Christmas day in the ER

two simple words that we take for granted on a daily basis are the words thank you. but today, as i took care of patients, i heard these words more often. patients in the Christmas spirit were upset that they were away from loved one's and parties and presents but found themselves surrounded by others who'd given up a day with family to work instead. and it's funny how people are, something like Christmas making them a bit softer, the spirit and joy of one man's birth who means so much can change a day from being nothing to everything. "Merry Christmas" and "happy holidays" being exchanged at the end of the visit, people smiling through their illnesses, today was different than most.
"thank you for working on Christmas" is what i was told by not one but two patients today. it could have been more. the first time i heard it i almost cried. people were grateful to have someone there to take care of them.
i may not have saved a life today but i shared a smile with many. the one who stands out the most is the lady in room 1. she was in her 70's and her blood pressure was really high (like 230/120 high). i gave her medicines and extra special care since she was by herself. we chit chatted a lot, she said i looked like her granddaughter and we gossiped about the ER tech working with me. i took a liking to her and when i finally took her upstairs and we got to her room she went to use the restroom. i gave the floor nurse her info since she was doing her business i started to leave. just then as i was about to turn the corner i heard her come out of the restroom and ask where i was and the nurse said i was on my way back down to the ER. i could feel the dissappointment in the air so i walked back in the room, wished her a Merry Christmas and gave her a hug.
maybe it's not allowed, maybe it's frowned upon. but i think the hug was both what she and i needed for Christmas.

death at the ER door

the holidays are the worst for the ER. every one that i've worked in becomes over crowded and understaffed right around Christmas time, it's utterly ridiculous.
today was just one of "those" days. there is a full moon out, we were understaffed and i knew before going in to expect the worst since christmas is right around the corner. it wasn't bad at first, lots of crazy people though. i had the ROOM 1, the heart attack/stroke/crazy/seizure room. i also had room 6 and 7, just regular rooms (although any of the above can go in there, just not heart attacks, those are reserved for rooms 1 and 2. at 7pm i was surprised that we had 2 patients in the whole er, i was hoping it maybe would stay that way. I was wrong. way wrong.
at 8pm the bus unloaded and migraines, chest pains, difficulty breathing and crazy were all on it.
at 11pm i inherited another room since we were down a nurse and the second room (room 2) is our OTHER cardiac/stroke/crazy/seizure/any-thing-remotely-serious requiring a second crash cart, a pediatric crash cart and a neonatal warmer room, it was also expecting an ambulance.
this blog isn't intended to be my vent system but today i need it, so i'm going for it.
he was in his 50's with a history of asthma, he complained of stomach pain to his wife a couple of hours earlier and when she went to check on him at one point he was face down on the floor and blue, like not breathing blue. his wife FREAKED out (as any right person in their mind would) and called 911. she said it took forever for them to get there.
he arrived in the ER unconscious and being bagged (not breathing on his own) because he was so "tight", his lungs weren't able to get oxygen because all the airways were so small due to his asthma. the doctor quickly intubated him and we started him on medications to keep him sedated and comfortable. he had also lost bowel and bladder control so he was soiled and in need of a good cleaning (which was obviously my last priority but still a priority). i never left his room except to accompany him to CT to make sure it wasn't a stroke and then at 2am i took him to his ICU room, he was still dirty.
let's talk about being in a room with someone who's blood pressure is 220/130 and almost waking up, trying to pull out their breathing tube, listening to the alarms tell me he needed something stronger, listening to his wife ask me a million and fifteen questions and all the while inhaling the smell of liquid poo leaking from his rectum, which was soaking up the sheets. it's 4:50am and my stomach still hurts. i know his wife was concerned but i almost couldn't take it. at one point i turned to her and looked her in the eye and said "hon i know you're freaked out and you have every right to be. hell if i were in your position, even as a nurse, i'd be scared, but you have to believe me when i tell you that i am doing everything i can to make sure he's comfortable. i know it's scary but i need you to calm down". it lasted for 2 minutes and then she started in again.
i'm glad the night is over and that i have off today/tonight/Sunday. i work again monday, tuesday and wednesday which now seem like any other day but i know it's Christmas eve and Christmas day i'll spend with coworkers. but it's a day i chose to be there, unlike my friend in ICU room 2 that was admitted.
lets not forget there are people out there who will spend their christmas staring at a hospital wall with horrible cafeteria food. we should all be so lucky to spend it choosing whatever it is we want to do, alive and well.

my christmas wish list

dear santa,
yes i know the list is late, what can i say? procrastinating is a quality that i seem to excel at. but here it is, better late than never.
1. please deliver a sign that will let my patients know the pain scale is from 0-10. 12 is not in that range, neither is 15 or 20. saying a higher number doesn't make me think they're in unbearable pain. it makes me think they're ignorant and missed the school lesson on how to count. that's funny, i didn't know 20 fell between 1 and 10, IDIOT!
2. please take the patient off your "nice" list that gives me an ugly look every time i go out to call another patient back. seriously her giving me a death glare won't get her back any faster.
3. i'd like also a sign that says "don't be mean to the nurses, they are the one's who deliver the medicines"
4. please deliver a doctor to work on new years eve that is fast and efficient (and maybe male- single, young and cute)
5. a doctor for me, personally like to be my boyfriend, that are also all those things: young and cute maybe not necessarily fast, if you know what i mean.

i guess that's all that i can think of for now. i work again tomorrow so there may be additions. thanks for all your help big guy!

you can't get me down

i know it's Christmas time and the holiday itself is right around the corner. i know i won't be home, i'll spend the eve of, the day of and the day after Christmas at work. patients will be happy someone is there to take care of them, i'm sure. i'm not sad really.
i have a day planned with my girlfriend Julia and our friend Craig in Claremont, CA for a Christmas dinner on sunday. i will drink wine and be merry with the closest friends i've made since i've lived here. i am thankful for them and their offer to cook, since i probably will just watch them. haha! at least i will try to help.
today on my way in to work, as i was passing by the mountains i started smiling. a smile from ear to ear, so big i scared myself. even at a time when i'm away from the one's i love, i know in my heart i will be going home soon.
i didn't really take care of anyone interesting tonight. a couple of kids, lots of people with abdominal pain (seriously, what's going on out there?) and a couple of kidney stones. the ER was quiet and i was glad to be cut early (today's an extra shift). I'm almost back to normal but the doctor told me not to start working out to my full capacity since my lungs are probably a little worn from all the phlegm in them. i swear today i blew my nose for what felt like two mintues, it was non-ending snot. pretty visual i know, but hey, it's a great share. :)
that's all, i'm off to bed. 5 days away, i hope your Christmas shopping is done!

strep

this past week has been rough on me, each day a little better than the one before. i have spent the majority of it though in bed or on the couch in my pajamas. i guess i started feeling bad on saturday or sunday. then monday i went to work for all of two hours and they sent me home. from monday until today, friday, i have eaten nothing but chicken noodle soup, saltine crackers, diet sprite and for dessert, tropical fruit cup in lite syrup. i've been on a strict regimen of ibuprofen, dayquil, muccinex and benadryl at night. and i've done nothing but rest.
the good part is i've been able to catch up on all my favorite shows: the hills, ace of cakes (i didn't even know i was a fan until recently), the real housewives of orange county, and saved by the bell.
here's the thing that sucks the most, there is no one to baby me here. i am by myself and although i have friends, i don't want to call anyone to come help me. i have to get up and go to the store and buy my own medicines, soups and sprite. if i had a boyfriend i'd make faces like i were dying and guilt him into going for me. or i'd call my mom or sister and beg until they gave in. i have strep throat, bacterial strep that is, the kind you need antibiotics for. i didn't think so but today at work i made the doctor check and he was positive that i had all kinds of pus in the back of my throat. how lovely.
now i just need to make it through this course of antibiotics and hopefully i'll start feeling a little more peppy.

the lady who cried hemorrhoid

at first i thought she was just crazy. she came in complaining of hemorrhoid pain which everyone just laughed at. she wouldn't sit down, refused even, while in triage. she tried my patience because we all just thought she was making a big deal, which she probably was a little.
once brought back to the room she asked the charge nurse every five minutes for pain meds. she asked the registration lady twice. she wouldn't stop, she was in pain and wanted EVERYONE in the ER to know it.
she went to the door and cried out for her husband in the most pitiful sounding voice ever. her son, who was around 6 or seven heard his mother's cry from the lobby and freaked out, he wanted to see her and was crying at the top of his lungs "i need to see her, i need to see her" which really upset me.
how are you going to freak your own kids out? seriously, when you're in pain, that bad, you don't even feel like yelling. you have so much pain, even yelling hurts you. i should have known she was an exaggerator when i asked her about her pain level between one and ten and she said fifteen (the pain scale STOPS at ten...get it through your thick skulls people).
i finally got sick of her outburst that i told her she needed to try and relax, needed to try deep breathing. i started an IV and told her the doctor would be in soon and then i reminded her the hospital was a place of business and that she needed to try to not yell.
bad idea.
she got 10 kinds of upset and told me i was a rude little witch. she went on and on about how rude i was, how she was the director of wound care at a hospital. then the doctor came to my rescue and stood up for me and he ordered pain meds to shut her up.
i walked back in with the pain meds (strong ones) and told her i was sorry, that i didn't want to upset her but just remind her that getting anxious and upset would only make the problem worse and she apologized profusely for her behavior. we were both in the wrong. but seriously...she was overdoing it just a tad.
in the end she was admitted because she needed surgery to correct her hemorrhoids, apparently they were really bad.
lesson from the story: don't push when you're on the toilet because it causes hemorrhoids= painful poops!

i see dead people.....and it freaks me out

i went in to work with the hopes that we'd be slow for a little while to allow me ample time to really wake up. 3pm seems like the middle of the day for most but when 4:30am rolls around and i am barely crawling into bed, 3pm is really my mid morning.
anyways, a patient arrived shortly after me that was a full arrest. he was in his 70's and had a large past medical history, i can't remember what now, but while eating soup he choked, or something like that. i guess i don't really know the whole story but he'd "been down" for around 20 minutes by the time he arrived. basically EMS had already tried giving medications although he had no IV and no ET tube, which now that i think about it...how the hell did they give it? so i guess they magically gave him medicines somehow but they didn't work. so he had no pulse and wasn't breathing when he got there.
we tried to start an IV which didn't work, and then an IV was established that DID work and by that time, really, what's the point? he'd been down for so long and if 4 rounds of epinephrine didn't wake him back up...then the sucker was just ready to go.
this is where the problem begins. i will work my tail off to save someone, i can touch them and go around them and look into their eyes with no problem while the code is going on (while we're working on the person). but the second the doctor pronounces death, i lose it. my mind does not want to comprehend that the person in front of me is no longer alive. i can't deal with their cold skin, their glazed eyes and limp extremities. every time someone dies in the ER i force myself in the room to try and help and every time i walk out nauseated and shaky like i'm about to have a panic attack.
give me blood and guts and all kinds of secretions from orifices that would gross most people out. sure i'll take that patient with a foreign object in their rectum, or a paper clip sticking out of their ear. bring the vag bleeding, COPDer, respiratory failure...just don't give me the dead person. or at least go in there and hold my hand through it because it just really, REALLY freaks me out.

one month away

in one month i will be 27. i will also be driving back to the great state of Texas where i will reside for an unknown amount of time. you could say i get the love of moving from my parents who carted my sister and i around from city to city every couple of years. my grandmother once called me a gypsy because in the year 2006 i lived with my ex boyfriend, my mom, my ex-boyfriend again, my mom again, my ex-boyfriend yet again, my friend mandi and then my grandmother. then i got an apartment with my sister for probably a year, and then i decided i wanted to travel some more and left for arizona. i actually hope that sometime soon the desire to bounce around will subside and the "grown up" in me will start to want more than the smell of a new apartment, the excitement of a new city and the thought of a new start somewhere.
but the realness is there, i will be going home. i will be starting again and hopefully settling down. i can't say that this will be the last time i move, i hope to one day live in Austin, have a house close to the hill country with my husband where we sit on our porch and watch the sunset and our children playing in the yard while i make dinner, drink red wine and listen to jazz.
until then i will continue to apply for jobs in houston. i sit right now on the floor in my room with an empty plate next to me where a lean pocket used to sit, with three empty diet coke cans from earlier today(one for breakfast, one for lunch, one for snack) and a wrapper from a granola bar that i had for breakfast. my whole day has gone to the internet, yesterday too. they have been dedicated to the websites of st. lukes and memorial hermmann and methodist hospital. over and over applications are filled out, i've spoken with two recruiters today who promise they will be sending out my applications to other hospitals.
i have faith that something will come along. i would hate to have to spend thursday and friday (my other two days off) doing this again. i'm still in my pajamas, hair uncombed.
don't freak out mom, buy the ticket. i'm going to texas no matter what. someone, somewhere needs an emergency room nurse and i'm bound and determined to get that position. even if it takes all day and all night searching websites.