Latrine Duty

I don't know how often I say it, but being a nurse is so much like being a mom. You change bums, dress wounds, hold hands during times of pain, deal with whiny people...although I do refuse to "kiss it better" when it comes to my patients. The most recent comparison? Emptying potty buckets. I am in full potty training mode. Potty training twins - they should make this part of the routine while torturing POWs. I have to say that they boys are doing phenomenally well. We're on day three and we've only had one accident today. Not too shabby for not even being 2 1/2 yet. But every time I empty out the little potty bucket and flush the toilet I suddenly find myself wondering why I'm not in scrubs listening to the incessant beeping of telemetry monitors.

In Plain English...

My children have discovered the orifices known as their nares and begun inserting foreign bodies, specifically their phalanges, into them.

In other words my kids are now picking their noses.

Lovely.

Christmas Wish List: iPod, Video Game And A Puffer

The Christmas season is upon us. My last two Christmas' haven't been the greatest but this year is going to be amazing. I love Christmas. So to have the opportunity to celebrate it the way that I like and that it should be is so exciting to me. I plan on throwing my boys into the Christmas filled world that will engulf our society for the next six weeks. It started this weekend with putting up our Christmas decorations, tree and heading out for a local Christmas parade.

Now your local parade is usually pretty hokey. Lots of pick up trucks pulling trailers that are covered in ribbons and fake snow. People in their leftover Halloween costumes with Santa hats. Suddenly The 101 Dalmatians is festive. I went with a friend and her little one and we sat patiently watching the bands, floats and other interesting characters march by. There are always people walking around giving out free candy canes. My friend was hard core set on making sure that the "kids" got free candy canes...her son is 6 months old. One man finally headed our way. Hanging out of his mouth was a cigarette with about 1/4 of it smoked through. The ash was hanging precariously from the end as he walked around handing out his candy. Apparently this year Santa was handing out candy and emphysema. Don't forget to add Ventolin to your wish list kids!

One Patient, Three Lessons Learned

So a Dude comes in. He's got a 2 cm puncture would just below his clavicle (collarbone). Happened an hour ago. Newbie triage nurse puts him in the Acute bed. O2 is fine, respirations are fine. Dude looks like he needs sutures. Newbie triage nurse gets jested for her choice of spots for Dude. The story comes out as ER doc happens to walk by and chats with Dude as me and partner start doing our vitals and full assessment. Turns out his girlfriend stabbed him with a pretty long knife. Suddenly...and I mean suddenly...Dude gets quiet. A quick blood pressure shows his pressure is 50...i.e. deadly - very very very bad (he just happened to have the cuff on and it went off). We lie down Dude and the left side of his chest is about double the size of his right. This also occurred very very suddenly. A Code Blue is called. Within minutes Dude has a chest tube that drains a bunch of blood - he had a tension hemothorax. The knife nicked a vessel and his lung causing it to collapse. The accumulation of blood pushed the lung over until it was compressing the heart. If he had shown up 5 minutes later he would have been dead.

Once he's stable, his heart is beating properly and lung is reinflating thanks to the chest tube Dude is sent over to CT to see what other weird and wonderful injuries might have occurred. There is myself, another nurse, two porters and the CT tech. I start thinking to myself and share my thoughts with the group. Why would a girlfriend stab her boyfriend? Not that I am condoning it of course, but what is the ONE reason you can think of? Sure enough when the police are talking to Dude the full story comes out and my suspicions are confirmed. Dude had a Dudette on the side. Tsk Tsk Tsk.

So people in Bloggerland...what does this little story teach us?
1. Never underestimate newbie triage nurse. She may look like she's 12 but she actually knows what she's doing.
2. Never forget how dangerous those penetrating wounds can be...what sort of damage they can cause even an hour later
3. Get rid of Dudette number one before you hook up with Dudette number two. If you don't, life may become a bit more complicated.

Skin

I hate political correctness, especially when it comes to describing someone's skin colour. Why must we say African Canadian/American? What if they're from Jamaica? Or what if they're Norwegian with dark skin? I have no problem describing my co-workers as "black" or "white". They know what colour they are! There are many people with similar names and to talk about one in particular, if I have to describe them by their skin colour then I will! It's not being offensive - it's stating a fact. Luckily my co-workers all have sensible attitudes about this.

I had a patient once who was waiting for an xray after having his dislocated shoulder put back in place. I couldn't figure out which doctor had seen him. Thinking about the two doctors that were on, I asked him "was the doctor that saw you white or oriental?" The non-oriental patient became quite offended by this. His response was a huffy "it's ASIAN, not oriental". Conveniently enough the ASIAN doctor walked by. I said "hey Dr. K, you don't mind if I describe you as oriental do you?" The doctor shrugged his shoulders, said "meh" and walked away. He obviously didn't care. And I smiled smugly at my patient and sent him and his annoying political correctness off to xray.

Self Scheduling Rules

There are certain rules that you learn to follow when you have self scheduling and work in an ER. Never work night the weekend of "fall back" - you end up working 13 hours. Never work days the weekend of "spring forward" - you only get 11 hours off instead of 12. Work the Labour Day weekend as one of your summer weekends - it's usually dead because everyone is away for the last hurrah of the summer. Never work the weekend closest to St. Patrick's day - you'll end up dealing with drunks and their green puke. And finally, never ever work Halloween...especially if it's on a weekend. These rules are not set in stone of course. They are just the common sense rules that any sane nurse follows when signing up for the schedule. Apparently I had a momentary lapse in my sanity when signing up for the Halloween schedule this year. Yes dear readers...yours truly worked nights all Halloween weekend.

I have to admit that we were all very surprised at the lack of drunk and violent idiots. There was an injured cat and a drunk bumblebee but other than that the normal Halloween hoopla was very subdued this year. That still did not prevent the evil spirits from making our lives hell. The acuity of patients was out of this world and it seemed that the spirits overtook the bodies of those patients making them confused and restless. On more than one occasion this weekend there were no more ventilators left in the entire hospital - they were all in use. I'm pretty sure that we also used up most of our stock of Haldol and restraints too. So despite the lack of stupidity showing up on our doorstep, the weekend was still hell. But I have nobody to blame but myself. NEVER WORK HALLOWEEN!!!!