Not my best day.

Do you ever have days when you feel like your life is one long spiral downward? And no matter how hard you fight you are just getting sucked down. Maybe it will be almost a relief to be sucked to the bottom - it's got to end there - right?

Okay I get really down when I work in rehab too much. I mean waaay down. I see all these lives shredded. A young man with a 1 year old baby. He's girlfriend is going to take care of him. Yep that's what she says. His dad tells us on the side - he is pretty sure that is not going to happen. Dad was right. Girlfriend had no idea what is involved in taking care of a quad. She cannot raise a one year old and take care of the quad too. She is gone now.

Another young man. Drunk off his ass and tried to drive home. Ended up eating dirt with his face out the window. His young sweet wife (also with a small child at home) is way past the "Please God let him live" part. He lived he is a quad as well. Now she is in the anger "why did you F*#@! up our life?" It's not just h is life that is fubar. So is hers and the her kids'. You have got to give her credit. She is sticking around. But there is all this tension in the room. She knows what she is facing. But how can you get pissed at a quad?

Then you get the 40 female with anoxia, the 35 year old stroke who will never walk, the 20 something paraplegic who will never again feel what it's like to make love.

Dante should have seen this before he wrote his masterpiece. This is several different types of hell.

Hmm ... murder? or too much CSI

So I am hanging around in the ER with my recently intubated - now ventilated patient. Waiting for the ICU to give us thumbs up to transport her. This felt like a run of the mill OD pt. to me. All of a sudden there is a shy knock on the door. I never had anyone knock on the trauma room doors before. Since I'm alone in the room (except for sleeping ventilated beauty there) I get up and open it. There is this guy with three camera's around his neck, a official looking ID tag, and a backpack. He says he's from the ME's office and needs to come in and take pictures. Hmmm- problem here - patients not dead. I told him to go find the nurse.

It really got me thinking though. How many patients have I had that we thought were routine OD? Husband/ wife/ boyfriend/ girlfriend tells us that the patient is a drug user, pt. has positive tox screen, so we just believe they got carried away this time. Wouldn't that be a fairly easy way to murder someone? Is that what happened this time? Why is the ME office interested in this patient? Kind of freaky.

IPPB Makes me laugh

I got an order to do IPPB yesterday. Haven't seen that in a while. So I dug the relic machine out and headed to the woman's room. Very nice very proper elderly woman. Surrounded by family. A family with money evidently. She is propped up in bed wearing a bed jacket. (Just like in movies from the 50's). Daughter is carefully doing the her hair just so. Patient has makeup on - the works. This extraordinarily proper family is having quiet conversations about golf, the market, and some social event.

So I get the machine rigged up, explain how to use it and we go to work. About a third of the way through the treatment - the lady rips off with the biggest fart I have ever heard. The family stops - there is no movement - nothing - as they try to decide how to handle this incredible embarrassment. The woman handles it quite well. She looks at me and days, "My goodness, that oxygen just goes right through you!"

The family busts out in one huge guffaw. I laughed the rest of the day.

How to tell if your pt. is a loser

My pt says to me, "these hospital beds are not very comfortable (pronounced comfurtble), the one's at the homeless shelter are better. But these beds are better than the ones in jail. They ain't comfortable at all".
Next time I get real sick I'm going to the homeless shelter ... the beds are better.

Don't you sometimes hate family's?

Big dude- bad brain -bad heart - eveything else is not so good either. I am in a new unit today. One I don't often work in. The big dude has had the same two therapists for the last week. I am new - (in this unit) so family equates that with new = incompetent. They keep asking me assinine questions like "Well, the therapist yesterday didn't have to change is oxygen level - why are you changing it?" "The therapist yesterday didn't have that peak pressure thing that high - what are you doing that it is so high today?" And even more snide remarks like "Maybe they shouldn't let the regular therapists have a vacation - hahaha".

I want to answer - well see your husband is a human - not a mannequin. Lungs get worse, bodies get tired, fluids get out of whack, stuff happens. So shut the crap up - or get out of the unit - and let me do my job.

Today - I hate familys.

Don't piss off the chick that may need to breath for you....

20ish female, heroin od, potty mouth, bad attitude, nearly combative. I vote we kick her ass out on the street and let her deal with her own self induced aspiration pneumonia secondary to heroin od. She won't take her treatments, fights with the RN every time she to check her artline, or even touches her. Becomes verbally abusive to nearly everyone that walks in her room. F ing this and F ing that and you F ing bitch......

Don't give me any sob story about drug addiction is a disease. That is bull and utter nonsense. Drug addiction is a choice and this choice galls me on so many levels. Level one is why the hell do we substitute an patients illegal but self paid for abuse (heroin) for a legal but taxpayer paid for abuse (methadone). Then because they have this terrible bullshit "disease" they are also on disability and medicaid. So we (the good taxpayers of this country) pay for their lifestyle, their addiction, AND their health care.... so they can come in here and call me an f ing bitch .... when in fact..... I paying for her f ing life!!!!!!