I'd Rather Have A Heart Attack

Man comes to triage complaining of chest pain.

Me: What sort of medical history do you have?
Man: I have high blood pressure but I haven't taken my pills for a few days. I ran out.
(Man's blood pressure is 192/113)
Me: What other history do you have?
Man: I have high cholesterol.
Me: And what do you take for that?
Man: Well I used to take statins but I stopped taking them a few months ago because I didn't like all of the negative publicity around them.
Me: (pause) Oh-kay. And what about all the negative publicity around heart attacks? Have you ever seen or heard any of that?
Man: Yeah I guess so.

Guess my lecture was too late. The man was having a huge heart attack. Practically preventable had he been taking his cholesterol pills.

Nothing Gets By This Kid!

I live in the 'burbs. A very WASP-y 'burb. It's not that my kids have never seen anyone who isn't white (we travel into the very multicultural city on a regular basis), it's just that they aren't used to seeing anyone who doesn't look like them on the outside in their neighbourhood very often. The other afternoon we were at the local swimming pool. A couple of kids with dark dark dark ebony skin swam by. My one 2 1/2 year old looked at them as they swam by. I watched as he sat for a minute observing them. Then he said to himself "dat black"...and swam on his merry way.

Timeout Corner

Accountability. Something that I am trying to ingrain in my children. For everything you do in life there is a consequence - negative or positive. Sometimes you may not like the outcome of your decision, but regardless of your choice you have to take ownership of it. If you choose to hit your brother when he steals your truck instead of asking for it back, you go into timeout. And as you sit in timeout, you can think about your action and it's consequence. I seriously wish there was a timeout corner for ER patients. The lack of accountability that a great deal of these people have is outrageous. The man who has a tempertantrum because he has to wait for 4 hours to be seen for the back pain he's had for 2 months (and naturally hasn't taken anything for since last Tuesday) or the lady who was given a prescription for high blood pressure that hasn't had time to fill it in the last three weeks who now presents with a headache and a blood pressure of 215/112. Our health care system could save hundreds of millions of dollars a year if the general public would just learn how to be accountable for their health. The 63 year old who didn't want to spend $20 on Accucheck strips is now costing the health care system thousands because he is now hospitalized for a week with a blood sugar of 68. Not only is there strain on the finances of the health care system, but on his household as he is now off work, his family has to pay $20/day for parking, the emotional strain of the family is unmeasurable, plus who really wants to spend a week in the hospital??? The timeout corner when you are 2 1/2 is horrible because you can't play with your toys or your brother plus it totally sucks having mom upset with you. The timeout corner for our unaccountable patients should have glaring bright strobe lights, be blasting that stupid "Friday" song full blast and smell like a combination of c-diff and a stage 3 pressure ulcer. One hour in the timeout corner. I would love to think that this would change the health accountability of most patients although I would also love to think that my son will not spend anymore time in timeout for hitting his brother. Needless to say there has been more than one timeout in our house.

A Lesson For All

A very intoxicated 16 year old enters triage:

Me: So what can I do for you today?

Drunk 16 yr-old (slurring her words): I had a lot to drink....only Sir Sam's...no drugs...I don't do that and I was outside and now my hands are yellow. And before my face was yellow.

Concerned Mother: Yeah, it's weird. She was outside for a long time and now her hands are yellow! They aren't going to fall off are they???

Me: What were you doing outside? Where were you?

Drunk 16 yr-old: Just at McDonalds. Nowhere else. I had fries and a milkshake. But no drugs. Are my hands going to fall off?

Me: Did you try washing your hands?

It was at this point I grabbed some cleaning solution, put them on a gauze and started to wipe the patient's hands...and amazingly whatever yellow crap was on them wiped off onto the gauze!

Me: Maybe you should have washed your hands.

Concerned Mother: So her hands aren't going to fall off?

And this boys and girls is the reason that some people should not be allowed to reproduce. I thank you for your attention.

Gas Exchange

This really doesn't have anything to do with anything but thought I would share this with the world. I am sitting here catching up on my blog readings and listening to my 2 1/2 year old twin boys fake burp in bed. They "burp" then say "fart" (apparently any source of gas is a fart) then start giggling. Ok, honestly, I don't know who is giggling harder right now - me or them.

Brilliance Personified

Me: So what brought you to the ER today?

Brilliant Mother: Well my kid's been coughing a lot since last night and I thought I should bring her in

Me: It says on the chart here that she had Ventolin at 0500 today.

Brilliant Mother: Yep. And it worked for a while.

Me: Well it's now 10 pm, has she had any since then?

Brilliant Mother: No and she's still coughing

Me: Really? (inside voice: SHOCKING!!) Well you do realize that the Ventolin is to help with the coughing that is related to her asthma. If you don't give it then she won't get better.

Brilliant Mother: Yeah....I guess.

Brilliant Mother left with her offspring with instructions by the doctor to use her Ventolin puffer. And the Canadian tax payers were charged $350.

My Little Hypochondriac

One of my sons is a hypochondriac. Fabulous. A feather can brush against his finger and he will then carry on for the next ten minutes about his sore finger...about how he needs mommy to kiss it better...about how it is going to fall off...about how there is going to be a nuclear holocaust if someone doesn't stop the North Korean regime before it's too late. Ok - he might not use words like Holocaust...he is only 2 1/2 after all. He also has this new excuse when he doesn't want to do something..."my (insert body part) hurts". I looked at him the other day after his 42nd body part of the day had been injured/hurt and said "I know that you don't understand what I'm about to say to you, bust you really have the wrong mother to be trying to pulling such stunts. I am in a profession where I know what it means to have something hurt and believe me - you are not hurt. And trust me, it is only going to get harder and harder for you to try and convince me otherwise". My 2 1/2 year old just looked at me and ran off to play with his fire truck...his decrepit, painful, injured body suddenly and magically cured. For the time being at least.

A Financial Plan

Dear CEO of My Hospital:

I know that times are tough. I can only imagine the stress that you must feel when budgeting for our hospital, when the province is breathing down your neck to try and cut your budget meanwhile you are serving a community that continues to grow at breakneck speed. There is a very good reason that you are in charge of such things and I am not. I have recently learned how to financially manage my own household, although I still have a long way to go. I do, however, have one suggestion on how you can save hundreds of thousands of dollars a year.

Please explain to me why if I would like a hospital porter to clean a bed, transfer a patient or do any other task, that I have to call a number which directs me to a person 30 km a way so that they can then page the porter standing right in front of me to do exactly what I could have asked them to do. (No people in Bloggy-Land....I kid you not). And then then the porter has to pick up the phone to call you to tell you that they got the page and that, yes!, I can clean the bathroom.

Not only is this a complete waste of time, but you could save so much money by completely eliminating a ridiculous system. I would like you then to consider putting that money towards hiring nurses or more porters - people who are actually useful in the hospital. And if that is not an option, then the ER nurses would like to request a big screen tv and karaoke machine in the lounge.

Thank-you,

Supernurse.

Make Work Projects

Note to self: Make sure that when boosting a patient up in bed that you gauge how close you are to the wall first. Boosting your patient into the wall will only lead to a night of doing a head injury routine.

Whoops!

Waiting Room Etiquette

Just for the record:

It is never ok to call out "brown lady with a psych problem" just because you can't pronounce their 48 letter name. Just sayin'...

Show Me The Money!!!!!

About two years ago our department started staffing two physicians on for 12 hours a day. The volume of patients was just too much for one physician to handle. Plus if you get one critically ill patient they can tie up the doctor for very long periods of time, leading to an even bigger backlog.

One of the duties of the new team is to work together while doing reductions. A reduction is something that is done for someone who has broken a bone or dislocated a joint that needs to be put back into place. We sedate them with Propofol...better known as the medication that aided in the demise of Michael Jackson...yank the body part back into alignment and presto!...a cast and you're on your way. In the olden days...i.e. 18 months ago...nurses were smart enough to draw up and administer the drugs used for these procedures. That suddenly stopped 18 months ago. Now that there are two physicians on, it has become necessary to pull the 2nd doc who could be productively seeing patients, to take the drugs the nurse has drawn up and administer it. And, of course, they get to bill the government for it!

So what I want to know is - where is my money for all the times that I was the "anesthetist"?

Who's Smarter Than A Two-Year Old?

If anyone reading this knows anything about Elmo's World than you can appreciate why we have a fish named Dorothy. It's simply a male beta fish in a fish bowl - just like the real Dorothy...only with male fishy parts...and he is a boy with a girl's name...and he can't be in a bowl with any other fish. Other than that he's just like the real Dorothy. When we went to the fish store to get Dorothy about six months ago there were no orange beta fish. Only black and white ones. So we got a white fish. Three days ago my "nursing" senses kicked in and I feared that Dorothy might have cataracts. Pretty bad senses considering Dorothy had in fact kicked the bucket. So I let it be known that Dorothy was very tired and in fact was sleeping all day. And then I had to develop a plan to get a new Dorothy and switch the new fish without the boys figuring it out and without waiting more than a day or so when old Dorothy would be sure to start melting away. Not an easy thing to do as a single parent!

Luckily my brother was in town and aided me in the big switch. Perfect. Dorothy was back, even feistier than ever and even ate her food!...something that may have contributed to the demise of old Dorothy. New Dorothy is quite a bit darker than old Dorothy but they didn't have any white ones left. I was one step closer to getting my secret stealthy Ninja certificate. Then it all unraveled last night. O was sitting looking at Dorothy swimming around very intently. Uh oh. He suddenly looked at me and said "Dat not Dorfee! Dat back!!". Uh.....ok Jenn, keep cool. "What are you talking about buddy? It's Dorothy. See?" "No! Dat back. Not Dorfee". Quick...THINK!!! Yes! Distraction! "Hey buddy, do you want a cookie and to watch some Nemo?" Nemo and a cookie. Haven't heard a word about it since. Yep - that's right...I'm smarter than a two year old!

Cold Much?

Here's a little continuation of my last post if it was written in form of a theatrical script:

(Nurse enters room and finds patient completely naked on bare mattress sitting with his legs stretched out and arms folded, hands tucked into his armpits)

Nurse: So...ah...Mark*...can I get you a blanket or something?

Mark: No thanks. I'm good. I've got gloves on.

(Mark pulls his hands out from under his armpits and shows Nurse the rubber medical gloves on his hands).

Nurse: Oh. Ok. Ah...if you change your mind let me know.


Seriously??? You can't make this stuff up!



*Patient's name has been changed

Thirsty Much?

So here's an interesting question. What do you do when you catch a patient drinking water out of their already used urinal? Nope. Can't even make this stuff up. Is it wrong that I just sat there until he was finished because he had already drunk half of it due to shock and horror? I sort of repremanded him after I collected myself and told him that I would get him a cup...just ask! And that his arguement that "I rinsed it out" wasn't good enough to EVER drink out of a urinal. I left a couple of cups at the bedside. An hour later he joked that he would pee in the cups. Ha ha.