Wednesday, January 30, 2008

An open letter

Dear Reader(s),

I'm not really as much of a bitch as my recent posts make me seem.

Of course some of my friends might disagree.

Hug and kisses,
Dead Nurse

Sunday, January 27, 2008

Separated at birth?

Sometime, I have a difficult time telling the difference between my cat:

And a certain obese character from Star Wars:

Saturday, January 26, 2008

Lowered expectations

In general, I believe people have unrealistic expectations when they are admitted to the hospital. They expect to be given around the clock care, but also expect to be allowed to sleep a full 8 hours each night. They want their nurses to bring them their medications exactly as they are timed at home, with absolutely no consideration to the fact that their nurse is also caring for several other patients.

One expectation I dealt with this week, is when physicians are suppose to see their patients. Many of the patients on my unit are seen by hospitalists. These are the docs that work for the hospital. These guys and gals work really hard and usually start seeing their patients around 7:30am. Now if you’re a pretty healthy person, say a 40-something year old female with cellulitis of your hand, then you’re probably not going to be seen first. You see, there’s this thing call “triaging”. This is where the physician places their patients in order of how urgent they need to be seen. That 78 year old lady in the ICU on a vent is probably going to fall somewhere near the top of the list. Your spider bite...well, let’s just say you’re not a real priority for your doctor today. They will get to you eventually, and if you need something they are only a phone call away. However, don’t expect to see them much before noon.

This concept is poorly understood by many patients and family members. They are living in a world colored by the many episodes of General Hospital and St. Elsewhere that they’ve watched. This is a world where physicians make “morning rounds” and see their patients several times throughout the day.

This world doesn’t exist.

Your doctor will see you as soon as they can. It’s not that they don’t care about you, there are just sicker people that need to be seen first. If you or your loved one were really sick, wouldn’t you want them to be seen first?

So please don’t complain to me when your doctor didn’t come to see you until (gasp!) 12:30pm! Did you have everything you needed? Were you in any pain? No? Good.

So take your vicodin and shut the hell up.

Thursday, January 24, 2008

The pain scale


The pain scale is bullshit.

There, I’ve said it. It’s out there and I can never take it away.

It’s bullshit because people are retarded and don’t use it properly.

Example: A patient has a wound on his foot. It’s infected and nasty. It must hurt. The patient appears fairly comfortable. He’s watching television and enjoying a milk shake.

“How would you rate the pain your having right now,” I ask.

He looks up from his milkshake. and says “10/10”.

I want to respond by saying, that we might as well go ahead and chop that foot off without using any sedative. It apparently can’t get any worse, right? While we’re at it, we’re gonna go ahead and take out those wisdom teeth of yours. No gas for you though! The pain couldn’t possibly be worse than you’re experiencing right now!

Instead I just opt to medicate the dumb ass and order him another milk shake.

Why I love my job

Setting: A hospital medical unit. A patient has been admitted with abdominal pain of an unclear origin and has just been started on a fentanyl PCA. She calls the nurses station complaining that the PCA is beeping.

Dead Nurse enters the room to find the PCA beeping.

Patient: This fucking thing isn’t working.

Dead Nurse: Well, it looks like there is an occlusion in the line somewhere. Let me try to fix it. Resets the machine and gets it working.

Patient: I don’t feel anything.

DN: This isn’t going to feel the same like getting the intermittent shots. You need to give it some time to work.

Patient: The fucking machine is broken.

DN: It’s working. You just need to push the button to get pain medication.

Patient throws controller on bed and rolls over facing away from Dead Nurse.

Dead Nurse exits.

Patient calls again to complain that the machine isn’t working.

Patient: I told you this machine wasn’t working.

Dead Nurse looks at the machine and sees that she has received 30mcg of fentanyl.

DN: The machine say it has given you 3 doses.

Patient: Can you find someone who knows what they're doing?

DN: The machine is working. Any nurse in this hospital will tell you that.

Patient: I need food. I haven’t eaten in 3 days. They want a sample from me. How am I suppose to go number 2 if I haven’t eaten.

DN: You still make stool even if you haven’t eaten.

Patient: Nu, uh.

DN: Why don’t I call the doctor and see if we can get you some clear liquids.

Dead Nurse calls the doctor who informs him that she told the patient that she couldn’t eat earlier in the day. Her rationale being that if something is really wrong with her, that food could just worsen the problem. Dead Nurse returns to the room to deliver the sad news.

DN: Your doctor doesn’t want you to eat. She’s afraid that it will just worsen your pain. If you start feeling better than we can get your something.

Patient: That’s the problem! You have to eat to feel better!

DN: I don’t think the food will make you feel better.

Patient: But I'm starving! I think I need to get an older doctor. Someone with more experience.

DN: I really think any doctor you see will tell you the same thing.

Patient: Nu, uh.

DN: Can I get you anything else?

Patient: I need some phenergan. I feel nauseous.

Wednesday, January 16, 2008

Tuesday, January 15, 2008

Kitchen Confessions

Portland is a foodie town. People here love to talk about food in great detail. They share their opinions on food freely and can have a tendency to look down their noses at people who dare to disagree. These are the people who visit the farmers market regularly, buy only local produce, and “eat seasonally.”

I am not one of those people.

I have some confessions to make that I need to get off my chest.

-I don’t always use fresh garlic. I have a jar of prepared minced garlic in my refrigerator that I use with some frequency.
-I visited the Portland Farmers Markets one time last year.
-I will probably not visit the Portland Farmers Market with greater frequency this year.
-I’m not really all that enamored with farmers markets. I think buying my produce at a grocery store is just more convenient and I don’t really notice a difference in quality or taste.
-I eat veal and do so unapologetically.
-I buy flavored ground coffee. Grinding my own coffee is a task that I have absolutely no interest in taking on.
-I have several favorite recipes that call for a can of condensed soup (usually cream of mushroom).
-I have never made my own spaghetti sauce and always use jarred sauce.
-I purchase produce with no thought to if it is in season.
-I believe that the Hostess Orange Cupcake could very well be the world’s most perfect confection.

I feel much better now. Thank you for your attention. If you need me, I’ll be in the kitchen sipping my hazelnut flavored coffee and eating my out of season produce. If you happen to see any orange cupcakes while you're out, could you pick me up a box?

Sunday, January 13, 2008

My marimba


Marimba, originally uploaded by twarlik.

I just wanted to share a picture of my new marimba. It arrived in November after several months of waiting. I didn't think it was possible to love an inanimate object so much.

Saturday, January 12, 2008

Gym People

I go to the gym on a pretty regular basis. The gym is where I de-stress and continue my ongoing quest to look better naked. It makes me feel good and I normally enjoy my time there. However, something has recently happened at my gym that is bothering me a bit. You know what I’m talking about...

It’s the attack of the New Year Resolution people!

They have resolved to lose weight and get in shape! They come in huge numbers to gyms everywhere in the month of January. They look like lost souls wandering the gym in their sweats; staring at the machines, uncertain how anything works.

I should say that I don’t dislike these people in any way. I think it’s great that they’ve decided to make a change in their life and get healthy in the new year. What bothers me is the number of them who have seemingly decided to ignore all gym etiquette. I can only assume that they are simply unaware of expected behaviors, so I have decided to help out a bit. Here for the first time anywhere is Dead Nurse’s Guide To Gym Etiquette for Newbies and Other Clueless Folks!
  1. Wear appropriate attire. This means you should change out of your jeans and polo shirt. Put on some athletic shoes because those flip flops are much better for the shower than the treadmill.
  2. Wipe your nasty sweat off the equipment. You’ve broken a sweat! GREAT! Now clean up the mess you left on the weigh bench. No one wants to lay in a pool of your body juice.
  3. Put the weights away. I’m glad that you think bench pressing 400lb is impressive, but not all of us can lift that much. So please put the weights back on the rack where you found them.
  4. The locker room is not your bathroom, so why don’t you try wrapping a towel around yourself while walking around. Perhaps you’ve identified me as gay and think you’re giving me a real treat by allowing me to see your twig and berries. You’ve greatly overestimated my interest. You are much more comfortable with your nudity than I am, so cover up! Now that young man over there who looks like the Abercrombie and Fitch model...He’s welcome to parade around the locker room with his pants off.
  5. Get help! You only look like a tool when you misuse the equipment. If you don’t know how to use something, just ask a staff member.
  6. Learn a little something about anatomy. What muscle do you think you’re working there with that crazy exercise your doing? You look more like an Amazonian bird doing a mating ritual than anything else.
That’s all I have for now. I’m sure this list will grow as the months go on, so stay tuned for future editions!