Dispelling Theological Rumors

For the record:

As a telemetry nurse, I think I can safely say I've seen enough of human nature to make me very suspcious about theological claims regarding Jesus loving everyone.

If He does Love Everyone, I'd like to know how the hell He does it, because I for one, think there are some really objectively unlovable fuck ups in this world, that anyone, even a Christian deity, who claims to love said persons is lying through His pearly-as-the-gates-of-heaven teeth.

I say this after a day of floating to a medical telemetry floor (and we all know medical telemetry is code for "Bill and Ted's Totally Bogus Telemetry Admission, but whatever, we can charge more for the bed this way/Fraud, who said fraud?!") Dude, two of my patients weren't even on telemetry, and of all five patients I had today, only one of them really needed the telemetry for you know, an actual arrhythmia.

Compared to Old Floor/Old Hospital, though, I would still have to say the assignment pain-in-the-ass scale (with 0 being no pain-in-the-ass and 10 being the worst-pain-the-ass I've ever had) would have only been a 2, and that was including an exceedingly unpleasant Etoh withdrawal chap who enjoyed cursing at me the entire day and refusing essential things like IV access (who needs that crap on a telemetry floor?! being his brilliant rationale), and a Jerry Springer smackdown of family members on a patient who wasn't even mine.

I mean, DUDE, does my badge say, "Hello random people I've never met before in my life, how may I let you bitch slap me today?"

What a bunch of assholes.

Hmmm... maybe my neuro nurse friend is on to something when she says she likes her patients intubated and sedated.

Meanwhile, I'm hoping the census on our floor is back to normal tomorrow, because I've had enough of floating for awhile, thank you.

Cold Mountain

So I have a crappy cold.

I have been treating it with liquid Benadryl/Tylenol remedies which has the effect of making me sleep most of the day, subjecting myself to daymares and waking up feeling just as log-headed and foggy as I did before the consumption of pharmaceutical wonder products.

Meanwhile, I'm thinking of the many good uses to which I could put lottery money to use, so if any one wants to clue me in on the winning numbers, I'd be much obliged.

Bunny Tales

This morning I witnessed something quite droll.

I let my lop-eared rabbit, Flip-flop, out of her cage for a morning cavort as I had to clean the house.

In what I imagine is a faintly ironic twist of inter-species sibling rivalry, the first thing she does when freed from her cage is to run over and nose into the dog bowls, because maybe he's got something she doesn't, like tap water(!), or dog food, which she has been known to munch on contentedly until I figure out it's the rabbit eating the dog food and hoist the bowl up and out of reach.

Sure enough, ignoring the perfectly okay tap water in her space age vacuum water bottle, she hopped over to a freshly poured bowl of delectable dog water, butted the dog out of the way and started to drink.

And drink and drink and drink (mostly I think to piss off the dog, who was standing there waiting for her to finish.)

Meanwhile, the dog was giving me a puzzled, "Help me!" look, and started whining piteously (confrontation is apparently not his strong suit, even when dealing with a prey species).

I have photographic proof of this late and great Bunny Tale but alas, no way to upload it onto the blogger.

A Nursing Fairy Tale

Once upon a time, in a galaxy far far away, on a planet much like our own, in a kingdom of darkness and cold, there lived a poor Graduate Nurse who unfortunately passed her boards and was thus gainfully employed by a hospital run by rich, evil Kings and Queens who cared not a whit about their patient population, but only money, and how much of it they could stuff into their deep and bottomless, soul-sucking pockets.

This poor graduate Nurse came to work under a particularily vicious Evil Stepmother of one of the Wicked Kings and Queens. The cruel Evil Stepmother made the graduate nurse and her fellow slaves-in-nursing work night and day, toiling endlessly, with out eating or resting, for mere scraps. Whenever any one was foolish enough to ask for the slightest compensation for their hard, endless work, the Evil Stepmother made certain that nurse would get the exact opposite of what she had asked for, and seemed to delight in making everyone completely miserable. Some times, the poor nurses were publicly humiliated by the Evil Stepmother, and it was widely rumored amongst the land that some nurses were even tortured into insanity. Many nurses became ill and withered away, never to be heard from again.

Then one day, the poor graduate Nurse found she was not a happy, smiling graduate nurse any more, but a bitter, cranky and half-crazed staff nurse who was quickly losing her ability to cope with anything more complex than getting out of bed in the morning. Without warning, she Ran Away from the Evil Kingdom of Hospital Doom, never to be seen again by the Evil Stepmother or her co-slaves.

She ran and ran, and when she could run no more, she found herself a job in another Hospital Kingdom. This time, however, she worked for a Fairy Godmother instead of an Evil Stepmother, who treated her nurses kindly and with respect.

And lo, the nurse believed she was having a psychotic break. And lo, her medical insurance hadn't kicked in yet, so she couldn't get a psych consult and a script for Seroquel just to cover her bases.

The mutual admiration went on and on, leading the Nurse to feel that perhaps she had mixed up her tale with that of Sleeping Beauty, and that she had fallen into a long, deep slumber and dreamt endlessly a reverie in which her job was pleasant and her boss respected her employees.

Then one day, the Nurse had an argument with a Snotty Princeling Attending So-and-So who had surronded himself with a court of Knaves and Jesters known as residents, because he was too gormless to face a skinny woman weighing less than a sack of potatos by himself. The nurse used her Super Ninja Jedi Mind Tricks--and hot temper and loud mouth--to great effect, and vanquished the Evil Princeling from her castle. The nurses lauded her for her ability to smite the Snotty Prince, and for her unwittingly sending the Snotty Prince's patients off to another castle to be cared for, at least for awhile.

And lo, the Fairy Godmother chuckled at the plucky resourcefulness of her nursing staff and said in commendation, "So, I see you've met our resident Napolean with a God complex! He's an asshole, isn't he?!"

And the nurse, who rejoiced and sent e-mails documenting the miraculous event far and wide to her ex-colleaugues still living under the frightful rule of the most Frigid Stepmother on the planet, lived happily ever.

The End.

thirtysomething

Friday was my birthday. No, I didn't spend the day snorting crack off my dog's rump (too furry, for starters). Yes, I did (predictably) go home. Because I am a sad, very broke individual with no friends my age living within a 600 mile radius of my person.

I spent My Birthday with my mom, doing Post Move errands. Basically I drove her around Jacksonville, because she's been up for about three weeks straight, Moving Stuff, Packing Stuff and Unpacking Stuff. You see my parents bought this Rilly Nice New House, and they just moved in, so I went to visit them and watch my mother Put Away Stuff all weekend long. That was pretty much my birthday entertainment.

Oh, that and:

I finished another baby kimino from Mason Dixon Knitting for Pregnant Person #3 on my unit (quit. procreating. people.) and two washcloths, both of which went to the New House. I also had a margararita and a Corona (on different days).

I'm telling you, I lived large this weekend.

So yey, thirty. You're predictable, boring and live with your parents. Or aspire to, at any rate.

Kerplunk and Kerplooey.

So today was my official veg-out day. Yesterday being a clusterf---k of a day at work (and my last of three-in-a-row twelves), I didn't have a lot of energy today to go out into the meltingly hot summer weather and join the rest of the greater NoVA population in chewing up the ozone in my gas-guzzling vehicle.

I also had a sinus headache when I woke up and felt very put-upon about having to clean the house when i just did it last week, man! I nonetheless spurred myself into action and have achieved a tidy living space as a result.

I like to think of myself as being a crepuscular creature; rising at dawn to forage for food and clean out the old warren, then sleeping in said warren for the rest of the hot, crappy day, and coming out again only at dusk to forage for more food.

Since I've been getting in touch with my inner- Victorian age recluse today, I really haven't much of an update, except a Handy Life Tip: grooming the family dog's fur aided and abetted only with a small child-size craft scissors is a thankless job, indeed.

Dude, Where's My Hematoma?

So today I had a patient who was two days post-op from a fem-pop bypass. Yesterday, vascular service decided to leave his old, yucky bandage on--breeding God knows what filth--whilst today, a vascular resident came by, took down the dressing, assessed the wound, and bandaged him back up without however, cleaning the incisions.

Then the resident advanced him from clear liquids to solid food, without the intermediate full liquid trial. I don't know for 100% sure since I haven't done any research on evidence-based practice on this matter, but I'm sure there's something to advancing the diet slowly after surgery, so that one's sleepy GI tract doesn't go all wacky-tabacky and vomit waffle chunks all over his nurse.

Luckily, I was in the room assessing the patient as the tray came. I had asked the resident earlier if it was alright to advance the diet and he'd said yes, so I was fully anticipating an order for full liquids. Soooo... apparently no one mentioned to residents that "advance diet" from clears does not mean "give waffles and syrup straight away!"

Anyhoo.

Later on in the afternoon, the patient had an incontinent episode, soaking his leg dressings. Being a dutiful nurse, I took down the dressings, washed them properly, assessed the sites, and redressed the incisions.

In the course of doing so, I noticed a small hematoma on the patient's right thigh. I was quite sure the surgical resident hadn't said anything about a hematoma (I was there when he assessed the patient and dressed the wound) and I didn't remember reading anything in the chart in the attending's note, either. It wasn't a very big hematoma, and I thought it rather unlikely to be much to be bothered about, but, having found it, I now had to deal with it, especially since the family (very lovely, by the way) was standing right there during the dressing change.

I went and dug through the chart--no mention of any small hematoma there, and the resident conveniently hadn't left a note. The attending didn't mention it either. So then I looked for an H/H to see what his blood count was doing; nothing ordered.

So Jamie pages the attending online with a nifty little text message (because he wasn't on CV surgery service and I didn't have any SuperCool Anytime You Need Me Physician Assistants on the flor for this guy) to mention the hematoma and ask for an H/H.

ATTENDING:
[curtly cutting across my spiel]
Yeah, I got your page about the hematoma; I saw it this morning and it wasn't very impressive.

JAMIE:
[doggedly, as she knows this particular attending probably thinks she and all nurses are syphillitic whores]
Uh, okay. He doesn't have an H/H, would you like to get one?

ATTENDING:
[Sounding like teenager saying "Whatever"]
Yeah, sure, that will be fine.

So dude. The funniest part about this story, and the reason I'm even mentioning it at all, is that yesterday the attending came in at 8:00a.m. all huffy because the guy's leg wasn't elevated (it had been, but you know, sleeping and stuff at night shifts stuff around). Any way, he went on and on about it, implying I was a shitty, stupid nurse because clearly, I somehow didn't comprehend the importance of elevating extremeties (just as somehow, his residents don't get how to properly order advance diet and dress and assess surgical wounds, but whatever).

That's not all.

I asked the patient twice just to make sure, "Hey, did the attending take down your dressing at all today?"

And the patient, alert and oriented as you and I said, "Nope. Just looked at. Never took it down at all."

Hmmm....

I ask you: Now who's the stupid syphillitic fibbing whore?!

National Treasure

No, I'm not in Philadelphia flapping around the back of a van at top speeds with The Declaration of Independence rolled up in a cannister (God I can't believe I watched that crappy movie).

However, yesterday I hopped on the Metro and headed into DC to see The National Zoo. (I seriously think I missed my calling as a veterinarian, because I really like animals. So much so that I consent to slogging around a confinement camp for exotic animals in a park like setting meant for children under the age of ten).

The Zoo was free, but it was hot and muggy, so taking longer-than-necessary reprieves inside The Reptile House, for instance, soon became top priority. The abundance of screaming spoiled children quickly became a nerve-shredder as well. Don't parents teach their children to use their "inside voice" any more? What happened to corporal punishment and going to bed without supper? And incidentally, whatever happened to common courtesy, as in Shut Your Kid The F--- Up so that other patrons can watch the adorable little gibbons eat lice off each others' heads? Some of us need silence for these kinds of contemplative activities.

From the Irony Defined Corner: while I was walking through the Outdoor Monkey Preserve (or whatever it was), I witnessed the following conversation between two youths about age eight who were hanging over the guardrail trying to catch a glimpse of that elusive, mysterious creature that obviously inhabits not the space-age world of Xbox and MTV videos, the... oh well, never mind, here you go:

KID NUMBER ONE:
[to another kid]
Oh my God! Did you see that squirrel?!

KID NUMBER TWO:
Whooooa! Coool! Quick, take a picture!

KID NUMBER ONE:
[snaps shutter on $300 digital camera]
Wow. That was like, totally awesome!

No, I'm not hyperbolizing. Yes, I'll wait a moment until the richness of the irony has set in fully with you, gentle reader.

(Sidebar: They actually saw a chipmunk but let's not confuse American youth with genus/species scientific nomenclature now, okay? Because clearly attempting to educate kids these days isn't working so why meddle with the system now?)

If that conversation isn't a sign of our times, nothing is.

Rend thy tunics and beat thy bosoms, future educators of America. For this is the raw material with which you will have to work.

May I suggest a moment of silence?

Arm[s] and the Man

Today I helped another nurse do a wet-to-dry sterile dressing on a poor guy who had a right arm fasciotomy. The wound was so deep, you could see the bone!

Any way, previously, I thought I would never be able to stomach trauma, but now I think maybe I might be able to give it a whirl someday. Sure, the guy was on a Dilaudid PCA (read: the good stuff) and had basically lost sensation in that arm any way (did I mention you could see the bone?) but it wasn't nearly as stomach-turning as I thought it might be. The smell wasn't even that noxious (thank God, because bad smell = infection = uh oh.)

The thing that impressed me the most was how nice the guy was about us changing his dressing. He acted as if we were doing this tremendously brave, noble thing and deserved riches and glory. Such a nice guy. Because if I were him, I'd be all cranky and whiney, and start wincing theatrically even if I couldn't feel jack. Instead, this guy was offering to take us out to dinner for being such brave soldiers. What a nice patient!

Meanwhile, I need to figure out what the hell is wrong with me. I mean, shouldn't lifting up a dead looking flap of skin, and packing sterile gauze into someone's mangled , bloody flesh bits make me nauseated, instead of thinking, "Wow! Dude! This is sooooo cool! I can't wait to tell my friends about this when I get home!"

Somewhere, just over the rainbow, my guardian angel is smacking her forehead with her own halo sighing, "Sweet baby Jesus, where did we go wrong with this one?"

Icecream, you scream...

So I'm sitting here on Friday afternoon trying to figure out if there's a way to make "pita bread, hummus, a chunk of chocolate, doritos and a can of diet coke" into a balanced meal. My initial thought is: probably not, but then again, who cares?!

We've had a pleasant reprieve from that four-letter-word known as "rain," and some of the humidity has left the area, resulting in very pleasant weather, the kind that makes me wish I wasn't a lazy ass and enjoyed things like camping, hiking, and walking from my front door to my car. For a staunch urbanite like myself, "outdoor recreation" means rolling the window down in the car--which I hate, because of the sound of wind rushing--or opening the apartment windows to let the breeze in. But not for long, because it's noisy outside, and too much fresh air consumption is bound to cause the other kind of consumption.

Why, you ask, didn't I join a comtemplative religious order and sit in a locked, windowless room for hours staring at a wall, or something? Ah, but you forget, my dear grasshoppers, I did that. And lo, it was called grad school. And lo, I'm not doing that again, either.

Oh dear. The Scary IceCream Truck is making its daily summer rounds. Not only does it have the World's Most Annoying Canned Music--a tune which sounds like a "It's a Small World" rip off--but it also has this creepy voice at the end of the jingle that says "Hello" in this vaguely pedophilic, robotic way. I'm sorry, but what conscientious parent in their right mind lets their children buy confections from a strange adult who has been exposed to hours of freaky looped carnival music whilst driving around neighborhoods at 5 mph in a big white lumbering van painted with pictures of dancing ice cream cones?! I suppose ice cream trucks aren't exactly the speediest of getaway vehicles, but still.

I mean, dude! Isn't the creepy weird music alone enough to tip you off to the Potentially Horrific Consequences, people?! It's like the audio-equivalent of the make-out scene in horror movies. You just know that all that on-screen adolescent lust is going to lead to Something Bad Happening. Well, likewise, I'm convinced people--and their offspring--should stay away from icecream trucks. Like clowns, there's just something vaguely unsavory about them.

Freedom To/Freedom For

If you're ever took a philosophy course in undergrad, then at some point, you probably had the "freedom to/freedom for" discussion.

This being the Fourth of July here in America, I thought it would be a good time to have another Jamie's Undergrad Days Flashback Corner.

I remember this discussion, in one of the so-called "fishbowl" Hamilton center classrooms (affectionately known as "Ham center") during a course called Freedom in Christian Thought, in which I Faked Reading A Lot of Philosophy, including Cornell West's Prophesy Deliverance! with the end result that I screamed and pointed yesterday when I saw him on public access t.v. giving a sermon at some church (those lucky church going bastards!) but wouldn't be able to tell you anything important about his works, except I think I probably should have tried reading them.

Any way, one of my beloved professors from that Great Era of Jamie's Pseudo-Intellectual Life always had these funny little anecdotes. Like once, he was talking about Kantian moral agency in terms of a us all being on a "space vehicle" which was about to blow up. The one about freedom to/for involved free agency involved in him "becoming a Harlem Globetrotter." It was very funny, and we all laughed, and I'm sure, learned something from it.

Thus endeth my token Fourth of July reflections on Freedom. (Yeah, that's it. I didn't say there was going to be a point to any of it, just like apparently no one in the government promised that there would be a point to the war.)

My day was spent at work, making time and a half, with only three patients. Talk about heaven. Okay, so cleaning up vomit, urine and--extra special!--liquid shit twice in one day (once while the patient was in bed lying in said mess) was not exactly the most celestial of nursing duties. But it was a good day, because I got time enough to spend with my patients. A nurse-patient of mine (who revealed she was a nurse only at the end of my shift) said she spent forty years as an ortho-neuro nurse. Forty years. I'm not even that old yet. Any way, she called me an "excellent nurse." I blushed madly with pride and thought, Isn't this the best job ever?! even as I carefully bundled away sheets full of liquid yellow poop and carried them to the laundry bin.

I always get all stressed about work, and there are days when I'm just so f-ing tired I could just about cry, but this job is just so much better than my old job that on a regular day I walk around in some kind of daze like, "Wow, I really like my job. It doesn't suck to be a nurse! That's like, soooo friggin' cool!" But then I go home, have a couple days off, and the PTSD incurred from my old job comes back, and I get all afraid of going to work and having something horrible happen. Then I go to the new job, and it's like having a come-to-Jesus moment at work almost every single day. I mean, dude, the charge nurse asked me if I needed help with a code brown. At Old Hospital, you could barely get a charge nurse to help you with a real code.

Soo--Whooo! Fourth of July! America may suck, but making time-and-a-half today with a stellar patient load didn't.