No peace to pee

So our ER has one staff bathroom in the locker room, and one staff bathroom on the fast-track side of the ER. Our fast-track is only open when we’re busy, but it’s also not nearly as convenient to get to that bathroom quickly so most people use the staff bathroom in the locker room. I started a post not too long ago about how I hate using that bathroom because without fail every time I sit down someone knocks on the door.

Today took the cake. I had a brief lull in duties so I stole into the bathroom for a quick pee break. No sooner had I started to pee when I heard someone punch in the code on the outer door and start heard yelling “SSFB? SSFB?!” I thought about ignoring her, but the cleaning lady turned me in, so I finally yelled back “Yesss?” and she said “Supervisor wants you to go into room 5 right now to watch the PA put on a splint!”

I mean jesus christ. Seriously?! I’m ON THE TOILET!

Now… granted our ER doesn’t get a lot of ortho, but today makes the 5th splint I’ve watched her apply… Was that really important enough to drag someone off the toilet to watch?!

Advertisements

Death March

So I just finished my 8-day death march of work and school. It was pretty brutal. I’m about to go to bed at 8pm and hope I don’t wake up until at least noon tomorrow… even it requires taking benedryl 😉 I’ve thought about posting nearly every day but was nearly delirious by the time I got home. Does thinking about posting count? I sure hope WordPress comes out with email posting soon, that would make things SO much easier.

Here is my quick update:

Hubbin and I are doing well, much better really. I think the iPhone has been worth every penny as we can now stay in near constant communication via email. We’re in hot pursuit of booking a Honeymoon in June. Comfortably talking about our future. (I’m unfortunately still having occasional nightmares that he’s buying plane tickets to Romania… but I’ve been telling him about them and we’re still talking about it, which I think is good. He knows it’s still on my mind) Hubbin this week is trading in his GTI for a Passat. He’s one of those total car-obsessed boys and would buy a new car every year if he could. VW had lots of deals going on so he’s now going to lease the Passat for about $100 less per month than his GTI payment and wasn’t required to give any down payment. He keeps reminding me the Passat has “four family friendly doors” I know my parents are going to completely roll their eyes about how fickle he is with his cars but I decided: “ehh, if it takes the payment down what’s the big deal” plus this one is leased which is a much better situation for him: someone who wants a new car every couple years and lives less than a mile from work.

I still have absolutely NO information about my internship that’s supposed to start in TWO WEEKS… come on, throw me a bone here people. I have only two more nights of clinical left THANK GOD. I hate clinical. Although I think my instructor rewarded (?maybe?) my non-confrontational attitude by sending me off the unit for a night last week to the Burn Unit which was MUY traumatic and I had no desire to go (other students had been begging to go –not me–, but she sent me and 1 other one instead) but I got to see somethings that were probably good to see (and I hope to never see again in my whole entire life)

Story of the week from work:

I went in to draw blood from a pregnant bleeder (age 20) and her mom looks at me and says “You look WAY too young to be doing this!”… I politely smiled but I really wanted to say “I’m older than your pregnant daughter! (bitch)”

Would you EVER?!

Much to my dismay I was not at work the other day when we had a patient come in for “abdominal pain” but I’m going to tell you the story anyway because it is PRICELESS.

So she wrote on her check in slip “abdominal pain” but when the nurse went to take her back to her room she told the nurse she didn’t want the nurse intern in there for the interview because she needed to tell her something. She then proceeds to tell the nurse that she’s not really having abdominal pain, she’s there because she’s was having severe chest pain. She was having trouble falling asleep the night before and thought that if she masturbated she would feel better. So she did, and it worked only after she had her orgasm she started having really severe chest pain.

Would you EVER….. EVER… admit that to someone?

How about: “I was climbing a flight of stairs”…. Or let’s try: “I was loading the dishwasher”…. I could think of a thousand excuses to avoid saying “I was masturbating…”

So this poor lady was then admitted to the hospital for her atypical chest pain secondary to masturbation. … and now everyone in the ER has heard about our masturbatory chest pain person.

Obnoxious

Back in the first few weeks I was working in the ER I had a patient who really stuck out in my mind. She was there with her mother and they came in because the girl (19 with a two year old at home already) had been pregnant and told her mom she had a miscarriage and her mother didn’t believe her. They were there for hours that night, they went so far as to send her for an ultrasound and everything, though I can’t remember why now. What really stuck out in my mind was this girl’s attitude. She was one of those people that you have to just really clench your teeth in their presence so you don’t bitch slap them. As that would be unprofessional in the work environment. She was EXTREMELY rude in that syrupy sweet kind of way that just makes it that much worse. She was borderline combative with care (in the “My mom is making me be here so you’re not REALLY going to make me get undressed and submit to bloodwork” kind of way) and I just got the general sense she was rubbing it in to her mother, who was frankly no nicer than she was. I distinctly remember thinking “If she was my child, I would beat her for having that rude gloating attitude of being in the ER because you had a miscarriage at 19”.

A few days later I was there when the same girl came in by ambulance with her aunt and boyfriend because she was having severe abdominal pain. She had retained “products of conception” that ended up needing to be removed via emergency surgery. The first time I walked into her room I nearly walked right back out because she showed up wearing nothing but a lingerie top and at first I thought she was in the middle of changing her clothes. Not so. Once again refusing to change into a hospital gown and refusing to cover her boobs up with even a sheet. Her family was once again extremely rude. And the girl rang the call bell every 5 minutes. We had to move her to a bed in the hallway that night because we were so busy and I remember vomiting a little in my mouth when I walked by and her boyfriend was bent over telling her how sexy she was. There’s a time and a place for that folks.

So guess who showed up this week a sobbing mess via ambulance again? About two hours before my quitting time…

I feel it’s pertinent to the story to inform you she showed up in tight jeans, large gold-hoop earrings, and a mid-rift showing halter top. She was there with excessive abdominal pain again. She somehow managed to immediately piss off the triage nurse because after she put her in a room she came into the nurses station spilling profanity out of her mouth. Told us the girl had decided after her emergency surgery that the antibiotics she was prescribed just weren’t important and though maybe she had an infection because her pain was just off the charts. I’m paraphrasing of course. She gave the nurse this whole long story about how she doesn’t have insurance so couldn’t afford to buy her antibiotics and blaaaah blah blah. Don’t worry, we can see she’s got her medical assistance in check. You know there are $4 generic perscriptions now right? But when I went in to collect a urine sample from her her cellphone was ringing. No money to buy antibiotics, but there’s enough to keep that cellphone operational.

She could barely get the words out to me through tears that she couldn’t give a urine specimen because her belly hurts too bad to walk by herself. How much was your belly hurting when you put those tight jeans on today? Don’t you worry, I offered to cath her. 😉 I’m sure it’s already clear to you how much I just despise this girl. So she hobbled over to the bathroom while sobbing and holding my hand but then SQUATTED over the toilet to pee because, “I ain’t sittin’ on no public bathroom” exactly how bad does your belly have to be hurting you before you stop thinking about things like that? or are physically unable to squat I ask you? After I saw she was capable of squatting over the toilet which by the way I can barely coordinate when I’m in tip top condition…. I wasn’t quite so worried about her falling on the way back to bed.

I took her vitals and I said to her nurse: “Don’t worry, her vitals are fine, despite her attitude”. After the doctor saw her he actually said “she just really needs to be smacked”… lol. He was even less sympathetic I think after her urine was positive for marijuana and opiates. I told her nurse “I feel like I’ve met her family enough times now to officially say I don’t like them. This is no longer a first impressions/judgmental kind of situation, I mean at this point I’ve met her mom twice, I’ve met her Aunt and boyfriend, and they’re just not nice people.”

In the two hours she was there before I left I answered her call bell no less than 15 times. Eventually I would just state out loud in the nurses station “nope, not going, I need to meditate” and the LPN said “What does she want? Before I go in there I just want to know what I’m getting myself into” and I said “nothing. honestly.” attention. pain medication. for you to turn the heat up. another blanket. how long will it be. a blanket for my mom. nothing. attention. and repeat. To the point when I went into another patient’s room they asked me if their call bell was broken (their bed was right next to the old nurses station so it buzzed every time this girl hit her call bell) I assured her that no they had not broken anything, it was just one patient. To put this into perspective for all of you, on any given 12 hour shift I might answer 2 call bells. period.

There is no end to this story because my shift was over, but I’ll be very interested to hear whether they sent her on her merry way and told her to use whatever narcotics she is obviously already using, or whether she had an emergency surgery to remove her uterus since her cellphone is more important than her post-op antibiotics.

In need of a 5 year plan…

So the other night at work my boss says “can I see you in my office for a few minutes when you finish that?”… yikes I thought. But really he just wanted to know if I would be interested in submitting an application for one of two RN positions he’s looking to fill. I told him yes indeed I would. I then had a conversation with Hubbin about various life aspects on the phone for 5 minutes then worked the rest of my shift (till 1:30am) and drove home. I’ve decided rather than trying to recapture all the billions of things bouncing around in my head that night I’m going to post the long-winded email I sent to Hubbin when I got home as it will be a far better update on my current life than any other post.

I smooched you when I got home, I don’t know if you remember… you cleared your throat but didn’t move much. 😉
I’m sitting on the floor of the bathroom right now, this may only be a quick email because, well it’s 3am, I got home and finished updating my resume and applied to be an RN in the ER… The starting salary says $20.50 an hour, which will most likely only partially kick in until I’ve passed boards. (A lot of time they start you out as a GN at a slightly lower salary until you’ve passed your boards, and then bump you up when you actually have a license)… I did a lot of thinking on the way home and had a lot of stuff bouncing around in my head, but after all that and looking up stuff about PA applications/dates I’m not sure I remember what all I originally wanted to put in this email.

So the two closest PA programs are A and B. B starts every January and A starts every fall… applications to enroll this fall 2008 were sent LAST may 2007, so applying now I’d really be applying to start in 2009 for either school, maybe even 2010 for B. There’s part of me that’s tempted to apply to everything (PA programs, Masters in Nursing programs) all at once and then just see what happens, but on the car ride home I think I decided I’d really rather do the PA program.

Part of what I don’t think I made clear is about nursing contracts… the issue with this supposed “nursing shortage” is nurses have the ability to job hop right now with little consequence, so what the hospitals have started doing is giving “signing bonuses” if a nurse is willing to sign on for a few years at a time. The consequence of leaving before your contract is up is you have to return your sign on bonus. That’s why as of March 1st Healthcare-Monopoly is getting rid of sign on bonuses because they’ve found it doesn’t really help their retention rate. So the reason there is a little rush to me applying now is if I have any interest in this bonus. Now… my boss didn’t have all the details but thought it was about $4,000 for 2 years. Which if I was already going to try and work for Healthcare-Monopoly for year so I didn’t have to repay my tuition and also get to keep my part of my retirement fund, then another year may be worth it. BUT if I leave after a year it would just mean repaying that… it doesn’t mean you CANT leave.

So if I’m going to get a $4000 sign on bonus, and I’m going to bargain for 2 weeks of vacation this summer, maybe we really could take a 2 week honeymoon? Would an extra $4000 allow us to tack on a flight and a few days in Germany too? Or another city in Italy? I do kind of feel like if I get the sign on bonus I’d like to use it purely for something fun.

Now, I know PA program B has the policy that once you’re admitted you’re -admitted- and you can defer for a year or two years, whatever… I don’t know much about A but I signed up to go to their open house in two weeks. I’ll have a sit down meeting with my mom in the near future about what kind of financial support exactly she’s got from my grandma. I mean I guess in an ideal world taking no time off and going straight into grad school is the best thing to do… but right this minute, I am TOTALLY burnt out. I mean going straight in, which I guess can’t even really happen now cause the deadlines for this fall are already closed, would mean I’d be done sooner and could get on with my life sooner, then I wouldn’t find it so challenging to wait till after grad school to talk about a baby. But if I can’t start till fall of 2009 then that’s 2011-2012? when I’m finishing (it’s a 2-2.5 year program) then I’m 31 when I finish? I know that’s probably the smart thing to do, but that just seems like forever. Plus I just feel like the work + school thing is murder on our marriage. From what I know about PA school it’s going to be just as intense as what’s going on right now… I think both programs have class from like 8a-5p M-F, plus you have all your clinical rotations… It honestly is just like doing the first two years of med-school.

I was discussing with my mom earlier, just cause I was asking her if she thought career wise it was an OK move to take the ER job… essentially cause it’s kind of a cushy nursing job, you’re not always drowning in patients, its short term care blah blah blah… but you also wouldn’t necessarily get all the “skills” you might at another job, which depending on who you talk to may or may not be important… but then on the other hand I also know what I’m getting into, I know the people, I know the system and yadda yadda yadda. Mom was very Pro-ER-job. (I mean if I’m applying to PA school, I don’t necessarily really *need* nursing experience?)

As a side note… MAN it is STORMING outside…. you should HEAR the wind and stuff blowing around!

I just have so much bouncing around in my head right now it’s driving me crazy… pros and cons of every little nuance of every decision for the next 5 years… work, school, family… everything. Alright… so I guess I managed to come up with everything I was thinking of on the drive home, I don’t know how much sense I made though… It’s 3:30 I’m going to FINALLY get my shower and tuck in.

1st Break

We had a patient show up on our board as “Alleged Sexual Assault”… 20 years old, came in with her mother. Through the course of the evening we learned that’s not really why she was there, she was there because her mother was at her wits end and didn’t know what else to do with her. The mother reported the girl was perfectly normal until about 3 days before when she thinks she started using drugs. The girl was claiming she had been assaulted by her neighbor and 50 of his closest friends. Her tox-screen was only positive for marijuana. Unfortunately, that wasn’t the issue, the issue was the girl was experiencing her first acute psychotic break. When I would go in to take her vitals I couldn’t believe the textbook symptoms she was displaying. Although she was communicating a completely heartwrenching story about the “Alleged SA” what I couldn’t get over was the nonstop talking and the textbook “flight of thought” being displayed. You would be in there for 5 minutes and the girl wouldn’t take a breath, and was switching wildly from topic to topic to completely unrelated topic. She voluntarily signed the commitment papers and spent the next hour frantically writing notes of warning in blue crayon to everyone she knew, including the nurses because she didn’t want us all to think she was crazy and she wanted everyone to know her neighbor was guilty. Switching wildly from being very polite to screaming profanity at her mother. We even had to park a security guard outside of her room while we were waiting for her ride to the psych hospital.

Oh the anguish in her mother’s eyes….