Friday, October 17, 2008
Going it alone tonight
At 430 pm this afternoon I found out I was going to be alone for the night shift in the ER. UUGGGGHHH! Talk about stress and being pissed off. Does the supervisor NOT look at the schedule daily and staff appropriately or what? This is the second time I had to go at it alone. Know I know we are a small ER, but it still doesn't mean I can't get the BIG ONE coming in or an assaultive creep come in. Besides, how do u run a code with one RN and one Doc? I took several deep breathes in the parking lot before venturing in and all was well until 2130. Then three patients all came in just about the same time. just as I try to start an IV the doorbell buzzes and I have to stop. Yup no one around to open the door. the telephone rings 2 maybe 3 different times, all of which I was with my patients, pushing drugs, hanging fluids, starting lines, mixing drugs.....what? Do they expect me to run and answer the phone too? Sorry, no can do! I try to keep my head together, be safe, prioritize and be cheery in the eyes of the patients. Even the patients cant believe I'm here alone, but they tell I am doing a good job and that I'm very nice and helpful. That helps my mood a bit, but when its all said and done, when I finally get the last one out the door about 0200 a.m. my back is sore, my feet are pounding, not to mention my head. I thank my guardian angels for keeping me safe once again and for allowing me to be the best nurse I can be under the circumstances. Now, I just keep finding myself glancing over at the security monitor with anticipation of what comes creeping up next.
Tuesday, August 26, 2008
When Docs get "Short Timers Disease"
There's this doc who will be leaving us shortly, who just doesn't seem to care anymore about how he treats his patients. In and out they come and go. A head lac, not cleaned, skin just pushed around a bit and stapled. No "nurse please irrigate this wound" but of course we do it anyway. No signed orders, writes for prednisone taper despite us writing down that the patient already takes 50mg daily. Why do we assess and document for it to be ignored? August 31st can't come to soon for this doc!
Thursday, August 21, 2008
Thursday, February 7, 2008
Off to work I Go
So today I head off to a local High school to escort and provide skilled care this teen. It's about time I got some work through the agency. Even the bus driver asked where I've been. He said that no one escorted this teen yesterday and the agency CD had to do it. It baffles me why they think I am not available. I gave them my availability for February and still they struggle to staff their cases. Do any of you agency per diem nurses go through this too?
Off the bus we go and head to the SPED classroom. Haven't been here since December and its nice to see familiar faces.
Sent via BlackBerry by AT&T
Wednesday, February 6, 2008
Blackberry Users: AudibleAir for your smartphone
Now you may enjoy downloading audible books, magazines, newspapers, even nursing text/reference materials directly to your phone!
Manual Installation of AudibleAir using your phone's Internet Browser:
Audible OTA Installation
* Open the following link in the Internet Browser of your phone:
* http://download.audible.com/audibleair/java.htm
* Select the install for your phone and begin downloading the Audible®Air application (~290K) to your cell phone.
Tell me what you think BB users.
Manual Installation of AudibleAir using your phone's Internet Browser:
Audible OTA Installation
* Open the following link in the Internet Browser of your phone:
* http://download.audible.com/audibleair/java.htm
* Select the install for your phone and begin downloading the Audible®Air application (~290K) to your cell phone.
Tell me what you think BB users.
Monday, February 4, 2008
Rules for the Emergency Room
Here are some tips to those who may end up in an ER, be it yourself or a family member.
*
If it requires the ambulance team and entire truck crew of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.
*
When you present to the triage nurse, do not tell him/her that your doctor called ahead. If you survey our waiting area, probably 50% of the people waiting said the same thing, and the other 50% use the ER as their regular doctor.
*
Never start out by saying, "I was searching the Internet . . . "
*
When asked how much you weigh, please do not give the "Deer-In-The-Headlights Look", and tell us you "really don't know". It's a simple question with a simple answer.
*
Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.
*
If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a ninnie and treated like one, enjoy the waiting area with your family.
*
One complaint/ailment per visit, please.
*
Just because you came in on a ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.
*
If you have one of these four, go to your own doctor in the morning: A Migraine; the Flu; a stomach virus; or a stuffy nose.
*
Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now,so I sure as hell don't know when you're getting a room.
*
We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.
*
If your mother is a patient and we ask her a question, let her answer it.
*
If your child has a fever, you had damn well better give him Tylenol® before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?
*
If you are well enough to complain about the wait, you are well enough to go home.
*
Do not utter the words "it is in my chart", I don't have your chart, and I don't have the time to call and get it. Just tell me. It is faster.
*
We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will have to assume you are lying about everything. You don't want that.
*
If you have diabetes and do not control it, you are committing slow suicide.
*
If you are a female between 16 and 42 and your last period was between 28-35 days ago, please don't waste our time if you are here for Abdominal Pain & Vaginal bleeding. Guess what!!?? You got your period, again.
*
Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to move around seven people who are in the way if you are really sick.
*
Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.
*
If you want something, be nice. I will go out of my way to piss off rude people.
*
Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We don't consider a kidney stone, sick. Painful, yes. Sick, no.
*
At any given time, one nurse has four patients. One doctor has up to 15.
*
There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. (don't be the whiner). Please.
*
If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate a*****e. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
*
If you can bi**h about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.
*
Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonald's®, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, and the lights dimmed, go to the Ramada®.
*
If you have any sort of stomach pain and you ask for something to eat, you are not sick.
*
Do not talk s**t about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
*
If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.
*
Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?
*
Please don't bring in a "show and tell". If you have to fish it out of the toilet, it's really not necessary to bring it in, we will take your word. If you did fish something out of the toilet, you may not use my pen.
*
If it requires the ambulance team and entire truck crew of firefighters to transport you and safely place you on a hospital stretcher, it is time to go on a diet.
*
When you present to the triage nurse, do not tell him/her that your doctor called ahead. If you survey our waiting area, probably 50% of the people waiting said the same thing, and the other 50% use the ER as their regular doctor.
*
Never start out by saying, "I was searching the Internet . . . "
*
When asked how much you weigh, please do not give the "Deer-In-The-Headlights Look", and tell us you "really don't know". It's a simple question with a simple answer.
*
Just because you have a phone and know how to call 911, we are not impressed by your arrival on an ambulance stretcher. You had better be sick.
*
If you came escorted via EMS for multiple complaints that started more than one week ago and your entire family followed the ambulance to the hospital, you will be labeled a ninnie and treated like one, enjoy the waiting area with your family.
*
One complaint/ailment per visit, please.
*
Just because you came in on a ambulance, doesn't mean you're going home on one. You better start making arrangements, now. I am not driving you home, or figuring out how to get you home. Cab vouchers are not an option.
*
If you have one of these four, go to your own doctor in the morning: A Migraine; the Flu; a stomach virus; or a stuffy nose.
*
Do not ask us how long it will be. We don't know. I don't know what is coming through my door 30 seconds from now,so I sure as hell don't know when you're getting a room.
*
We have priorities. We understand that you have been waiting for two hours in the waiting room. If you don't want to wait, make an appointment with a doctor. The little old lady that just walked in looking OK to you is probably having a massive heart attack. That is why she goes first.
*
If your mother is a patient and we ask her a question, let her answer it.
*
If your child has a fever, you had damn well better give him Tylenol® before coming in. DO NOT let the fever remain high just so I will believe the child has a fever. Do you want your child to have a seizure? Do you?
*
If you are well enough to complain about the wait, you are well enough to go home.
*
Do not utter the words "it is in my chart", I don't have your chart, and I don't have the time to call and get it. Just tell me. It is faster.
*
We know how many times you've been to an ER. We can usually tell if you are faking it during the first 5 seconds of talking to you. Do not lie to us. If you lie about one thing, we will have to assume you are lying about everything. You don't want that.
*
If you have diabetes and do not control it, you are committing slow suicide.
*
If you are a female between 16 and 42 and your last period was between 28-35 days ago, please don't waste our time if you are here for Abdominal Pain & Vaginal bleeding. Guess what!!?? You got your period, again.
*
Do not bring your entire posse with you. One person at the bedside is all you need. It is really difficult to move around seven people who are in the way if you are really sick.
*
Every time I ask you a question, I learn more about what is wrong with you. I don't care if I asked you what day it is four different times. Each time I ask, it is for a reason. Just answer the questions, regardless whether you have answered them before.
*
If you want something, be nice. I will go out of my way to piss off rude people.
*
Our definition of sick is not your definition of sick. If a member of the ER staff says that someone is sick, it means that they are in the process of DYING. They have had a massive stroke, are bleeding out, having a heart attack, or have been shot. We don't consider a kidney stone, sick. Painful, yes. Sick, no.
*
At any given time, one nurse has four patients. One doctor has up to 15.
*
There is a law (similar to Murphy's) in the ER. If you have four patients: one of them will be sick (see above for definition); one of them will be whining constantly; one of them will be homeless; and one of them will a delightful patient. (don't be the whiner). Please.
*
If you see someone pushing a big cart down the hall at full speed and you hear bells going off, do not ask for a cup of coffee. Someone is dying, you inconsiderate a*****e. In the ER, bells don't ring for nothing. Sit down, shut up, and let us work.
*
If you can bi**h about the blood pressure cuff being too tight, or the IV hurting, you are not in that much pain.
*
Physicians and nurses are not waiters. We are not customer service representatives. This is not McDonald's®, and you very well may NOT have it your way. Our job is to save your life, or at least make you feel better. If you want a pillow, two blankets, and the lights dimmed, go to the Ramada®.
*
If you have any sort of stomach pain and you ask for something to eat, you are not sick.
*
Do not talk s**t about the other members of staff I work with. The doctor that you hate? I work with him every day, and I know that he knows what he is doing. I trust him a lot more that I trust you. I am not here to be your friend, and neither is he. I will tell him what you said, and we will laugh about it. If you want a buddy, go somewhere else.
*
If you are homeless, don't ask for a bus token or cab voucher to get home. It just confuses the staff.
*
Please don't tell us how to do our job. Do we go to your place of business and tell you how to do your job?
*
Please don't bring in a "show and tell". If you have to fish it out of the toilet, it's really not necessary to bring it in, we will take your word. If you did fish something out of the toilet, you may not use my pen.
Nursing Inspiration
I asked for Strength
And was given Difficulties to make me strong.
I asked for Wisdom
And was given Problems to solve.
I asked for Prosperity
And was given a Brain and Brawn to work.
I asked for Courage
And was given Danger to overcome.
I asked for Love
And was given Troubled people to help.
I asked for Favors
And was given Opportunities.
I received nothing I wanted. I received everything I needed.
And was given Difficulties to make me strong.
I asked for Wisdom
And was given Problems to solve.
I asked for Prosperity
And was given a Brain and Brawn to work.
I asked for Courage
And was given Danger to overcome.
I asked for Love
And was given Troubled people to help.
I asked for Favors
And was given Opportunities.
I received nothing I wanted. I received everything I needed.
Nursing Inspiration
I asked for Strength
And was given Difficulties to make me strong.
I asked for Wisdom
And was given Problems to solve.
I asked for Prosperity
And was given a Brain and Brawn to work.
I asked for Courage
And was given Danger to overcome.
I asked for Love
And was given Troubled people to help.
I asked for Favors
And was given Opportunities.
I received nothing I wanted. I received everything I needed.
And was given Difficulties to make me strong.
I asked for Wisdom
And was given Problems to solve.
I asked for Prosperity
And was given a Brain and Brawn to work.
I asked for Courage
And was given Danger to overcome.
I asked for Love
And was given Troubled people to help.
I asked for Favors
And was given Opportunities.
I received nothing I wanted. I received everything I needed.
Thursday, January 31, 2008
My Ultimate Dream Job.....Flight Nurse
I really want to be a flight nurse! I am looking into getting some more ER under my belt, sitting for some Trauma Certification course in February and seeing what else I might need to do to achieve this goal of mine. I am drawn to this type of career, I love the fact that I can be a nurse and have the thrill and personal challenge of being a trauma flight nurse. My boyfriend isn't thrilled with it, but I am! If I could get back into the military and become a flight nurse I would in a heartbeat! So any flight nurses out there, give me some pointers and stear me in the right direction on how I can obtain this career goal. :)
Wednesday, January 30, 2008
US Navy Signalman E-3
I thought I'd post a little something about who I was in the past. I use to be an E-3 Signalman for the US Navy back in 1989. Here is a picture of a sailor doing his thing with the semaphore flags 
and a pic of me (last year) standing at a signal light aboard a ship that we SM's use to do morse code with. 
The following is a brief description of a Signalman's (SM) duties:
SMs stand watches on signal bridges and send/receive messages by flashing light, semaphore and flights. They prepare headings and addresses for out-going messages; process messages; encode and decode message headings; operate voice radio; maintain visual signal equipment; render passing honors to ships and boats; and display ensigns and personal flags during salutes and colors. They perform duties of lookouts; send and receive visual recognition signals; repair signal flags, pennants and ensigns; take bearings, recognize visual navigational aids and serve as navigator's assistants.
and a pic of me (last year) standing at a signal light aboard a ship that we SM's use to do morse code with. 
The following is a brief description of a Signalman's (SM) duties:
SMs stand watches on signal bridges and send/receive messages by flashing light, semaphore and flights. They prepare headings and addresses for out-going messages; process messages; encode and decode message headings; operate voice radio; maintain visual signal equipment; render passing honors to ships and boats; and display ensigns and personal flags during salutes and colors. They perform duties of lookouts; send and receive visual recognition signals; repair signal flags, pennants and ensigns; take bearings, recognize visual navigational aids and serve as navigator's assistants.
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