proud owner of a robot.

We have acquired an “iRobot Roomba”.

To the world-at-large, this is simply an automatic vacuum.

But to me this is a form of artificial intelligence.

It cries if it falls down the stairs! I’m not kidding!

I have named it “Asimov” and I hope they programmed it with the three robotic laws.

I talk to it.

My kids have been instructed to treat it with respect, for as a form of artificial intelligence created by man, we are obligated to respect it and care for it.

Okay, maybe I’m watching too much “Twilight Zone and maybe I do need an appointment with Shrinkette.

But I bet my carpet is cleaner than yours!

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I love the whole art of linkage. I like to link to new blogs. I like to be linked by new blogs.

The problem is, I can hardly keep up with all the blogs.

Maybe if I kept my blog-mouth shut and read instead of write, I’d have time….

So on that note, I shall remind you that Grand Rounds is up over at Medviews

And a wonderful edition it is.

I am now off to read…..

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June 26, 2006, 11:11 pm

A Wedge of “The Literary Cheese Wheel”: Med Meets Man

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UPDATE: HERE IS THE LINK TO ALL THE OTHER CHEESE-WHEELERS: LITERARY CHEESE

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cow

What was he expecting, breast milk?

As a card-carrying member of the “I Was A Teenage Dork” fraternal organization (or should that be “maternal” organization), I hereby submit this dorky ad as a supplement to my contribution.

Actually, I was an anomaly amongst dorks, for although I was a dork I also held the highly coveted title of “Head Varsity Cheerleader” at the same time.

Today, I may look like a upstanding member of the nursing community, caring for those sick, frail and more often than not, constipated.

But deep down inside, in places you don’t talk about at parties, I am still a dork.

And now for our feature presentation.

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They lived in darkness and although he shared his space with 15 others, it wasn’t bad. Thin cardboard separated the inhabitants. In an odd way, he felt secure.

His ID was indelibly stamped on his body. It kept him separate and accounted for. He never questioned why.

It was the only life he had known.

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His world was shattered by a sudden intrusion of light. He felt the jostling of his cubicle-mates. He felt himself being ripped away. A change in temperature shocked his system. He was thrown on a hard surface, nearly fracturing him in half.

What had he done to deserve this abuse?

He was pushed out of his living quarters and dropped into a solid plastic cage with others he had never seen before. He tried to keep his distance. Another one, somewhat older, looked at the youngster.

“It’s our time”.

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The cage was held in a warm, sweaty appendage.. They were moving quickly.

And what did the other mean by, “It’s our time”?

The motion stopped. His transportation device was handed to a moving mass who tossed the inmates into a moist, soft cavity, followed by an odd substance.

Was that….water?

He had heard the rumors, stories that made their way from cubible to cubicle.

He never believed them.

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He no longer had control. He tumbled down a long tube as he felt himself disolving, softly torn apart by the water molecules until finally his emaciated body was dropped into a hot cauldron of hydrochloric acid, where he was broken down into his component parts.

And as he absorbed into the life form that consumed him, his last conscious thought was of his mother in the beaker at the lab.

Mommy!!!!

And Lorazepam the pill, his life force but a memory, was no more.

The End.

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June 25, 2006, 1:47 pm

The Answer Nurse Speaks

coke

Ladies and Gentlemen, it’s time for The Answer Nurse!

Having posed the idea in a previous post, The Answer Nurse never thought she’d get so many questions in such a short time!

She thought it best to answer the ones she has received, but do continue to send them. The Answer Nurse lives for these inquiries and hopes someday to have a life!

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Some questions are serious, some a farcical, but all require a professional look at the world through the eyes of The Answer Nurse!

If you are disappointed in the answers, The Answer Nurse suggests re-evaluating the nature of the submitted question and increase the quality accordingly.

And so, let us all strike a pose by our nearest Coke machine and fresh flowers, grab a patient’s chart and begin….

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Question Number One:

  • Why would a mom with a rash also sign in her 2yo and 4yo [to the ER] with matching complaints of “insect bite?”
  • The Answer Nurse Speaks: The average human has approximately 60 trillion synapses in their cerebral cortex. The Answer Nurse knows this because she looked it up on Google. Your particular patient obviously had only three synapses; one for herself and one for each child. One can only hope that said patient had a tubal ligaton.

Question Number Two:

  • From the UK: Who would turn up at 7am on a Monday morning after a weekend of agony with toothache….abscess, plain as paint. “How long have you had toothache?” “Errm, about a month, Nurse.”
  • The Answer Nurse Speaks: Greetings from the Colonies! The Answer Nurse is a sucker for a British accent. But she does wonder, doesn’t The Prince of Wales have his own dentist?

Question Number Three:

  • If your left toe has been hurting for 3 months, why would you decide to come in at 3:00 in the morning on a Friday night????
  • The Answer Nurse Speaks: It seems to The Answer Nurse this poor soul has no life and that when he attempted to ask a woman if she rented by the hour, she stomped on his foot with her 4-inch pumps. It has take him this long to swallow his pride and obtain care. The Answer Nurse notes that the silver lining to this pitiful cloud is that the patient has nine other toes with which to work.

Ouestion Number Four:

  • I’m graduating in December, sitting boards in January. Tell me why I should consider ER nursing.
  • The Answer Nurse Speaks: The Answer Nurse notes that this inquiry is in the form of a command as opposed to a question, but she deems it significant enough to respond none-the-less. Here are the reasons The Answer Nurse would consider ER nursing:
    • Never the same job two days in a row
      • you will alternate hours of sheer terror with moments of pure boredom
      • unless you work in a small ER at which point you would reverse the above.
    • Nurses gravitating to the ER are out-spoken, in-your-face personalities.
      • This makes the ER a very lively place to work.
      • Of course The Answer Nurse, being of genteel breeding would never reveal this side of her personality in public.
      • May the Lord have mercy, however, on her family.
    • You will learn technical skills and assessment skills rapidly.
      • The Answer Nurse feels that the ability to prioritize is the epitome of the skills required in an ER.
      • Should the candidate for the ER have no prior experience in the nursing field, this prioritization can be learned by working initially in med/surg and/or ICU/CCU prior to transferring to the ER environment.
      • The Answer Nurse also acknowledges that some of the best ER nurses she has had the honor to address as “colleague” have been new graduates.
    • Working in the ER is fun – and that is the best reason The Answer Nurse can provide!

Question Number Five:

  • Where do ya’ll ER nurses get all your adrenalin?
  • The Answer Nurse Speaks:
    • Legally: usually via caffeine in the form of coffee, chocolate, Coke, Pepsi
    • Physiologically: via the adrenal medullae by the enzyme phenylethanolamine-N-methyltransferase (PNMT). The Answer Nurse knows this because she looked it up on Google.
    • (Now aren’t you sorry you asked?)

Question Number Six:

  • Why do some ER staff members (doctors, nurses, techs, secretaries) get so darned JADED?
  • The Answer Nurse Speaks: As The Answer Nurse does not suffer from this condition, she can only assume the facilitating factors are that ER workers are:
    • Overworked- much overtime is done
    • Underpaid – in most of the country
    • Not appreciated – taken for granted
    • The distinct tendency for every homo-sapien to want what they want immediately combined with the inability for said health-care givers to be two places at once. The Answer Nurse does not see a cure for this particular factor in the near future.
    • The requirement to occasionally miss “American Idol” because they are needed on the schedule.

Question Number Seven:

  • Ok, so, you have often explained that your facility is superior to the one that you use as a patient. Why do you go there? Is it just that the desire for privacy outweighs the benefits of a superior facility that happens to know you, or is there something more?
  • The Answer Nurse Speaks: Ah, The Answer Nurse has asked these very questions and here are some of the reasons Inferior Medical Center has been utilized:
    • The Answer Nurse lives approximately 22 miles from her place of work.
    • The Answer Nurse must cross a loooong bridge to get to the Superior Medical Center in which she works. Travel time at 75 miles-per-hour on a good day at a good time with no one getting in her way takes 35 minutes.
    • The Answer Nurse lives in a different county than where she works.
      • Medics will not cross county lines to take The Answer Nurse to where she really wants to go.
      • During the chest pain experience, The Answer Nurse thought it would not be prudent to drive herself that far and so ended up at Inferior Medical Facility.
      • The Answer Hubby now has instructions to drive just across the bridge and then dial 911 to get that county’s medics to take The Answer Nurse to Superior Medical Facility.
        • Should The Answer Nurse code on the way across the bridge, she assumes it will no longer be an issue,
        • and will be happy to say hello to all those family members who have gone before her.
    • During The Answer Hubby’s experience with his gall bladder:
      • The Answer Nurse figured the Inferior Medical Facility would diagnose him with gas and place him on Protonix, as that seemed to be the diagnosis/medicine-of-the-month.
      • Had she known the severity of the illness, The Answer Nurse would have dragged herself out of bed and personally driven him to the Superior Medical Facility.
    • Privacy is never an issue with The Answer Nurse, in a true emergency she wouldn’t care if the attending was Harrison Ford, himself. In fact, she would prefer it.

Question Number Eight:

  • Have your recent experiences from the “other side” changed any of the ways you do your job?
  • The Answer Nurse Speaks: Yes.
    • She makes sure patients are updated on a regular basis about what labs are back and what they are waiting for.
    • She makes sure that holding orders are written ASAP once the diagnosis is made for admitted patients and works with ER docs who share this goal.
    • She has no trouble telling the hospitalist the patient is on their way and can be evaluated upstairs (said very politely, of course)
    • She writes and faxes report as a priority so the patient can get up to their room 30 minutes after that is done.
    • She is less toleratnt of excuses as to why the patient cannot go upstairs, although she is willing to work with the floor nurses on extenuating circumstances.
      • To Superior Medical Facility’s credit, the floor/unit nurses are totally about gettting the patient as fast as they can.
    • While all this was already a part of The Answer Nurse’s mode of practice, she is now more empathetic with the family and patient.

Question Number Nine:

  • Given your years as an ED/critical care nurse, what would you say is the percentage of people who present at the ED of your hospital who really shouldn’t be at the ED (i.e., those people don’t have “emergencies”)?
  • The Answer Nurse Speaks:
    • 70%
    • 69.9% of those are pediatric patients with fevers, runny nose, vomiting x1.
      • (Yes, The Answer Nurse is being sarcastic, despite her impeccable manners.)
      • The other .1% are constipated.
    • The Answer Nurse does not include those with abdominal pain, possible DVTs, large lacerations or obvious fractures in the 70%.

So, that concludes this session of The Answer Nurse Speaks! Thanks for all those who participated.

The Answer Nurse must now get ready for work so that she can accumulate more blog material and an aching back.

Who says you don’t get anything out of nursing?

(PS: The Answer Nurse also apologizes for the sudden inability to de-bold her print. She has tried four times and will now be late for work. She apologizes for any eyestrain.)

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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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