Tuesday, April 29, 2008

Nurses week...

OK, I'm not sure exactly when it is, but it's coming up sometime. Let me start this post by saying that I have the greatest job in the world. I wouldn't trade it for anything in the world, and there is absolutely nothing else I'd rather do for a career. I've spent a lot of time in triage the past week, and I've done a lot of contemplating about human behavior. Anyone looking for a good observation of human behavior at it's finest, I have a suggestion. Go to your local emergency room and just sit somewhere in the back of the waiting room. You don't need to check in, you don't need to talk to anyone, just sit back and watch. You would be honestly amazed at what you will see. Apparently to most people, the rules of common courtesy, politeness, manners etc go out the window when you think you're sick. For those of you not familiar, let me explain. Triage is the system that we use in emergency rooms to evaluate patients. A nurse will see and evaluate the patient and assign an acuity based on the assessment. Most patients seem to think of the triage nurse as the magic key to unlock the door to get them seen by the almighty doctor. Thus, the amount of acting that is done to elaborate the stories is frequently quite comical. In the past week I have seen a woman down an entire 1lb bag of peanut m&m's in about 15 minutes while waiting to be seen for her nausea and vomiting. I've been yelled and, cursed at, swung at, spit at, and I even had a voodoo curse placed on me (I'm not exaggerating).

As nurses, we understand that everyone who comes to the emergency room thinks they are having an emergency. Each one thinks they are sick and/or dying. We have a different definition of sick than most people. Not all our patients understand that the kidney stone they are having, while extremely painful, is not an actual emergency. The thing is, the sprained ankle you have in one room is as important to that patient as the heart attack is to the patient next door. It is frustrating I'm sure to have to wait. What people don't understand is that airway trumps elbow pain. As nurses we have 4 other patients. In the emergency room it is commonplace to have one patient who is intubated, having and acute heart attack, or is otherwise actively dying. Part of our job is separating and prioritizing between the hurt, sick, really sick, circling the drain, and call the code patients. The fact that you have to wait 4 hours to be seen for your stomach pain does not mean that you are not sick, but you need to realize that there are people who are more sick than you. I had a father of a patient tell me once that he was grateful each time he got to wait in the emergency room, because there was one time when he didn't have to wait. His 3 year old son was having an asthma attack, and was blue by the time they ran him in the doors. He marvelled at how instantly there were people surrounding his son who was in the bed, intubated with 2 IV's started, labs drawn, meds given all within 15 minutes. It is fortunate that most people don't understand this. Let me assure you, if you are actually having an emergency, you will be treated immediately. And I hope that you never have to find that out.

Nurses are patient advocates, doctors eyes and ears. We are not cocktail waitresses, maids, or dirt underneath your shoe. We are professionals with college degrees. If you want two pillows a warm blanket and the lights dimmed, go to the hotel down the street. No one else goes to work with the understanding that they will not be able to sit, drink, eat, or pee for the next 12 hours ...again, not exaggerating. No one else goes to work where people think that it's okay to cough in your face without covering their mouth. I can't think of another field where college-educated professionals get hit on, grabbed, groped, yelled at, pushed and pulled in half, and still go back with a smile on their face the next day. I love my job. I love the stress, I love being on my feet running my behind off for 12 straight hours, I love that I'm so busy that i frequently don't have time to sit eat or pee for even a couple seconds. I'm writing this post not to complain, because as i said, I love my job and wouldn't trade it for anything. I've come to take it as a compliment when someone calls me a dirty name (see the next post).

Nurses week is funny to me. It's nice to be appreciated, but people go all out with the pink frilly fluffy stuff that irritates me to no end. I look at all the 'nurses care' crap and throw up in my mouth a little bit. This is why I work in the ER. You see, not all nurses are created equal. I would rather die than work labor and delivery. And I'm sure they feel the same way about the ER. I do care about my patients, but what you should care about more than the fact that I care is the fact that I am smart and good at my job. It might not take a lot of skill to fetch your pain pill, but what you don't see is that i can tell you the chemical structure of the pain medication, how it is absorbed and processsed and takes effect in your body. I can tell you every possible side effet, and the way to fix it should you have any kind of a bad reaction. This knowledge applies to your pain medicine and each and every drug that I give, including the more complex ACLS drugs that will start your heart again and keep it going. I have all this information in my head and will keep track of who has had how much of what medications, and could even tell you in the middle of running a code how much longer it will be before you can have more pain medicine. Of course I can't stop doing chest compressions to come tell you how much longer, but that doesn't mean I don't know, or that I've forgotten about you. I saw a tshirt once that perhaps sums it up the best. It said, 'I work in the ER, my job is to save your a**, not kiss it.' Now, to the point of me writing this post. You don't need to tell your nurses how wonderful they are and how much you appreciate all that they do, and think that they are the greatest things alive. If you feel so inclined, no one would stop you, but I would settle for some simple manners. Say please and thank you, cover your mouth, etc. Just be a normal person. Call me by my name. It's on my name tag, and I've told you 15 times. If you can't remember my name, do NOT holler 'NURSE!' down the hallway at the top of your lungs. Use your call light, or say a simple 'excuse me' or 'miss' or 'sir' as someone walks past and we will gladly attend to your needs. If you have to wait, this does not mean you do not have to be polite. We are not making you wait to punish you, or because we don't like you, rather we are attending to the needs of another patient who, like yourself, thinks that he is the only person in the department, or more likely, we are trying to stop the acute dying process on any one of our 40 other patients. Yelling and screaming and demanding things aren't going to get you treated any faster. We're used to the abuse, and it doesn't phase us one bit. It's kind of like when you were little and you asked your mom what she wanted for her birthday, and she said that she just wanted you and your siblings to get along, or you to clean your room. For nurses week, I don't need flowers and cards with pink hearts on them (gag). What I really want is one whole shift where people say please, thank you, and cover their mouths. Or even one whole shift where people don't argue with me about putting on a hospital gown, and complain about needing to have an IV started and blood drawn. I'll keep dreaming, but for those of you who come in contact with nurses --especially over nurses week, remember, we don't need a lot. A simple thank you means the world to us.

You might be an ER nurse if...

A compilation of my favorites --Honestly, I have had each of these happen at least once!

You believe that all bleeding stops ... eventually.

You find humor in other people's stupidity.

You believe that 90% of people are a poor excuse for protoplasm.

Discussing dismemberment over a gourmet meal seems perfectly normal to you.

Your idea of fine dining is anywhere you can sit down to eat.

You plan your dinner break whilst lavaging an overdose patient.

Your diet consists of food that has gone through more processing than most computers.

When you refer to vegetables you aren't talking about food.

Your bladder expands to the size of a Winnebago's gas tank.

Your idea of a good time is a traumatic arrest at shift change.

You disbelieve 90% of what you are told and 75% of what you see.

You believe that "shallow gene pool" should be a recognized diagnosis.

You watch your patient walk into the department and know exactly what the discharge diagnosis and instructions are going to be.

You believe that the government should require a permit to reproduce, and you should be on the committee that grants the permits.

You believe that unspeakable evils will befall anyone who utters the phrase "Wow, it's really quiet isn't it."

You say to yourself "great veins" when looking at complete strangers at the grocery store, and it is a struggle to keep from reaching out to touch them.

You have ever wanted to hold a seminar and/or write a book entitled "Suicide ... Doing It Right."

You have ever had a patient look you straight in the eye and say "I have no idea how that got stuck in there."

You believe the waiting room should be equipped with a Valium fountain.

You want the lab to run a "dumb shit" profile.

You have been exposed to so many screaming children that you no longer need other methods of birth control.

You believe that waiting room time should be proportional to length of time from symptom onset. (You've had pain in your left thumb for 3 weeks? Have a seat, and we'll get to you in three days)

Your most common assessment question is "what changed tonight to make it an emergency after 6 days / weeks / months / years)?."

You have ever had a patient control his seizures when offered food.

Your idea of gambling is a blood alcohol level pool instead of a football pool.

You can identify what kind of diarrhea a patient has just by the smell.

Your immune system is so well developed that it has been known to attack squirrels in the backyard.

You believe a good tape job will fix anything.

A majority of your patients (and their family members) fall into one or both of two categories –hypoxanaxemia and hypochondriac with Internet access.

Your idea of comforting a small child includes placing them in a papoose restraint.

You believe that “ask-a-nurse” is an evil plot thought up by Satan.

You take it as a compliment when someone calls you a dirty name.

You don’t think a referral to Dr. Kevorkian is inappropriate.

As long as stupidity is a pandemic, you will always have a job.

You have ever referred to a doc or charge/triage nurse as a “shit magnet.”

You have a shrine in your home to the inventor of Haldol.

You think OD not BBQ when asked to get the charcoal.

When checking the level of orientation in a patient, you aren’t sure of the correct answer yourself.

You circle the dates of full moons on the calendar in red ink a year in advance and plan to schedule your days off accordingly.

Your family members have to have a fever of at least 105 or have an actively bleeding stump where a limb recently was to be in order to receive your sympathy.

People lean obnoxiously over your triage desk while munching on Doritos and inquire how much longer before they are seen for their excruciating abdominal pain.

You’ve ever held a 14 gauge iv over someone and said, “You’re going to feel a little poke…”

You believe the more people whine, the larger the IV needs to be.

You have ever tried to hang a closed sign on the hospital doors.

You ever have to remind yourself that you can’t cure stupidity.

You automatically multiply by 3 any answer to “How much have you had to drink tonight?”

You assume every female between the ages of 6 and 106 is pregnant until proven otherwise.

You plan your summer vacation by location and reputation of the trauma centers.

You firmly believe that by the time the patient needs a bedpan they’ve been here too long!

You know the therapeutic advantages of a foley for an unruly patient.

You can compliment a co-worker on his/her attire while performing cpr.

You’ve had a patient start off by telling you what happened at the last three ERs they went to.

You’ve ever asked “Why are you here at 3:00am for the problem that has not changed for the past three years?”

You see nothing wrong with eating popcorn, chocolate, etc. out of a clean bed pan/emesis basin.

You have ever contemplated that your job is often just interfering with natural selection.

You refer to the ‘mega-code’ portion of ACLS as the fun part.

Your greatest fear in life involves a pregnant woman shouting “It’s coming!”

You realize that a patient's effective use of Tylenol Benadryl and condoms would cut your workload in half.

Your friends and family refuse to watch tv with you if there’s a remote possibility that the show will contain any scenes from a hospital (known as the ‘they’re not doing it right’ syndrome)

You’ve ever had an adult look you in the face and say “I can’t swallow pills.”

You calculate dopamine dosages and titrations in your head but can’t seem to balance your checkbook.

You’ve ever said (to anyone) “So, did you find the fingers?”

You’re able to keep a straight face when your patient with multiple piercings and tattoos tells you they are afraid of needles.

You’ve identified the ULTIMATE cruel practical joke (getting someone drunk, taking them to the er and announcing that they’ve overdosed on ‘some kind of pills’ just prior to arrival.)

You find yourself diagnosing passers-by at shopping malls, movie theaters, restaurants, etc based on presentation and the noise they make while breathing

Tuesday, April 22, 2008

A little piece of Heaven...

Ah the salon! Seriously, getting my hair done is one of my favorite pastimes! I love the smell, I love the sounds, I love sitting in a chair for three hours and having someone rub my head and play with my hair. (Someday when I 'm rich, I'm going to hire someone to come wash and style my hair every day!) And I love walking out of the salon feeling like my head is 15 pounds lighter (I have a lot of very thick hair that has to be thinned extensively if I want it to be any form of manageable, so we take out a lot of hair) And I love how shiny and smooth it is! It doesn't matter that I have every product they sell in the salon, and the same flat iron, and various flat and round brushes, and use it all the same as they do, it is never quite the same as when you're leaving the salon. The only thing I don't have is the $300 blow dryer. I'm convinced that would make all the difference! To be right honest, I'm surprised I haven't caved and bought it yet. I got a $100 one that was supposed to be the same, but it's not. It's still really nice, and my hair is shiny and smooth, and it's ionizing and tourmaline-conditioning and all that jazz, but it didn't cost $300, therefore it's not quite the same. I think I have a sickness!

No matter how many products I have, there always seems to be a new one for me to get every six weeks when I go in. This time it was my own bottle of personalized conditioner. My stylist mixed it specifically for my chemically processed-dry-naturally wavy hair. And she mixed the color that we dyed my hair in with it, so I can keep the red for longer --anyone who's ever tried to keep red in their hair will appreciate this. And I got to pick the scent and everything! It was one of the greatest experiences of my life :) All in all it was a good day at the salon. Some of you will appreciate the story more than others, but I felt a need to share my day in heaven with all of you!

Oh, and I had a good time trying to take pictures of myself and my new hair ...

The one on the left I look scared for some unknown reason, and the one on the right I look stoned with an abnormally large forehead, but these are the ones that turned out the best :)

Wednesday, April 16, 2008

Home Sweet Home

I heard a quote the other day, that I absolutely love, but can't remember verbatim. It's something to the effect of "True friendship is not about being inseparable, it's having miles between you, but nothing changes." This quote very much applies to my recent visit home. One of my favorite things I got to do this last weekend was see my best friend from high school, Kristy --who is the cutest pregnant person ever! I haven't seen her for years, but it was like nothing had changed in the time we spent chatting. That is true friendship --it was really like we had both been in Logan all these years and going to lunch every weekend instead of being several states apart. I love that!

I also got to see the mountains again --I forgot how much I love them, and I find myself missing them already! I got a little obsessive on the way home and took about 30 pictures of them trying to capture as much as I could so that I would have plenty to look at when I got back here. It was so gorgeous! It was warm enough that the snow was starting to melt, so the white covered mountains were all shiny and glittery ...so pretty!

Let me back up a little bit ...it was so cool flying out of Seattle! It is amazing how used you get to the cloud cover and the dim sunlight. When you take off from Sea-Tac you fly through the clouds and it's like someone literally flipped a light switch on in the airplane. All of a sudden there is undiluted sunlight streaming through the windows, and when you look out the window there is nothing but pure blue sky! It was incredible ...to be looking down at the clouds with the top of Mt. Rainier peeking through the top. I love to fly! It never gets old, and now matter how many times I've done it, I still just can't help but grin when you feel the engines roar as you take off --it's the best feeling ever!

Anyway, back to home. My brother Cody plays baseball with Utah State, and they had a tournament in Smithfield this weekend, and it was awesome to be able to soak up all the sunshine while watching the Aggies play ball! I have the cutest brother ever! I also caught the opening day of the Bees --the AAA team of the LA Angels. It was a little different not having Jeff there, but it was a lot of fun to watch anyway. I love baseball! And it was good to catch up with LaDawn. I was so cold by the time the game was over that I couldn't feel my legs, but it was totally worth it!

Apart from all the baseball and sunshine, I had an incredible time just being with my family and friends. It never really gets any easier to leave. I'm always fine when I get back home, but the actual leaving is always hard. One more thought before I leave you with a few more random pics from my visit home, it was a good day of church on Sunday, and I had a renewed appreciation for the fact that I am a daughter of my heavenly father who loves me. There were two 8 yr old girls who had been baptized, and I thought a lot about how it doesn't seem like all that long ago that I was that little worrying about my poofy white dress, holding my daddy's hand as we walked into the church with the baptismal font. Things seemed so simple then. Things really are still that simple now, we just let ourselves complicate them. I felt so strongly as I watch the two girls in sacrament meeting that my heavenly father loves me just as much today as he did the day that I was baptized. Even with all my imperfections and mistakes. What a true miracle the Atonement is. I am so very grateful for the testimony and knowledge that I have. There are some things that I know, some that I believe, some that I'm working on, and some that I have up on a shelf for when I tackle some of the others. I have been so very blessed with the absolute best family and friends, and I am so grateful for that. I'll leave you with a few random pics of some of them from my most recent trip home.

Heidi, Taylor, and Mom at Cody's first game on Saturday

Sarah, Kristin, Jill and me at the cookout --thanks mom!

Cody and Me

Me and Kristin coloring :)

My cute Mom

My cute Dad

Thursday, April 10, 2008

Quick update...

So the elevator company was able to retrieve my keys from the depths of the elevator shaft in time for me to go to work, I was stuck in triage for 6 of the 8 hours --which reminds me --if you are a parent and you bring your child to the emergency room for a fever (104 in this case) without giving them tylenol and motrin (why would you do this? Do you want your child to have a seizure? Do you?) and we give them said medicines in triage, it does not mean that you should leave when their fever breaks in the waiting room. This is what happens when you properly medicate your child --their fever will go down, and they will start acting more like themselves! Ah, the marvels of modern medicine. This does not however mean that your child is not sick. If you decide to leave AMA before we have evaluated your child, that is your decision. A stupid one, but your decision none the less. We will also be more than happy to rush your child through triage when you bring them back in 5 hours when the temp is back to 105, and your child is breathing at a rate of 50 breaths per minute with retractions and nasal flaring. We will also lecture you sternly on how to make better decisions regarding your child's health in the future.

Anyway, I made it through triage and 2 hours of a trauma assignment --thank goodness for good company at work! Then I made it to the airport, and I'm sitting here chilling --trying not to be too irritated by the 4yr old with the camera sending flashes in everyone's face. When what to my wandering eyes should appear but the Dalai Lama. Seriously. Entourage and all. How random is my life?!

Wednesday, April 9, 2008

You can't make this stuff up...

So there I was... (that's how all good stories start) I got home from work this morning, ran down to the market to get a couple presents for old roommates for when I travel home this weekend. I came home and thought I'd check to see if my accountant had mailed me my tax stuff yet. So I changed into my pj's, traded my contacts for my glasses --this was my first mistake :). So I head down to the elevator were I wait patiently for what I swear is the slowest elevator in the world. The bell dings, the door opens, a large dog runs out of the elevator into my hand that was holding the keys, and I watched in utter disbelief as my keys dropped down the elevator shaft. Seriously. Then in horror I looked up into the very pretty blue eyes of the very attractive man who owned the dog who caused the keys to go plummeting to the depths below. Both of us stared down the inch wide gap that my rather large assortment of keys and key chains had managed to slip through. I think my exact words were, "Oohh, this is very not good!" Intelligent right?! Let's remember that I'm in my jammies. We ran down the stairs, and after not seeing my keys miraculously at the ground floor of my apartment complex (and profusely apologizing) the attractive man left with his stupid dog.

To make matters even more comical, I still have to go back to work tonight, and I am leaving right from work to go the airport to leave to come home. And the keys to my car and to my apartment and to the apartment building and my mailbox etc were all on the ring that is lost in the unknown levels of elevator cables and concrete. And it's a state law that building maintenance workers can't interfere with the elevators, so the cute maintenance guy had to call the elevator company, who said that they'll add it to the list of calls they are going out on, and that if we don't hear from them today that it wouldn't be until tomorrow. Which is fine, but I won't be here tomorrow. Oh, and the spare key to my car is at my parents house in Logan, UT. You're seeing the humor right? :) And let's remember that I'm still in my pajamas!

I'm sure it will all be fine, it's not like it's a big deal to take a cab to work and a cab from work to the airport, I just found the whole situation rather funny and thought you all might enjoy a good laugh! Now I should really try to sleep for an hour or so before I have to go to work. But my recommendation for the day: Stairs. They're healthier, and should you happen to drop your keys for whatever reason, all you have to do is follow down the stairs and pick them up.

Wednesday, April 2, 2008

Spring in Seattle

Spring has always been one of my favorite times of year. Usually because it means that it is finally getting warm! My definition of warm has changed over my first winter outside Logan, but I still love spring! Spring here in Seattle is interesting! There are Cherry Blossoms everywhere you look --so pretty! Then the other day when I left to work it was raining --not unusual. But as I drove the 20 minutes, it turned into a giant lightning storm --one of y favorite things ever. Then as I was getting into work the hail started --lots and lots of huge hail. Then it just stopped. All of it, all together. It was instantly back to being just plain old overcast.

So I was driving home from work today, and I was mystified by the sky. It was a really pretty color --I couldn't figure out what was wrong. It took me a long time to realize that the sky looked so weird because it was blue --there were no clouds! The strange color was due to the sun coming up without any clouds! Yay! Spring must be on it's way! I was so excited that I had to pull off the side of the road and take a picture... then I had to take more from the roof when I got home.
I forgot how pretty the sky is without any clouds in it! I can't remember the last time I saw it like this :) Yay for spring!