Archive for March, 2008

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I wanna smoke!

28 March 2008

No smoking

If you are my patient and you are a smoker, then be well aware of the following:

  • I do not escort gambling addicts to the casino for a bet.
  • I do not escort alcoholics to the pub for a drink.
  • I sure as hell do not escort smokers outside to the smokers’ area for a smoke.

I will not hesitate to offer you nicotine patches; but at the end of the day, your addiction is your problem. Don’t attempt to guilt trip me or resort to threats.

I will not compromise your care, or the care of other patients, to pander to your desire to light up.

If you’re too sick to go outside unescorted, you’re too sick to smoke.

Deal with it.

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The odd couple

23 March 2008

They were the odd couple - two patients who, to all appearances, had nothing in common; but together formed a friendship that made us all smile.

Fred was in his early seventies, a funny old bloke who’d taken a tumble down some stairs resulting in a SDH. He was old, confused, and was as funny as a frog in a sock. Put simply, he was a lovely old man. He was also a wanderer.

Greg was a young bloke in his thirties - MVA with all of the associated injuries - initially combative, but once the swelling went down, turned out to be a sweety. AOx1, and still in PTA, Greg was pleasantly confused. Although he couldn’t be trusted to go off the ward by himself (he too was a wanderer), he would always keep an eye out for the other wanderers, alerting staff to any problems and helping other confused patients back to their beds.

In the course of their extended stay with us, Greg and Fred struck up a friendship - watching out for each other, keeping each other company, and keeping each other from wandering off.

One day they were playing cards on Fred’s bed while the wife of the patient in the next bed was coming to terms with the newly delivered news that he husband was going to die soon. She had been crying and the two boys came over to me and asked what was wrong with the patient.

“Guys, I’m sorry but I can’t go into the details of another patient”, I responded.

“But he’s going to die, isn’t he?” Fred asked in hushed tones.

I could see the concern on the two boys’ faces and let them know that their roommate was going die and that he probably didn’t have very long.

Things got a bit busy on the floor after that, and about an hour later I noticed them loitering at the front reception desk. They looked pretty suss, trying to play it cool and look incognito, but it was clear that they were up to something.

They were trying to hide something between them as they inched back to their room. The ’something’ was a beautiful bunch of flowers that had just been left in a vase on the front desk by a patient’s relatives. Although the vase was still at reception, a trail of dripping water on the floor lead to Fred and Greg’s feet. I kept an eye on them as they made their getaway. They were trying not to grin, and I’m sure that the felt that they were pulling off the perfect crime. I knew that they had been pinching the occasional chocolate from the front desk, but couldn’t work out why they had decided to shift to Grand Theft Floral.

After being distracted by another patient, I made my way down towards Fred & Greg’s room to find the wife of the dying patient while giving them both a hug before she left for the night. In her right hand was a bunch of flowers that looked remarkably familiar…

She said good night to me on her way out, and let me know how much she appreciated the kind words from Fred and Greg, and how they had gone and bought her some beautiful flowers that they insisted she take home with her to brighten her house up. I didn’t have the heart to set her straight and wished her a safe drive home.

When I went to see the boys, they realised that they were sprung when I held up the empty vase with a raised eyebrow.

They sheepishly looked at each other and Greg turned to me and said, “That lady was so sad that her husband is going to die. We had to do something to make her feel better…”

It is always a thing of beauty to see compassion and kindness in an environment where abusiveness, generalised rudeness, and a sense of entitlement is the norm with many patients.

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quizER

23 March 2008

Last week I was lucky enough to win Volume 2 of NY Emergengy Medicine’s quizzER.

The cool thing is that there is a prize, which I’m looking forward to receiving - a copy of Adam Rosh’s Emergency Medicine: PreTest Self-Assessment and Review.

So check out the NY Emergency Medicine blog and have a go at the quizER and VizD quizes.

Make sure that you read this story - it serves to highlight that not all patients are drug-seekers and scumbags.

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Bob’s not happy…

20 March 2008

Bob’s sister: “Yeah nurse, you’d better do what he wants, or he’ll get really agro.”

Me: “Pardon?”

Bob’s sister: “Bob’ll get really agro if he doesn’t get his way, so you’ll have to do what he wants.”

Me: “No… actually I don’t have to do that at all.”

Bob’s suddenly confused sister: “What? No… but you’ve go to…”

Me: “Look, Bobbo can get as agro has he likes, but it won’t make any difference to …”

Bob’s now interupting sister: “But, but, but…”

Me: “Look. If Bob wants to get agro, we’ve got well-trained security officers who rejoice in catering for the needs of aggressive patients. Plus, I’ve got a whole truckload of sedation ready to roll at a moment’s notice. Bottom line - we do not have to do what Bob wants.”

Bob’s suddenly enlightened sister: “Oh…”

Seriously, sometimes I have trouble understanding why people continue to positively reinforce their loved-ones’ shit-house behaviour…

angry-gazebo.jpg

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Most embarassing moment

13 March 2008

If there is one thing that I’ve learnt, it is that nurses, as patients, are either a total pain in the arse to look after or they are pretty good value. I’ve come across a few nasty ones, but the award for the coolest old nurse ever goes to the old girl that I looked after in my first ever prac placement as a very nervous first-year nursing student.

She was constipated and needed a visit from the suppository fairy. As you do, Andrea, the nurse that I was working with was more than happy to palm of sticking her finger up someone’s bum to the eager student. After going through what I needed to do, we went in, and I let my patient know what was about to do. After five days BNO, she was more than happy to get the supps.

Informed consent? Check.

Medication order valid? Check.

Patient positioned? Check.

Supps and finger well lubed? Oh yeah, that’s a check.

Gloved up, I was ready to rock. I was confident. I was ready. I knew what I was about to do. I was about to poke some medication way, way up a little old lady’s arse.

The grossness of the thought of my impending rectal excursion was pushed aside by the joy of practising a new skill.

It was at this point that my buddy CN decided to inform me that Betty was an old nurse. Betty chimed in, as relaxed as all hell, about how she knew exactly what I was about to do. My exuberant feeling of confidence started to evaporate.

But, no time for doubts - onwards and upwards…

I pushed on, letting old Betty know that “this might fell a little cold”.

Boy, that suppository was slippery. I fumbled and then managed to get it in. “Here we go, Betty…”

It was as the second knuckle of my finger passed through her sphincter that she let rip with, “Oh God, yeah! That feels wooooonderful!”

Sweet Jesus…

I wanted the ground to open up and swallow me up. I had no idea what to say. My buddy CN must have been a bloody fantastic poker player, but she was having trouble not cracking up.

“OK”, I squeeked, “one more to go…”

My nurse and I finished up, excused ourseleves, and drew back the curtain… only to find 3 other randy 80 years olds sitting up in their beds with ear-to-ear grins giving me finger waves. I even scored an attempt at a seductive “you hoo…”

I looked back at old Betty, who laughed and explained that Andrea had prewarned her that this was the first time that I had given anyone supps.

Crazy old bitch…

I hope that I’m a funny fart like her when I’m old.

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Image of the month

8 March 2008

Lysol. They don’t make ads like they used to…

lysol.jpg

I would seriously love to see a copy of the new “booklet of information from leading gynecological authority”.