Diary Of A Trauma Nurse

Suggestions for bitter ANONYMOUS commenters

2011-11-14T22:54:00.007-06:00

Suggestions for bitter ANONYMOUS commenters

Suggestions for bitter commenters who have missed their calling, did not pursue their dreams of a career in a medical field or are just looking for company to join in their misery.

1. Read then REread the blog you are going to comment on
2. Research the topic prior to posting to prevent posting incorrect information
3. If you disagree with something, say you disagree, do not post false information
4. Try to find a new hobby other than looking for blogs to attempt to discredit the blogger
5. Grow some and post your name
6. Get a life

But most of all........ have a great day!

Ambulance Calls

2010-10-22T23:01:00.000-05:00

Ambulance Calls:

Imagine the ambulance coming screaming down your street to find out it was to bust a boil, clip a hangnail or check on smelly body parts.........

*Do people really call the ambulance for flatulence? Yes they do.

*Do people really call the ambulance for a cough? Yes they do.

*Do people really call the ambulance because they are intoxicated? Yes they do.

*Do people really call the ambulance for constipation? Yes they do.

*Do people really call the ambulance for tobacco use disorder? Well, I can only imagine what he called for but that was his diagnosis in the ER.

****Shaking my head****

The average cost of an ambulance call is $700.00. In one year, 30 people accounted for 2400 ambulance calls. One of those 30 people called 243 times.

Why is this blatant abuse tolerated?

People, please realize that while the ambulance is rushing to get you due to back pain you've had for a week, there are reall 911 emergencies out there that they AREN'T going to.

(Please excuse the frustration)........

Obamacare

2010-10-22T22:48:00.004-05:00

Obamacare's Unkeepable Promises
The Washington Times, October 21, 2010

By Dr. Milton R. Wolf

We are witnessing the unmistakable collapse of an American presidency. While this may not yet be irreversible, it certainly was predictable and preventable. Chief among its causes has been the unbridled hubris that prompted this president to force Obamacare, the government takeover of the finest health care system in the world, against the clear will of "we the people" while turning his back on the free-market principles that once made us the most prosperous nation on earth.

A diminished president, even - or perhaps especially - if his fate is self-inflicted, is not good for America and should not be pleasing to any patriot regardless of his or her political leanings. It certainly is not pleasing to me, as this president is my cousin. But as a physician who took an inviolate oath to my patients, I am duty-bound to take this stand, particularly after watching Barack Obama make so many unkeepable Obamacare promises:

Obamacare would reduce our deficit. We were to believe that millions of Americans would be added to the insurance rolls, that medical care would not suffer, and somehow, almost magically, costs would go down. We might as well promise it will never rain on weekends. Gravity caught up to this wishful thinking, and even the president's own actuary now admits the overhaul will increase, not decrease, the deficit.

Obamacare would allow you to keep your doctor and your current insurance. How can you keep your doctor if your doctor can't keep his practice? The New England Journal of Medicine reported a survey that showed nearly half of America's doctors are being forced to consider leaving their practice if Obamacare is implemented. And businesses already are finding they can no longer provide the same insurance policies to their employees that they had before Obamacare. Oklahoma's Republican Sen. Tom Coburn, also a physician, estimates 90 million Americans will lose their current insurance policies because of the takeover. Millions of them will be forced into Medicaid and government exchanges.

Obamacare would not jeopardize senior citizens' care. The continued viability of Medicare Advantage is in serious jeopardy because of Mr. Obama's Medicare cuts to pay for other parts of his health care overhaul. Companies already are announcing that they can no longer offer this very popular free-market Medicare reform. What's more, fewer doctors are able to accept Medicare patients with the downward pressure on reimbursement levels, currently stuck at 1980s levels. Too often, physicians' practices cannot survive being in business with the federal government. Already, 42 percent of doctors do not accept Medicare, and that number is increasing. Your shiny government-issued Medicare card is meaningless without doctors who will accept it.

Obamacare would not ration health care. The president promised time and time again that he would not ration health care, and then promptly, under the cloak of a recess appointment, installed as the head of Medicare a man who would do it for him. Dr. Donald Berwick has announced unambiguously and with glee many times over that he will indeed ration America's medical care (in addition to his own bizarre promises to redistribute your wealth) but he assures us that he's our intellectual better, so it will be fine. He also declares he's "romantic" about the British-government-run system and specifically admires how the British purposefully undersupply medical needs to alleviate "bottlenecks." They've been alleviated all right. Britain's colon cancer mortality rate, for example, is 40 percent higher than America's; breast cancer 88 percent higher; prostate cancer a staggering 604 percent higher. All those unnecessary deaths unburden the system of patients seeking care. Some might call this rationing. Mr. Berwick, by the way, created his own health care golden parachute to assure that he and his wife would never be forced to submit themselves to the Medicare rules he creates. How convenient.

Obamacare would not raise taxes on anyone earning less than $250,000 a year.

"I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes." New excise taxes on pharmaceuticals and medical products will, of course, by necessity be passed on to the patients who depend on these lifesaving medicines, pacemakers, MRI machines or even tongue depressors. Even more flagrant, there are new Obamacare taxes on everything from tampons to tanning salons, from gold to the sale of your home.

Obamacare would create 4 million new jobs, 400,000 almost immediately. Not to be outdone, House Speaker Nancy Pelosi added this grand promise of her own. However, since the health care takeover was signed into law, no such jobs boom has occurred.

Obamacare hearings would be held in public. Unlike the other promises, this one could have been kept and in fact may have prevented all these other catastrophic failures, but sadly, it was wantonly ignored by this president. Candidate Obama pledged eight times to hold health care hearings in public. Invite the C-SPAN cameras, he said, because open hearings would allow Americans to know who was on their side. Indeed it would have.

Mr. President - Barack - I offer to you the next best thing. Let's you and I hold a public discussion on America's health care for those C-SPAN cameras once and for all. I know your administration is desperately attempting the full-court press to promote your health care reform as it continues to suffer badly in all the polls, and you with it. Health and Human Services Secretary Kathleen Sebelius even said Americans need "re-education." Let's finally give Americans the honest and cordial discussion they deserve. You know that I have dedicated my life to serving patients, and nowhere will you find a person who will be more respectful to you. You also know I hold nothing against you personally. I understand you may feel, as a lawyer, that you're a little out of your element discussing health care with a physician, so I urge you to bring Dr. Berwick along. America deserves to hear, at least one time, from the man who holds more health care power over them than even a U.S. Supreme Court justice.

Until then, what should we do? We must defund, repeal and replace Obamacare before it defunds America, destroys the finest health care system in the world and replaces it with a European social-welfare government-run version.

Can we really repeal Obamacare? Let me be clear. Yes, we can.

First, in 2010, elect candidates who understand that health care freedom - like our other freedoms - saves lives. Elect candidates who pledge to first defund Obamacare immediately and then will vote for its repeal. Second, let's convince this president that it's in the nation's best interest - and his own - to undo this unholy government takeover that bears his name. If we cannot, then in 2012, let's find a president who will. Link to Original

Who Is A Nurse?

2010-08-14T17:44:00.000-05:00

Reposting from Original post on 3/16/09

WHO IS A NURSE?

I am a nurse.

I went to school for 4 years. I sat through long, harrowing lectures, studied for hours upon hours, spent my weekends doing research papers while my kids went on trips, I sat through very intense, nerve-racking boards, or the NCLEX as it's better known. I deserve my initials behind my name: R.N. I earned them.

I read a blog from a VERY cool chick ERRN about Veterinarians calling themselves "doctors" that got me thinking of all the patients, families, friends of patients, cousins of friends of families of patients that over the years have told me that "mama is a nurse" or "sis is a nurse" or "I'm a nurse" because they:

1) Work as a Administrative Assistant in the ER
2) Work as a CNA on the med-surge unit or in a nursing home
3) Work as a CMA in a doctor's office
4) Work as a phlebotomist in the hospital or doctor's office
5) And most recently, someone who is nothing more than a medication "pez dispenser" and doesn't know one thing about the medication she is distributing and will flat out tell you she doesn't know.

The list goes on..........

Let me start by saying, not one of those jobs is less important than mine. (Except number 5) There are many jobs I've held that I could NOT have done without the absolutely AWESOME CNA's I've worked with. (Some not so hot......but whatever.....) Back to what I was saying.........

If you pass medications and are certified to do so, kudos! That is great. We both do that.

If you work as a CNA and take vital signs, give baths, wipe poop, feed patients, and give them extra TLC, then we both do that as well.

As a phlebotomist, you draw blood. In Critical Care, we do the majority of our own blood draws as well, but it's out of arterial lines, sheaths, shunts, central lines, and yes, the occasional peripheral sticks. Many times I've needed a phlebotomist badly!

I can't say that I could do the work of an Administrative Assistant in the ER because they run their asses off, but I have done many of my own orders in the ER , so we have that in common.

What I do want to say to the friends, families and friends of cousin's families, they are NOT nurses because they work in a health care setting. I know you are proud, but be proud of what they do and call a leopard by it's spots!

I have a friend who is a nurse and has been for many years. Even before I became a nurse, when speaking with her husband, he would call her a "doctor." I never understood this and realize now that for one he either has little respect for nurses or has great pride for her or doesn't know the difference between the professions. I just know a doctor that spent 12-15 years in school would not appreciate someone who went to school for 2-4 years calling him or herself a doctor. Especially when the two jobs are nothing alike.

Same here.

When You're a Nurse:

2010-07-11T00:37:00.015-05:00

When You're A Nurse:

When you're a nurse you know that every day you will touch a life or a life will touch yours.

Nursing Students

2010-07-10T23:40:00.003-05:00

Nursing Students - One of my main reasons for blogging:

Some of the following are comments that I've received from Nursing students/aspiring nursing students and wanted to share one of my main reasons for blogging. I love teaching new nurses (and have been a mentor for multitudes) but never realized by sharing my experiences, it would encourage others as it has. I hope you enjoy reading these as much as I do. And thank you to all the up and coming nurses who I know will make such a difference in other's lives!

I'm currently a nursing student going into my 2nd semester in the fall and I just read your blog from beginning to end. I've laughed and cried and am more inspired to become a trauma nurse by reading your blog. You are a great blogger and a great nurse. Thank you so much for all that you do!!!

KB

I am 25 years old and work as an accountant. It is not a fulfilling job for and I am not satisified either personally or professionally. I have wanted to be a nurse since I used to spend many hours in the hospital visiting a sick grandparent. I was always inspired by the care and knowledge those nurses had. I have recently been thinking of taking a leap into the field of nursing. Your story is inspiring and I hope that if I choose to pursue nursing, I will be as passionate about it as you are. Thank you!
# posted by Anonymous Jennifer : 1:44 PM

I love reading your blogs, so please keep posting. I'm getting ready to begin Nursing 203 and I'm sure when the stress level elevates, I'll need a laugh or two. Cassandra

I love reading all your blogs!! Because of you, I plan on pursuing a career as a trauma nurse after graduation in June. I have always been interested in the medical field but reading your blogs has made it much more clear on how bad I really want to be a RN. I know it's a lot of work and that with being a nurse, you face ups and downs but to be able to help anyone or impact their life in some way, is the real reason why I want to become a nurse. If you could give me any advice at all, it would be greatly appreciated. Thanks again for the great blogs! =) -Brittany

I am a senior in High School and I just finished our senior project involving the career we want to persue after high school.. and I an VERY interested in Nursing. I just wanted to let you know how much you have inspired me even more to persue this career. Iv'e always been pretty interested in trauma, but ever since I read some of your stories of your experiences, it really made me realise how much I want to make a difference in society just like you. I just wanted to thank you for making a difference... I hope I can become like you someday.
# posted by Anonymous sara : 4:41 PM

I'm now 28 and am going back to school...hoping to get into a nursing program this fall to get my ADN. It's my dream job to be a trauma nurse. I randomly pop by your site and read your entries. I love your posts...and, hopefully, one day I can be like you. :)
# posted by Blogger Jennie : 12:17 AM

That is really beautiful and I am keeping it with me under my name badge so I remember when the day has been too long. I am so glad I found your blog. I will finish nursing school next May and I am excited and terrified all at the same time. I work really hard to learn as much as I can squeeze in my brain, because I love patients and want to be the best I can be for them. I am 32 with 2 kids and a husband.... so I relate. Trauma is where I think I belong and your posts make me smile and cry and give me confidence! So thanks!
# posted by Anonymous Andie from Nebraska : 4:48 PM

Thank you for responding to my comment. You are absolutely right to say that I went into nursing for the right reason. I had wanted to become a nurse for a very long time. While in nursing school I got very sick and was diagnosed with Stage IV Melanoma with mets to the brain, not long after lost my grandfather to cancer, then found out my grandmother had breast cancer. All of this only made me stronger and made me want to continue on the path of nursing and be as great as the nurses that cared for myself and my family. I will NEVER forget how wonderful those nurses were. I know how stressful and scary it can be to be in the hospital, and I want to be able to make the patients as comfortable as possible.
Your writing has been an inspiration to me and I hope you continue to write and inspire me as well as others. Thank you so much for taking the time to write! If you ever have plans to visit Florida we'll have to meet!
Sincerely,
Christina

I am a 29 year old mother of five. I came across your page while doing research for an essay in my english class. It is about the carreer that we have chosen. I have a passion for emergency nursing. While reading your page and your stories i am even more motivated to persue my dream in hope that I too one day can as many life changing expererences as you do. You have inspired me....thank you
diana

This is such a great message. There were many nights where my parents thought I was somewhere I wasn't. I was always the "good girl," got straight A's, etc. They never thought I'd sneak out or go to parties. Looking back, there are SO many horrible things that could have happened to me. I simply thank God for His protection. It's so true though...KNOW WHERE YOUR KIDS ARE...even if you don't think they're the "type" that would be doing *something.*

My names maria and im 16years old.Well ive read alot of your post and the little about me section that you put. && thats EXATLY what i want to be. (Trauma/ER/ICU) && i was just wondering if you can answer some questions and stuff lol. If you have like a facebook or anything that would be great. Please get back to me as soon as possible. Thank your for your time :) -Maria

Hey Cory, My name is Madalina, and I have been reading all your postings , i wish u to post more often because your stories are great and you r really a winner by everything you r doing , I hope one day I can speak out just like you ,i am preparing to become a trauma nurse .... english is my second language so please excuse my misspells .
ps : hope u dont mind i post on this story of yours , but i just finish reading all of them
# posted by Anonymous madalina : 4:57 AM

I love to read through blogs like yours because it gives me a sense of what I am working so hard for in nursing school. After reading this post I have come to realize more than ever that nursing truly is the hardest and most rewarding career out there. I am so proud that one day I will be working with someone like you. Thanks for all the inspiration that you give to us struggling nursing students.
# posted by Blogger Christy : 9:34 AM

I'm so glad that I found your blog. I intend on reading every post. I have always been medically inclined, I'm 20 years old and my name is Talia. I want to be a Trauma Nurse. I've always wanted to work in the medical field. After all the years of watching every medical show under the sun and seeing in real life I know thats for me. Im not asking for a mentor but I can tell you now your blog is going to inspire me in ways unknown to you. If you do have words of wisdom or advice I ready with open eyes and a pen! - Talia

Sometimes You Gotta Relax

2010-07-10T23:33:00.003-05:00

There is no need to go to India or anywhere else to find peace. You will find that deep place of silence right in your room, your garden or even your bathtub.
-Elisabeth Kubler-ross

Sometimes we nurses just have to say "ok, enough" it's time to spoil myself. (Of course this trip hubby was the one spoiled. LOL)

Please Drive Safely

2010-05-06T21:19:00.002-05:00

PLEASE . . . drive safely.

The 411 on 911

2010-05-04T08:17:00.001-05:00

THE 411 ON 911
1. “Denial kills people. Yes, you could be having a heart attack or a stroke, even if you’re only 39 or in good shape or a vegetarian.” —Dennis Rowe, paramedic, Knoxville, Tennessee

2. “Don’t call us for a broken finger. If there’s no real emergency, you’ve just clogged up the system.” —Arthur Hsieh, paramedic, San Francisco

3. “Your emergency isn’t necessarily our emergency. In my region, we send an ambulance for all calls, but we don’t use the sirens unless it’s Code 1, which means someone’s bleeding or having chest pain or shortness of breath—basically things you could die from in the next five minutes.” —Connie Meyer, RN, paramedic, Olathe, Kansas

4. “Don’t hang up after you tell us what’s wrong. The operator may be trained to give you instructions in CPR and other medical procedures that could be lifesaving.” —Dennis Rowe, paramedic

AN AMBULANCE ISN’T A FANCY TAXI
5. “In a true emergency, we’re not going to drive 30 miles to the hospital that takes your insurance when there’s a good one two miles away. But if there are many ERs near you, know which one you prefer because we might ask. Find out where your doctor practices, where the nearest trauma center is, and which hospital has the best cardiac center.” —Connie Meyer, RN, paramedic

6. “In most cases, we can’t transport someone who doesn’t want to go. Uncle Eddie may be as sick as a dog, but if he says he doesn’t want to get in an ambulance, we need to respect his wishes.” —Arthur Hsieh, paramedic

7. “If the patient is stable, and 97 percent are, there’s no reason to drive 60 miles an hour on city streets. Have you ever tried to put an IV into someone’s arm in the back of a speeding ambulance?” —Don Lundy, paramedic

YES, WE KNOW YOU’RE WAITING … AND WAITING
8. “We hate it too! But don’t be angry at us. If you’re waiting, there’s one reason: We’re out of beds.” —Jeri Babb, RN, Des Moines, Iowa

9. “The busiest time starts around 6 p.m.; Mondays are the worst. We’re slowest from 3 a.m. to 9 a.m. If you have a choice, come early in the morning.” —Denise King, RN, Riverside, California

10. “People who are vomiting their guts out get a room more quickly. The admitting clerks don’t like vomit in the waiting area.” —Joan Somes, RN, St. Paul, Minnesota

11. “We like the rapid turnover, so we don’t want you stuck in the ER while you’re waiting to be admitted. If we wanted to care for the same patient for hours at a time, we would work on an in-patient ward.” —Denise King, RN

12. “Never tell an ER nurse, ‘All I have is this cut on my finger. Why can’t someone just look at it?’ That just shows you have no idea how the ER actually works.” —Dana Hawkins, RN, Tulsa, Oklahoma

13. “Don’t blame ER overcrowding on the uninsured. They account for 17 percent of visits. The underlying problem is hospital overcrowding in general.” —Leora Horwitz, MD, assistant professor, Yale University School of Medicine, New Haven, Connecticut

WE NEED YOU TO COOPERATE
14. “We don’t have time to read the background on every patient. So if you’re having stomach pain, and you’ve had your appendix or gallbladder removed, tell us so we don’t go on a wild-goose chase.” —Dana Hawkins, RN

15. “Be honest about whatever happened. Don’t be a hypochondriac, and don’t answer yes to every question. It will only screw up your care.” —Emergency medical technician, Middlebury, Vermont

16. “I once had a patient say he didn’t take any medications. Later he mentioned he was diabetic. I looked at him and asked, ‘Do you take insulin?’ He said yes. Well, that’s medicine.” —Allen Roberts, MD

17. “If you haven’t had your child immunized, admit it. That’s important information for us to have.” —Marianne Gausche-Hill, MD, emergency physician, Torrance, California

18. “Some ERs don’t allow more than one visitor per patient for a reason: You get in our way. Nominate someone to be in the ER and have that person relay information to everyone else in the waiting room.” —Donna Mason, RN, ER consultant, Nashville, Tennessee

19. “Tell us about any herbal treatments you’re taking. I treated a young man who had put aseptil rojo on some abrasions. It turned his urine red—but we didn’t find the cause until after we’d done a lengthy workup.” —Marianne Gausche-Hill, MD

20. “It’s not uncommon that I get a patient who refuses to have the tests I recommend. I had a volatile conversation with a family who didn’t believe in medicine. What did you expect in the ER?” —Joan Shook, MD, emergency physician, Houston, Texas

WE DON’T BELIEVE YOU
21. “Never, ever lie to your ER nurse. Their BS detectors are excellent, and you lose all credibility when you lie.” —Allen Roberts, MD

22. “Some of us are pretty good at spotting people who come in to score pain medication—especially if you’re specific about the drug you want or you don’t look like you’re in that much pain but you drove an hour from your home to get there.” —Denise King, RN

23. “We hear all kinds of weird stuff. I had a woman who came in at 3 a.m. and said she’d passed out while she was asleep.” —Emergency physician, suburban Northeast

WE PLAY FAVORITES
24. “Get rid of your entitlement mentality. It’s bad in your general life but really bad in the ER. We’ll treat you, but we might not be nice.” —Allen Roberts, MD

25. “Your complaints about your prior doctor will not endear you to us. The more you say, the less we want to deal with you.” —Allen Roberts, MD

26. “If you come in with a bizarre or disgusting symptom, we’re going to talk about you. We won’t talk about you to people outside the ER, but doctors and nurses need to vent, just like everyone else.” —Emergency physician, suburban Northeast

WE CAN ONLY DO SO MUCH
27. “If you come into the ER with a virus, don’t get mad if we can’t tell you exactly what it is. If we’ve ruled out any serious problems, you’re going to have to follow up with your primary care doctor.” —Jeri Babb, RN

28. “We really don’t have anything to offer the person who comes to the ER with cold symptoms that have lasted a day or two. It’s a waste of everyone’s time.” —Emergency physician, suburban Northeast

29. “It’s common to see families who have overmedicated their kids with asthma medication. You can’t just give your children two or three times as much as they’ve been prescribed.” —Joan Shook, MD

30. “Because so many hospitals are overwhelmed, we may not be able to unload the ambulance as soon as we get there. We’ll stay with you until we can hand you off to the nurses. We do the best we can with a bad situation.” —Connie Meyer, RN, paramedic

31. “No, I don’t know what your insurance covers.” —Allen Roberts, MD

SPEAK UP, PLEASE
32. “If your doctor sends you to the ER so you can be admitted to the hospital, ask him to send the orders to the hospital instead. It’s more paperwork for him but could be quicker for you. And it doesn’t jam up the ER with nonemergency patients.” —Denise King, RN

33. “Some patients withhold information they’ve already received from their primary care physician just to see if we come up with the same diagnosis or treatment. Don’t. All you’re doing is slowing us down.” —Joan Shook, MD

SAY THANK YOU
34. “Some people have no clue how close they came to dying before being saved by emergency interventions. I’ve seen serious stroke, heart attack, and trauma patients lead normal lives after events that should have killed them. If only they knew.” —Ramon Johnson, MD, emergency physician, Mission Viejo, California

35. “ER staffs are pretty good at zebra hunting—recognizing an unusual diagnosis—because we’re looking at your symptoms with fresh eyes. We’ve diagnosed cancer and brain tumors in the ER.” —Joan Somes, RN

ER VITALS
• Average cost of an ER visit: $707
• Number of visits to U.S. emergency rooms in 2007: 117 million
• Increase in the number of ER visits from 1996 to 2006: 32%
• Average time spent in the ER: 2 hours, 40 minutes
• Number of ambulances per year that are diverted to a different hospital due to lack of staff and space: 500,000

IN CASE OF EMERGENCY
• Bring someone with you, or have someone meet you there.
• Check the heart attack and pneumonia success rates of the ERs near you at hospitalcompare.hhs.gov.
• Make a list and carry with you at all times: your doctors’ names and phone numbers, medications you take, food and drug allergies, a short medical history, phone number of a relative or friend to call in an emergency (find a form online at medIDs.com).
• Enter your emergency contact into your cell phone too.
• Make sure your house number is clearly visible from the street. The faster EMTs can find you, the faster they can help you.
—Becky Batcha

14 REASONS TO GET TO THE ER
• Loss of consciousness
• Chest or severe abdominal pain
• Sudden weakness or numbness in face, arm, or leg
• Sudden changes in vision
• Difficulty speaking
• Severe shortness of breath
• Bleeding that doesn’t stop after ten minutes of direct pressure
• Any sudden, severe pain
• Major injury, such as a head trauma
• Unexplained confusion or disorientation
• Severe or persistent vomiting or diarrhea
• Coughing or vomiting blood
• A severe or worsening reaction to an insect bite, food, or medication
• Suicidal feelings

HELP YOURSELF: LEARN FIRST AID “Something as simple as knowing how to apply pressure to stop or slow bleeding can save a life,” says Marni Bonnin, MD, an ER doctor in Birmingham, Alabama. To keep handy: the American College of Emergency Physicians’ newly updated First Aid Manual ($14.95; acep.org).

1. “People call 911 for the wrong things all the time. They wait too long to call—or don’t call at all—when they’re having a heart attack or stroke and we could actually save their lives. But they don’t hesitate to call for non-life-threatening things. I once had a guy call who turned out to have a hangnail.”
-Connie Meyer, RN, paramedic, Olathe, Kansas

2. “Even though we go on 20 calls a day, we try to remind ourselves that calling 911 may be a sentinel event in your life. We’re not Dr. Phil, but we do try to be reassuring.”
-Anthony Kastros, fire department battalion chief, Sacramento, California

3. “The 911 system was designed to help people in an emergency—not as a social agency or friend.”
-Don Lundy, paramedic, Charleston County, South Carolina

4. “I’m amazed at how many parents are reluctant to administer any first aid. If your child has a cut, apply pressure.”
-Joan Shook, MD, emergency physician, Houston, Texas

5. “Just because you told the triage nurse your problem doesn’t mean the doctor in the ER knows why you’re there. Be prepared to tell your story several times.”
-Linda Lawrence, MD, emergency physician, San Antonio, Texas

6. “I’ve had patients come in and say, ‘I haven’t been breathing well since yesterday.’ I’m thinking, ‘Oh my God, really? Why didn’t you come in sooner?”
-Marianne Gausche-Hill, MD, emergency physician, Torrance, California

7. “If three of your relatives are with you, only one of them needs to tell the story of your illness. I realize it’s validating for everyone to tell their version of events, but I’m not here to validate you.”
-Allen Roberts, MD, emergency physician, Fort Worth, Texas

8. “A classic way a doctor-patient interaction can get off on the wrong foot is if a patient comes to the ER to get antibiotics. Most infections are viral, so they don’t respond to antibiotics. If we say you don’t need them, don’t argue.”
-David Newman, MD, director of clinical research, Department of Emergency Medicine, St. Luke’s-Roosevelt Hospital, New York City

9. We had an injured woman in our ER who said indignantly, ‘Do you know who I work for?’ In unison, all six of us who were treating her said, ‘No, and we don’t care.’”
-Allen Roberts, MD

10. “People are all up in arms about universal healthcare. Well, guess what: Those of us working in the trenches have been providing universal healthcare for years.”
-Arthur Hsieh, paramedic, San Francisco

Nurse at the walk in clinic - you're an idiot

2010-01-30T18:05:00.009-06:00

To The Nurse At The Walk In Clinic:

"You're an idiot and give nurses a bad name!"

My daughter had a sore throat for several weeks and it appeared to be strep from the white craters all over her tonsils and in her throat.
I suggested she go into the local walk in urgent care center. So, everything after this is what she relayed to me after her visit: (Keep in mind my daughter has grown up in and around hospitals.)

After the typical long wait my daughter was taken back to an exam room. Her vital sign were taken and the nurse left the room. A few minutes later the doctor came in and examined her by using his otoscope in each ear and then putting it in her mouth. Then he left.

A few minutes later the nurse came back in the exam room with gloves already on. The exam room has a door. So, I'm assuming unless he has very talented thighs, the gloves touched the doorknob. The nurse then stuck a long handled q-tip into the back of her throat (not swabbing, I asked) made her gag and left the room, still wearing the same gloves and holding the swab out in front of him like it was a torch leading his way. Yep, you guessed it, a few minutes later, the nurse came back in the room wearing gloves. The same gloves? Who knows. He then took them off as he had to rifle through the drawer to find the glucose monitor and strips. So now, WITHOUT GLOVES and WITHOUT ALCOHOL, he proceeded to stick her finger to check her blood sugar. Even my daughter knew that was wrong. He didn't give her a cotton swab or a bandaid so she proceeded to drip blood everywhere. Finally he decided to get her a bandaid. Her sugar was ok so the physician came in, told her she didn't have strep and prescribed her cough syrup with hydrocodone and left.

What is healthcare coming to? My biggest disappointment is that my daughter didn't say anything. All I can say is the nurse at the walk in clinic needs to thank God that I wasn't with my daughter!!!!

Left For Dead. . . . by a Nurse!!!

2010-01-30T17:46:00.005-06:00

Left for dead . . . . . by a Nurse!

The first line of the American Nurses Association Code of Ethics begins. . .
"The nurse provides services with respect for human dignity"

The last line of marriage vows is "until death do us part"

One night when I went in to work I got report on one of my patients who was a quadriplegic. He was malnourished and wasting away. His electrolytes were jacked up and he had a severed spinal cord. Apparently he wanted to die. Not saying anything derogatory about anyone, but that is the report I got. Oh yeah, and "Jim" was 29 years old, married, and had two little girls.

Jim was angry, bitter and rude when I went in to assess him. I normally have an easy time bonding with my patients but it was not happening with Jim. He didn't want me or anyone in his room. He refused to be turned, refused his medication, had refused food and wanted to be left alone. I didn't understand.

I was thinking that Jim must be in a lot of pain, not just emotional, but physical. I looked at his MAR and noted that he had nothing ordered for pain. Knowing about phantom pain, I woke the Dr and asked if I could have an order for some PRN pain meds for this member. The Dr balked at this and I pleaded for him to just order it times 3 q 4-6 hours. He agreed.

I went into Jim's room and he immediately told me to get out. I asked him to just listen to me for a minute. I told him that I didn't know what he had been through but I knew he had to be in some serious pain. I then went on to tell him that I bet his pain was a burning pain in his groin and in his legs. He started to listen. I explained phantom pain and that it is a very real pain. I said that I had no idea what he had been through but I knew he was angry at the world and I understood. He told me that I could never understand. I offered him the pain medication as a peace offering and he accepted it by not saying no. I told him I had to reassess his pain in 30 minutes so I would just wait. He got quiet again but agreed. A few minutes later Jim started to talk to me. (Narcotics are wonderful assistants at appropriate times.)

Jim had a wife, who was a nurse and two beautiful little girls who he loved with all of his heart. His wife had been talking about a divorce for awhile and that was the last thing he wanted. He didn't want his family broken up. He then told me the most horrific thing I've ever heard. A week before, he had been shot in the back of the neck (C-2) and left for dead. . . . by his wife!!! Who is a Nurse!!! Or was, rather. I'm sure by now she has had her license, revoked (at the very least) and is spending time in the big house!

I sat there and didn't know what to say. I didn't think I could find the words to even express the way I felt, much less even think that I knew the way he felt. All I could mutter was "I'm so sorry." He continued with his story. His parents who lived 200 miles away kept calling his house and all he could do was lay there and listen to the phone ring and pray. When his parents who he spoke to daily couldn't get ahold of him or his wife they grew concerned and drove the 200 miles to his house. Looking in the window, they saw him, broke into his house and called an ambulance. He had been told by the doctors that he was very lucky that his respiratory drive hadn't been shut down as his C-spine injury was very high. Jim stated that he didn't feel lucky at all. We continued to talk and before long I realized that I'd been in his room for over an hour. I had to go check my other patients. Before leaving, I asked him if I could please turn him and he said no. I made a deal, pain medicine before turning. He agreed. I told him I would be leaving in a couple of hours and would be back that night. He asked if I would be his nurse again. At that moment, that meant more to me than helping to save a life!

2010-01-30T15:46:00.004-06:00

Hey Girl, You Forgot Your Book at the Crash Site!

Warning: This is just a rant I have to get off my chest. Trauma story coming up next! (However this could have been a Trauma Story. Thank God it wasn't.)

A driver’s license does not gurantee intelligence, nor do traffic laws interrupt or prevent stupidity. Bad drivers are bad drivers. Several weeks ago (2 weeks before Christmas) my son and my husband were following me to an important meeting when all of a sudden a girl, probably about 23 years old driving a Ford Taurus hit them because she misjudged the timing and apparently the space between vehicles. My husband was driving our Dodge Durango and to give you an idea of the impact, after spinning 180 degrees and stopping, there was no doubt our Durango was totaled. The rear drive shaft was knocked off and was dragging on the ground! It was unable to be moved until the tow truck got there. The girls in the Ford jumped up over the curb onto the lawn of a business where they sat. At least nobody was hurt. My son and my husband were sore but ok. Thank God.
The girl/girls didn’t apologize albeit they didn’t speak very much English, but if you cause someone that much distress and potential harm, I would think that you could at the very least say you're sorry.
Anyway, this led to hassle upon hassle with rental cars, insurance claims, car payoffs and the search for a new vehicle for my husband. What a way to spend the holidays. We finally found one on New Year’s Day. This is his new toy. Niiiiiice.

Anyway, to those of you that are bad drivers, here's a book you may want to trade the one above for:

Breast Cancer Awareness

2009-12-05T14:22:00.003-06:00

Breast Cancer Awareness - Pink Glove Boogie

Providence St. Vincent Medical Center in Portland, Oregon put this video together to
raise breast cancer awareness and it's so cool that they included everyone in it! Had to share it! Love the janitor at the end! (His mother actually died of breast cancer.)

Blog for Brit (to make her smile)

2009-12-04T21:52:00.000-06:00

Blog for Brit (to make her smile)

Ok, before, during and after working in Trauma, I worked in various emergency rooms. In general, working in the ER especially at night can be heinous. Part of our job as ER nurses is to make your unfortunate experience as pleasant as possible. We do try really hard to keep things moving as fast as possible in the ER but as you can imagine, the continual flood of mayhem and carnage makes this challenging. In addition to the pandemonium, we have the non-emergent emergencies such as the teenager with the socially crippling zit so I decided to share a few blurbs of some of the more memorable patients.

1) Lady calls the ambulance for flatulence. Yes, for flatulence. Ok, I’m not a doctor, but I feel safe in saying that she could have paid 2.79 for a box of bean-0 or Gas-X rather than the 895.00 that was charged for the ambulance. Because as you know, flatulence requires the ACLS wagon!

Now, we get to the ER and her diagnosis is . . . wait. . . ………. wait for it………..……hemorrhoids! YEP! So here we are with an additional bill for the ER visit that could have been taken care of with some Preparation-H!!

So, this evening probably cost around $2,000.00 and all it needed was some “O” “X” and “H”. Ka-Ching!!!!

2) Ok, this one was a walk in but apparently “pediculus humanus capitis” is an emergency. To the rest of the world, this is known as head lice.

People, keep in mind that you want the LEAST amount of exposure to others in a case like this. We all itched for the rest of the night. Funny how that happens.

3) An elderly man who cathed himself with a coffee straw because he “just couldn’t pee and it was starting to hurt.” Did the coffee straw NOT hurt you genius? And anyway….it would have at least taken a Sonic Route 66 sized straw! Geez!

4) This is a little more crass but true. A guy literally dumps his girl at the ER (slows at the doors and she gets out) with a “vibrating device” stuck in a “nether region”, and not the “normal nether region.” The girl went to x-ray and it kept on going, and she went to surgery and it kept on going and going. Guess she used Energizer. OOOP!

5) The sweet lady that comes in after fainting at her doctor’s office while having blood drawn.

So what is the first thing we do in the ER? Yep, draw blood. She passed out again. When she woke, she said “oh I always pass out when I have my blood drawn.” So why is it that you are in the ER again?

6) Ok, this one really got me. A female paraplegic patient comes in via ambulance. Of course I immediately feel compassion for someone in such a state. EKG leads placed on patient, vitals taken, foley in place r/t obvious incontinence, some 02 for a slightly below normal Sat. When the physician comes in to assess the patient and find out her reason for the ER visit she states: (I kid you not) “I want a cheeseburger.”

It has taken me a LONG time to see the humor in that one.

7) The guy who was seriously over utilizing the emergency room. A report showed that this patient had been going to 4 or 5 ERs in one day and always the same complaints, low back pain or abdominal pain. When questioned about this he stated “it’s not me.” I told him, of course it’s you. Your insurance card and identification are shown each time you go to the hospital. His reply? “My insurance card might be going to a lot of ER’s, but it’s not my body in the bed.”

And I'm just certain one day with all the radiation exposure from the 70 x-rays per week, this guy's bones will turn into a pile of dust.

8) And my final little blurb………I’d heard of this happening but was not prepared when it did. You ALREADY KNOW, don't ya! A very, very large woman came in complaining of chest pain. While quickly rushing to get her on the monitor, put a gown on her, start an IV and draw blood, we lay her back slightly and from Lord only knows where, out falls a remote.

Her response? Not “OMG I’m so embarrassed” but......“I’ve been looking for that!”

So to all my brothers and sisters who continue to do this day in and day out, sometimes thanklessly, you can look forward to being at the table with the biggest and best goodie bags in Heaven, I’m sure of it!

Saturday Serenity Picture

2009-11-07T23:04:00.001-06:00

My Saturday Serenity Picture

My Serenity Picture For Today

2009-10-20T22:06:00.004-05:00

MY SERENITY PICTURES For Today. . . .

Hopefully I will be in this beautiful country before too much longer!!!

Texting While Driving

2009-08-26T19:31:00.002-05:00

My Serenity Picture For Today

2009-08-25T22:52:00.005-05:00

My Serenity Picture For Today and Current Favorite Song

2009-08-14T20:32:00.003-05:00

KEEP BELIEVING IN YOURSELF

There may be days
when you get up in the morning
and things aren't the way
you had hoped they would be.
That's when you have to
tell yourself that things will get better.

There are times when people
disappoint you and let you down,
but those are the times
when you must remind yourself
to trust your own judgments and opinions,
and to keep your life focused on believing in yourself
and all that you are capable of.

There will be challenges to face
and changes to make in your life,
and it is up to you to accept them.
Constantly keep yourself headed
in the right directions for you.
It may not be easy at times,
but in those times of struggle

you will find a stronger sense of who you are,

and you will also see yourself
developing into the person
you have always wanted to be.

Life is a journey through time,

filled with many choices;
each of us will experience life
in our own special way.

So when the days come that are filled
with frustration and unexpected responsibilities,
remember to believe in yourself
and all you want your life to be,
because the challenges and changes
will only help you to find the dreams
that you know are meant to come true for you.

Serenity

2009-07-31T00:00:00.001-05:00

Serenity. . . .

LOYAL BLOG STALKERS

2009-07-22T22:23:00.001-05:00

DEAR LOYAL BLOG STALKERS

I will post more for your entertainment soon!

XOXOXO

Inspiration

2009-07-13T19:19:00.008-05:00

INSPIRATION: This made my day and I hope it does yours too.

The Starfish Story
Original Story by: Loren Eisley

One day a man was walking along the beach when he noticed
a boy picking something up and gently throwing it into the ocean.

Approaching the boy, he asked, “What are you doing?”

The youth replied, “Throwing starfish back into the ocean.
The surf is up and the tide is going out. If I don’t throw them back, they’ll die.” “Son,” the man said, “don’t you realize there are miles and miles of beach and hundreds of starfish? You can’t make a difference!”

After listening politely, the boy bent down, picked up another starfish,
and threw it back into the surf. Then, smiling at the man, he said…

“I made a difference for that one.”

Anniversary Roses

2009-07-07T18:30:00.001-05:00

Happy Anniversary To Me!

I got this beautiful arrangement sent to me at work! It's our 2nd Anniversary! What a guy!

African Thunderstorm

2009-07-02T20:41:00.006-05:00

African Thunderstorm
(No Instruments)

This is an amazing video!! Breathtaking!

What is a Trauma Nurse

2009-06-20T22:59:00.009-05:00

WHAT IS A TRAUMA NURSE?

A trauma nurse is a nurse who specializes in emergency care. Trauma nursing focuses on identifying serious problems in incoming trauma cases, and on stabilizing those patients so that they can receive further medical treatment. There are a number of arenas in which a trauma nurse can work, and employment prospects in this field are generally very good, as trauma nurses are constantly in demand around the world.

One of the most common places for a trauma nurse to work is in an emergency room, processing incoming patients. Trauma nurses can also work in critical care units, applying their specialized training to patients who may be prone to experiencing medical emergencies and various crises. A trauma nurse can also work for a transport company, keeping patients stable while they are moved by helicopter or bus to a new medical facility, and trauma nurses are also vital in battlefield medical care.

The key requirement for people in this field is the ability to work while under pressure. Trauma nurses may be able to cope with chaotic environments, stressful situations, and catastrophic trauma cases. They must often contend with cultural and language barriers, and they must be able to coordinate with doctors, other nurses, and healthcare professionals who work together as a team to provide patient care. Trauma nursing can also have long and unpredictable hours, and it tends to put a lot of strain on the body, with a lot of prolonged standing, heavy lifting, and other sources of physical stress.

To work as a trauma nurse, candidates usually get their nursing qualifications and try to focus on emergency care in their nursing training. Some trauma nurses pursue additional certification in trauma or emergency care so that they are more employable after graduation from nursing school. Many like to keep up their training with trade journals, periodic workshops, and memberships in professional organizations for trauma nurses.

Work in this field can be very emotionally stressful. A trauma nurse may need to cope with very seriously injured patients along with their family members, and the ability to triage patients and injuries is critical. For example, when a patient who comes in with a gory broken leg after a car accident, the more immediate concern might be the patient's airway, even if the leg looks awful. A good trauma nurse can overlook the superficial appearance of the patient, and focus on keeping vital signs strong and stable so that a doctor will be able to provide the additional care required by the patient. source

And Most important. . . . . . . . . . . . . . .

THESE CAN'T GROSS YOU OUT!!!!! Happy Nursing!

The world needs more nurses like this......

2009-06-20T22:40:00.002-05:00

The World Needs More Nurses Like This:

This is an e-mail I received from one of my readers who just graduated and is aspiring to be a Trauma Nurse. (posted with permission) I had to share it because it really touched me. NOT ONLY the last sentence, but the fact that THIS is the type of person who needs to be a nurse, who our society needs to be a nurse. There needs to be more compassionate, caring, and quick thinking nurses out there! Way to go Brittany! You will be an AWESOME Trauma Nurse.

I'm starting to get some stories as well =) I thought about you the other day (sorry if that sounds weird!!). I was saving people all day!! lol... it started off with my little brother who fell and landed on some sharp rocks... i never knew i could run that fast!! He was perfectly fine.. only one small bruise and some hurt feelings but besides that everything was in perfect condition. Then me and my mom were walking along the mini shopping center when a man just collapsed in front of us!! Once again, i never knew i could run sooooo fast! (lol) I was scared when i thought about working in trauma because i know that you have to think fast on your feet.. but now, im even more excited because in those situations, everything came so naturally... like instinct. The man was fine as well... just a little embarrassed. I will admit, i didn't do much at all but check to make sure he was ok and check for cuts of course =), but i walked away with the best feeling in the world. This career is absolutely for me and im so excited to graduate and get started on it. Thanks for making me realize what exactly i want to accomplish after high school. In my eyes, you are the BEST nurse in the world and i pray that i can be the best just like you! =)

-britt

Blog Stalkers

2009-06-18T17:20:00.005-05:00

Blog Stalkers………

Have you ever wondered what a blog stalker is? Well let me tell you:
A blog stalker aka: Blokker is someone who is so obsessed with someone and their life, he or she will sign on to that blog 2 & 3 times a day to see if there is anything new posted or if anyone they know has left a comment. (By the way stalkers, feel free to leave comments, you can leave them anonymously!)

Gradually, checking the blog daily begins to feel like a grind to the blokker. And when we don’t update as compulsively-obsessively-frequently as they are checking on us, they start to feel resentment. Update, dammit! (I can hear them now.)

Little do they know that they can be followed, and noted when they are on the blog, how long they are on the blog and which stories and comments they read. But even those that do know they are being monitored, just can’t help themselves. It’s like an addiction. I know you’re out there, I can hear you breathing……… =)

Here is a definition: Blog Stalkers: secretly reading someone’s blog with the express purpose of learning more about them without their knowledge; to stalk via blog
Most stalkers are believed to be under a great amount of stress and mentally unstable.
‘Stalker’ is such a harsh word and one not to be used lightly but in December of last year I realized that I had not one but two. And then of course one of them told a friend, and that friend told a friend, and so on and so on. It’s quite interesting to see how often they are signing on to read about me and my life. It’s kind of flattering actually. =)

There is a point where it can become dangerous. One of my stalkers has looked up my address, knows how much I paid for my house, keeps going back to look at my pictures on my blog, etc. She’s very interested in my life for some reason. Not quite sure why yet, or if I even care.

When we write in a public forum we are doing so with the hope that people will read us. The unfortunate side of this is that we have little control over the perceptions of others towards us and that from time to time people will disagree with us and even become agitated towards us. (ie All nurses are perverted and unprofessional – my favorite comment yet!) This is both one of blogging’s biggest strengths (ie the conversation, diversity and dialogue) but also one of it’s biggest weaknesses when it goes too far.

The nice thing about web stats though, is in case something does ever happen to you, your family or your property, you have proof of who was stalking you. I personally keep a log of all of mine. It amazes me to look at the number of hits from one place in particular. Pure obsession.

I work hard at presenting myself online as fairly easy going, polite and well mannered. This is partly because it’s my character and personality. I was brought up to always consider the feelings of others. Here’s a tip: Consider the costs of your actions and words both on yourself and others before you post.

WebStalkers

Traumatic Hair Cut

2009-06-09T21:51:00.001-05:00

How does this relate to Trauma? His first haircut by his parents was very traumatic!!! We had to take him to have it "fixed." LOL

More Trauma

2009-05-25T21:05:00.000-05:00

More Trauma........... coming soon!

2009-05-20T21:39:00.010-05:00

Dedicated to a very special friend: I hope you will always reach deep inside and grasp from the reserve that you have stored there. You are a strong person. You are a good person. Don't let anyone make you feel different CN!

Follow Your Dream

Before you look for things to change...
look deep inside your soul.
The Lord has given you all the clues...
always follow your dream.

Inviting trouble is so easy to do...
it happens without warning.
Avoiding problems is easier said than done...
always follow your dream.

Sometimes things just turn out bad...
and you don't know where to turn.
The answer is as close as your heart...
always follow your dream.

Hope has always been the key...
it's sometimes our only hope.
When things are darkest and looking bleak...
always follow your dream.

Only the Lord has all the answers...
and he shares them with only a few.
But faith is as close as we sometimes can get...
always follow your dream.

Perhaps you feel the end is near...
and you've done everything you can.
Never give up, anything can happen...
if you always follow your dream.

~Donald Hayes~

Ash Prom

2009-05-09T22:47:00.008-05:00

Our Beautiful Daughter - Prom 2009

2009-05-09T15:40:00.007-05:00

“Vanity Kills”

My reason for writing this article is for educational purposes. If it helps just one person seek help, then it will be worthwhile. I have an acquaintance who makes her family totally miserable and has never realized what a problem she has. I will give examples throughout and I will call her Anne.

Vanity: the excessive admiration of one's own appearance or achievements

Narcissism: an excessive or erotic interest in oneself and one’s physical appearance.

Selfishness: being concerned excessively or exclusively with oneself; seeking or concentrating on one’s own advantage, pleasure, or well-being without regard for others.

Self Centered: concerned solely with one’s own desires, needs or interests.

Today's society is full of people desperate for acknowledgment. What we wear, what we drive, how we look, how we act, how we practice religion; it goes on and on. These all feed the need for acknowledgment. Everyone wants to be noticed, and will do anything to make it happen. It's an "acknowledge me" society. Vanity plays a role in many of society's problems. But there are those who take it to the next level.

Anne tries to dress too young, wears WAY too much makeup, tries to act way too young which makes her look ridiculous and even takes anti-aging pills. I hate it for her when she realizes what those are actually doing to her. It's very sad to watch and to hear people talk about her.

In early Christian teachings, vanity was an example of pride, one of the seven deadly sins. Today, vanity kills.

Anne is someone who cannot and will not put anyone or anything before herself. Her family could be destitute and she would still be shopping on QVC, HSN, or MSN. I remember one time we all went camping and we sat waiting for her to “get ready." She emerged from the camper about an hour later with hair, make up and clothing all in place. We were camping for goodness sake!!! I mean come on!!! Some shorts, a baseball cap, ponytail, and brush your teeth!

A narcissist wants to control others and needs attention from admirers.

Anne loves to go out with her girlfriends and loves to have attention of men when they go out but will not allow her husband to talk to or have female friends. She also can spend as much money on clothing, makeup, vacations, and whatever else she wants to but if he were to try to spend any money on himself, that would be unacceptable. Starting to see the pattern? She spends more money on makeup per MONTH than the homeless shelter spends for food for their homeless. (this is not a joke….) At one point her husband lost his job and instead of buckling down to help the family who was struggling financially, she continued to shop, go out with girlfriends and even go on trips WITHOUT her family!

Not everyone who is Vain is a Narcissist, but someone with Narcissistic Personality Disorder (NPD) has at least 5 of these symptoms:

*requires excessive admiration
*lacks empathy: is unwilling to recognize the feelings and needs of others
*has a grandiose sense of self-importance
*is preoccupied with fantasies of unlimited success, power, beauty, or ideal love
*believes that he or she is "special" and unique
*has a sense of entitlement
* takes advantage of others
*is often envious of others or believes that others are envious of him or her
*shows arrogant behaviors or attitudes

Someone with Narcissistic Personality Disorder (NPD) will also exhibit:

*Jealousy and possessiveness
*Excessive need to feel special, adored, loved, appreciated, or admired
*Rage attacks when you do not sufficiently meet his/her needs
*Controlling behaviors (trying to control how you spend your time, who you talk to,
*Inflated self-esteem, or grandiosity (bragging, "fishing" for compliments)
*Dramatic, insecure behaviors
*Expecting you to take responsibility for making him/her feel better about him/herself
*Blaming you for behaviors ("YOU made me do this," or "YOU made me feel this way.")
*Not taking responsibility for angry behavior and justifying angry outbursts
*An attitude that demonstrates "you need to cater to my opinions, thoughts, and feelings."
*An unwillingness to reflect on his/her own behaviors 

A NPD on a rampage is dangerous, they are calculating and vengeful - any slight they feel they have suffered has to be punished. Think of how a spoiled child acts and you will understand NPD rage.

Anne at one point believed that her husband was having an affair with absolutely no proof whatsoever. Only suspicion on her part. (Is it true what they say? You blame others for what you’re doing) This was even after he had caught her in a compromising position with another man. She made threats against this woman’s life, called her family on multiple occasions, stalked the woman, all the while continuing to go out with her girlfriends and seeing another man on the side herself!!! Unbelievable!

-Narcissists are jealous of people who they think are more attractive or smarter
-Narcissists use sex to exploit, control and to receive attention

Knowledge is power, and once you understand why they do what they do - because they are sick - and then see how they do it, you will suddenly feel more powerful. Just don't think you can win by playing by their rules - they make up the rules to their games.

It’s easy to say, just walk away but many people can’t just walk away. Because of family responsibilities, children that are involved or whatever else. What you CAN do, is walk away mentally. Take care of YOURSELF! And don't allow yourself to be treated sub human.

And if you’re wondering if this article is about you, then it probably is. Get some help.

National Institute of Mental Health's Hotline (888) 826-9438

2009-05-09T12:54:00.002-05:00

CONGRATULATIONS BRITTANY!!!!!

I knew you could do it!!!!!
Now....how long before you become a Trauma nurse?

2009-05-09T12:47:00.003-05:00

Coming Soon: VANITY KILLS
Not Trauma Related unless of course your narcissistic self flies into a rage and kills someone, then I suppose it could be considered Trauma. =D

IDIOTS

2009-05-09T12:24:00.007-05:00

I couldn't help but repost this. It's too good not to share!!!!!

Summary: In case you haven't noticed, the world is full of idiots. Here are some ideas on how to deal with them.

IDIOTS

Albert J. Bernstein, Ph.D.

The world is full of idiots. Of course, you don't need me to tell you that. Look around. They're everywhere--in the next cubicle at work, on the highways as you drive home, and probably hiding out in your own house as well. Just think how easy your life would be if the people around you would just use their heads for once and do what they're supposed to do.
Dream on. While you're at it you might want to think about what you'll do when you win the lottery.
The rest of us have an existential question to ponder. How do we do our jobs and live our lives in a world where most of the people are idiots who cant be counted on to do what they should? Your answer to this question will, in large part, determine how effective you are in your job and how happy you are in your life. Here are some options to consider:

Get mad -- The idiots certainly deserve it. If it weren't for (put the name of your favorite idiot here) your life would be so much easier and more productive. Of course if it weren't for gravity, you could fly, too.
Get even -- The advantage of this strategy is its utter simplicity. You don't have to be very smart to use it, in fact, chimpanzees are quite capable of grasping the concept. What they miss is the law of physics that states “For every action there is an equal and opposite reaction”’ The psychology can be stated in this simple equation: Get mad, get even, get retaliation.
Help the poor fools by explaining what they're doing wrong -- This is how people get even without admitting it to themselves. Some may actually believe they are doing a kindness by showing people the error of their ways. There is a special place in the afterlife reserved for the holier than thou, and it's a lot warmer than they expect.
Nag -- People may change in response to nagging, but they seldom change in the way you want. Keep trying; you may be able to convince yourself that you've done everything you can, but since the fools just wont listen, whatever happens to them is their own damn fault.
Go on Oprah and talk about your favorite idiot -- You can also call in and tell Rush; I'm sure they'll be interested. Other people who cant do anything may sympathize as well. Remember, the more you repeat the story, the better it gets.
don't say anything to the idiots themselves but think about them all the time -- This is the way people create stress related physical symptoms for themselves. The idiots around you wont listen, but maybe your doctor will.
Give up because you cant do anything anyway -- Depression strikes someone every ten seconds. The minute you give up, the next victim could be you.
Learn how to share the planet with the competency-challenged --You are never going to make idiots into smart, responsible people like you. The best you can hope for is to keep control of your own life and not give it to them by letting their problems push your buttons.
Can you imagine how miserable life would be if every idiot had the power to make you miserable?

Happy Nurses Week

2009-05-06T23:59:00.000-05:00

Happy Nurses DAY!!!!!!

My little thought for the day......

2009-04-18T01:03:00.004-05:00

My little thought for the day…….

While talking to a very special friend of mine today, he told me something that really touched my heart. He said “you always know just the right things to say.” I thought about that long and hard this evening and I’ve come to the conclusion that I don’t always know what to say although I would like to think I do. =) I realized that the reason it appears to him that I always have the right things to say is because I listen to what he has to say and I then respond to what he has said.

So often we take for granted friends and loved ones talking to us and don’t really “hear” what they have to say. We may listen, but not actually hear them. There IS a difference. Let’s remember that each time we talk to them could very well be the last time we’ll ever get to talk to them, and then let's really hear what they have to say! And then REALLY share with them what we think and feel. It’s a good feeling to make someone else feel good with words. A very good feeling.

"HEAR" Don't just Listen

What is METH??

2009-04-18T00:02:00.009-05:00

WHO DOES METH HURT??

WHAT DOES METH DO??

THE FACES OF METH

DID YOU KNOW...

- 1 out of every 10 people in North Georgia uses meth.
- 50% first-time meth users will become instantly addicted.
- 90% second-time meth users will become instantly addicted.
- 75-80% of Fannin-Copper Basin law and court cases involve meth.*
- 78% of Fannin-Copper Basin DFCS cases involve meth.*
- Reported meth user age range is now between 9 and 76 years old.
- Some Fannin-Copper Basin babies are being born addicted to meth.
- Every pound of meth "cooked" = 5-6 pounds of toxic waste.
- It costs $5,000 - $150,000 of your tax dollars to clean up a meth lab.
- Chemicals from dump sites contaminate water supplies, kill livestock, destroy national forest lands, and render areas uninhabitable.
- When given the choice between going to drug court and keeping their children, or going to jail and losing them, METH ADDICTS ARE CHOOSING JAIL.
- Fannin County is #1 of all Georgia counties for having the highest number of children removed from their homes and placed in foster care, group homes, or adoption BECAUSE OF METH.*
- 38% (21 children) of Fannin County's children who have been taken from their homes have had to be placed in OTHER county group homes because we don't have enough foster or adoptive parents in Fannin to care for these children.*
- 174 meth labs seized in Georgia in 2004
- Georgia meth arrests increased 132% from 2001-2005
- Georgia meth prison admissions increased 96% from 2001-2005
- More than 12.3 Million Americans age 12 and older have tried meth at least once

*Statistics fluctuate week-to-week.
**Statistics from the Georgia Statistical Analysis Center/Agency of Criminal Justice Coordinating Council

LEARN MORE ABOUT METH

WHAT IS METH?

Methamphetamine is a synthetic (manufactured as opposed to being produced naturally) drug that can be "cooked" in home labs or easily purchased. Meth is made out of ingredients such as:

Iodine

Battery acid

Coleman fuel

Red Devil Lye

Hydrochloric acid

Anhydrous ammonia

Toluene (sulphuric acid)

Muriatic acid (brick cleaner)

Drain cleaner (sulphuric acid)

Acetone (fingernail polish remover)

Red phosphorus (match strike pads)

Methamphetamine is an extremely addictive drug that causes significant brain damage. Meth is much more toxic to brain cells than cocaine. It is a potent central nervous system stimulant. Meth use kills brain cells and they never regenerate.

Meth can be smoked, snorted, injected, or taken orally, however, the most frequent method of use is smoking. In addition to being addicted to methamphetamine, users who inject the drug become even more addicted to the needles they use. In large doses, unlike cocaine, meth metabolizes slowly in the body. Up to three days (72 hours) are required to eliminate a single dose.

The "high" it produces is the result of a surge of a chemical called dopamine in the brain. Dopamine is a neurotransmitter, the chemical that communicates a message from one brain cell to another. A normal brain creates 16 units of dopamine. A meth-user's brain creates 10 times that normal dose. The meth "high" can last for days, causing extreme mood swings, decreased or no appetite, anxiety, paranoia, aggression, incessant talking, jerky or hyper movements, irritability, extreme nervousness, hypothermia, and convulsions.

This is what meth does to a person. You age. You have scabs and scars from
digging at the imaginary bugs on your skin. Your teeth decay and fall out. You
like the hell you're living in.

WHAT DOES IT DO?

Meth causes accelerated heart-rate, elevated blood pressure, and can cause irreversible damage to blood vessels in the brain. Meth residue leaves actual pieces of glass in the brain that cause tearing and leave holes in the brain. It also causes respiratory disorders, dizziness, tooth grinding, impaired speech, dry and itchy skin, acne, skin sores (also known as "crank bugs"), numbness, and sweating.

Meth takes away the central brain's ability to control other parts of the brain that used to be connected to it. That means that a meth user no longer has control over their moods and emotions. The ability to feel joy is no longer there. You have personality changes, you are paranoid, you are irritable and grouchy. You can't eat or sleep. You have panic attacks that go on for days. Cravings control your life. You have twitches and tremors and muscle spasms that in some documented cases, NEVER GO AWAY.

And when the "high" wears off and you begin to "crash", it is intensely painful and lasts a lot longer than the high. The only thing that relieves the anguish of the crash is another high.

WHAT DOES IT LOOK LIKE?

Because of various production methods, varying degrees of skill of the lab operator, and different chemicals used to manufacture meth, the finished product varies in color and texture. Pure methamphetamine is most commonly a shade of tan or white. Crystal meth, most commonly called glass or ice because of its appearance, is a colorless, odorless, large-crystal form of d-methamphetamine. Ice is most often produced by slowly re-crystallizing powder meth from a solvent such as methanol, ethanol, isopropanol, or acetone. Ice typically is smoked, using tin foil, empty soda bottles, or light bulbs which are heated to produce the smoke that is inhaled from the crystals.

HOW MUCH DOES IT COST?

Meth is sold in "baggies", "eightballs", and "teeners". Reports also indicate that young girls and women are trading their bodies for meth.
"Baggie" 1/4 gram $20-$25

2 gram $40-$50

1 gram

$50-$80
"Teener" 1/16 oz. $80-$100
"Eightball" 1/8 oz. $225-$350

2 oz. $500-600

METH STREET SLANG

Methamphetamine:

ICE, GLASS, CRYSTAL, speed, lith,crank, chalk, meth, fire, batu, crypto, quartz, trash, wash, spackle

Cook, chef, or chemist :

a person who manufactures meth

Craters :

the skin sores on meth users

The "High":

tweeked, wired, cranked, fried, lit, ripped, speeding

Usage :

slamming (injecting)

hot railing (inhaling heated meth from a glass table)

Tools for injecting meth :

syringes, spoons, lighters, bandanas, belts or surgical tubing used to constrict the vein

Tools for smoking meth :

mini torch lighters, ink pen casing, glass pipes, pop cans, light bulbs, mini glass vases, rolled up dollar bills, pipes, pieces of glass/mirrors

WHO USES METH?

Doctors, lawyers, grandmas, middle-school kids, soccer moms, truck drivers, college students, cashiers, grandpas, homecoming queens, business dads, football players, church members, straight-A high school students,...shy, outgoing, rich, poor, successful, down-and-out, white, black, yellow, red...Meth doesn't care who you are, where you live, how old or young, who your parents are, who or what you know. If you're rich, you'll just buy more dope. If you're poor, you'll steal to buy that next hit. Meth users have one thing in common: they're all people who are hurting, for one reason or another, and are looking for something to make the pain go away.

source

**************************************************************************

For families dealing with a loved one addicted to meth, please visit Prisoners of Meth. You'll find information about the book "Prisoners of Meth" by Jesse Hambrick, of the Douglas County, GA sheriff's office. Jesse is one of the country's leading authorities on the use and production of meth, and has worked with countless community leaders to stop the spread of meth.

**************************************************************************

March For Babies

2009-04-09T21:02:00.006-05:00

One Day All Babies Will Be Born Healthy.............

I am very grateful for my very precious and healthy grandson and I am not too proud to ask for sponsors to help me raise money for this very worthy cause. If you are interested in walking or donating, my personal March for Babies website is:
http://www.marchforbabies.org/CoryTraumaRN

Love to My Readers

2009-04-05T23:09:00.003-05:00

LOVE TO MY READERS

Thanks for all the great comments! Keep reading and leaving those great comments. Those are inspiration for keeping me sharing my stories!!!

I love you all!

2009-04-01T22:11:00.004-05:00

Homeless Thomas

If there ever was a trauma patient that touched my life, it was a homeless man named Thomas. I was working step down one day and when I came in to get report, I noticed my first patient kicking, screaming, writhing on the bed, looking like a trapped, wild animal.

"What's up with that" I asked the nurse giving me report? "His haldol has worn off. He's due for more" she said. The night shift nurse offered to "pop" him one more time before she left but I wanted to get a good neuro assessment before putting him back out. "If that was even possible" I thought to myself with a sigh.

I started with my "easier patient" who was on a ventilator and on sedation so I could get a quick assessment and chart it later as there was no telling how long I would be in with "jumping, screaming, kicking, frustrating, test-me-to-my-limits Thomas." Ok, so I've prejudged him. How many of us do that? Yes, we all do at one time or another. Well, this is one time that it kicked me in my butt!

I proceeded to go ahead and draw up my IV Haldol before going in to the room. I seriously doubted I would be able to even get close enough to him to assess him without being strangled by my own stethoscope or kicked in the head or head butted for that matter. As I walked in Thomas noticed the syringe in my hand and he started yelling at me not to give it to him. He was yelling that we were all crazy and trying to kill him. (How often have we heard THAT?) From crazy patients of course. I assured him in my monotone voice that I was not there to kill him, only to calm him down and I wanted to help him. I really did too but I'd gotten a detailed report from the night nurse that he gave her nothing but problems when he was awake, that he was combative, dangerous, etc.

I made a deal with Thomas. If he stopped yelling and calling me crazy, I wouldn't give him the shot (yet!) He wanted me to untie his hands and his feet as well. Ummmm, yeah right! Like THAT is going to happen!!!! We talked for a little longer and I agreed that if he quit kicking and didn't yell anymore I would untie his feet but only if he didn't try to get out of bed. He had been hit by a car and had some pretty severe wounds we were doing frequent dressing changes on, not to mention him desaturating when he would exert himself.

So, after about an hour of sitting with Thomas and talking about the crazy medical staff that worked nights (his words, not mine) hehe, and getting his 02 sats up in the mid 90s, I agreed to take off one wrist restraint. He explained to me how he felt that he was treated like an animal because he was homeless. That made me feel about 2" tall.

I explained to him that I had meds to give to my other patient and that if he would work with me, we could get him totally out of bed, showered, and possibly up in a chair if he didn't act like the crazy man he was acting like when I came in that morning. (He chuckled at that) but agreed. At this time, I had one arm restrained at which any time he could have reached over and removed it with his other hand. But we had an agreement and we were showing one another mututal respect. Wow.

By the time I had spent 8 - 9 hours with my two patients (thank God my second one was on a vent) I had learned a lot. Thomas taught me that his feelings are just as important as mine. His need for respect is just as important as the President's. He falls in love too. He has family the he worries about too. He has pets that he loves just like I do. He taught me that just because someone lives on the street doesn't mean that they don't hurt inside. He taught me if I want to ever do something wonderful for a homeless person, give them a new pair of socks or a pair of gloves. I have never forgotten that.

Thomas kept a book with him that someone had given him sometime before. It is:

Before I left for home that evening, I went in to see him sitting up in his chair, freshly bathed and even with a new haircut (I would do that sometimes when I had the time which was rare.) Imagine the night nurse's SHOCK when SHE came in!!! ha/ha! (BTW..... the haldol had been d/c'd thank you very much.) (I know, night nurses hate day shift nurses like me!)

Anyway, He handed me his book that someone had given him. And on the inside cover he inscribed it. I was prepared to but I have chosen not to print the inscription here because for some reason, I feel it would take away from it's meaning. I don't know if that makes sense, but in rereading it right now, it is very personal and very special. The fact that he gave me his book, The Meaning of Life has changed the way I look at people, places and situations in my life.

Thank you Thomas.

Do you know where YOUR Kids Are??

2009-04-01T21:14:00.004-05:00

Do You Know Where YOUR Kids Are?

I was in charge on the night shift when I got the page from our resident in the E.R. We were getting a Level I Trauma: A 16 year old female that had been in a roll-over MVA, 1 of 3 passengers, 2 dead at the scene, also female, also 16 years old. It was 3:00 a.m. and I’m wondering “where are the parents” and what were these girls doing out this late?

As she rolls through the doors with CPR in progress and our team starts to work on her, I notice an officer accompanied the ER staff bringing her up. “Does she have any family with her” I asked? I was told that when the officer called the girls house a few minutes before, he was yelled at by the father and told he had the wrong phone number, then hung up on. An officer was on the way to the address that was on the girl’s identification but in the mean time I told him I would gladly call the house back.

When I called, I was wondering what exactly I would say to the father if he yelled at me for disturbing his sleep but the mother answered instead. I told her I was a trauma nurse calling from a Level I Trauma Center and that we had who we believed to be her daughter in very critical condition. She told me I was mistaken because her daughter was asleep upstairs. I then asked her if she could give me her daughter’s name as I got their phone number from some information from this patient’s belongings. She told me her name was Sophia Smith. I then asked if her birthdate was April the 8th 1989. She said yes and I heard her tell her husband to go upstairs to check on Sophia with a now shaking voice.

I explained that we had sent an officer over to their house to bring them to the hospital if in fact it was their daughter we had. At that time, over the phone I heard the doorbell ring and about the same time her husband must have found the bed empty upstairs because I heard crying and commotion on the other end with no response to my questions.

Sophia did not survive her injuries. Soon after when her parents arrived, we found out that Sophia as well as her other two friends had all snuck out of their houses.
I often wonder if that father ever asks himself if he’d gotten up with the first phone call if he would have seen his daughter alive one more time. I ask myself the same thing.
I might get chastised for this one but parents……KNOW WHERE YOUR KIDS ARE!!!!!

Blood, Guts, and Gore

2009-03-31T22:50:00.002-05:00

BLOOD, GUTS, AND GOOOOOOOOOOOOORE!

COMING SOON........ For all of you sick people, like me!

Gatlinburg, TN

2009-03-31T22:45:00.008-05:00

GATLINBURG, TN

(As close to Heaven as you can get.........)

I know, I know. The natives are getting restless. No more posts (after this one) until I post another trauma memory. I was just remembering some happy times I had in Gatlinburg and wanted to post some pictures.

If you've never been, it's a HAVE to place to go!! I haven't been in several months but I used to take my kids at least twice a year. It's an amazing place..... (even when rain is beating down on you......)

Knoxville Lake

2009-03-30T22:15:00.003-05:00

My Serenity Photo For Today

Knoxville, TN

New Work Uniform

2009-03-29T19:12:00.007-05:00

This is the kind of uniform I wear now! YEY! Will kind of miss the ol' scrubs!

Yes, for those of you that don't know, I've accepted a position of ER RN Case Manager. I started a week ago and it's been veeeeeeeeeeeeeery interesting. I've gotten to meet with some quite engaging and thought-provoking people already. More updates to come but no worries, I still have many, many, trauma stories that I've experienced that I have yet to put down from the diary in my mind!

Opryland Christmas

2009-03-29T18:26:00.027-05:00

For You!!! Christmas lights at Opryland Hotel and views of the hotel. It's beautiful.

Absolutely beautiful lights - and this doesn't even show the half of what they exhibit!

These are all taken inside the main area of the hotel!

These are all inside the hotel as well!

The trees are made out of individual poinsettias and stands 25ft tall. Featured in the NY Times.
In Nashville, Poinsettias, and Glitter

These pictures are also taken INSIDE the hotel. An incredible place to stay, or just visit! =)

Serenity

2009-03-29T13:59:00.004-05:00

My Picture of Serenity For Today.......

New Post Coming Soon

2009-03-27T22:38:00.001-05:00

New Post Coming Soon

Be Patient, keep the kind words and e-mails coming. (Thanks Britt, you're fab!)
I'll update soon. New job, hectic life. It goes without saying..................................

A Tribute to days gone by......

2009-03-24T22:50:00.019-05:00

A Tribute to days gone by......

You know who you are.......

And SO do YOU! (Bigley! Bigley!)

Days from the Rock:

And lest we not forget our favorite sales pitcher...........................

And this trio combo pack describes one female in general to a "T". Bless her heart.
=============================================================
Two more memories from "The Rock" We shall call them both..... "Spiritual"

=============================================================

And LAST but not LEAST......................those (one in particular) who was more than compassionate my first few days........

==========================================================

And along with the iiiiiiiiiiiiick......................... there are great memories with no explaination needed.......

8 Most Horrible Tumors

2009-03-19T14:12:00.017-05:00

Also taken from A Happy Hospitalist. Great blog. Go read. And be grateful today for what you have and DON'T have.

8 Most Horrible Tumors

Jose: the man with no face

Jose has one of the most extreme facial tumours ever seen in medical history. The 51-year-old, from Portugal, is in danger of being suffocated by it unless he undergoes drastic surgery. Unemployed, he is blind in one eye as a result of the giant weeping growth that has consumed his features; the tumour has taken over his mouth and tongue, ballooning his lips, twisting his gums and breaking his teeth off. The deep, 15cm long growth - which started as a birth mark when he was just 11 - was sparked by abnormalities in his capillaries and veins. It started to get much bigger when he hit 16 and has been expanding ever since. H e recently flew to the UK to discuss the possibility of surgery to remove part of the tumour. But because his mother was a Jehovah's Witness, he refused any surgery because his religion means he can't have blood transfusions. Doctors in London came up with a plan to remove parts of the growth bit by bit - without transfusion.

Huang Chuncai: 44 pound (20kg) tumor on his face

On 2008, a Chinese man named Huang Chuncai underwent surgery to remove a 20kg or 44 pound tumor on his face. The surgery was successful but due to the large size of the tumor, only a part of it was removed at that time. Just a few days ago, Huang Chuncai went into the operating room again to remove another part of that facial tumor. This time, it was a large 4.5kg (9.9lb) chunk of flesh from his face. The tumor was originally 23kg in total. This still leaves 17.5kg of facial tissue from this tumor on his face (1kg was removed in the first surgery and 4.5kg was removed in the second surgery). Huang Chuncai suffers from Neurofibromatosis, a rare genetic disorder that causes growth on nerve tissues.

Huang Liqian: 33 pound (15Kg) tumor on his neck

This man from China finally had a huge tumour removed on 2007, after discovering it 17 years ago. Huang Liqian, 58, first discovered a bizarre growth on the back of his neck in 1990, but chose to ignore it. However, as the years rolled on, it continued to increase in size at a rapid pace, with the growth ballooning to 15kg. Liqian was taken to the First Affiliated Hospital of Chongging University of Medical Services in southwest China's Chongging, where he had the tumour removed.

Chen Zongtao: 154 pound (70kg) tumor on his right leg

Victim Chen Zongtao, 29, lives in a remote Chinese village and hasn't been able to afford medical help. The growth first started on his left foot when he was two years old. But it soon spread across to his right leg and engulfed it. Over the years, it has ballooned in size to weigh more than 70KG or 154 pounds. Doctors at the hospital in Changsha, central China's Hunan province, have been probing the tumor. Zongtao is said to be suffering from neurofibroma - a usually-benign tumour originating in nerves. It is not yet clear if medical teams plan to take action on the growth.

Gao An-ni: tumor in her underlip

Gao An-ni, an 8-year-old girl from the rural countryside in An Yuan county in East China's Jiangxi Province, suffers from a tumor in her underlip. An-ni was born with a tumor in her underlip, and she couldn't receive timely treatment for the poverty. On 2007, her father took her to see doctors at the Hospital affiliated with Gannan Medical College. But when doctors there told him that the operation to cure the tumor and the following cosmetic surgery might cost a lot for the family, the father decided to bring back his daughter to their hometown.

Lai Ti Dao: 10 pound (4.5KG) tumor on her face

Vietnam's Lai Ti Dao suffered from a massive Schwannoma tumor, a benign growth that began with a small lump in her tongue but swelled over the years to a size roughly one-third her body weight. The tumor makes it difficult to eat, talk and even walk because its size throws the girl’s small frame off balance. The growth is now dangerously close to cutting off her airway. On 2008, a team of surgeons at the University of Miami had a marathon 10-hour procedure to cut away the growth, which weighted an estimated 10 pounds.

Phuon: another facial tumor, no luck

Phuong is a 27-year old who has a facial tumor that began to grow at age 7, and quickly took over his entire left face, enveloping his eye and ear, clearly keeping him from living a normal life. He has had three surgeries before, but the tumor grown back each time. Recently, no local doctors or international team visiting the area has offered to take his case, due to the risk involved with the blood loss and the need for careful post-op care. This case would be considered a difficult case and booked for a full day in the OR.

Chantal Sébire: Suffered from esthesioneuroblastoma, died through euthanasia

A retired French teacher, Chantal Sébire suffered from esthesioneuroblastoma, a rare form of cancer, and fought for the right to die through euthanasia. In 2000, she was diagnosed with esthesioneuroblastoma, a rare form of cancer of which only 200 cases have been reported in the past 20 years. Sébire refused any treatment at the time of her diagnosis, not wishing to take the risk of the surgery or medications. On March 19, 2008, she was found dead in her home. An autopsy conducted on March 21, 2008 concluded that she did not die of natural causes. Subsequent blood tests revealed a toxic concentration of the drug Pentobarbital, a barbiturate that is not available in French pharmacies but is used elsewhere in the world for the purpose of physician assisted suicide.

10 Worst Plastic Surgery Disasters

2009-03-19T13:53:00.021-05:00

10 Worst Plastic Surgery Disasters

I found these interesting, taken from a blog I read called A Happy Hospitalist.

Hang Mioku: injected cooking oil into her own face

Hang Mioku, a 48 year-old woman from South Korea, became so addicted to plastic surgery that she was left unrecognisable after her obsession led her to inject cooking oil into her face. She had her first plastic surgery procedure when she was 28. Following operation after operation, her face was eventually left enlarged and disfigured, and the surgeons she visited refused to carry out any more work on her and one suggested that her obsession could be a sign of a psychological disorder. So Hang resorted to injecting cooking oil into her face. It became so grotesquely large that she was called "standing fan" by children in her neighborhood - due to her large face and small body.

As Hang's notoriety spread she was featured on Korean TV. Viewers seeing the report took mercy on her and sent in enough donations to enable her to have surgery to reduce the size of her face. During the first procedure surgeons removed 60g of foreign substance from Hang's face and 200g from her neck. After several other sessions her face was left greatly reduced but still scarred and disfigured.

Jocelyn Wildenstein: a US$4 million monster

Known by the press by the nickname of "The Bride of Wildenstein" --a reference to The Bride of Frankenstein--, Jocelyn Wildenstein has allegedly spent almost US$4,000,000 on cosmetic surgery over the years, ending up as one of the worst and most famous cases of plastic surgery addiction. But who did that happened?

Once upon a time, in the late 70’s there was a beautiful woman named Jocelyn Wildenstein. Jocelyn really had it made. She was a fresh-faced mother of two and married to an extremely rich art dealer. That is until she caught her husband in bed with a 21 year old Russian model. Now, any normal person would just leave her husband and take all of his money with her, right? Not Jocelyn Wildenstein! Instead she decided to win back her husbands love and make herself more beautiful by going under the knife. Well, her husband left her anyways, but Jocelyn will always have her plastic surgeon.

Michael Jackson: more than 10 nose surgeries

Does this really need to be explained? It’s incredible to forget how absolutely normal Michael Jackson looked back in the 70’s and 80’s, attractive even, before turning into the sideshow freak that he is today. He is rumored to have had more than 10 nose surgery procedures on his life.

Pete Burns: famous singer, spent almost all of his life savings on reconstructive surgery

Pete Burns, former frontman of the British band Dead or Alive --famous for their single "You Spin Me Round (Like a Record)"--, has had extensive polyacrylamide injections into his lips, along with cheek implants, several nose re-shapings and many tattoos. He revealed in early 2006 that he had spent almost all of his life savings on eighteen months of reconstructive surgery after a procedure on his lips went horribly wrong.

Dennis Avner: the Catman

Dennis Avner, also known by "Catman" or his native american name of "Stalking Cat", has undergone incredible extensive surgery in order to look like his totem animal, the tiger. Modifications include extensive tattooing, transdermal implants to allow whiskers to be worn, subdermal implants to change the shape of the face and the filing and shaping of the teeth to make them look more like a tiger's.

Eric Sprague: the Lizardman

Born Eric Sprague in 1972, the Lizardman was one of the first people to have a split tongue and in some circles is seen to be wholly responsible for the recent popularity of this particular modification. This 37 year old man has transformed himself into a reptile via 700 hours of tattooing, five Teflon horns implanted beneath the skin of his eyebrows, filing down of his teeth into sharp fangs, bifurcation of his tongue, and stretching of his septum and earlobes.

Donatella Versace: a caricature of herself

Since taking over for her brother Gianni Versace, platinum blonde fashion designer Donatella Versace has gone through some drastic changes thanks to plastic surgery, turning herself into a caricature. Although nose jobs are usually done to make a nose smaller, Donatella’s has grown larger over the years. It is also wider and flatter and slightly crooked, indicating that at least one bad nose job took place. In addition to her big nose, Donatella also has large lips, like the trout pouts of the Hollywood divas the designer dresses. Although the fashion icon has always had big lips, the oversized upper lip indicates that fillers, like collagen, have been used liberally. For a 53-year old, Donatella’s skin is very firm, indicating a possible facelift. She probably also uses dermal injectables like Botox to eliminate wrinkles, even when she smiles. Her tight face is a strong contrast to the loose skin on the rest of her body. And yes, Donatella’s weight loss also revealed her breast implants. Anything left?

Jackie Stallone: facelift, brow lift, cheek implants, nose job...

The mother of famous actor Silvester Stallone, Jackie was also famous for claiming she can talks to dogs about the future, she also once set up a psychic hotline which would charge callers for advice. Now she’s relatively famous for what looks like a little too much plastic surgery, as she has tried everything: facelift, brow lift, cheek implants, nose job and, of course, lip jobs.

Amanda Lepore: world's most famous transexual

Once a poverty-stricken young boy, Amanda Lepore's countless surgeries have made her one of the world's most famous transexuals. She had her first plastic surgery at the age of 15, getting a sex change in her last year of high school, and countless surgeries after that.

Michaela Romanini: italian socialite, famous for her collagen abuse

Last but not least. Meet italian socialite Michaela Romanini. This lip collagen abuser is only 40 years old, and became famous after her many surgeries.

WHO Is A Nurse???

2009-03-16T23:59:00.006-05:00

WHO IS A NURSE?

I am a nurse.

I went to school for 4 years. I sat through long, harrowing lectures, studied for hours upon hours, spent my weekends doing research papers while my kids went on trips, I sat through very intense, nerve-racking boards, or the NCLEX as it's better known. I deserve my initials behind my name: R.N. I earned them.

I read a blog from a VERY cool chick ERRN about Veterinarians calling themselves "doctors" that got me thinking of all the patients, families, friends of patients, cousins of friends of families of patients that over the years have told me that "mama is a nurse" or "sis is a nurse" or "I'm a nurse" because they:

1) Work as a Administrative Assistant in the ER
2) Work as a CNA on the med-surge unit or in a nursing home
3) Work as a CMA in a doctor's office
4) Work as a phlebotomist in the hospital or doctor's office
5) And most recently, someone who is nothing more than a medication "pez dispenser" and doesn't know one thing about the medication she is distributing and will flat out tell you she doesn't know.

The list goes on..........

Let me start by saying, not one of those jobs is less important than mine. (Except number 5) There are many jobs I've held that I could NOT have done without the absolutely AWESOME CNA's I've worked with. (Some not so hot......but whatever.....) Back to what I was saying.........

If you pass medications and are certified to do so, kudos! That is great. We both do that.

If you work as a CNA and take vital signs, give baths, wipe poop, feed patients, and give them extra TLC, then we both do that as well.

As a phlebotomist, you draw blood. In Critical Care, we do the majority of our own blood draws as well, but it's out of arterial lines, sheaths, shunts, central lines, and yes, the occasional peripheral sticks. Many times I've needed a phlebotomist badly!

I can't say that I could do the work of an Administrative Assistant in the ER because they run their asses off, but I have done many of my own orders in the ER , so we have that in common.

What I do want to say to the friends, families and friends of cousin's families, they are NOT nurses because they work in a health care setting. I know you are proud, but be proud of what they do and call a leopard by it's spots!

I have a friend who is a nurse and has been for many years. Even before I became a nurse, when speaking with her husband, he would call her a "doctor." I never understood this and realize now that for one he either has little respect for nurses or has great pride for her or doesn't know the difference between the professions. I just know a doctor that spent 12-15 years in school would not appreciate someone who went to school for 2-4 years calling him or herself a doctor. Especially when the two jobs are nothing alike.

Same here.

Bumper Stickers

2009-03-16T22:42:00.010-05:00

SOME OF MY FAVORITE BUMPER STICKERS: Hope they at least make you smile.

How often do we want to SAY this and DESERVE to say this? =)

How often does THIS happen?

Isn't this the truth!!!!

I prefer full time to PRN!

How Much Do Trauma Nurses Make?

2009-03-16T12:34:00.006-05:00

How Much Do Trauma Nurses Make???????

There have been so many of you that have asked this not to mention the multiples that have actually Googled this question that I would try to give you some insight. It may or may not be helpful. Hope it at least sheds some light on it and answers some of your questions.

Basically from the many different jobs I've held, there is a pay scale based on years of experience. Let me stress, this is not THE pay scale, this is just an example because the pay differs not only from companies, but hospitals and geographic areas. For example, there is an annual difference of approximately 6K between Los Angeles and New York. The "Add - Ons" are based on what I've been paid at the various jobs I've held.

EXAMPLE:
0-1 YRS - Approximately 20.00/hr. BASE Pay
1-4 YRS - Approximately 24.00/hr. BASE Pay
5-9 YRS - Approximately 26.00/hr. BASE Pay
10-19 YRS -Approximately 28.00/hr. BASE Pay
20 + YRS - Approximately 30.00/hr. BASE Pay

ADD ON's or DIFFERENTIALS:

Critical Care which some hospitals pay and some don't. (Yes, I know, it's unbelieveable!)

Some pay anywhere from $2.00 - $6.00/hr. differential

SHIFT DIFFERENTIALS:
3-11 PM Shift Differential ranges anywhere from 2.75 - 4.00/hr. ADDITIONAL
11p-7a Shift Differential ranges anywhere from 4.00 - 6.00/hr. ADDITIONAL

WEEKEND SHIFT DIFFERENTIAL ranges anywhere from $0 - 6.00/hr extra.

So, based on where you work and your experience, you could get paid anywhere from 20.00/hr to 42.00/hr.

Then again, there are always hospitals willing to pay "INCENTIVES" which are time and a half for signing up extra or pay bonus'. One job I had would give up to $300.00 per night for coming in when they were short of staff. (At times, depending on the incentives or bonus' it could even be anywhere from 60.00 - 75.00/hr.) That doesn't include overtime for the extra shifts worked either. I did that 2-3 times in one week and had a pretty nice pay check but it gets old working short after awhile and never being home with the family.

I CAN tell you this. Don't think about going into Trauma Nursing for the money. You can make the SAME money by doing other types of Nursing. Make sure if you are choosing Trauma Nursing, ER Nursing, or any other type of Critical Care nursing you:
1) Are going into Nursing because you are COMPASSIONATE and want to HELP PEOPLE
2) Can handle LONG FREAKING HOURS and WORKING HOLIDAYS
3) Can stand blood, guts, and basically any type of GORE.
4) Have a brain that can think CRITICALLY
5) DON'T get your feelings hurt easily, either by doctors, other nurses, patients OR family members.

Last but not least, if you DO want to be a nurse, don't let ANYONE or ANYTHING stop you. It's an AMAZING career!

I'm sure I left a lot out, but I hope this little bit of information helped.

The Three Amigos

2009-03-12T15:27:00.007-05:00

More Non-Trauma Bits and Pieces

THE THREE AMIGOS

I love my Bob and Shane! These two have helped me through some rough times. Bob, you were the best roommate I've ever had. Well, you were the ONLY roommate I ever had, but still the best! (ha/ha) You were always there for me. Shane, you and I have so MANY memories I can't even begin! We never run out of stories. I'm so glad you have the happiness in your life you so richly deserve and I am SO proud of you!

The Three Amigos (THEN)

The Three Amigos (Now)
Bob, we're waiting on you so we'll be the SIX Amigos!!!! ha/ha!

An Amazing Moment

2009-03-12T15:22:00.002-05:00

This was such an amazing moment...........

2009-03-09T09:00:00.000-05:00

TO ME!!!!!!!

See How He's Growing!!!

2009-02-22T16:20:00.006-06:00

SEE HOW HE'S GROWING!!!!

My reason for not blogging much lately and not working.........

Landon Cruz

Since I haven't had time to blog lately since I've been home with this precious angel, I thought I'd add a couple of pictures showing my reason for not having time to blog. We have our "little monkey" (as my husband calls him) full time now and although I am missing nursing.....at the moment I am thoroughly enjoying being a stay at home NaNa.

Dear Anonymous commenter with the "New Nurse Syndrome"

2009-01-23T13:08:00.003-06:00

Dear Anonymous Commenter With The "New Nurse Syndrome"

First, let me start by saying, don't EVER change and don't spend one minute worrying that you will ever change! I was told the same things. I was told that I was wearing "rose colored glasses" that I had the "new nurse syndrome" that I would one day be "calling patients by room numbers instead of names" etc.

I can tell by reading your comment on my last post that you are a true nurse at heart and that you went into nursing for the right reason. As did I. I'm grateful to this day for my coworkers that went into nursing with their hearts and not looking to fill their pocketbooks. And I'm thankful for nurses like you.

It is sad to hear some nurses and doctors talk about patients the way they do but just continue treating patients the way they deserve to be treated and you will find that you CAN truly make a difference in people's lives!!!

"You Killed Your Daughter"

2009-01-17T23:55:00.012-06:00

“You Killed Your Daughter”

It was Friday night and as we typically did around 11:30, we started getting our empty Trauma beds “set up” for the “witching hour” which was when the bars closed and the worst traumas came to us. We were all pretty relaxed and not expecting much to happen for another 2-3 hours when we got the call from life flight that there was a serious single vehicle MVA gifting us with two victims.

One was a female driver in her early 40’s, Level I trauma, multiple open fractures, severe facial lacerations, internal bleeding, bilateral pneumos, intubated and a head injury of unknown severity. The other: a young female passenger that looked to be about 9 or 10 years old who also had to have bilateral chest tubes placed in the field, was intubated en route to the hospital and was not faring well.

As we were admitting who we found out was the “mother” of the 10 year old little girl and had a blood alcohol level of over 0.48, we found out the little girl died in the E.D. (Legally drunk blood alcohol level for those of you that don’t know is 0.08) So in easy to understand terms, 80 versus 480! Most individuals would potentially succumb to alcohol poisoning at this level.

It turned out this patient was in a coma in our TICU for over a week due to an intracranial hemorrhage. When she finally started following commands and woke to the point of probable extubation, we let her doctor know. His immediate response was, “well let’s go tell her that she killed her daughter!!!” I, along with several other nurses were no less than horrified. Granted, we were more than a little upset the night her daughter died especially when we found out it was due to her being intoxicated.

My question is this: If she had diabetes and her blood sugar dropped to a level that made her non-responsive and wreck her car, would we still storm in and tell her “you killed your daughter?” If she had a massive heart attack due to Coronary Artery Disease, would we storm in and tell her “you killed your daughter?”

Do I condone drunk driving? HELL NO! Not at all. Do I understand that alcoholism is a disease and that some individuals without treatment will never understand their disease and continue to put others at risk? Yes I do. Will they continue to risk losing their children day after day? Losing their spouses? Losing their self respect and their own lives? Yes they will.

Thankfully, we were able to convince this doctor that it would be much more appropriate to let a minister talk to this patient and also to wait until she was extubated which happened that afternoon. This woman will never be able to hold her daughter again, to tell her daughter she loves her, or to have a chance to say she’s sorry. Her daughter's funeral was over before she ever woke up.

To me, that seems like a lifetime of punishment in itself. I can only hope and pray that she has gotten the help she needs so that she no longer has to live in the hell on earth that she has surely created for herself.

A Nurses Prayer

2009-01-13T13:24:00.002-06:00

A NURSE'S PRAYER

May I be a dedicated and caring nurse, Lord.

May my HANDS be competent and soothing.

May my SMILE be sincere and understanding.

May my MANNER be warm and professional.

May my HEART be compassionate and giving.
And

May my SPIRIT be hopeful and uplifing.

Multimedia message

2008-12-23T11:29:00.000-06:00

Pictures dont do justice!

All Female Nurses Are Perverts Commenters:

2008-12-14T22:00:00.008-06:00

All Female Nurses Are Perverts Commenters:

To those of you who choose to comment on my blogs, especially the one about All Female Nurses Are Perverts and Unprofessional (from August) I challenge you to leave your name rather than to continue to appear so highly uneducated as to lump all of the thousands of nurses into one category because of the nurses that gave you poor nursing care. Or worse, to show how uneducated you really are like the second commenter by not even being able to compose a gramatically correct sentence. Leaving anonymous messages shows an ignoble lack of courage.
But, thanks for taking the time to read my blog anyway. Have a great day!

Losing A Friend

2008-12-13T16:07:00.002-06:00

Losing a Friend (K - you will be missed terribly)

I hope she remembered
All the people who said they cared
And knew that we really did

I hope she remembered
How happy we all were when we were together
When we were laughing until the tears ran down our faces

I hope she remembered
Our arms around one another
And saying we loved her

I hope she remembered
The pain she saw in our eyes when she left
Because we hoped she would return

I hope she won't remember
The feeling of being so alone,
The feeling that no one cared
The feeling that she couldn't call on us
The feeling that life wasn't worth living
The feeling that her children didn't need her
The feeling that her friends didn't need her

I hope she knows
That we will remember her
That we will love her regardless
That we don't stand in judgement
That we shared in her pain
Just as she did it and
we have a daily reminder of it

Many of us lost a wonderful friend a few days ago and will never forget the loss. She was an amazing woman with two beautiful children and a husband who is a physician so on the outside appeared to have the "perfect life". She just had more pain than she could deal with. There aren't enough words to describe her beauty, her humor or her love for people. What she did was selfish yes, but that won't make us love her any less. She injected herself with a lethal dose of drugs and then cut her wrist.

I feel good about where I am at in my life today. I am blessed in so many ways. As always, thanks for listening.
(dual post)

What My Family Means To Me

2008-09-16T14:03:00.005-05:00

What My Family Means To Me

Today for some reason I felt so inclined to write a blog about what my family means to me.
My husband Micheal is the best life partner anyone could ask for. Ladies, I’m not making it up when I say that he does dishes, he cooks dinner when he gets home from work first, he does laundry, he makes the bed, however, he does not clean the bathroom. Lol We have an agreement he will do the above if I will just do the bathrooms. I say “hell yeah!” lol He truly is Heaven sent to me and my true soul mate. I promised myself I wouldn’t get too mushy here so I will try not to. Micheal and I can have fun whether we’re working in the yard together, making Saturday morning breakfast together, sitting in bed surfing the net together, watching TruTV trying to figure out who dunnit together (it’s always the husband he always says), playing mobsters online together, or just hanging out and being together.

(And I just have to clarify the above.......) I was rereading this post and I realized that it sounds like Micheal does all of the housework. We SHARE the housework. I mean he helps with the dishes, the laundry, the cooking, etc. In the past (before my career change) I worked 12-14 hour shifts in critical care and he was home before me and those are things he would start/continue/finish. So, I just wanted to clarify that. THANKS!!!! =)

My son. Wow. What a road we’ve traveled. We were a “family” the two of us when he turned 1. I was a single mom with this amazing little boy who was always happy. He has now turned into this gorgeous young man with his sights set on being the best man in life that he can be and I’m so very proud of him. He has really stepped up to the plate when he needed to. He has a beautiful 1 year old son that he absolutely adores (I’ll get to him) and I’ve seen him become the father that he never had when he was that age. He however was blessed with a Dad who loved him later in life and of course has Micheal now who will always be there for him. I’m proud of you son. I know I’m not the hero you say I am, but I love you like no other mother could.

My absolutely stunningly beautiful daughter Ashley Nicole. She is a mother’s dream child. She is beautiful. She makes straight A’s in school. She has a job and when she’s not at work she’s babysitting to make extra money. She has a good heart and loves her Mom. She has been my best friend for many years. We’ve struggled with dominance but she finally realized that I am THE MOM (ha/ha) and she too has stepped up to the plate when she needed to. She is a precious gem in a world of fakes. She has loved me when I really didn’t deserve to have her love or at least I didn’t feel like I did. She is growing up to be much more than I ever dreamed she could be and I am so very proud of her. More proud than she will ever realize.

My gorgeous grandson Landon Cruz. He has brought me so much happiness. We got a rocky start when we were unable to share in his first months but from 5 months on he has been constantly in our lives and he has brought us nothing but joy. He is precious. Each day that he is here, he is showing us how much he is learning and changing. He is so intelligent and I couldn’t imagine our lives without him. I love him so much. Thank you Nikki and Thank you Adam. Landon is amazing.

Baby With 8 Broken Ribs Dies After Social Workers Leave Him With Abusive Parents

2008-09-11T23:04:00.002-05:00

(Dual Post)
Baby With 8 Broken Ribs Dies After Social Workers Leave Him With Abusive Parents

This news story has troubled me terribly. I don't know if many of you have read it but first of all, how in the hell can social workers leave an abused child in the home with the abuser to later be murdered by same? And abused by his own grandmother as well??? I don't get it! The horror this child must have suffered. When I think of someone doing this to my grandson, I have no doubt I could kill them with my bare hands. To take a child and break his back over a bannister, pull his fingernails off. It makes me want to puke. And if you read further, 48 hours before his death, there was more evidence of new abuse and they were told that there would be NO FURTHER CHARGES PRESSED AGAINST THEM. And he STILL wasn't removed from the home!!!!! Where is the justice for this baby? Sorry for ranting, I had to get it out!!!!

A 17-month-old baby boy was murdered by his mother and her boyfriend despite being on a council "at risk" register and having already suffered a catalogue of injuries including eight fractured ribs and a broken back that left him paralyzed, a British court heard Tuesday.

The child, who along with the two adults cannot be named for legal reasons, was subjected to "a course of assaults of increasing violence" over many months at his home in North London even though he was being monitored by experts, the Old Bailey was told.

He was examined many times by doctors and was seen by a health visitor, social workers and was put on the Haringey Child Protection Register under the category of neglect and physical abuse for nine months, a jury was told.

Despite this he received numerous injuries — computer-generated images of which were shown to jurors to protect them from having to see the real thing.

Parts of the boy's fingernails and fingertips were missing, his head was covered in ulcerated sores and the skin between his upper lip and gum had been torn which, the court heard, was "highly suggestive of non-accidental injury, usually by forcing the teat of a bottle into a child's mouth or by a hard glancing blow across the mouth."

His fingernails, it was said, may have been deliberately removed.

His spine may have been broken when he was forced over the back of an adult's knee or banister rail, jurors heard.

He also had many bruises to his face and body and was probably bitten on his scalp by a dog at the house. The baby was hit so hard on the night that he died in August last year that one of his teeth was found in his stomach.

The tot's 27-year-old mother, who has other children, her boyfriend, 32, and another man, Jason Owen, 36, all deny murder. The two men deny causing or allowing the death of a child, although the mother has admitted allowing the death of a child, but denies causing the death.

Sally O'Neill, QC, for the prosecution, told the seven men and five women of the jury: "Over the last seven or eight months of his short life (this child) was subjected to a course of assaults of increasing violence.

"The Crown's case against these defendants is that either they themselves inflicted this unlawful force on (the child) or that they participated in a joint enterprise to do so."

"The death of any child is tragic. The death of a child in these circumstances is likely to fill any reasonable person with revulsion."

The trial, expected to last up to eight weeks, continues.

Click here to read more on this story from the Times of London.

2008-09-10T22:07:00.003-05:00

Advice To Nursing (and PRE) Nursing Students

Recently I’ve been contacted by a slew of nursing students and PRE nursing students who want advice on going into Trauma nursing. I personally believe that once you get through nursing you will have a pretty good idea of what area you want to go into. Or at the very least what you DON’T want to do. That’s not to say that I didn’t graduate and think “good grief, there are too many options” and I was really afraid to choose just one. Well, I knew from the first time I stepped into the ER as an Extern that I was an adrenaline junkie. After some time in the ER as a nurse, I felt I wanted to follow my patients to see how they were progressing which of course lead to Trauma (via the NICU to get my foot in the door.)

So, my advice to the last few who contacted me was this: If you are a nursing student, try to get a job in a Trauma Unit (or whatever unit that interests you) as a tech. Most of the time I’ve found that if you work as a tech in a unit they will hire you as a new nurse when you graduate because you know the routine and you’ve been “around.” Also, I suggest whether you are pre-nursing or a nursing student or a new nurse, contact your local hospital and take a tour of the different areas. I can tell you I was scared shitless when I toured the Trauma Unit for the first time and I had been a nurse for a while. And if you’re gonna do Trauma, go for Level One!!! Don’t play around! Ha/ha.

I also suggested reading CrzeGrl and ER RN’s pages. I get a lot of traffic from them, read them regularly and know they’ve got good stuff on their sites. Also, all of the links on my page I suggest they read. I believe we all tell it like it is. My actual “trauma stories” are older in my archives since I’ve gone to ICU but there are more stories to come. I’ve got masses in my memory that still haunt me, make me cry, make me smile, and that I think about daily. I just don’t have the time to put them all down.

Rest assured, they’re coming. And if nothing else, the best of luck to ya!!!!! It’s all worth it if you're doing it for the right reason!!!

September

2008-09-01T21:10:00.002-05:00

September!!!!

YES! Finally! September is here! Thank GOD!!!!
Bring it on..... It can only get better!!!!!

2008-08-31T05:00:00.004-05:00

SUICIDE for DUMMIES

Ok, I know that sounds kind of cruel but let me tell you, I have seen all the WRONG ways to attempt to kill yourself and I’m sure if I wrote that book it would be a best seller!!!!

People, do NOT shoot yourself in the gut, you will have a long, miserable hospitalization, many painful and pricey surgeries followed by the liklihood of having a lifetime of pooping in a bag. This is called a colostomy. Doesn't sound fun, does it?

One of my favorites is the guy who shot himself in the leg to see how bad it would hurt first. OMG! He actually told us that. Don’t think we didn’t get a chuckle or two over that in the break room!!!

Then there was the guy who had lain on the train tracks and had survived but had a leg amputated by the train. Several years later we see him in the unit again. He jumped off of an overpass into traffic on a busy interstate, was run OVER by a car and still survived. My words of wisdom to this fellow. “God don’t wantcha yet. Give it up man!”

Another was a guy who used an AK-47 and basically just blew his face off. It was horrific but he survived. He actually does talks in schools about not using drugs. Although he's pretty scary looking, he makes quite an impact.

And although you see people holding the gun up to their temple in movies, this is one of the saddest things you can do to your family members. What is going to happen is you are going to cause irreversible brain damage at the same time making yourself look like a cartoon character with bulging eyes. This was the saddest yet funniest looking trauma I ever saw.

We had a very young man drink antifreeze and in the end it did end his life but not after many days of painful suffering for himself and his family. They finally withdrew life support when all of his organs finally shut down.

Another favorite of mine was the dude who ate snake poison and convinced the assessing case manager that it was accidental ingestion!!!!! WHAT????? PEOPLE! Have you ever SMELLED snake poison???!!! OMG! You can barely BREATHE when you get close to it!

And then there is the ever popular Tylenol Overdose which many people think is a “safe way” to scream for help when in actuality it’s one of the most horrible and painful deaths you can imagine. But if you are lucky enough to get to a hospital, you get to drink this nasty smelling stuff called mucomyst and be put on a drip that is basically an antedote. I won’t go into the details that cause death, but if you don’t believe me, google it! (Tylenol Overdose)

So, if you are here actually looking for the quick and easy methods to kill yourself, sorry. Not giving it up that easily. Just remember this. Suicide is a permanent solution to a temporary problem and tomorrow will always look brighter than today. And I can say that because I’ve been there!

2008-08-30T15:11:00.002-05:00

GOOD vs EVIL In The Trauma Unit

Ok, you know how they teach us in nursing school we have to be non-judgmental and remain neutral in all cases and treat all patients the same, give equal care, yadda, yadda, yadda?

How do you do that when your first patient is a Youth Minister who has been in a devastating car crash with multiple fractures and internal injuries, is on full life support, PRVC on the vent, Levophed, Neo, you name it. He is loved by all, said to be one of the most devout and spiritual men ever and he's in his mid 30's.

And your second patient is also on full life support, intubated through the side of his neck where it was slashed in prison. He's shackled to the bed with two prison guards at the bedside. "What did he go to prison for?" I asked the guards. "He's killed numerous women" they said. "Oh nice" I'm thinking. This is going to be a challenge. It's bad enough this guy resembles Satan. No joke. Well, not that I've ever SEEN Satan or PLAN on seeing Satan but from pictures depicting what Satan looks like, he looked just like him. He had the fire red hair and the fire red long goatee.

Of course with most patients in these conditions we either have them on Fentanyl and Versed drips or Diprivan drips or all of the above. Each morning we do what we call a "sedation vacation" where we wake them up for a few moments to ensure that their neuro status is still intact. What I saw in the early morning hours from the guards is what finally made me realize that no matter what this guy has done, he is still human and deserved medical care. When we allowed him to wake up for a few moments the guards proceeded to tell him "you're died! you're in hell! "you got what you deserved!" I saw pure fear in his eyes. And on and on they went. I couldn't believe it! I was in shock!!! I immediately told my Charge Nurse who in turn contacted the guard’s supervisor and we had them removed and made DNR’s. (Do not returns)

I’m glad I wasn’t put in the position but I have always wondered if they had both coded at the same time, which one would I have gone for first? Nah, I really don’t wonder. I guess I just like to think that I really do have that objective nature we’re supposed to have.

Bob Marley

2008-08-29T18:04:00.002-05:00

One of my very favorites........

"Who are you to judge the life I live
I know im not perfect
And I don’t live to be
But before you start pointing fingers
Make sure your hands are clean"
-Bob Marley

Who Matters

2008-08-29T17:58:00.005-05:00

This is something I read and it hit me like a brick!!! How true is THIS!!!!!!! WOW!!!!! Take it to heart people!!!! It is SO TRUE!!!! SO SO SO VERY TRUE!!!!

"There comes a point in your life when you realize who matters, who never did, who wont anymore, and who always will. So don't worry about people from your past, there's a reason why they didn't make it to your future."

August Sucks

2008-08-29T17:33:00.000-05:00

August Sucks And I’m Glad It’s Almost Over!

I can’t tell you exactly why, but ever since my husband and I started dating, we noticed that August was an unlucky month for us. Nothing really stands out about it, our house didn’t burn down, our children weren’t kidnapped, we didn’t grow 3rd arms and we don't have atrocious breakouts of hemorrhoids but August has always sucked. And this year is no different.

At the beginning of this month, I believe it was the 2nd or 3rd of August, Micheal said something like “I can’t wait for this month to be over, it’s gonna be a bad one.” Now, I said something back about “self fulfilling prophesies” and boy was I right. This month has sucked. I could do without an August next year. Once again I have to wonder if I was a mafia hit man in a previous life and this is my payback month or something.

We ALL do things that deserve amending and most of us have true friends that help us through those times. Mine have been beside me without fail. Besides my family, Chris and Amie are God sent. They have shown what true friends are. I thought at one time I had many friends, a few in particular that really meant the world to me but when the chips were down, they all turned their backs which hurt in the beginning and then I realized, “what the hell” there is a reason that people grow old alone and there are reasons that people are miserable in their lives. What goes around comes around.

I can say for certain though, through good and bad, through thick and thin, I am a true friend, no matter what. And for anyone that might be reading this and see yourselves here, I am a friend, and will always be here if you need me.

Clarification

2008-08-28T13:56:00.003-05:00

CLARIFICATION

Somone asked so I thought I would clarify this. Many of my stories come from the diary in my mind but ALL are TRUE. I worked Trauma from 2000-2004 so many of these stories are from that time. Some of my stories come from recent ICU experience and some from periods between 2004 and 2007 when I started in the ICU at the last place I worked. All names have been changed of course for HIPPA compliance but again, all are true and nothing has been added. Thanks again for reading!

2008-08-28T05:33:00.000-05:00

NON TRAUMA Bits and Pieces

Ok, with a new grandson, you have to understand I have to throw in a few pictures here and there that aren't trauma related, right? It just wouldn't be right if I didn't share some of these pictures of my absolutely precious grandson Landon Cruz. He will be one year on September 6th. Thanks for being so understanding. Love you faithful readers!!!!!

Landon with daddy outside . . . . . . . . . . . . . . Landon with NaNa outside

NaNa, Landon and Grandpa in our
front yard.

2008-08-26T21:25:00.001-05:00

Stabbed With a Pen

(This is one of my favorite stories)

“Please take this medicine” begged my coworker to her patient, “it will help you stop getting sick!!!!”. The non English speaking patient with the trach refused to take the phenergan to stop his nausea. He was angry, paranoid, and was violently shaking his head. He told me in Spanish that he thought we were giving him medication to harm him. I explained to him in Spanish that the medication was to help stop his nausea and vomiting. He didn’t buy it. I sat beside him and assured him that we didn’t want to harm him but that we were trying to get him better so that he could get out of our unit. He was so close to moving to a regular room, having his trach removed and going home. He was pacing and acting very nervous. I walked out and told my coworker “sorry, I tried.”
Within 15 minutes there was chaos! There was ear-piercing screaming, we heard tables being turned over, people running, just downright pandemonium on the stepdown side of the trauma unit. Our emergency button had been pushed to call for Security and METRO PD and our trauma surgeons and residents were in the room instantaneously. The patient had become crazed, picked up a pen from the bedside table, grabbed his nurse around the neck and stabbed her in the chest multiple times. Holy Christ!!!!!
He was trying to kill her. It only took a few seconds for him to be taken down by our docs and when the police officers got there the trauma attending said “take him to jail.” The response, and this is the part I LOVE that makes it one of my favorite stories. The response was, “we can’t take a trached patient to jail.” So, you guessed it, the trauma doc reaches over, snips the trach ties, pulls out the trach and says “ok, NOW take him to jail.” I loved it.
Our coworker was out for many months but finally returned and we were so glad she did. You never know what is going through a psychotic mind, but then, you never know what is going through a trauma surgeon’s mind either. =)

When you're a nurse

2008-08-26T13:21:00.000-05:00

When you're a nurse you know that every day you will touch a life or a life will touch yours. ~Author Unknown

Current River '08

2008-08-24T15:41:00.018-05:00

Annual 4th of July River Trip - Current River

What a blast!!!

Back: Jamie,Amie,Micheal and Me

Front: Corey, Ashley (our beautiful daughter)

Paige and Adam (our handsome son)

Me and my gorgeous husband

Google Hospital

2008-08-23T16:34:00.000-05:00

This was just too good not to repost. Thanks Nurse Ratched!

Google Hospital

from Nurse Ratched's Place by Mother Jones, RN

Hospital administrators all over the country are trying to figure out how to keep their nurses happy. Some are even hiring expensive consulting firms in order to find out what’s on our mind. People, this isn’t rocket science. All you have to do is ask. Personally, I think that the nursing shortage would resolve itself overnight if Google started running hospitals.

Imagine a chair like this at the nurses station. Google takes the welfare of its employees seriously. This decompression (stress) capsule is impermeable to sound and light. I can see myself crawling into one of these chairs when I’m stressed out. Sorry everyone, I’m taking a timeout.

Does your back hurt after transferring patients in and out of bed all day long? Google’s employee health department has the answer to your aches and pains. Professional masseurs, also known as eusses, are available to help Google employees get through their day.

I hate waiting to get on a crowded elevator, especially when it’s lunchtime. Look at this young lady entering the Google cafeteria. Google installed slides and fire poles, allowing employees to get around in a flash. Google serves good food, too. Employees can eat all they want from a vast choice of food and drink.

This is my favorite goodie from Google. These are private cabins where employees can attend to personal affairs. No more sneaking off to make personal phone calls. Some people might suggest that Google’s way of doing business would never work in a hospital. Google is different. After all, what kind of people enjoy working in an office building that looks like the inside of a big plastic gerbil cage? On the other hand, maybe that’s why Google would be good at running hospitals. Nurses are accustom to being treated like rodents by hospital administrators, so we would naturally feel at home within our new working environment.

I know that Google loves nurses. A couple of years ago, they chose Nurse Ratched’s Place a as a Blog of Note.

I wonder if Google is looking for a nurse blogger.

All Female Nurses Are Perverts and Unprofessional

2008-08-23T13:31:00.002-05:00

“All Female Nurses Are Perverts and Unprofessional”

Ok, before you guys start commenting and calling me names, let me explain if I can keep from laughing long enough. The heading is the last comment I got (on my last post)from an anonymous and let me just add “quite indomitable” poster that I first rejected and then decided to go ahead and post.
I figure it is either a male nurse who has some real “performance issues” of his own, or a very bitter ex wife who still cannot get a life of her own. I’m going to bet on the second one just because I know she is still overly obsessed with our wonderful life. But, just for the fun of it, let’s say it is someone who isn’t even a nurse.
So, to the oh so courageous, bold, and daring anonymous poster let me tell you how unprofessional and perverted we nurses are. When your loved ones are lying in the critical care unit on life support and they can’t move and they crap on themselves, we go in and clean them up. We don’t enjoy particularly looking at genitalia or we would have gone into gynecology or proctology or some other form of “below the waist-ology”. When your loved ones are dying of low oxygenation because they are drowning in their own secretions we are the ones in the room suctioning out their lungs and their oral and nasal cavities. Not because we are orally fixated, it’s because we love what we do and we care about our patients.
We see death too often. We see family members turning to us asking us to help them make decisions to take Mom or Dad off of life support because Mom or Dad didn’t make that decision before their car wreck or before they were diagnosed with end stage cancer. We work long hours to make sure the patients AND families are taken care of. If for some reason you are someone that is not in the medical field, I truly feel for you the day you become a patient and you honestly feel that way about nurses.
And if you are a male nurse, you need to get out of nursing NOW! Today! I’m sure Hugh Hefner would hire you at his mansion doing something.
And last but not least, if it’s you, and you know who you are, isn’t it about time to get a life?
And to all of my sisters and brothers in health care……. Keep on doing the good work! There’s only good in return for what we do.

Multimedia message

2008-05-11T21:39:00.000-05:00

My husband rocks!

ACLS Stress, Cinco de Mayo, & Wild Eyed Peers with Paddles

2008-05-07T13:18:00.004-05:00

ACLS Stress, Cinco de Mayo & Wild Eyed Peers with Paddles

Many of you will know what I'm talking about when I say that every two years there comes a time when your stress level is OFF THE CHARTS when that time comes when your education coordinator hands you your little blue, or red, or green packet and says: "two weeks to renew your ACLS" or better yet you get that e-mail a MONTH ahead of time that says "you are scheduled to renew your ACLS on May 6th so make sure you come by my office to pick up your study materials." That's even better because that gives you an ENTIRE month to worry, stress, and be sick over it.
Now maybe there are some of you that have been given the Advanced Cardiac Life Support Holy Peace Genes that prevent any stress because you know that you have NOTHING TO FEAR but I am not one of them.
Can I run a code? Well yes. Do I know which drugs to give? Well yes. Do I know how to save a life? Well yes. Most of us in Critical Care do but for some reason, when it comes time to renew, I don't know what it is, it's a very stressful time. I thought for awhile it was just me but when I walked in yesterday and heard some of the others talking (others being people from other hospitals who I did not know - that right THERE adds to the comfort level let me tell ya!) it just reinforced what I already felt. I heard "omg - I'm gonna throw up" and "OMG! If I don't pass this, I can't work tomorrow." etc. etc. I knew then and there I was in the right place! YES!!!

Why am I writing about this? For two reasons........
I want to know who in GOD's name schedules someone to take ACLS the day AFTER CINCO DE MAYO?????????
Did you read the stress I went through up there? And yes, I was a lucky one that got the e-mail a month a head of time. I actually knew the entire year that May was my “MONTH OF DOOM” but I was in major denial……. Let me add that I am a procrastinator so although I had the study materials 2 weeks in advance, I didn't start studying until the day before, which was CINCO DE MAYO!!!! (And thank God for co-workers who will trade days with you so that you CAN study the day before!!!)
I got up early that morning prepared to study all day and into the night.................

So after exhibiting much avoidance behavior…… vacuuming, cleaning the kitchen, straightening the bedroom and living room and checking e-mail, I decided I could put if off no longer. I studied and read, and studied from 10am until 6pm. About that time my husband got home and we decided that "heck, if I didn't know it after 8 hours of studying and 8 years as a Critical Care Nurse then I probably didn't deserve to have my certification anyway so out we went! Since we are “of the blood” we felt the need to celebrate the Mexican victory over the French in the Battle of Puebla in 1862. (And we wanted beer and tacos too!!!!!) LOL
Ok, so maybe we stayed out a wee bit too late……..it was fun! And remember…. we did it for our people!!!!!
Man! For some reason I woke up at 0330 and laid in bed and stressed over the mega code that I knew I would have to “perform” (I have major performance anxiety! You guys have NO idea!!!!!)lol.
So, at 5:00 I finally just got up and got ready to go. Got there 45 minutes early feeling like crap. Went in and sat with people I did not know. Knew it would suck when I found out it was going to be held in Centennial Medical Center’s (our largest Hospital's) AUDITORIUM. How many freaking people were gonna be there and how many people would I have to perform in front of? Geeeezzz!
Ok, so we start out by having to perform & be checked off on one man CPR! Wow! Started feeling a little paranoid here……. Then got tickled at the situation. My partner and I soon named our guy “stiffy” then when his body flipped up because he’s just a torso you know, we proceeded to create his life story. He’s a bilateral amputee named stiffy. Anyway, won’t go into all the details. Moving on……. You have NO idea how hard it is to inflate a dead man’s lungs when you’re blowing out etoh rather than 02! Lol WOW! Won’t do that again. (J/K)Kind of.

Ok, the funny part. In ACLS - when did they start shocking Bradycardia?
There was a woman in our group who really had no clue. We were running through our mega codes and she apparently is not familiar with codes OR defibrillators. Let me add right here right now she is a Supervisor. Yep, a supervisor. Ok, it’s her turn. The scenario is a lady in the ER comes in with a heart rate of 38, b/p 70 palpable, yadda yadda yadda. She grabs the paddles,simultaneously while stating we only have AEDs where I work, she flips the jules up to 360 before the instructor can stop her and which NONE of us has done but we've stated we would do on a monophasic defibrillator and hits charge! HOLD ON A MINUTE! The instructor tells her to wait and she TURNS towards the instructor with the paddles charged!!!! Instructor is ducking and dodging then she turns towards us and we’re ducking and dodging and we are laughing so hard by now that we are trying to do a constant kegel so as not to pee ourselves. This lady has a wild look in her eyes and is ranting, “ok, is she talking to me, is the patient alert, don’t worry Mrs. Smith, we’ll take care of you, put some 02 on her, start an IV” . OMG!
I guess it was at that point I relaxed and thought…….. Ok, no problem. I’ll go next!

2008-05-01T15:50:00.001-05:00

HE LET HER GO

Ok, so here it is guys…… my rant on making your loved ones DNR’s before they ROT in front of yours and our eyes. I DO understand how hard it must be to make that decision being a NON-medical person but please listen to those of us who ARE from the MEDICAL side!!!!! They are SUFFERING!!!!!! It is TORTURE!!!!!! We CANNOT give them enough pain medication to stop their pain because their blood pressure will not TOLERATE IT and YOU are the ones that say we HAVE to do everything to KEEP THEM ALIVE which means we have to keep their blood pressure WITHIN NORMAL LIMITS!!! I know you don’t realize that that means they are suffering beyond belief!!! I know you don’t realize that while we are in the room changing their bedding for the 5th time that day so they don’t lie in a pool of fluid that is oozing from their very pores, we are crying silently because you step out and don’t see the skin falling to the floor. You don’t see them crying out silently because they are now trached. You obviously don’t remember hearing them plead “Cory, no roll, please, no roll BEFORE they were tubed and then trached!!!!” It broke my heart each time I had to do it and without the additional pain medication or sedation that it would take so they wouldn’t feel the pain. What I have to say now is THANK YOU SO MUCH for FINALLY seeing the light. Although it took over a month of pain and suffering for this patient and multiple surgeries, and nothing short of pain and torture, it was the right thing to do to let her go. She would NOT have survived. She would NOT have come back from the gruesome being she had become. Her skin was literally falling from her body. She was rotting. She had infections few had heard of. She was in hell here on earth. She was freed, finally freed from the pain and torture and my hope and my prayers are that her husband does not suffer one day of guilt or uncertainty that he did the right thing. He didn’t let her die. He just didn’t prolong her suffering.

2008-04-20T13:16:00.003-05:00

DNR SONG

Although this isn't a funny issue, we all have to deal with this frequently in our jobs and it can be very frustrating. This shows a nurse's view and maybe we're the only one's that will see the humor in it but we are also the only one's that sometimes see the torture we put patients through that are Full Codes until the bitter end.

Short of getting D.N.R. tattooed on my chest (and I've threatened my family that I will do it) lol I've made it pretty clear what my wishes are. And I suppose my point to this blog since my blogs usually have a point is this: talk to your family, make your wishes known, don't make them make the decision for you.

Our New Grandson

2008-03-05T12:39:00.005-06:00

We have a new addition to our family. This is our grandson Landon. Certain circumstances prevented us from seeing him for a few months but he is here now and we have fallen sooooooooo in love with him. Just wanted to share with you guys since I haven't blogged in awhile. I wanted to let you know why!

This is his baby picture.
This is now with Micheal and me. (Nana and Grandpa)

This is Landon with Daddy Adam and his Aunt Ashley.

You KNOW you are a nurse when . . . . .

2008-01-24T20:56:00.003-06:00

I know most of you have read these but some of them were new to me and too hilarious not to pass on!!!!

You know you are a nurse when......

1) the front of your scrubs reads "Nurses... here to
save your ass, not kiss it!"

2) you occasionally park in the space with the
"physicians only" sign... and knock it over.

3) you believe some patients are alive only because it's
illegal to kill them.

4) you recognize that you can't cure stupid.

5) you own at least three pens with the names of
prescription medications on them.

6) you believe there's a special place in hell for the
inventor of the call light.

7) you believe that saying "it can't get any worse"
causes it to get worse just to show you it can.

8) you wash your hands BEFORE you go to the bathroom.

9) you believe that any job where you can drive to work
in your pajamas is a cool one.

10) you consider a tongue depressor an eating utensil.

11) eating microwave popcorn out of a clean bedpan is
perfectly natural.

12) you've been exposed to so many x-rays that you
consider it a form of birth control.

13) you've ever heard a patient with a nose ring, a brow
ring, and twelve earrings say "I'm afraid of shots."

14) you've ever placed a bet
on someone's blood alcohol level.

15) you've told a confused patient that your name is that
of a coworker and to call if they need help.

16) your bladder can expand to the size of a winnebago's
water tank.

17) you have seen more penises than any prostitute could
dream of.

18) you believe that not all patients are annoying...
some are unconscious.

19) your family and friends refuse to watch medical
sitcoms with you because you spend the whole time
correcting everyone and pointing out upside down
x-rays.

20) you don't get excited about blood, unless it's your
own.

21) you've sworn to have "do not resuscitate" tattooed on
your chest. Soon.

22) discussing dismemberment over a gourmet meal
is perfectly normal to you.

23) your idea of fine dining is anywhere you can sit down
to eat.

24) your idea of a good time is a cardiac arrest at shift
change.

25) you believe in the aerial spraying of prozac.

26) you believe that "shallow gene pool" should be a
recognized diagnosis.

27) you believe that the government should require
permits to reproduce.

28) you believe that unspeakable evils will befall anyone
who utters the phrase "Wow, it's really quiet, isn't it?

29) you have ever wanted to write a book entitled
"Suicide: getting it right the first time."

30) you have ever had a patient look you straight in the
eye and say "I have no idea how that got stuck in there."

31) you've had to leave a patient's room before
you begin to laugh uncontrollably.

Cardiogenic Shock

2007-12-20T22:30:00.000-06:00

CARDIOGENIC SHOCK

So my assignment is a fairly young male in his late 40's that is in cardiogenic shock. He had previous heart attacks which had caused the heart muscle to be weak and unable to pump an adequate amount of blood. Doesn't sound funny does it? Well.... read on.

This patient (I'll call him "David") arrives home from work at his apartment complex. When he gets out of his car a kid about 16 steps up to him and pulls a gun on him demanding his wallet. David says no and the guy says he will shoot him. So David decides to take off running. Ok, so he gets about 10 feet away because his HEART is GARBAGE and he stops unable to breathe. He tells the kid "ok, I can't run away from you but I'm not giving you my wallet either." Then he proceeds to lean over, grabbing his heart and gasping for air. The kid asks "dude! what's wrong with you? Are you sick!!??" David answers that he has a bad heart and has never had the money to get the surgery he needs and doctor's had been telling him he needs to have open heart surgery. Get this: The kid starts crying. Then he starts telling David about his life and how no one cares about him and this man who is going into cardiogenic shock is COUNSELING THE KID!!! Guardian Angels.....that's all I can say!

Senseless Death Of A Coworker

2007-12-14T10:42:00.000-06:00

Senseless Death of a Co-worker and friend - ??by her own hand??

I'm sad, I'm frustrated and I'm so damn angry!!!
Again I got a call from work. The sweet, kind, compassionate coworker who called me regarding my LAST post has apparently committed suicide. Why does senseless stuff like this happen? I just don't get it.

Usted será extrañado Noel (You Will Be Missed Noel)

2007-11-23T19:33:00.000-06:00

Usted será extrañado Noel (You Will Be Missed Noel)

So I got this phone call at 0530 telling me that I was being put on call. I thought it was kind of strange that a coworker was calling rather than the Nursing Supervisor. Her reason for calling? To tell me that a patient I had become very close to had died last night, on Thanksgiving Day. A piece of my heart broke off at that very moment. I cried for two hours before falling asleep. Life is so unfair.

About 3 weeks ago, we got a patient in that was severely emaciated and had a persistent cough, night sweats, fever and chills. He was put on AFB isolation until we could rule out TB which we did. He did not have TB, he had full blown AIDS.

There is so much more to this story than I can even go into.

This patient was Spanish speaking only and I was one of the few in our unit who could communicate with him (without using a language line) so naturally I spent a lot of time caring for him, translating for other nurses and doctors as well as talking to him about Code Status which brings me to a subject that infuriates me. Why in God’s name do some doctor’s insist on discussing code status with patients day after day after day???? If a patient states he wants everything in our power done to help him even knowing that his illness will kill him, why must doctor’s persist until they get the Code Status that they think is right!!!!?? This is so wrong. And it ticks me off! (Noel had a 9 year old son he wanted to get well enough to get home to.)

Regardless, the other things that bothered me regarding this case is the indifference from caregivers I saw at times because of not only his diagnosis, but the communication barrier. We as healthcare professionals tend to be “uncomfortable” in situations where we cannot communicate, I’ve been there myself. But I've also been the patient in a different country that couldn't communicate. We as nurses have taken an oath to care for others, in any circumstance! I saw nurses go in with masks, gloves and gowns (knowing the patient was no longer on isolation), I saw a nurse with the FLU assigned to this patient (his WBC count was 1.2 for Christ’s sake!) It makes me shake my head in wonder at times. Too often we forget that we are still treating human beings. They feel. They hurt. Just like we do.

No, I don’t have AIDS and don’t know how he must have felt but I can imagine, and I imagine it feels awful. I sat for hours on end in those 3 weeks on his bed talking to him, helping him through the horrendous bone and bone marrow biopsies. I bathed him when he said no one had touched him for a week. Before I left on Tuesday evening, I told him I felt “uncomfortable” about being off for two days. I just didn’t have a good feeling. (He told me: "No se preocupe. Así es la vida" which means "Don't worry, that's life". I figured he would rent a vent before I got back but during one of the two days I was off the doctor talked him into a Code Status II which states he does not want intubation or defibrillation. I wasn't naive enough to think that he would beat this disease, but I did hope that we could strengthen him enough so he could see his son again.

I know there are still millions of people out there that are uneducated about HIV and that are scared. Please, if you are one of those people, READ! ASK QUESTIONS! Life is too short not to help others in every way that we can. Here is a wonderful site that gives great, easy to understand information and has an awesome question and answer section. The Body

As always…….thanks for listening!

Flashback: My very first night in Trauma

2007-11-23T17:00:00.000-06:00

Flashback: My very first night in Trauma

I was sitting and thinking about the newbies we're getting in our critical care unit where I work now at Southern Hills Medical Center. I thought back to when I was a fairly new nurse and had just started in Trauma and how I felt. My very first night on the unit. I arrived in this very large, scary unit. An intimidating place to say the least. I had worked in the Neonatal Intensive Care Unit (NICU)at Vanderbilt but Trauma was an entirely different world. (Now remind me, WHAT was I doing making THAT transition as a nurse less than a year old?)

I found my preceptor who was very kind and reassuring. Then she is told that 3 nurses called in, we were to be in the "Sand Box" (which I find out later is where the Level II or less critical are admitted). But one thing I did learn, if they are bad enough to be sent to the Trauma Unit at Vanderbilt, they are CRITICAL.

So we start to get report on 5 patients. (Ratio is normally 2 pts: 1 nurse). She then says "these are your two and I'll take these three. Think you can do it?" OMG! My very first patient I got report on was a 24 year old that had shot himself in the face with a shotgun because his girlfriend was breaking up with him. (He had been there for awhile so he was one of the "stable ones".) When I looked at him I was ashamedly horrified. I was silently thankful that I was able to keep my composure although I did not know how. He still had his eyes, his nose was gone, just the orifice where a sound between snoring and a gurgling choke was emitted. Where his mouth had been was tissue that had been sewn up. He had a peg tube where meds as well as nutrition was given. The patient would continue to write notes asking for a mirror. I was told not to give him one. To this day I wonder if that was the right decision. Anyway, in my job now I've learned so much more about suicidal patients and 6404 papers.

I inquired about this patient about 6 months later and was told that when he finally did go home he put antifreeze into his peg tube. He was found dead by his parents.

In all honesty, I can't even remember my other patient.

Throughout the world, about 2000 people kill themselves each day. That's about 80 per hour, three quarters of a million a year. In the U.S., there are more than 80 deaths from suicide every day, 30,000 every year. This is the equivalent of a fully loaded jumbo jet crash every fifth day. From another perspective, you are more likely to kill yourself than be killed by someone else.

Affirmation

2007-11-17T21:40:00.000-06:00

AFFIRMATION

Today I received affirmation that I'm doing what I was meant to do.

Some days I question if I might be better off doing something else. Some days I get tired of fighting doctors to do the right thing or to get things done that need to be done. Some days I hate facing another overdose just trying to "gain attention". Some days I feel like I can't do another 12 hour shift where lunch was a "goal unreached".

Today was different somehow.

I had a patient who'd had a massive stroke. I took care of her for two days. Before I left I had time to help her bathe, put on her own nightgown and put on some makeup and even curl her hair. Things that are typically unheard of in the critical care unit. As I hugged her she kept trying to say something. It took multiple attempts and then she said slowly, "people like me are lucky to have people like you". That is all I needed.

Some days we just need to hear that what we do does make a difference.

(dual post)

Prayer

2007-09-09T21:44:00.001-05:00

Lord please help me to bring comfort where there is pain,
courage where there is fear,
hope where there is despair,
acceptance when the end is near,
and a touch gentle with tenderness, patience, and love.

Patients who are P.I.A.s

2007-08-01T21:45:00.000-05:00

Patients who are P.I.A.s

Ok, so I'm getting report on a patient on Monday morning. I get all the basics, demographics, history, admitting diagnosis and the prognosis that he will most likely not live through this hospitalization. He had a medical history as long as my daughter's Christmas list that included DM, COPD, CAD, new onset rapid A-fib but mainly Cirrhosis of the liver. (He was found noresponsive with a bp of 57/23 when he was brought in). He had been diagnosed years prior and at this point hospitalizations were for paracentesis (to drain the fluid from his abdomen)and respiratory issues from fluid overload. He was ventilated, on multiple cardiac drips, vasoconstrictors and the wonderful "milk of amnesia" propofol . Oh, and let me not forget, he had MRSA, Pseudomonas, VRE and God knows what other bugs not yet identified. His skin would peel off when we turned him. He was only 61.

We continued to care for this man and were able to extubate him and wean his sedation. As I came back day after day, I would get various reports from nurses and it seemed that many had the opinion that this man was a P.I.A. He woke and was able to talk and ask for things. A LOT of things. He wanted to turn every 15 minutes or so because he was in so much pain. Any nurse can tell you that NONE of us have time (or energy) to turn a patient 36 times in a shift and do everything else that we need to do. I was lucky enough to only have one patient on my last day (the 4th caring for him) and have time to spend with him, to talk to him, to hear about his wife (Ms. Mattie) who always took care of him but had died a year earlier. He spoke of how they were so compatible, how she listened to his never ending stories, how she loved him regardless, even through all his years of drinking before he decided he had to stop. I spent the afternoon between assessments, medications, treatments, and charting taking him ice cream and feeding it to him now that he was able to eat. He did show me that day that my emotional and physical limits are beyond what I ever dreamed...... (worn the h*** out).

When I returned on Monday I was on the "high side" in the ICU and decided to go over to see if he'd made it through the weekend. His smile made up for the aches and pains that required my husband to rub my back and feet for hours. I asked him how he was feeling and he told me "fine" and I asked what was new over the weekend while I'd been gone and at that point I noticed his trembling lip........ he must have seen my expression and then he said "the doctor just left....... he told me that I have less than 3 weeks to live." Wow. What a wake up call for Monday morning. The only thing I could think to say (because I'm a firm believer in NEVER lying to a patient) was "well, doctor's have been wrong before BUT if for some reason they aren't this time, I know Ms. Mattie is waiting with open arms for you." He thanked me for being so kind to him and for staying with him when he was scared. (I never sensed he was scared but should have known by him always wanting something - he wanted someone in the room with him.)

***My point to sharing this story is I hope those of you who may be burned out, or new to nursing and get "frustrated" or those who are just tired of people asking for things (because most ICU nurses are happy with a ventilated patient on propofol or fentanyl and versed) to remember that we never truly know what is going on in someone's life and as long as we are standing beside the bed, we CAN and DO make a difference."

Thanks To My Awesome Husband

2007-07-22T22:38:00.000-05:00

Thanks To My Awesome Husband

Just wanted to add a quick thanks to my awesome husband for designing this fabulous layout for my blog. You are the bestest Micheal! XOXO

2007-07-22T21:56:00.000-05:00

KUDOS to all who give day after day!

We SOOOOOOOOO Did It !!!!!

2007-07-15T00:52:00.000-05:00

We SOOOOOOOOO Did It !!!!!

.... and the wedding was amazing! It couldn't have been more perfect. God I'm lucky!

Quickie Update

2007-05-30T11:42:00.000-05:00

QUICKIE UPDATE

It has been awhile since I've posted and with my love of writing/blogging that in itself is heinous..... but I have a very good reason.
Most of you know that on Christmas morning last year the greatest guy in the world proposed to me and we set the wedding date as 7/7/07 (so he could remember). Ha/ha! I am only joking about the "so he could remember part."

We decided to get married in one of our favorite places.
(flashback)
He lived in San Francisco and I lived in San Francisco (at separate times) and there is a little paradise that not many "non-Californians" know about called Half Moon Bay. We will be getting married on Miramar Beach and planning from afar has been quite an undertaking.

In addition to having a January birthday (our daughter) two March birthdays (Micheal and myself) and an April birthday (our son) to celebrate, we're spending a lot of time organizing the house we bought in September of last year and preparing for a new little one to join our family in September of this year! We are very excited.

I have also started a new job in a new Critical Care Unit which has been the blessing of a lifetime. I have great coworkers and am now precepting a new nurse coming into our unit. Teaching is one of the things I love to do so it makes the job twice as much fun.

So there is my quickie update. Don't give up on me, I will soon be back to posting and sharing!

Ya Gotta Be A Little Nuts To Work NightShift Series #4

2007-01-08T10:01:00.000-06:00

Ya Gotta Be A Little Nuts To Work Nightshift SERIES - Story #4

Story #4

Ok, a short one:

Ya gotta hate when you forget to turn the volume down on your cell phone when you've previously thought it would be funny to assign "goofy" ringers for your family and friends. The first time this happened, I had a patient crumping (going bad, circling the drain, trying to get on the Jesus train) and I was up on the bed doing chest compressions when out of nowhere we hear (very loudly) "Hoooooooooooooommmmmmmmmmeeeeeeeeeee WRECKER" (Gotta love that Gretchen Wilson)

The next time was not too long ago when I was talking to my manager before she left for the night. She tends to be very opinioned! (That's putting it nicely). Anyway, my daughter decided to call me because she was at her dad's house in KY. All of a sudden we hear "Little Miss, Little Miss, Little Miss Can't Be Wrong" (thanks Ash, didn't mind that one too much as I'm just appreciating the humor in it now.)

The last time I was in a dying patient's room I got a call from an "unknown" person and "I want to break free" started playing loudly. (Thank GOD there was no family present.)

The most memorable was probably in Trauma when we had a very well liked young man who his family said had a great sense of humor and he was being taken off of life support due to the severity of his injuries. The family were all around his bed reminiscing about the "good times" with him. We always kept the radios on at the bedside for the purpose of stimulating patient's as well as it made a hard job a wee bit easier. On the volume scale of 1-10, we kept them at about a 2-3 as "background" sound. All of a sudden "Stairway To Heaven" started blaring.......after the shock wore off, the family insisted it was his sense of humor and he must have done it. (Good thing it wasn't "Break on through to the other side" by the Doors) (thanks Shannon!)

Ya Gotta Be A Little Nuts To Work The Nightshift Series - #3

2007-01-08T09:56:00.001-06:00

Ya Gotta Be A Little Nuts To Work Nightshift SERIES - Story #3

Story #3

Ok, this one several of you have heard me tell but I'm going to post it anyway. I love it.

We had a very depraved and heinous nurse that came to us from the ARMY!!! Yes, she was tough, and a very good nurse but she loved to play practical jokes. Again, the newbies......(poor things).

Usually we only had to tell the newbies to lay on the stretcher (empty of course) so we could test it for something or other. They would (silly little untrodden RNs) hop right up there and lay down. They are quickly pinned down and two nurses with 3" silk nurses tape (which gives Duct Tape a run for it's money) tape newbie to the stretcher like a mummy. Then of course we push him or her through the entire unit showing off our newest hireling......

THAT isn't what is so funny about this story though. The newbies gang up on poor Ms. Army Nurse! And there's nothing that none of us can do to stop them. (*cough* absolutely nothing *cough* *cough*) She is sitting at her bedside in a rolling chair (the kind that you would find at a desk in an office. Out of NOWHERE, 6 newbies (which quickly came to be called "the adventurers") grabbed "R" and speedy quick started taping her to the chair. When she was totally taped to the chair with her arms taped to her sides and her feet taped together, a thick strip across her mouth, they rolled her out to the elevators. Yep, and remember, I said we are on the 10th floor! At this time it was about 4:00 a.m. so not many people around (other than other nutty nightshift workers.) I have to admit, as I walked behind this fiery and spirited group with a smile on my face, her eyes were shreiking "HELP ME DAMN IT." I couldn't do anything but laugh and walk along to see what was going to happen (like I didn't know). This story gets better......

Onto the elevator she goes and EVERY button, let me say it again..... EVERY BUTTON, the COMPLETE PANEL OF NUMERIC ORBS were pushed until they were glowing like a kid's first campfire....... (there were some unusual grunting noises coming from "R" but just then the doors close and we all are bent over in hysterics.) We hear a "CODE" called and rush back to the ICU to help somehow forgetting about our desperate and unlucky coworker. All turns out well with the code and about that time the swinging doors swing in and we see two guys we know from the ER (which is on the 1st floor incidentally) pushing our still torso taped teammate up to the nurses desk. She is now screaming obscenities (and for those who know me, that's where I learned it!) We quickly split in several different directions and were happy later to see that she was actually appreciative of the cleverness of my joke. (Although to this day, she does NOT know where the grasshoppers (another name for new nurses on orientation) got the idea and I'M not telling!