Being a patient

I just wanted to recount an experience I had.
So two nights ago I had the pleasurable experience of being a patient in the ER. I would have to say this was the first time I was a patient for something other than an Asthma related problem. I have not ever worked in that particular ER and for the last year and a half I have not worked in any ER, just labor and delivery. Originally I did not intend on going in to the ER at all, just the clinic or to my regular Dr.
So starting on Sunday I had a slight ache in my left flank area. I thought that maybe I had slept in a weird position or stretched it. By Monday the pain became more intermittent and slightly stronger. I though possibly I was getting a kidney infection. I drank a ton of fluid and figured I would try to get an appointment on Tuesday. Tuesday came with the pains more often than not so I drank a couple of liters of fluid and called the Dr. I am a "member" of a very large established HMO that is well known. So when you call to make an appointment you have to go through several different people and then the call you back. So I ended up with an advice nurse. She informed me that there were no clinic appointments available that day and my regular Dr was booked. She then said that I could have a "phone appointment" I was thinking OK sure why not. This was around 430pm that they finally figured out I could get a phone appointment. The Dr was to call my home (I had to verify the number to call 3 times) at 540pm. She said to be available 15 minutes before and 15 minutes after. I said sure and waited. I sat by the phone from then on. By this point the pain was becoming worse and worse. Earlier in the day in addition to drinking a ton of fluids and peeing often I tried icy hot- (what if it was muscle), ice packs, repositioning, Tylenol and had massage from hubby. None of the aforementioned treatments helped, well the ice did for a few minutes. I even had a BM just in case I had a really bad case of FCS (fart caught sideways). So I kept an eye on the phone and another on the clock. by 605 I figured the Dr was not going to call as promised. I called the advice line again. I guess no matter how many times I verified my number the Dr was going to call my cell either way. Cell reception in the house can be spotty that is why I wanted to house phone to be the point of contact. By the time I get the advice nurse she tells me that she will have a Dr paged and to wait on the line. I wait for what seems like forever. The advice nurse gets back on the phone to tell me that she is having a hard time reaching the OB on call. I was thinking what does flank pain have to do with OB but apparently if you have a uterus you need OB (I thought you had to be 20 weeks pregnant for them to be concerned with anything). she asks me to wait on the line again while she pages. I then hand the phone over to my husband because I can no longer sit still with the pain. I try a slightly cold shower to help with the pain. My hubby tells me that they want me to go to the ER for evaluation. I told him why didn't they tell me that when I could still tad upright. I get out of the shower and call my friend. I figure with the tears from pain and nausea I shouldn't drive myself to the ER and since it was already after 6pm hubby and my boy should not spend time waiting with me. So my friend offers to drive me there and stay with me until I am ready to go home. Which was awesome I owe her big time. It is 740 when I check in to the ER. I had to wait until 815 for triage. So sitting in the big lobby with a few other peeps was fun. I could not find a comfortable position sitting or standing since about 5pm. I am finally triaged and they offer me a gurney in the hall until there is a room available. I accept the gurney and wait. My friend at least can stay with me. at (15 I am placed in a room, I am introduced to the girl who was to be my nurse on the way into the room. I change in the gown and offer a urine sample (I offered the triage nurse but she declined). So the next wait begins. the Dr comes in the room at about 940ish he does a quick exam of my side and makes me move my legs. He says the nurse will be in to give me fluids and pain meds. Just before 10 the nurse shows up for the first time, starts an IV and says I am going to set you up for your pelvic. WTH again with the uterus being the topic of interest despite the absence of pelvic or abdominal pain no discharge or bleeding or cramping. Whatever. The nurse says the Dr ordered morphine, I thought at this point I will try it. So she gives me the first half of the dose really slow and I swear half way through the push I feel my head get really hot and the room spin. WOW. I hate drugs. So Dr rough fingers comes back for the pelvic. During the second swab (I think) I say out loud "Well I didn't think I had tonsillitis but now we will know for sure." my friend who stayed upstream for the invasion laughs out loud. The Dr was not amused. So Dr and nurse leave the room with their specimens and I wait. I look at the clock and see that it is 1025. I figure I would be out of there by 1130. I try to make the fluids go in faster and make my own pressure bag. The bag is now empty and I have not seen or heard from the nurse or the Dr. It is now 1130. The pain is coming back full force. I go to the bathroom to rid myself of the liter. When I come back from the bathroom one of the OB residents I work with is standing in the room. Apparantly Dr rough fingers called a consult. So being that left flank pain has nothing to do with the uterus she tells me that the only thing wrong in my labs is calcium crystals in my urine. WTH? She says that I should follow up with my regular Dr as scheduled and that the stone will probably pass soon. We chitchat for a few minutes and she says the nurse will give me another liter of fluid a little more pain medicine and I could go home. So I wait some more. The nurse has not been in the room since the pelvic. My friend and I figure at this point I will be able to go not long after the 2nd liter is in. Yeah we are hungry and the pain is still there but hydration will help it pass. By 1215 with no sign of the nurse or Dr I decide that maybe I should hang my own bag especially since the fluids are in the room. I hang the bag and put my blood pressure cuff on it to speed it up. My friend was feeling really anxious that we would get caught or in trouble. So at 1240 a different nurse comes in and introduces herself. She asks if I need anything for pain, at this point I really do. I also ask if I can have ice chips ( I hadn't eaten since lunch and hadn't had anything to drink since 6pm). She says OK, she will be right back. She comes back around 115 with pain meds and no ice. She slams the meds so fast while I am talking to her that I stop mid sentence. All that could come out of my mouth was "OH shit" the room was spinning so fast and my head felt like it was on fire. The nurse asks if I am OK and then leaves the room. So after a little while I get inpatient and I decide to call the OB resident around 200 and ask if she knows what is going on (I figure since I know her direct line and we are some what friends I could do that)she says I should be going home soon and I should follow up. I get dressed with the IV saline locked thinking that maybe the nurse will be in anytime now. Around 215 another nurse comes in the room, I figured out she was a nurse only by looking at her badge she tries to hang another liter and I ask if she knows what my status is and how many liters I need before I can go. I also ask for ice chips. She leaves the room and comes back to tell me that I need a total of 2 liters. I let her know that I have had 2. She says Ok and leaves again. I find my call light and use it so I can see about maybe getting pain meds and ice chips. Some one at the nurses station turned off the call and didn't answer. 10 minutes later a ER tech comes in to see what I need. I ask her if I can see the DR and get pain meds. She says she will find my nurse. Another 10 minutes pass and my nurse comes in. She ask how I am doing I tell her that I am in pain and would like ice chips and to know what my dispo is. She says that she will have to ask the Dr. I then ask if I will be going home, she sees the IV fluids that the other nurse was going to hang. She asks if Someone hung my second bag. I told her that the second bag finished infusing by the time she came in the first time. She get really upset and then stomped out of the room. My friend and I looked at each other like WTH? A couple of minutes later another nurse walks in and ask if I need pain medicine. I tell her that I just really want ice chips and to find out what is going on. She then walk out of the room and starts talking to my nurse (she left the door open so I heard the convo). She tells my nurse that I didn't want pain meds, my nurse said that I asked her for some. My friend and I mouth to each other that I did not. So another ten minutes goes by- no ice chips no pain meds and no DR. I hit the call light again. A couple of minutes later yet another nurse comes in. She offers me pain meds. I tell her that if I am going home soon I can just wait for the RX, she says the DR should be in in a minute. So another 10 minutes goes by it is 330 at this point and no DR. the last nurse that had come in is back and she offers me pain meds. I say sure why not I am in pain and the Dr still hasn't come by she also hands me half a cup of ice chips. The charge nurse opens the door and asks what I need. I only know he was the charge nurse by looking at his badge. I tell him that I would like see my DR he says that the Dr is making rounds with the other patients and will be in shortly. He then says that the Dr has been in a code for a while (I was thinking for 3 hours, wow some code). The Charge nurse also informs me that "We are waiting for your Ultrasound in the morning" in a tone that would infer that I already new the answer. I tell him well at least now I know I will be here for a while. I tell my friend to go ahead and go home so sorry that she had to stay that long. So I am alone.... At least the pain meds are helping. Around 400 the nurse that gave me the last dose of pain meds comes in to ask if I want my nurse back. I tell her that I don't mind, but only if she wants to take me back. She tells me what a great nurse the other girl is. OK. So around 430 am a tech comes in and moves me to another room on the other side of the ER. OK, fine. I meet my next nurse, he says he will be my nurse for 45 minutes and then proceeds to actually examine me, including filling out my med history and assessments. I was thinking I have been in the ER since 915 and now they are doing this. At least he is kind and gives me a warm blanket and shows me the room has a TV. I try to doze for a while but the pain is still there. at 515 my new nurse comes in to introduce himself and offer pain meds I ask for half of a dose because the full dose makes my head hurt and the room spin. He agrees. I realize that I am wearing my own clothes but don't even care at this point. I again try to doze. At 60 I get up to pee. When I get back from the restroom the nurse and taken the linens off my bed. I was confused, maybe I did get to go home after all. HE tells me that I can change rooms to a more "comfortable gurney" OK. I then try to doze some more. The pain of course doesn't allow sleep. He comes back with another half dose just before change of shift. being that my new room is only a curtained room, I can hear everything that is going on at the nurses station. Change of shift comes and I hear my nurse give report to the next shift. So he tells the next nurse that I didn't get along with my previous nurse so they moved me over there. Whatever. So my new nurse comes in, introduces herself and talks to me about what the plan is for the day. Finally a nurse that will tell me what is going on. She does and assessment. I ask her when the Dr would be coming by and let her know the situation from the night. No Dr since 1025pm and it is now 7am. I also tell her how I changed my own IV fluids because I thought that it would speed things along. She laughed at that, she thought it was nice of me to help out. She was very surprised that I had not seen or heard from a Dr all night and the way I found out about the ultrasound. I felt a little bit vindicated. So the ultrasound would not be until 9 am. A Dr came in the room at 715 and did an exam and told me my lab results and what they were hoping to find on ultrasound. He offered my more pain meds and said he would be back. I was finally being treated!! It took 10 hours but OK. Ultrasound came and went, very painful and inconclusive. The Dr said that since I was pregnant even only a few weeks that the other tests to diagnose stones could not be done. He also said that treatment would remain the same. OK. I was discharged at 1215 with an RX for an anti emetic, I declined the pain meds because I had some Vicodin at home that I never took from 6 months ago. He was fine with that. I was finally on the way home. No food for 24 hours and only a half cup of ice chips since 6pm. I felt drained, tired and hungry. I have to say the pain is still there but not nearly as bad as it was when I went in to the ER. So that was by far the worst experience I have ever had in a hospital. The Dr told me right before discharge to come back if I wasn't feeling any better. I kind of laughed to myself, I would rather die at home thanks. Food and water never tasted so good.

Where oh, where???

So I have a huge dilemma- do I keep traveling in hopes to find the perfect place to settle down and plant roots, or do I go back home tail between my legs and try to survive there for a few more years. My hubby has made it pretty clear that he does not want to live "forever" in my home town. My son is dead set on staying put- he has a best friend. My uncle keeps trying to convince me to go to Fresno, my sister wants me in Dallas. And me, I would love to live back home, only if I knew I was going to stay. I actually wouldn't mind staying here if I could get a job. I have applied at every hospital in this area and no one has called me back. They all have openings posted, but the recruiters don't return phone calls. So far my favorite places have been Tulsa, OK; Cour d lane Idaho; Maui; Albuquerque, New Mexico. I guess my time in Tucson was nice, but the pay was lousy and the schools were not great. Georgia seems nice, and so does Texas. I have heard that the Carolina's are beautiful. I really just want a place I can call home, maybe have a house. I would love for my son to go to the same school all of his life, and give him siblings. It would be nice to have friends and family where we live too. I know that I am asking for a lot here. If anyone knows where I should go I am open to opinions.

JAN (Just a nurse)

OK, I have been holding out for a while about posting this but maybe once I do I will finally be able to let it go... But, maybe not
OK here is the scene. very sick liver failure pt with enlarging belly and possible GI bleed comes in. This pt arrives by EMS in another RN's station. I drop what I am doing to help out. While primary RN is doing the NGT I am starting lines, drawing blood etc. in walks attending ER MD and resident ER MD
Attending- (not knowing he was asking the resident) "What is in the NGT?
Me- "Lots of blood- mud like really"
Attending- (icy stare and icier tone)"are you the Stanford ER resident?"
Me- "Why no, not today."
So I quickly finish helping the other RN and go back to my team tail between my legs. a little bit later I hear the liver patient yelling. I go into the room to see what he needs, he asks for pain meds. I go to attending
ME- "the liver guys wants something for pain"
Attending "Are you serious? Did he just ask for something?"
Me (while walking away) "Well I am no Stanford Er resident, but that is what he said"
Attending "I was joking when I said that earlier"
Me "Yeah it sounding very joking when you stared me down and said that"
So fast forward a couple of shifts. same attending different critical pt. This one liver failure no BP renal failure
Attending "What is wrong with this pt?"
Me- "Well I am no Stanford ER resident but I think he is not feeling well today." (as I walk away)
About 2 hours later and after several requests for a central line to give all the meds and blood said pt needs. Attending is at bedside while I am mixing meds. I come back to the room as Attending says to ICU fellow "NO I am not the nurse! I am the Dr. forget the nurse work you saw me doing."
ME- "nurse work? I am so sorry you had to do nurse work"
Attending " didn't see you there, the ICU MD thought I was the nurse."
me "OIC, I am not a Stanford ER resident after all."
Attending "Well you are just as good as a resident."
ME- look of disgust.- (nothing personally wrong with residents here, but after being an ER nurse for so many years, I would think that I knew a little bit more than the new residents.) "Thank so much!"
So now I am not really sure if the attending does not like ER nurses, does not trust the nurses or thinks we are stupid. Either way, I try to make myself a valuable part of the team. I don't think I am better than anyone else, I don't think that any one else is necessarily better than me, but we are a team. Each person is an integral part of this team as we can not function as one person alone. I try to learn something new and expand my knowledge daily, and I do know that there is always more than one way to skin a cat. Anyway I think that my blog has quickly become one rant after another. I feel a little better about getting this out. Although I can not guarantee that I will not throw the Stanford Er resident thing in Attending's face again. AS I do lack the filter between my brain and my mouth

Things that irk me

Something that have really annoy me:
*Some days I feel as though I we should have a sign out that says Marriott resort. I often wonder why people think we have room service in the ER. No I can not drop everything to bring you another warm blanket, no we do not have a pillow.
*And I am really sorry that you have not eaten all day, but you have only been in the ER for a total of 20 minutes so why is it so important that I find you food? What were you doing all day that made it impossible for you to feed yourself? *Asking "how long will I be here?" or "How long is the wait? don't have an exact time, but if you are in that much of a hurry why did you come in? And If I don't know the answer the probability of one of the other people walking buy your room knowing is pretty slim.
*When patients ask me to dress them, feed them or wipe there ass. when 20 minutes before stepping into the ER they were able to care for themselves without help. It is one thing if you truly can not do it yourself, but pure laziness is deplorable.
*When you ask a patient what they came in for and the answer is "You are the nurse/or Dr, you should know!" Well let me consult my magic eight ball for that answer.
So when you come to the ER remember This is not Burger King we do not do your way

I love ERnurseys blog about the same stuff. I guess we are all in the same boat, without a paddle and we know where this creek is headed

Just another night

Well it is just another night in the ER. Hard to believe that I get paid to do what I do.
So a typical night starts out a little crazy. 20 people in the lobby for hours waiting their turn for a coveted bed. Ambulances backed up in the halls that are littered with drunks and the cops that are waiting to take them away.
Tonight was more like a typical Friday or Saturday night with more Police officers than nurses. The police waiting for the "medically cleared for jail" dispo. And the gems that they bring in, I mean how many people can go to work to be called "cock sucking slut, faggot, f#$%^ing bitch nigger"? I think that Tourette's syndrome is more and more common these days. How else can you explain the things that come out of the mouths of the 20 somethings will thrashing about on a stretcher. You would think that it was my fault that Jr decided to drink, do a little meth and then ram his car into someone while going 95MPH. So you have to wonder why would anyone would want this job? I ask myself this question frequently. Maybe the adrenaline rush of getting that STEMI off to the cath lab in under 60 minutes, or starting the Stroke protocol. I know that I have to do this job, some days not because I want to, but because it is what I was born to do. I do like to take care of my share of "train wrecks", I actually prefer them. I also love to take of the Peds. But it is very difficult to take the constant disrespect from the many jerks out there. I can not count the number of times I have spit on, kicked, swung at, pissed on and cursed at by the belligerent drunks and drug addicts. I understand that alcoholism is a disease and that addiction is horrible, but when did society decide to make it OK for these people to treat everyone like a roach. Some days it is almost to hard to take and I find myself fantasizing about knocking their teeth out. But for now I guess I will have to settle for being "cock sucking slut, faggot, f#$%^ing bitch nigger" while I get you that warm blanket and boxed meal. I will sign this JAN- (just a nurse)

Orifices

Never a dull moment in the ER
OK, it has to be said, enough is enough
Ladies- when you put something in your vagina it will need to come out! You really can't leave it in forever, and please for the love of God do not forget that you put it in there!
You would not believe how many times we have to fish something out of there that has been in for only God knows how long. Do you not realize it has a foul odor? I mean really. They put the strings on the tampons for a reason! Maybe should you set your cell phone alarm when you place one in so that in 5 hours you remember to take it out.
I understand the occasional lost condom, and you just need someone to pull it out.
Another thing nurses are not completely stupid- if you have sex there is a chance you could be pregnant. You would not believe how many females come into the ER with abdominal pain and try to tell us that there is no way they could be pregnant and low and behold they are crowning. I love that they just can't be pregnant even with their amniotic fluid running down their legs.
So this really goes to my theory that maybe people should have to have a license or permit to procreate. Maybe pass a test, be able to prove that they can actually take care of another living being, and to be able to understand that you can buy a thermometer and Tylenol at the store Another thing when you have a fever do not wear everything in your closet to come to the ER while carrying the largest blanket you could find. And it is OK to take Tylenol or Motrin before coming in if you have a fever. And if you are vomiting do not ask me if you can have something to eat or drink. I will tell you go right on ahead, but I will not hold your hair, or clean up your vomit!
OK enough said for today.

MUD!

This is my last day off for a little while and I decided it would be mud day. Collin my 4 year old and his friend played in a huge mud pit for a few hours today. They were both head to toe mud. I should have taken pictures.
They are so lucky to have parents that will actually make the mud for them. I filled a dirt area of the backyard with water, trucks and sand toys, they did the rest. I hope that as Collin grows we can still do that sort of thing. I really would like for him to have everything I didn't, including mud days!
Mud day started the other night when we went to a friends house for dessert and Collin and his friend disappeared into the backyard. The two of them were a little too quiet, and when we found them they had mud all over their backsides. They had used a little hill in the backyard as a mud slide. All we could do was laugh, then of course strip them naked to get a bath. So today was officialy mud day to make up for the short lived mud play they had the other night. The next door neighbor saw the boys and just laughed. It sure was fun to watch the boys cover themselves with mud. Maybe tomorrow could be official bubble day.