People are nuts

On the whole,  people are just nuts.   I have worked with the public for many years and this is true more often than not.  I have a dying patient, comatose now, and the family is grieving.   Now I know everyone gets to grieve in their own way but sometimes their way is crazy.   This was crazy on a whole different level.  The mom is repeatedly kissing the woman's lips despite the breathing tube and NG tube and the stench of old mucus,  the brother sneaks in alcohol and gets so drink off his ass he had to be escorted out by security,  the step mom is praising Jesus with increasing volume over and over and over, and the husband is repeatedly kissing his wife's TOES- yes her Toes!  while loudly proclaiming he will not apologize for it.

Only the Dad sits in the corner quietly, tears in his eyes, looking miserable and broken.  I think his sorrow is for the daugher he is losing, but then again, it might also be for the life he has lived with these nutsos.

Maybe I should be a pooper scooper.

Why in the hell do we let patients dictate their own care? Why is a patient allowed to tell me what they want or don't want?  When they want the lifesaving Bipap taken off or when they should be allowed to stay on the vent and not breath on their own because they need to rest?  Yes this is real.  I have trach patients who do not want to come off the vent during the day because it is so much easier to let the vent breath for them and not have to exert an ounce of energy in their own behalf.  We put them on a vent at night to theoretically rest them.  And who needs to rest from breathing anyway?

I have patients that order water or coke , knowing full well they aspirate everything into their lungs.  I have patients that refuse their breathing treatment because they need to take this phone call.  Or patients that won't do th therapy ordered to combat the illness which brought them into the hospital in the first place.

I absolutely detest when patients start ordering their care as if they were at Burger King.  I want to ask them, "Could you take care of this at home? Oh you couldn't? that's why you're here? Then lay back, shut up, do what we ask, and let us do what we do very well. If you can take care of this feel free to go home. Wouldn't hurt our feelings at all. "

On another note.,,, we have this room we should call the PITA room. Nearly every single patient we put in there becomes the biggest pain in the ass. And it doesn't matter the diagnosis.  Every patient assigned this room start a running chant of "I need pain meds, I need a drink, I can't breath, I need pain meds, I need a drink, Where is my pain meds, I can't breath.",  and it goes on and on and on and on, all day and all night, until some nurse gets fed up and narcs their ass.

And of course every single patient that goes into this room has some gnarly infection for which we have to glove, gown, mask, and sometimes put booties on. And each and every one refuses to tell you what they want until you get all protected up and go into the room. Then and they launch into the chant ... "I need pain meds, I need drink, I can't breath, I need pain meds.......... and of course it'snot time for pain meds, they are on a vent or a bipap so they CAN breath and no they can't have a drink. Thus, you have wasted all that time and energy to come in the damn room and repeat what the nurse had told them not five minutes before!

Maybe I should go scoop dog poop for a living. You still have to deal with shit but it's at least quiet and just lays there. 

Staff Meeting - the reason I'm on Prilosec

Can I just say how much I HATE staff meeting. Maybe "hate" is not the right word.... ummm detest, loathe, abhor. I have never yet come out of a staff meeting feeling like management thinks any of us are competent. It is two hours of either a new process that is going to make my life hard, new paperwork that is going to make my life hard, new device we are not really going to get trained on but expected to use - which makes my life hard, or why aren't you guys doing anything right????? All this by management that is not even remotely clinical.

So we are trying to up our satisfaction score. Apparantly reimburesement is tied to this - thank you Obama. There is a desperate attempt to make every single patient happy. The underlying problem is that I am an RT. I don't do one single thing that isn't uncomfortable or downright painful. I suck snot out of your lungs, I shove tubes up your nose, I stick needles in your arm, I make you cough and deep breath with an abdominial incision.

So I listen to the staff meeting spiels - the first speaker is a complete idiot I have absolutely no respect for so I blow that one off. The second was interesting and although I don't agree with their basic premise I do think that okay I probably could work a little harder at a pleasant deamanor, calling people by "Mr. or Ms." etc.

First patient of the day. I am set. I have worked thouroghly on my attitude. I am going to help this gentleman today. I am going to get high scores. I am going to go out of my way to be pleasant. He tells me to "fuck off".

Looks like our remiburesement is going to suck.

600 pounds of lovin! No kidding 300+ kilos. I have never seen a human this wide. Her neck is bigger than my butt. (And that is saying something!)

I am standing in the room as the dietician goes over her diet. Nice little dietician says ,"Is there any foods you dislike that we should not bring you?" I am thinking "does she look like there is anything Orca doesn't eat ?" And Orca pipes up "I don't eat celery - it's a personal choice."

The laugh through my nose came out as a snort. The only food known to man that takes more calories to digest than there are in eat and that's the one she WON'T eat !

you know it's a bad day when....

your first report is...
"40ish female came into the ED with OD, lying naked on a stretcher, pulled a bottle of pills from her VAGINA and proceeded to take them all."......

....so is this diagnosis called a vaginal OD?

Ah another day at Mercy Medical. (Yeah that's a made up name). Had the nicest little old lady. She's dying. She knows it. I was trying to pamper her. Got her a warm blankie, some juice, did her treatment. I was leaving and told her thank you very much. She looked at me and said "Be good to yourself today." Now I don't know why she said that but it did make me think. Am I good to myself? Do I take care of myself? Hmmmm. Probably not as much as I ought. So I am going to go buy chocolate. :)

57 Female. 3rd admission. Positive for opiates, barbituates, and benzoids. Doc can't figure out wahy she isn't waking up and insists on a head CT, and MRI, carotid artery studies, CT angio to rule out pe, and DVT studies. I ask him - um could it be the opiates barbituates and benzoids? Since she was in here a month ago - same problem. He patiently explains that she has an infiltrate in her right lower lung. Uh-huh - could she maybe have aspirated??????????
Well - he says it COULD be a PE so we have to rule it out.

Family is asking doc if this is stoke? Bleed? Infection? Why does this keep happening to mama and why can't we figure out what is wrong?

I want to scream "BECAUSE MAMA IS A BIG TIME FREAKIN' DRUGGIE AND YOUR DOC IS A JACKASS !!!!!!!!!!!!!!!!!!!!!!!!



Really really glad I am in a different unit today.