Update

I may be on a bit of a break for a while. Personal issues. But I shall return!

Performing Arts

I came walking out of the break room the other day when I heard Bob say (in a very sing song voice mind you) "Turn around......" I couldn't help myself. I had to do it. I had to complete the song.

"Bright eyes. Every now and then I fall apart.......and I need you now tonight......and I need you more than ever.......and if you'll only hold me tight......we'll be holding on forever......" I sang back at him as I walked down the hall.

The entire staff joined in.

"And we'll only be makin' it right ........cause we'll never be wrong.... together we can take it to the end of the line. Your love is like a shadow on me all of the time.....I don't know what to do and I'm always in the dark...we're living in a powder keg and givin' off sparks................."

By now we were virtually shouting.

"I really need you tonight! Forever's gonna start tonight.....forever's gonna start tonight."

We were all laughing hysterically by the end of the song. I felt like I was in a really bad musical episode of ER. Frightening.

Addiction

Guess who came back yesterday? Mrs .420. She called the ambulance for "pain everywhere." Paramedic Pete responded and rolled her through my ER doors at about 10 in the morning.

"Paula, have you been drinking again? 'Cuz you know I can't give you any pain medicine if you've been drinking," I told her.

"No I haven't Julie. I've been puking all morning. I promise I haven't drank anything. My belly hurts so bad - can I just have something for the pain?" she asked.

We transferred her to the ER stretcher and I quickly disrobed her and changed her to a gown. Her abdomen was twice the size as it was during her previous visit. Oh Lord.

"I just don't feel right," she said.

"I bet," I replied.

I finished a rapid assessment, started and IV, drew some labs, got a quick catheter urine sample, and notified my doc of her arrival.

30 minutes later we saw that her liver was shutting down. Her liver enzymes had quadrupled since her last visit, and I noticed she was a bit yellow when I got her out of the exam room and into radiology. Let me just say here that lighting makes all the difference on a skin assessment.

2 hours later we got her admitted to the floor. Dr. Q set her up on the alcohol withdrawal protocol and I reported off to the accepting nurse.

I went back to the ER and started talking about addiction with another nurse. It seems so foreign to me that something could have so much power over you as a human that it can make you crave it while simultaneously destroying your life. I see it every day and yet I don't really think about it all that often.

But here was a lady in her early 50's who could have been anything in the world when she was younger. She could have been a teacher, a lawyer, a politician, a nurse, a mom - anything.

Yet her biggest accomplishment in life was to become a die hard alcoholic and drug user.

So sad.

ED nurse stat!

Dr. J and I were standing at the nurses station when someone came running down the hall shouting "I need an ED nurse!"

I grabbed my soda, took a drink and started flipping through a magazine as the radiology tech flew by me.

Dr. J looked at me and smiled. "Is that a new treatment?" he asked. "Do they have to be dressed in a french maid's uniform?"

"Hmmm?" I asked, looking down at a half naked picture of Hugh Jackman in my People magazine.

"You know," he said as he started twirling around pretending like he was dusting the light fixtures along the top edge of the hallway, "ED nurse - erectile dysfunction nurse? They could dress in costume, come in to the patient room and poof! Patient cured."

"You're an ass," I said as I laughed.

"Yeah, but think of the research!" he replied.

Sometimes you just have to shake your head working in a place like this.

Nothing Special

Today was absolutely dead until 5PM. Then voila! They came out of the stinkin' woodwork. I had a broken arm, another fall down go boom, a rectal bleed, a head injury, a dislocated knee, a dislocated shoulder, and a suicidal ideation all within about 35 minutes. And that was just me. The patient's were a completely different story.


Psych! (Remember that stupid word? Everyone was running around in junior high saying it to be cool whenever they were playing a joke on someone. I saw MC Hammer at the store yesterday. Psych! I hit a dog with my bike on the way to school. Psych! I saw your mom blowing my uncle in the shed last night. Psych! Oh whoops, that one was true.)


Anyway................. I ended up staying 2 hours over to help settle things in for the next shift. I missed my kiddos going to bed. I hate it when that happens. I love to settle them in for the night and give them hugs and smooches. They smell yummy from their baths and they are so willing to cuddle with mom. That doesn't happen so much during the day. That's the only time I really ever hate working the ER - when I don't get to tuck the chitlins in for the night.

Sigh..........................

Ah well, they're gonna need therapy when they get older anyway. What's one more thing to add to the list, eh?

Night.

Linky Love

Ambulance Driver needs your help.

Passing on the link so he can get the info he needs. He's looking for gun bloggers and medical personnel who work with gunshot victims.

Have They Checked The Clocks?

Slow day today. I had a whopping total of 3 patients. What the hay? Something ain't right here.

My day consisted of the following patients:

• a nosebleed
• a migraine
• a fall down go boom

I felt like the day would never end. Every time I looked at the clock it was only ten AM - and it stayed 10AM until I finally went home at 5PM. Ever have one of those days? It just refused to move any faster. I did get a lot of QI analysis done on the trauma charts. Yeehaw. I know how much you all care.

Oh! I did get in a debate about pain control with one of our docs. Thaaaaaat was an interesting conversation. Hoooboy. Seems we have differing opinions there, such as I think people who hurt should get pain medicine and he doesn't.

Anyway, back home now wasting time on line.

Miscalculations

I lost a bet this morning. I thought she'd be about a .238.

She was a .420.


At 8 o'clock in the morning.



Sigh........................................

Hope

Sherri and I hopped in the van and hit the backroads around Biloxi, Mississippi with a cooler full of tetanus vaccine, a box full of syringes, and multiple dressing supplies. We were 2 weeks out from Hurricane Katrina and the devastation still amazed me. Every road revealed something ripped apart and given to the winds as if it were an offering to the gods.

I will never forget the people we met that day. They were resilient, hopeful, hardworking people of the South - and I fell in love repeatedly with their spirit. I had spent the previous week working in a shelter where the majority of people were angry, mean spirited, and had the largest sense of entitlement I had ever seen. It was quite refreshing to get out and meet some of the people who loved their homeland - even through the devastation. They had hope and did not fear working hard to get back what they had lost.

We dressed the arm wounds of a lady who had literally hung onto a rope in a tree for eight hours while the water swirled around her. She talked of seeing snakes swimming at her feet and watching the remnants of peoples lives float by her. She was sifting through the wreckage that used to be her single wide trailer and trying to pick out anything left. She had a handful of photos that had been trapped under some debris. That was it.

We found an elderly lady sitting in her home laughing as she went through the boxes at her feet. We could see the water marks on the walls of her living room - black mold and dirt approx 4 feet high. Her couch was in her kitchen and her car was halfway through her living room wall - filled with plant debris. But she was still laughing at the memories in her box.


We wrapped a leg wound on a man who was cutting apart the tree that had fallen on his house. His kids were running around the front yard playing tag with each other while his wife sifted through their belongings scattered over the driveway. He talked about coming back home after they had evacuated and the first thing he saw was the foundation to his neighbor's house. No house - just the foundation. He still didn't know where his neighbor was. They had been best friends for the last 10 years.

We rounded a corner in Ocean Springs and came upon a lady whistling and hanging out her laundry. I remember how unbelievably white the sheets were on the line. She offered us some ice cold sweet tea and some cookies. Her house had flooded but she refused any help from us. "I got it all taken care of hon," she said. She sent us on our way with a pitcher of tea and a box of snacks. "Y'all do some good out there now, OK?" she shouted as we drove away.

We dressed wounds, gave shots, helped people move furniture, and spent hours helping sort through debris. But I gained more from the people there than I could ever have given them. They showed me that great sorrow and huge tragedies birth hope.

The Birthing of the Bowels

I think I'm on a poop roll. Everything I do lately seems to be centered around someone taking a crap. There is a black cloud of shiznit hovering over my head. Sigh..............................

I walked into Exam 2 to help Lucy "roll someone over" yesterday. She's learned how to manipulate me - and manipulate me well. "It'll only take a second," she whimpers.

I walked into a wall of odiferous haze. Oh..........my.............god.

It smelled like the bowels of hell. Literally.

Mr. Intoxicated had crapped himself. For the first time in 8 days. Lucy looked at me from the back of the stretcher and winked. I flipped her off. We set to work and got him cleaned up, changed to a fresh gown, and settled back in.

"I have to crap!!!!!!!!!!!" he screamed.

Oh Lord.

We quickly assisted him up to a bedside commode where he proceeded to give us a play by play of his bowel movement. We apparently had ringside seats.

"OH OH OH! It's coming! It's coming!!! I can feel it starting to come out."

Grunt.

"Oh, wait. It stopped. I think I'll push harder." Grunt, Grunt, Strain.

"Here it comes! I think I've got it!"

Long pause.

"Nope. I was wrong. Lordy, I can feel it hangin' there."

Lucy was holding her hands over her mouth trying not to laugh. I just stood staring at the guy with my mouth hanging open.

"Seriously?????" I mouthed to Lucy.

She snorted.

"Oh!!! Here it is! Here it is!" PLOP. The bowel movement finally arrived.

I felt like I should have clapped.

We proceeded to admit him to the floor for detox and some abnormal labs. I volunteered to take him up - not the smartest move of my day by any means. The floor nurse and I transferred him from the stretcher to the bed where he decided he had to crap again. Instead of waiting for us to get the bedside commode, he just let loose - and loose is a definite understatement. The dramatic ejection of the poop plug in the ER had broken the dam. The river was overflowing the banks! My lower legs were suddenly (and shockingly) covered in his diarrhea.

Sometimes I wonder why I go to work every day.