Tales of an ER Nurse

I'm reading The Geography of Bliss , a nonfiction account of a curious and somewhat discontented journalist who decides to hunt out who the most happy people are and why. On his search, he visits Bhutan and meets a man who runs the country's think tank, appropriately named Karma. Karma advises the author, "You need to think about death for five minutes every day. It will cure you, sanitize you....It is this thing, this fear of death, this fear of dying before we have accomplished what we want or seen our children grow. This is what is troubling you....Rich people in the West, they have not touched dead bodies, fresh wounds, rotten things. This is a problem. This is the human condition. We have to be ready for the moment we cease to exist." But I touch dead bodies, handle fresh wounds (both physical and mental), and rotten things. I, and my fellow emergency department coworkers bear the brunt and weight of the rancid realities of life and death and what happens in be...

In the year + that has passed since my last entry, I've developed a new fascination. I'm having a difficult time focusing on real life or ordinary details, especially when driving due to my new interest. Everywhere I go, I see them. Sidewalks, grocery stores, malls, and of course, the ER. I've become obsessed with Hoverounds. Also known as motorized wheelchairs, these modes of transport fill my thoughts. Multiple times, I've come close to crashing my car just because I couldn't take my eyes off one. They make me smile, laugh, and without fail, start singing the Hoveround theme song in my head. It's played during such quality daytime programming as The Price is Right. If you're not familiar with this jingle, do me (and yourself) a favor and google "Hoveround Song." You won't be disappointed. The main lyrics are: "Hoveround takes me where I wanna go. Where will it send me?" Oh, I, too, have been pondering this question. It implies...

It's been over a year since I posted anything, and not for lack of material. Stories pile themselves in my head, and it's time to type some of them out. "Laverne" was brought back to my open room, and right from the get-go, a strong crazy vibe was palpable. I always say that there are a few trademarks of the insane: 1. Untamed female facial hair 2. Wearing a puffy coat (especially old-school Seahawks or Raiders) on a hot day 3. Insisting on representing oneself in court 4. Painstakingly reading every word of every document before signing, especially the privacy statements or discharge papers. Laverne met #1 and #2. Probably #3, too, but I was not privy to that information. Her chief complaint was that her husband was trying to kill her. She thought he was putting Drano in her cereal in the mornings. "Why not just stop eating food he gives you?" one might ask. And one might ask to no avail. Please see aforementioned list. I introduced myself as us...

Today I took care of a patient who used to be an ER nurse. She's married to a man who used to be an ER nurse. After years of diverting and shooting up Dilaudid and other drugs, both she and her husband lost their nursing licenses, their jobs, and their health. She checked in today because she's detoxing off of methadone and alcohol. In order to function, she has to drink alcohol every half hour. Even during the night, she wakes up every 30 minutes to take a drink. This woman brought her 10 year old son to the ER with her. He sat in the corner and drowned out reality by playing his hand-held video game. She has other children, too. Her veins are scars, and her limbs are pock-marked with scars from shooting up for so many years. She laughs at everything, but the smile didn't reach her eyes. She terrified me. In nursing school, I remember learning about a shocking percentage of nurses that end up abusing drugs and stealing medications from work, or even using at work. It seems...

During this last work rotation, I met a few people that have not left my mind. I've actually prayed for them each, several times. This is unusual since often, I have forgotten yesterday's work entirely as I rush into today's workload. The first was Margaret, a woman who had had multiple miscarriages. She was angry, and crying in a wheelchair in the ER waiting room, and I apologized for the wait (about 2 hours) as I rolled her back to one of my rooms. Hallway, actually. As soon as I could, I got her into a room, and heard her story. She was about 10 weeks along, had just stopped taking Prometrium, and had had a sudden onset of bleeding while at work. She was scared, panicked, anxious, and upset. Instead of telling her "we won't really be able to do anything except an ultrasound since you're so early in this pregnancy," I just listened. Blood work was sent off, a pelvic exam was done, and off she went to ultrasound. Her husband waited in the room. Hours late...

Although I started this blog with the intention of MUCH more frequent postings, it's turned out that I'm not a diligent blogger. Big surprise. It's just an electronic version of my pile of half -empty journals that intermittently chronicle three decades of life. Part of it is that I don't want to be a chronic whiner. Especially about work, which is so difficult even with a positive attitude. I'm also unsure at this point what I really want to share publicly about my life. Another aspect is the fake Hollywoodish stuff where Meg Ryan sends out her emails "into the void" or Julie writes to the scores of "servantless American cooks" or Sarah Jessica Parker sums it all up in one question. I don't necessarily want to be like them. Deep down, I'm just insecure enough to want validation from friends, or even strangers online. But my pride keeps me from writing from the real depths of myself. One of my life goals is to write a book. Whether fictio...

My friend and fellow nurse, Elise, asked me to come into one of the patient rooms with her to help prepare her patient's eyes for cornea donation (actually, the word used is "harvesting" but that just seems too grotesque and industrial). "She died from thyroid cancer with mets," Elise explained as we entered the dimly lit room. The family had said their goodbyes and gone home. Unthinkingly, my hand flitted to my own thyroid. Although her body was already cold, the woman didn't really look dead. I kept waiting for her chest to rise. It didn't. I asked what the woman's name was, and Elise told me. Even though we knew somewhere deep down that she couldn't hear us, we still explained what we were about to do. Holding her eyelids open gently, I watched as Elise instilled saline in the woman's already cloudy eyes, and then I taped the eyelids closed. I fought the temptation to wipe what looked like salty tears from her cheeks. "Should we put a...

During my last shift, I checked in an ambulance that brought in an 87-year old man. Chief complaint: decreased LOC. His eyes were almost gunked shut, his skin and mucous membranes were dry, and he answered questions with barely understandable words. His body was weak and limp. I did the usual nursing things....started an IV, drew blood, got blood cultures, took a rectal temp, got vital signs and an EKG, and ordered the typical gamut of stuff. I left the room to chart and check on my other patients. A little bit later, after the patient returned from x-ray and CT, I looked over to the room and saw, below the curtain, two feet encased in navy blue socks, standing by the bed. Racing to the room, I threw the curtain aside to find my 87-year old man, IV yanked out, blood dripping down his arm, oxygen tubing off, all EKG leads off, gown off, standing completely naked except for the aforementioned socks, peeing on the floor. He had removed all the wires and tubes that beset him, and climbed o...

The other day, a patient asked me, "Do you have any pets?" Immediately, I pictured Spike and his cute little mustached face and hilarious personality. I replied, "Yes, a little Cairn Terrier. How about you?" She told me about her three Italian Greyhounds, and showed me pictures on her phone. It struck me suddenly that this is a fabulous question to ask people. It's not invasive, it won't make the childless people hurt, and there may be some fascinating stories behind the answers. Usually, patients and other strangers ask me if I have children. I say, "No, not yet" and leave it at that, quickly getting back into my therapeutic nursing communication mode to get the focus off me and back onto the patient. But I always feel the ache of having to say "No, not yet" over and over again. It just felt so good to be able to say, "Yes!" to the pet question.

Yesterday, I got report on my rooms, including Room 5. Room 5 was a female, in her late 40's, and weighed somewhere between 250 - 300 lbs. She had come to the ER because her chronic back pain had gotten too intense to handle at home. She was unable to lie on a bed because of her severe pain and had been sleeping sitting up in a chair at home for a few weeks. When offered pain medication, the pt. declined. She also complained of abdominal pain and diarrhea, but since she couldn't lie flat, we weren't able to do a CT scan or MRI or pelvic ultrasound. We tested her stool and it was positive for blood. She gave a urine sample, and there was also blood in her urine. I told the doctor about these results, and he said that "we" needed to get a sterile urine sample by catheter. "We" in these situations means ME. About every 10 minutes, the patient had to go into the bathroom to have bloody diarrhea. Her sheer girth made it impossible for her to clean herself th...

The other day, a 50-something year old male came into the ER, guarding his abdomen, hunched over due to pain. I introduced myself and started an IV, and told him I needed him to give a urine sample. I offered to put a robe on him so he wouldn't be flashing his backside. He commented, "Oh, that's okay. I have panties on." I waited for a second, then looked at his wife and smiled, and she smiled back. I asked, "Did you just say you were wearing panties?" He said, "Um, yeah." We all started laughing. A few hours later, when I was discharging him, he asked, "You're not going to tell anyone that I called my underwear 'panties,' are you?" I replied, "Oh, you bet I'm going to tell people!"

The movie that came to me from Netflix this week happened to be "Beaches." A poor choice to watch tonight, as it turns out, given the timing of events this week. Yesterday, we received a medic call to alert us that in less than 10 minutes, they would be bringing a 50 year old male who was pulseless; CPR in progress. This is never a happy prognosis. Upon arrival, the pt. was a big, strapping, overweight black man with cornrows, still wearing his waterproof construction pants. He had been on the job site, and had collapsed, vomited, and was unresponsive. When the medics arrived, apparently he had no pulse, so they commenced with CPR and then got a pulse back, and a shockable rhythm. They shocked him and followed the ACLS algorithm with the appropriate drugs and electricity. Twice, they were able to "get him back," as we call it. Probably his soul was gone, but his heart responded with a normal rhythm for a few seconds, and a palpable pulse. That's plenty to give...

Today is the birthday of one of my first big childhood crushes--Ben Lee. He was tall, older, dark, handsome. And ever since I was 9 years old, I've remembered his birthday. I wonder what he's up to today. I hope he's happy:) And hopefully not visiting an ER. Like one of several interesting patients that came through triage today, where I was assigned. One was a 50 year old male with a dildo stuck up his rectum. Obviously, he was unable to retrieve this accessory on his own, and after 10 hours of trying and straining away (talk about an urge to go), he showed up, shamefacedly, at my ER. Embarrassing....but not an automatic surgical case like the guy from a while ago who came in with that long, flat-ended vacuum cleaner attachment stuck up his rectum into his intestines which were necrotic by the time he checked into the ER, with poop coming out of the vacuum end. Another patient after being discharged immediately checked in again. Hoping for a better outcome, I guess. Or, mo...