Twenty years ago, I would have thought it scary to have an attempted murder next door. Now what is scary is that I don't. I was curious, yes, as to why the CSI van and yellow caution tape were at my neighbors' house tonight. But it all made sense now, coupled with my daughter's casual "there were police cars outside this morning" comment when I woke up this afternoon. Evidently the police were there for a different reason; not the recent overblown eviction across the street from last week. Now it seems that the insanity has stretched its long and menacing fingers into the lives of our seemingly quiet and content next door neighbors. Who knows what set him off. It could have been a million things, it seems. I wonder if history books will ever truly represent this steep downturn in the moral fabric of society. And more than that, I wonder if there will be anyone left who cares.
I dropped the charges against the guy who hit me back in December, while I was working at our local hospital. Some states say it is a felony to assault a healthcare worker. Others, like our lovely state, believe it is just a risk you take. Part of the job, you know. I couldn't see pursuing my own personal vendetta against him, especially after he really did make a life change of his own accord. Prior to our quaint little "mediation" meeting, I really wanted to turn the screws to this guy, to make an example out of him that said to the rest of the scum bag drunks "hey jackass, us nurses aren't going to take your crap anymore. Get your own damn sandwich and if you think about laying a hand on me, I'm gonna break your arm into three different pieces before I have you arrested." Much to the chagrin of my internal justice, he straightened up (quite nicely, to his credit) and I couldn't do anything but congratulate him and sign the request to let all this go. Strange.
Food costs too damn much. And so does gas. Bills suck too. And I get tired of hearing the police chopper overhead at night. I really want to quit smoking, and then ten minutes later I want to get a second job so I can afford to keep smoking. That's a little schizo, I think. Probably comes from the nicotine withdrawl, since I haven't had a smoke in three hours and I know I don't have any more. Smoked the last one. And I won't go out and spend my last $40 to get another pack. I'll be lucky if I'm not sleeping in a motel by Monday because we're both trying to quit and subsequently bite each others' heads off. I wonder if preserving my marriage is a valid reason to keep smoking....
I think I need to go to bed. I'm looking at the front side of four nights, and they don't look very pretty. And even after all my whining and bitchy complaints, I know there are plenty of people out there who have it a hell of a lot worse than I do. Lord, if you're listening, please bring your peace to my worldly, tumultuous soul and help me keep my eyes on the beautiful end of all of this. Amen and goodnight.
Saturday, June 28, 2008
Friday, June 13, 2008
When patients stick
So, back to the wonderful world of ER nursing, as I have strayed from the topic for the past few posts. Just finished up a run of 3 12's last night, which is tame in comparison to my buddies K and Blissful Entropy, and am finally regaining my strength and mental functioning enough to write. Also looking forward to a well-deserved BBQ with buddies tomorrow, and some overdue garden weeding and fertilization. Ahh, home.
This last run of days on left me with a sour taste in my mouth, not because of the usual frustrations and musings I usually write about, but because every night I took care of someone that in all honesty should never have ended up in the ER, if the world were perfect. We'll start with Monday night.
A little background here, before I get into this. There are two major Level II trauma centers in this town, and I have worked at both of them. The first ED I ever worked in is in what will now be referred to as Hospital A. The ED I work at now will be Hospital B. Not too confusing, just limits the number of bridges I can burn without it coming back to bite me.
Anyhow, when I used to work at Hospital A, which is the city hospital, I cared for a greater than average number of our city drunks. Even began to welcome them back, by name, to the "behavioral" section of the ER when they would return. Some of them you hope to never see again, probably because they threw/spilled/misaimed some bodily fluid in your direction or called you one of many lovely names as you gave them their sandwich. (See Blissful Entropy's side-blog, http://emshumor.blogspot.com, for a nice compilation of such names.) But there are those that you feel sorry for, WAY deep down, and hope that someday they pull themselves out of the gutter.
So, Monday night at Hospital B, I happened to receive a patient by AMR that I had taken care of many, many times at Hospital A. He is one that I have often found myself wondering about, musing that he must have moved (or died) because it had been so long since I had seen him. And I hardly even recognized him as he walked past the nurses' station flanked by AMR medics. He had put on about 20 pounds, and didn't even resemble the emaciated and chronic pancreatitis-inflicted person he was before. And he was walking. Every other time I had seen him, he was far from independently ambulatory, and more often was nearing the ammonia cap-popping stage.
As I got report, I realized that the presenting complaint was the same as it was every other time: constant abdominal pain and alcohol on board. Sigh. So I went into the room and said "T, are you going to behave for us tonight, or am I going to need to put you on a watch?" He assured me that he would behave, and I believed him because (most of the time) he did. Some nights, though, he would get a wild hair and decide to get all froggy. Always good to find out how he planned to do things from the get-go.
The double-take he gave me once he decided to make eye contact was strangely reassuring and the smallest bit rewarding: he remembered me, even in his BAL .414 stupor. Which means that at some point, I made a mark in his life, and not through strategic pressure point utilization or loud, repetitive requests to "lay down and be quiet, and if you try to leave I'm going to have these nice large security officers come talk to you". I never did have to use those on him. And, as it turns out, the reason he had put on weight and I hadn't seen him was because he had been serving time down in the southern part of the state, and he couldn't drink while he was there. He had just gotten out a month ago and, in his words, "I slipped". We had the same conversation about how he needs to quit drinking, talked about how his kids and brother and mom are, asked about my family and how I've been, etc. He even said please and thank you, and remembered my name. Heartwarming and crappy all at the same time.
Tuesday night was more of the rock-in-the-pit-of-my-stomach kind of nursing. 16 year old male, barely conscious, brought in by private vehicle and accompanied by his 16 year old buddy, and the driver still waiting in the car. Which I guess was arranged for quick departure once the "friend" made sure the patient was going to live, and found out that we contacted the patient's parents. Yep, you guessed it: alcohol. Turns out the boy's BAL was only .155, but he almost bought himself a tube, and his clothes were nicely packaged up in a belongings bag in the hopes that he could someday get the alcohol vomit smell out of them.
Mom and Dad, once they arrived, were strange to say the least. According to Mom, she and Dad were his foster parents, involved in the middle of a nasty divorce, and Dad was a raging alcoholic himself. I began to believe that he probably was, since he arrived and soon turned into an ass, asking why his son had to be in the ER and couldn't he just take him home. Duh, stupid rabbit. Alcohol is bad for kids. I gave him just enough of a dose of ER attitude to make him realize this was serious, then proceeded to fix his kid and send them on their hungover way.
Turns out, Wednesday night was not any better, and strangely just a continuation of Tuesday. I never did very well in Statistics, but I have a feeling I should have won the lottery last night if my luck is any indication. Double trauma patch, one full and one modified, the modified being mine and consisting of 16 year old male passenger on dirt bike rollover, multiple facial trauma and positive loss of conscious, stable vitals. Unknown speed, no helmet.
Well, after sifting through the info, I find out he had literally been sipping on gin and juice, and partaking of the green leafies, as evidenced by the pipe that fell out of his pocket in front of the police in the room. Oops. "But I'm not intoxicated, ma'am." Uh huh, just like the one I had last night....hmm, maybe I need to investigate this a bit, because this kid sounds and looks a lot like the one who dropped off Mr. YoungDrunk last night....hey, do you know what happened here last night? "Yeah." Were you the one who dropped him off? "No, I think you're talking about C."
Yep, sure enough, when he dropped his name I remembered that WAS the kid who dropped and ran last night. So these kids seem to be running in the same circle of "friends", and I end up taking care of them in my ER. I read this kid the riot act, and told him to pass it along to all his buddies when he got out: I do not want to see any more of you kids in my ER, drunk and injured and making my heart wrench taking care of things you should never have done in the first place. You are lucky to be alive. And you may not get another shot if you keep up this crap. I hope the gaping laceration on your cheek and the maxillary fracture you have will make you think twice the next time.
But I told the cops and his father too, just to make sure the message gets out. Moral of this story, take care of your kids and know about their lives, or they might not be lucky enough to survive to be the chronic alcoholic on Monday night.
This last run of days on left me with a sour taste in my mouth, not because of the usual frustrations and musings I usually write about, but because every night I took care of someone that in all honesty should never have ended up in the ER, if the world were perfect. We'll start with Monday night.
A little background here, before I get into this. There are two major Level II trauma centers in this town, and I have worked at both of them. The first ED I ever worked in is in what will now be referred to as Hospital A. The ED I work at now will be Hospital B. Not too confusing, just limits the number of bridges I can burn without it coming back to bite me.
Anyhow, when I used to work at Hospital A, which is the city hospital, I cared for a greater than average number of our city drunks. Even began to welcome them back, by name, to the "behavioral" section of the ER when they would return. Some of them you hope to never see again, probably because they threw/spilled/misaimed some bodily fluid in your direction or called you one of many lovely names as you gave them their sandwich. (See Blissful Entropy's side-blog, http://emshumor.blogspot.com, for a nice compilation of such names.) But there are those that you feel sorry for, WAY deep down, and hope that someday they pull themselves out of the gutter.
So, Monday night at Hospital B, I happened to receive a patient by AMR that I had taken care of many, many times at Hospital A. He is one that I have often found myself wondering about, musing that he must have moved (or died) because it had been so long since I had seen him. And I hardly even recognized him as he walked past the nurses' station flanked by AMR medics. He had put on about 20 pounds, and didn't even resemble the emaciated and chronic pancreatitis-inflicted person he was before. And he was walking. Every other time I had seen him, he was far from independently ambulatory, and more often was nearing the ammonia cap-popping stage.
As I got report, I realized that the presenting complaint was the same as it was every other time: constant abdominal pain and alcohol on board. Sigh. So I went into the room and said "T, are you going to behave for us tonight, or am I going to need to put you on a watch?" He assured me that he would behave, and I believed him because (most of the time) he did. Some nights, though, he would get a wild hair and decide to get all froggy. Always good to find out how he planned to do things from the get-go.
The double-take he gave me once he decided to make eye contact was strangely reassuring and the smallest bit rewarding: he remembered me, even in his BAL .414 stupor. Which means that at some point, I made a mark in his life, and not through strategic pressure point utilization or loud, repetitive requests to "lay down and be quiet, and if you try to leave I'm going to have these nice large security officers come talk to you". I never did have to use those on him. And, as it turns out, the reason he had put on weight and I hadn't seen him was because he had been serving time down in the southern part of the state, and he couldn't drink while he was there. He had just gotten out a month ago and, in his words, "I slipped". We had the same conversation about how he needs to quit drinking, talked about how his kids and brother and mom are, asked about my family and how I've been, etc. He even said please and thank you, and remembered my name. Heartwarming and crappy all at the same time.
Tuesday night was more of the rock-in-the-pit-of-my-stomach kind of nursing. 16 year old male, barely conscious, brought in by private vehicle and accompanied by his 16 year old buddy, and the driver still waiting in the car. Which I guess was arranged for quick departure once the "friend" made sure the patient was going to live, and found out that we contacted the patient's parents. Yep, you guessed it: alcohol. Turns out the boy's BAL was only .155, but he almost bought himself a tube, and his clothes were nicely packaged up in a belongings bag in the hopes that he could someday get the alcohol vomit smell out of them.
Mom and Dad, once they arrived, were strange to say the least. According to Mom, she and Dad were his foster parents, involved in the middle of a nasty divorce, and Dad was a raging alcoholic himself. I began to believe that he probably was, since he arrived and soon turned into an ass, asking why his son had to be in the ER and couldn't he just take him home. Duh, stupid rabbit. Alcohol is bad for kids. I gave him just enough of a dose of ER attitude to make him realize this was serious, then proceeded to fix his kid and send them on their hungover way.
Turns out, Wednesday night was not any better, and strangely just a continuation of Tuesday. I never did very well in Statistics, but I have a feeling I should have won the lottery last night if my luck is any indication. Double trauma patch, one full and one modified, the modified being mine and consisting of 16 year old male passenger on dirt bike rollover, multiple facial trauma and positive loss of conscious, stable vitals. Unknown speed, no helmet.
Well, after sifting through the info, I find out he had literally been sipping on gin and juice, and partaking of the green leafies, as evidenced by the pipe that fell out of his pocket in front of the police in the room. Oops. "But I'm not intoxicated, ma'am." Uh huh, just like the one I had last night....hmm, maybe I need to investigate this a bit, because this kid sounds and looks a lot like the one who dropped off Mr. YoungDrunk last night....hey, do you know what happened here last night? "Yeah." Were you the one who dropped him off? "No, I think you're talking about C."
Yep, sure enough, when he dropped his name I remembered that WAS the kid who dropped and ran last night. So these kids seem to be running in the same circle of "friends", and I end up taking care of them in my ER. I read this kid the riot act, and told him to pass it along to all his buddies when he got out: I do not want to see any more of you kids in my ER, drunk and injured and making my heart wrench taking care of things you should never have done in the first place. You are lucky to be alive. And you may not get another shot if you keep up this crap. I hope the gaping laceration on your cheek and the maxillary fracture you have will make you think twice the next time.
But I told the cops and his father too, just to make sure the message gets out. Moral of this story, take care of your kids and know about their lives, or they might not be lucky enough to survive to be the chronic alcoholic on Monday night.
Sunday, June 8, 2008
Things that make me appreciate my job
So, gotta say that there are definitely some professions that make me glad I have the job I do. I've been watching a couple of shows as of late, since I have no internal motivation to do anything on days off, and have honestly enjoyed just being a TV bum. Anyhow, they are at least a tad educational, being on the History Channel and all. Ax Men and Ice Road Truckers. I've found myself gasping and shaking my head at the crazy, dangerous, white-knuckle moments these brave and somewhat-lunatic men endure. Makes the menial, pseudo-adrenaline filled moments at the ER seem pretty darn tame. You should check these out. Next time I think that I've had an overload of adrenaline-rush activity, I'll just pretend that I'm dodging logs on the side of some Oregon mountain, or trying to escape after my semi just fell into the frozen lake (which is, BTW, one of my terror-filled nightmares--falling into a body of water in a vehicle). I'll take the safety, however minimal, of the ER any day. Thanks, History Channel.
Addendum to previous post
Ok, so now I have a witness. It isn't just me, possibly reading more into the situation, or blowing the whole thing out of proportion. He actually had the nerve to come up to me, in front of my conscious, breathing, alert and oriented co-nurse and co-blogger pal and, you guessed it--straight up asked me on a date. To Old Chicago, no less. Besides being dumb-founded and strangely without words, I had the presence of mind to only say, "no, I'll be spending my four days off with my family that misses me." I'm sure this isn't the end of this interaction. Unfortunately, I've been as polite and direct as I could without telling him to go bat his eyes at someone who isn't HAPPILY married to a very large, muscular, possessive-in-his-own-right man. And kudos to that wonderful man for not taking advantage of my sleepiness to drive down to the hospital and introduce himself to said security officer. Ugh. This has not been fun, and I hope it's over soon.
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