you'll get used it, eventually.. maybe?

there are tons of things we see on a daily basis in the er.. death is one of them..

if a day goes by without someone dying its a shock and huuge. actually, we kept a tally before when it got past 3 days and let me tell you they were some of the happiest 3 days in the er ever.

but regardless, i guess its something you have to get used to.

but how?

how do you get used to watching someone die? or trying so hard with everything you have and then.. you have to just stop. its not fun. at all.

i think for most of us we kinda have to come to this realization that well, duhh, everyone dies. sometimes we feel its not their time but who are we to say? we aren't God, we ultimately cannot make those decicions.

realistically this is what goes through a lot of peoples minds (and I'm not saying this is how anyone in particular thinks, just stating the obvious so please don"t take offense to this.)

for peds cases: there too young to go, they haven't lived a full life.

for adults: again, didn't live a full life, or we wish someone could've been there for them to help them either physically or mentally or just to talk (especially in cases of suicide and/or overdose)

for geriatrics its hard.. either: they've lived a full life and they need to rest now, or, they still have good years ahead of them and we need them around.

I've experienced enough death in my life and i have to say, I'm pretty much done with it. too bad my career path is only going to expose me to tons more. regardless, i still get mixed emotions. i hate to see people suffering and i want to do anything to help them, but sometimes the best thing you can do to help them is to let them go.

i know this from personal experience but holding on to someone who is in pain from cancer of any sort isn't fun. its horrible for them to go through and for you to watch and i am not implying that "Kevorkian-ism" is a great way to go, at all. but I'm not a fan of keeping people hooked up to machines when they just need to go home.. the saying is "rest in peace" for a reason.

since Ive seen it from pretty much all sides i can honestly say, no. you don't get used to it. ever..

I've been the daughter who looses her father at a young age. I've watched my two of my grandfathers die from cancer. seen the affect of Alzheimer's on our family. and most important, I've lost wayy to many friends in my lifetime.

but I've also been on the other side. watching my patients and praying with and for them to get better and i come into work and they died overnight. i cant tell you how many times I've done CPR on a patient who was "fine. just had dinner and then they went". I've even had to perform CPR on a long time family friend who is going through soo many different things but didn't give up and were fortunate enough to still have her around. you don't get used to seeing people you know worry about there family member. or seeing a john or jane doe come in and your the one who has to identify them. i still think the worst is hearing someone you knew, grew up with, had so many memories with died.. i cant speak for anyone else in the field but, i feel helpless. a lot of "what ifs?" come into my mind.

but i also know from personal experience that you can what if all you want, its not going to change anything. it will drive you crazy though. which doesn't help.

so next time your in a hospital with a loved one and think that the way we act is cold or callous, please remember we have a family too. and in order to keep our sanity and not cry every couple minutes, we almost have to be that way. we are great at keeping walls up. God forbid they ever come crashing down though cuz it will be worse than if the Hoover Dam caved in.

to all those I've lost in my life: my family and my patients and to all those I've been with in their last moments, may you rest in peace and i pray an angel guided you to heaven.. please save me a spot! although, i don't plan on coming anytime soon. I've got to many things to finish here..

<3

please don't ask me how long it will take for anything..

so. its been a while.. and alot has happened so theres a ton on my mind and.. well.. I'm not sure where to begin, but i do hope you can keep up:



so first things first.

if you watch greys anatomy and saw "golden hour" (shown on 2/17/11) it should've helped people understand what we, on the other side, go through all the time and why we get soo pissed when you ask "how long and why its gonna take that long"

most of the time, we don't know and its not because were stupid. its because we don't know what could happen in the next two minutes and you could be bumped due to a trauma or any priority one patient. kind of like how the father got mad because his son had waited so long to see ortho, for a very valid reason, things happen.

when we say we dont know,it is not to be rude, it is simply because your foot pain you've had for so long that you all of a sudden had to come in today, isn't as serious as a person who possibly has a brain bleed or who has something impaled in their body or who just had a car accident. just saying..



i think what makes me the most mad is when people come into triage and get mad because there's a wait to be seen. welp. like i said, your foot/abd pain (that is so bad, by the way, that you couldnt eat all day but you sure can get down some hot cheetos while waiting) or whatever that you've waited months to come in for when you could've went to your doctors office isn't emergent therefore i cannot take you seriously especially when someone who is having by the book stroke like symptoms comes in. I'm sorry. i took an oath to save lives, not kiss them.

okay, so. pet peeve i need to get out. we live in Michigan correct? the great, mostly frozen mitten.. so every year it snows.. correct? or, for right now, almost every day. so why is it that people, especially those who have lived here there entire existence, still cannot seem to understand how to drive in the snow! its not rocket science! you do it for at least 4/12 months.. yet for some reason people still end up head first into trees or other rock solid objects or, my favorite, being hit by someone who lost control of their car and someone was driving a bit too close.
OR
at the first signs of spring, which we will be seeing this week, or so i hear, the motorcylces come out to play. totally not gonna knock people for wanting to get out and finally enjoy the sun but please remember that it can still be slippery out and, since there still will be snow on the ground, people tend to not remember *shocker! i know* what its like to drive with motorcycles. so look out and be aware of your surroundings.. especially big huge mini hospitals that tend to try to help people.
again, just saying but..
GET IT TOGETHER PEOPLE! YOUR NOT THE ONLY ONE ON THE ROAD!



so recently our trauma room has been very full with what i call actual traumas. according to the Merriam-Webster dictionary (online of course) the definition of trauma is "an injury (as a wound) to living tissue caused by extrinsic agent.

this could be due to any number of things, but my point is, we have been busy with legit cases (sometimes).. and i blame 2/3 things: billboards and were the only hospital who stays open in our county. the third is because things just happen.

some of them took me off guard more than others mostly because of what happened and why and i feel what i learned from them i need to share with.. anyone that wants to hear.

so. the following are things that everyone should know:

1. always! call the ambulance for chest pain and stroke symptoms.

-for signs of stroke symptoms please see http://www.stroke.org/site/PageServer?pagename=symp and remember FAST

2. when you see the ambulance, fire engine, or cop car on the side of the road please try you best to avoid hitting them. moving to another lane would be wonderful if possible but usually the incident there dealing with is enough, they don't need you too..

3. coming to the er and lying to get seen faster will never help your case.

were not stupid.

we know when your lying and when your in actual pain. as mean as that sounds

its the plain and simple truth and the truth hurts.

4. if you think its okay to drop your friend off because you were doing something wrong and don't want to get in trouble for it, but your friend is half dead when you get there.. jsuk. your probably gonna end up in more trouble for leaving then you would for staying.

again, just saying.

sometimes i wish they would make up a medical game show for the public called "which is a medical emergency" so lets play now!

A. a 65 yo man complaining of chest pain, left arm pain, and is sweating so much he could fill a small kiddie pool or B. 24 yo woman complaining of abdominal pain, nausea, but is eating McDonald's and mad because she just dropped a fry on the floor. (one fry).

how about another.

A. a 28 yo woman who was in a car accident, 5 months pregnant, complaining of difficulty breathing, and lower leg pain (could be a fracture, or few) or B. a 38 yo with tooth pain, who just got done with her dairy queen coincidentally before she was called to be triaged. yeah.. not so hard to understand so why, oh why, does it take making a pamphlet and explaining every time the same person asks to understand that in the emergency room?

so you see. legit vs non legit. huuge difference. and while this may seem completely ridiculous, this is exactly what im talking about and what is driving us all a little bit insane but getting it out in a way that it may actually help the people who read it definitely makes me feel a little bit better.

until next time ladies and gentlemen..

peace, love, and bandaids..

Im sorry, your here for what?

sometimes i really wonder if people understand the point of the emergency room.

i say this and cringe..

its been a while since ive written and i guess its because i feel like nothings changed. not that it ever will, but i sure do wish that common sense was a disease that the world could catch.

in the meantime, im glad i can laugh about it.


So we recently got our trauma 2 cert and most of us are pretty excited! not gonna lie, when i first saw it plastered all over macomb county i did freak out a bit thinking we were gonna be busy but now im just excited for it! what can i say, im a major trauma queen :)
its not that i like seeing people hurt and bleeding, well i do, but not for that reason. I like it because its a great.. uhm, learning experience?
yeah, i guess thats the best way to describe it..

so beyond the normal traumas we usually get we have been getting an abundant amount of ridiculous calls. (i guess i shouldn't say there ridiculous but im not sure i can think of a better word..)
My favorite so far was the one i got today: "Hi, my 15 y/o daughter has a knife and is threatning to stab me and my husband and herself. shes having a complete meltdown because we asked her to, wait, STOP DOING THAT!, we asked her to do her chores" during this call i can hear the teen screaming "IM GONNA F&*#ing KILL YOU AND MYSELF!" over and over again. the mom continued to ask me what she should do. really? My reply: maam, you need to hang up and call 911. there is nothing i can do over the phone, you need to call 911 and they will dispatch police and the ambulance to bring her here if needed. "well what am i supposed to do" (again, really?)
i really wish i was kidding when i tell people this but, sadly, im not..
we also keep getting the "im having chest pain on my left side radiating to my left arm and having a hard time breathing" calls. im not sure why, who, or what is so difficult about calling 911.. there was a woman last night apparently in ohio who had no problem calling 911 for a husband, why cant you call 911 for a possible heart attack?
some things are just completely not understandable.

another one of my favorite things is either i dont have insurance or my insurance wont cover it. okay, so your telling me that your potentially dying (insert heart attack/stroke like symptom call here) and you dont wanna call the ambulance or come in because of insurance? really?
but yet we always have the person who calls the ambulance for a blister on their foot or a stomach ache youve had for 20 mins (and yes, both have happened, many many times)
really does not make sense at all.

so please do not judge us when we ask you, why are you coming in today.. not only do we ask for a normal reason but sometimes we just have to reassure ourselves you are there for a good reason, even if your really not..

soo, its been a while and its kind of a given that nothing has changed in the er scene.
besides the fact that we the got a level 2 trauma cert. in our county, but, no biggie (go us!!)

i must say im quite excited now that flu season is finally over, not that we dont get the few laggers still coming in, but finally its truama season!

been there, done that

most of us have no problem saying " have you had it happen to you? because if not you dont know". i know ive said it before too and it all the time in the emergency room. well after today i can say yes, yes i have..
so far to date the only common test i havent had was an mri.


today i was seen in the er for some severe "im gonna rip out my female anatomy" pelvic pain. normally i get mad when people come in for this because primarily they come in for a check up. the er is not the place for a check up..

i had blood drawn, urine sent, a pelvic exam (sucks) and even a foley so i could go to ultrasound... all, except the blood, sucked but because its neccessary it wasnt so bad. the foley, as uncomfortable as it was wasnt half as bad as everyone makes it.. so i can say, your being a baby *unless your a guy* when you whine about it..


as much as i hate being a patient and i would honestly rather die than come to the er, and i work in the er.. so how much sense does that make?


i think people dont realize thats just because we are medical staff, we are human too. we get sick.. we have to come in and be seen too. so yes, we have been through what your going through and we know that its hurts and its aggravating and gives you anxiety not knowing what is wrong. but we know, and were only here to help you, if you let us.
all you have to do is come in and ask..

everything isnt always as it seems..

i say this and truly mean it. not all signs and symptoms will show up clear as day. we wish! it would make things so much easier!!

for example: text book signs of a stemi aka heart attack:
chest pain or discomfort
jaw pain (woman)
left sided arm pain (mostly men but varies)
upper back pain
neck pain
dizzyness
chills
sweating
shortness of breath
nausea
(if you have these symptoms call 911 asap!)

so a guy comes in today with chest pain but not horrible and that was it. no dizzyness, no nausea, no sweating, chills, arm pain..

turns out he had a stemi (st segmant elevation myocardial infarction, or MI, or heart attack) but it only showed on his ekg. his blood pressure was only partially elevated.. not much.


chest pain can come from many things. could be an anxiety attack, a heart attack, a start of a pulmonary embolism, or a pneumothorax.
but you dont know until you have it tested!

just because you think its one thing, you could be wrong. heck, we could be wrong. thats why we test and question and observe and look and do what we do..

so when you get mad about how long something is taking, please! take a second to remember when you come to the er and get what feels to be a thousand tests ran, we dont do it for our health, for fun, or for the money! its done to save your life.

xrays only show so much, so then catscans are ordered. if they cant see off that they go to mri annd so on. and one tube of blood does us no good when drawing labs.
each lab tube has a different thing in it to obtain results for different tests.


so before you come yell at us and complain about how long its taking, please remember its not really our fault. test results take time.

so before your next visit to the emergency room bring your patience, and a good book. :)

"do you wanna talk to the doctor in charge or the nurse who knows whats going on"

this makes me laugh everytime i see it. its actually quite true. sorry to burst your bubble for all the people who thought doctors were god-like, there really not.

they do know alot. alot from the books they study. as for how people actually work *realistically how they work* nursing staff know more because we deal with them more..

an issue just came about that made me laugh and think of this. im pretty sure i pissed the attending off but when you fight with a nurse who knows what shes talking about and try every effort to prove her wrong, and two hours later shes right, i get to laugh at you..

im sure most of you dont know much about medi-ports and central lines so ill explain them simply: there a larger more productive version of an IV.

a pt came in wanting us to draw blood and do cultures off of her medi-port. what she didnt say right away was why.. they were suspected to be infected (nice rhyme i know..)

nurses, lab techs, not even most doctors will ever draw off of any mediport (or central line) that may be infected. these can spread anything faster than ivs or anything else. so after many many phone calls to her doc, other docs, our lab, our charge nurses, ect.. we finally all came to the conclusion (actually the doctor and patient did) that WE CAN NOT DRAW OFF OF THAT LINE and we wont. its not worth our liscense or job.

not to say this happens all the time but, this happens all the time!

we get it. you trust doctors and thats great, you should. they go to school they learn alot and they save lives.. but they dont have the people skills we do and they def. dont have the time we do to spend with you. 98% of people (<<this comes from my head, not actual statistics but its pretty accurate. ask anyone who works in the emergency room)

another reason why nurses know as much as doctors is because we see it all. over and over and over again. no two cases are the same for anything. but when we see symptoms we've seen in a pt before we notify the doctor who can say "yeah ive read about that" or "ive seen that once before and yeah it seems that way" theyve seen it once to our 100 pretty much.

so the next time you say you want to talk to the doctor in charge, you may want to rethink that decision. by all means tell your doctor whats needed, especially when your in the er. dont keep anything back because it could only hurt you in the end. but let the nursing staff know whats going on to. especially since you'll see us more than you'll see the doctor.