My first day back to work was halloween, and thank goodness it was slow. I'm still not 100%, but I got my sense of humor back yesterday (didn't really realize it was gone until one of the doctors looked at me and said, "you're feeling better, arent you?") It's nice to work in a hospital; I take patient admits to the floor and then turn on the portable oxygen tank on the way back down to the ER, suck some O's until I have to go back to work again. The nurses laugh at me, but they're also very careful to make sure I'm not pushing myself. Awww, isn't that sweet?
Meth Central Med Center is now a fully operational cardiac hospital. We've had our emergency cath lab open for a couple of months, and we've had a few emergency caths in that time, but my first one was last week. It was the night I was wearing new shoes, which you may not give a hoot about, but it's an important part of the story. Those of you in EMS already know what that means.
So it's about 15 minutes before my break, and we all know what happens when firefighter girl gets hungry. Well, we don't all know, but RevMedic, you can fill them in. It's not pretty. Medics call in with code 3 traffic. Their patient is a 69 year old male who crumped and did a face plant at the dinner table right into his pasta salad. Heart rate initially 20, they have him externally paced at a rate of 70, on a non-rebreather mask and an assload of versed. All other vital signs are within normal limits.
We get the guy on our table, I get him on the monitor, move the oxygen to our wall outlet, etc. etc. One of the nurses grabs me by the shoulder and hisses in my ear, "I can't get our defibrillator to pace him! Make it work!" so I sigh, and connect the our zoll to the pads already on the patient. I look up, see one of the medics watching the exchange. We try not to laugh, because this is a serious situation.
The 12-lead EKG shows some stellar ST elevation; highest I've ever seen. Dr. Twitchy is in rare form tonight, and his 3 espressos and 4 diet cokes were obviously not enough caffeine. He's going by the cath alert check list instead of his normally well-working brain, and the nurses and I wait impatiently for his orders. He ticks off the cath alert sheet-- nitro drip dopamine drip heparin drip oxygen-- and asks if the patient has had aspirin since entering the hospital. We all stare at him in disbelief, then stare at our mostly non-responsive patient, who still has pasta salad stuck in his ear, and moans occasionally with the jolt of the pacer. There is no way that man is chewing up and swallowing anything.
I try to draw blood with the third IV I start. You can tell the patient smokes- the blood is dark and thick and hard to draw, even through an 18g catheter. Lab tries drawing on the other side. We finally end up with maybe 20 mL, and as I'm pushing it into the tubes, I notice the floaties in it- little chunks of what look like butter.
I am not kidding you.
Let's remember, this is a cath alert, and the man is having a heart attack. Lest we forget, a heart attack happens when the vessels in the heart become clogged with blood clots or plaque-- stuff very similar to the chunkies sitting in the test tube in front of me. This guy is maybe 5' 10" and weighs approximately 165 lbs. He is not a large man. Although his oxygen saturation is 99%, his skin is still grayish. This concerns us until his wife walks in. She looks a lot like him, down to the gray skin. She also reeks like cigarette smoke. We're starting to have a really good feeling about the success of our impending heart catheter placement.
We get the guy onto the cath lab table. The cath nurse asks my charge nurse if I can stay to help, and that's pretty cool because I've only ever seen one of these from the outside. We get him all hooked up and they're swabbing him with iodine in his nether regions and he starts shivering a little so we cover him with a blanket and I've got all the lines and pumps untangled and running and the oxygen is ready to transfer from the gurney to the wall and I reach to hand the tubing to the cath nurse and the guy hangs his head over the side of the table and starts puking into his mask which I yank off his face so he doesn't aspirate and they're grabbing suction and he pukes again
all over my new work shoes. And my scrub pants. And the floor, and the cords and tubing and everything else. There is a moment of silence, when all you can hear is the plop plop of the puke dripping off the table. And then the guy's top dentures slip out of his mouth and clatter on the floor, and the tech behind the glass- the only member of the room not currently coated in regurgitated rotini pasta salad- tries very hard not to laugh.
on a completely different note: remember John, from the last post? We got a letter letting us know that much of his bone and tissue was used in transplants. And I wish I could tell the people who got his stuff about John's last three hours.
Sunday, November 11, 2007
Thursday, November 1, 2007
levaquin dreams
Got called into the director of Human Resources office yesterday to discuss the traveler nurse and his traveling hands. I made the mistake of telling the assistant manager of the ER two weeks ago, and he was actually really cool about it. But then he told the manager, who called me into his office for another meeting. I came away from that one feeling like shit. He kept insisting that I must be suffering some ill effects from the incident. I just stared at him, told him I wasn't sleeping, but I'd get over it if everyone would just leave me alone about it. I work in the ER, for chrissakes. You have to be able to let go of things, or you'll go crazy. He finally threw up his hands and told me to talk to HR, which I put off until yesterday.
We do that more often than we think, at least those of us who are emotionally and mentally healthy. Letting go, I mean. There is a resiliency in the human spirit that we don't think of very often, but I see it almost every day. I watch patients and their families adjust to news they never thought they'd have to face. . .the smart ones, the ones who will make it, take it in stride; they let go of the whole life they had planned and open themselves to whatever it is that's been thrown at them. Sure, there's some shock involved-- "yes, ma'am, you've just been diagnosed with a very large tumor in your liver" takes some getting used to--but you can almost see the shift in their minds as they adjust and move on, and face whatever it is they need to face.
I see it in the dying, too, although resiliency becomes grace at that stage. I know that certain things take on almost mystical properties when my emotional armor gets left at home, when I'm over-tired or under stress, like I have been because of the traveler nurse issue. But we had a code a couple of weeks ago that shook me, and everyone else in the room, in the three hours the patient was there.
I'll call him John. He was 46 years old, found down by his sister and mother. No history of drug use, this guy was clean. Medics almost tubed him but he came around, and was conscious by the time he came into the ER. I sat with him, started his IV, drew his blood, cleaned the vomit from his face and neck, smiled at him, talked to him, reassured him. He looked so scared, and I told him everything was going to be okay. He nodded, and smiled, and I squeezed his hand before I left the room. His mom waited outside the room to hear the prognosis of her only son.
Next time I passed the room, they were pulling out the defibrillation pads, and John was seizing. As I was wrapping my brain around that, one of the nurses in the room screamed for me, the doctor started shouting for an NG tube and suction, and all hell broke loose. John's heart rate was over 200 bpm. We cracked the crash cart and the nurse went to push drugs, and we realized that John had sweated his IV right out. I started another on the left arm, then another on the right. And then his heart stopped.
The doctor ordered CPR started, and one of the nurses began. I shoved him aside and started compressions, screaming for a stool to stand on. Once I could get leverage, I discovered something: the chest of a 46 year old man is much different than the chest of an 80 year old man. And ribs break a lot harder and a lot louder. I could feel them pop with every compression.
We got pulses back, and then a pressure. John's left pupil was blown. We all sighed, and looked at each other, and stepped back from the bedside, shaking. The doc shook his head and ordered for the air ambulance to take John to OHSU in Portland for definitive neuro care. I left the room and headed to start a couple more IVs.
Ten minutes later, he flatlined again. His mother still sat stoically outside the room. Turns out she'd lost one of her two daughters two weeks before; her other daughter, the one who had been closest to John, was racing to the hospital from out of town. John's mom just sat, and waited. We explained what we were doing, the care John was receiving, the fact that his prognosis wasn't good. She nodded, said she'd just wait for her daughter to come.
I did CPR on John two more times before he finally died for good. The doctor called the code twice-- the first time, we had a spontaneous return of pulses before the monitor was turned off. But this is where grace in the dying comes in:
John laid there, tubes in every orifice, vomit in the creases of his neck, bedding soaked with sweat, ribs broken, wires everywhere, brain dead but heart still beating. He waited there, until his sister came, and that was truly one of the most beautiful things I've ever experienced-- watching that woman kiss her brother's face, rub his shaved head, tell him how much she loved him, told him he could go. And then he did, and nothing we did could bring him back that third and final time.
By the end of the three hour code, even the doctor was crying. Say what you will, but the human spirit is resilient. And some people who haven't amounted to much in life leave that life with an enormous amount of grace. And I am honored to be part of a leaving that is so graceful, even when I fight so hard against it.
We do that more often than we think, at least those of us who are emotionally and mentally healthy. Letting go, I mean. There is a resiliency in the human spirit that we don't think of very often, but I see it almost every day. I watch patients and their families adjust to news they never thought they'd have to face. . .the smart ones, the ones who will make it, take it in stride; they let go of the whole life they had planned and open themselves to whatever it is that's been thrown at them. Sure, there's some shock involved-- "yes, ma'am, you've just been diagnosed with a very large tumor in your liver" takes some getting used to--but you can almost see the shift in their minds as they adjust and move on, and face whatever it is they need to face.
I see it in the dying, too, although resiliency becomes grace at that stage. I know that certain things take on almost mystical properties when my emotional armor gets left at home, when I'm over-tired or under stress, like I have been because of the traveler nurse issue. But we had a code a couple of weeks ago that shook me, and everyone else in the room, in the three hours the patient was there.
I'll call him John. He was 46 years old, found down by his sister and mother. No history of drug use, this guy was clean. Medics almost tubed him but he came around, and was conscious by the time he came into the ER. I sat with him, started his IV, drew his blood, cleaned the vomit from his face and neck, smiled at him, talked to him, reassured him. He looked so scared, and I told him everything was going to be okay. He nodded, and smiled, and I squeezed his hand before I left the room. His mom waited outside the room to hear the prognosis of her only son.
Next time I passed the room, they were pulling out the defibrillation pads, and John was seizing. As I was wrapping my brain around that, one of the nurses in the room screamed for me, the doctor started shouting for an NG tube and suction, and all hell broke loose. John's heart rate was over 200 bpm. We cracked the crash cart and the nurse went to push drugs, and we realized that John had sweated his IV right out. I started another on the left arm, then another on the right. And then his heart stopped.
The doctor ordered CPR started, and one of the nurses began. I shoved him aside and started compressions, screaming for a stool to stand on. Once I could get leverage, I discovered something: the chest of a 46 year old man is much different than the chest of an 80 year old man. And ribs break a lot harder and a lot louder. I could feel them pop with every compression.
We got pulses back, and then a pressure. John's left pupil was blown. We all sighed, and looked at each other, and stepped back from the bedside, shaking. The doc shook his head and ordered for the air ambulance to take John to OHSU in Portland for definitive neuro care. I left the room and headed to start a couple more IVs.
Ten minutes later, he flatlined again. His mother still sat stoically outside the room. Turns out she'd lost one of her two daughters two weeks before; her other daughter, the one who had been closest to John, was racing to the hospital from out of town. John's mom just sat, and waited. We explained what we were doing, the care John was receiving, the fact that his prognosis wasn't good. She nodded, said she'd just wait for her daughter to come.
I did CPR on John two more times before he finally died for good. The doctor called the code twice-- the first time, we had a spontaneous return of pulses before the monitor was turned off. But this is where grace in the dying comes in:
John laid there, tubes in every orifice, vomit in the creases of his neck, bedding soaked with sweat, ribs broken, wires everywhere, brain dead but heart still beating. He waited there, until his sister came, and that was truly one of the most beautiful things I've ever experienced-- watching that woman kiss her brother's face, rub his shaved head, tell him how much she loved him, told him he could go. And then he did, and nothing we did could bring him back that third and final time.
By the end of the three hour code, even the doctor was crying. Say what you will, but the human spirit is resilient. And some people who haven't amounted to much in life leave that life with an enormous amount of grace. And I am honored to be part of a leaving that is so graceful, even when I fight so hard against it.
new moan ya
yep. some little tiny bug in my right lung. And today is the first day I've been able to hold my head up for longer than 2 minutes at a time. I don't really feel sick at all, just incredibly weak. I've been in bed pretty much since I got off work a week ago Tuesday morning, although I have attempted the bedroom to bathroom route once or twice, and I did manage a 24 hour change of scenery by exchanging my walls for someone else's this past weekend.
On Friday, after giving me a 2cc shot in the ass and a bag full of Levaquin, the doctor informed me that I'll be 100% in six fucking weeks.
Okay, he didn't say fucking.
On Friday, after giving me a 2cc shot in the ass and a bag full of Levaquin, the doctor informed me that I'll be 100% in six fucking weeks.
Okay, he didn't say fucking.
another lesson or two
If you're looking for levity, you probably shouldn't read this post. I've been trying to write this for a week, now, and make it funny or sarcastic or witty. . .but I start it, and everything that comes out sounds so unlike my usual self that I get disgusted and cancel the whole thing. And even now, I've taken it down, and put it back up, and changed it and messed with it and I start to think that maybe I shouldn't leave it up here for all my friends to read. . .like I have something to be ashamed of. And that's just wrong. I need to be able to tell this. The thing is. . .I can't sleep lately. And yeah, I could blame it on my funky work schedule (even though I've been on a crazy schedule for the past 4 years. . .), or loneliness (umm. . .doubtful. . .I love sleeping alone--or used to. . .) or all my injuries or too much coffee or dry air or noisy neighbors or insert other excuse here. But I know that none of those are the reasons why.
I've worked really, really hard to become the person that I am, and I've lost a lot along the way, but I'm generally happy and content, even if my life isn't so-called normal. I'm a very private person, I like being alone, and it takes a lot to get to know me. I don't let many people get close to me, and the people I've dated in the past would be hard pressed to tell you much about me, and honestly, I'm skittish about relationships. But. . .I like my life, and I love my home and my kids and my art and poetry and writing and plants and books.
A month ago, a traveler nurse I considered a friend developed traveling hands and a traveling tongue a couple of nights before transferring to his next assignment. He's married, and has a bunch of kids, and he trapped me in the stock room and seemed a little shocked when I shoved him away. And two nights later, on the last night he worked, at the end of my shift, when I told him that he creeped me out with the kissing and the groping, he apologized, asked if he could make it up to me, and tried to do the same thing again. Which is when I ran out the back door of the break room and called for the friend who was waiting outside. There is more to this story, of course--how this brought up feelings for me from an incident last summer; how I blew it off when I was telling friends about the nurse because I didn't want them to think I wasn't strong, or that I'd somehow asked for it; how afraid I was the full twelve hour shift I worked with him that last night, and how nothing got stocked in the ER because I didn't want to chance getting cornered again, all the things he said to me the first time in the stock room and then on the last night before I ran away.
You wouldn't think that one person could take away something so integral to who you are. But that's exactly what happened: someone took away a piece of the person that I am. It is amazing that something so simple can strip so much away from somebody-- although of course I've still got my self-respect, and my independence--I've worked too hard to let anyone take those away from me. But I can't sleep. And I haven't written or painted or read a book in the last two weeks. I stay awake and restless until my eyes can't stay open anymore and then I fall into bed.
We are all so very fragile, with so many walls we think are solid and indestructable. I've built a few myself, and maintained them carefully, not letting anyone get too close. I'm not sure what the lesson is in all of this, but I'm finding something cathartic in the telling of it. . .and I guess I'm realizing that right now, I could let this experience and the fear it caused close me off again, just when my heart is starting to open up for the first time in a long while. Or I can use that energy to tear down the remaining walls I have built around me. . .because as much as it hurts, I would rather feel too much than nothing at all.
I've worked really, really hard to become the person that I am, and I've lost a lot along the way, but I'm generally happy and content, even if my life isn't so-called normal. I'm a very private person, I like being alone, and it takes a lot to get to know me. I don't let many people get close to me, and the people I've dated in the past would be hard pressed to tell you much about me, and honestly, I'm skittish about relationships. But. . .I like my life, and I love my home and my kids and my art and poetry and writing and plants and books.
A month ago, a traveler nurse I considered a friend developed traveling hands and a traveling tongue a couple of nights before transferring to his next assignment. He's married, and has a bunch of kids, and he trapped me in the stock room and seemed a little shocked when I shoved him away. And two nights later, on the last night he worked, at the end of my shift, when I told him that he creeped me out with the kissing and the groping, he apologized, asked if he could make it up to me, and tried to do the same thing again. Which is when I ran out the back door of the break room and called for the friend who was waiting outside. There is more to this story, of course--how this brought up feelings for me from an incident last summer; how I blew it off when I was telling friends about the nurse because I didn't want them to think I wasn't strong, or that I'd somehow asked for it; how afraid I was the full twelve hour shift I worked with him that last night, and how nothing got stocked in the ER because I didn't want to chance getting cornered again, all the things he said to me the first time in the stock room and then on the last night before I ran away.
You wouldn't think that one person could take away something so integral to who you are. But that's exactly what happened: someone took away a piece of the person that I am. It is amazing that something so simple can strip so much away from somebody-- although of course I've still got my self-respect, and my independence--I've worked too hard to let anyone take those away from me. But I can't sleep. And I haven't written or painted or read a book in the last two weeks. I stay awake and restless until my eyes can't stay open anymore and then I fall into bed.
We are all so very fragile, with so many walls we think are solid and indestructable. I've built a few myself, and maintained them carefully, not letting anyone get too close. I'm not sure what the lesson is in all of this, but I'm finding something cathartic in the telling of it. . .and I guess I'm realizing that right now, I could let this experience and the fear it caused close me off again, just when my heart is starting to open up for the first time in a long while. Or I can use that energy to tear down the remaining walls I have built around me. . .because as much as it hurts, I would rather feel too much than nothing at all.
Friday, October 19, 2007
some things I learned last week
a couple of nifty EKG rhythm tricks from some other cardiac nerds, firsthand knowledge of caffeine toxicity, a punch in the chest really can start a flatlined heart beating again, and- of utmost importance- shoving vicks vaporub up your nose too many times in one night may indeed keep the dookie odor out and clear the sinuses, but it can also make your nose bleed.
Wednesday, September 26, 2007
save a life
The days I forget my armor are the worst. . .when the dregs of humanity
fill the waiting room coated with a slick of dirt and sweat and desperation,
the running joke of “save a life today?” plays out every time I start an IV
for a migraine or a toothache and the junkies line up to have their abscesses drained
without pain medication because even if I could find a vein, anything the doctors could give them isn’t nearly as strong as the heroin they injected with their dirty needles. I don’t
expect to walk into a room after a particularly bad drainage, blood and pus all over
the floor, scrawny junkie whimpering on the bed, and feel anything but the usual
businesslike disgust of caring for yet another slow suicide.
But I surprise myself, and I start crying. Not terribly good patient care, I
suppose, but there you go. And as I finish taping the gauze over the hole
in his flesh, the junkie grabs my wrist with his other hand and says “thank you”
and promises to get clean. I look him straight in the eye, tell him he's lying, dare him
to prove me wrong
Guess it doesn’t matter what he said after that, because a week or a month
or a year from now, it’ll be his body on the gurney the medics bring in,
CPR in progress, his eyes fixed and staring, code called after five minutes of
definitive care in the hospital.
My friend Luke wrote me last night from work: “One of my patients just passed. . .what
a strange job we have. . .time goes so fast you know and there is just no way
to go back. . .sometimes I wonder what the hell I am doing. . .am I leaving
the world better than I found it. . .”
And I remember, again, “did you save a life today?” and the code we had
last week, 76 year old guy in town to celebrate his 50th wedding anniversary with
his family. . . I did compressions for 10 minutes, sweat pouring down my face and back, while the doctor pushed every possible drug and the man’s wife waited in a wheelchair
in the lobby
I looked at his face. . .what was I thinking, I never do that, dangerous when you’re breaking someone’s ribs trying to push their blood to the rest of their body, dangerous
to think of them as a person instead of a collection of cells and blood and systems
that all need to work together to be a life. . .it haunted me, his face did, but I don’t
know now if I could tell you what he looked like.
and I’m wondering, really, if I’m saving anybody’s life but mine
fill the waiting room coated with a slick of dirt and sweat and desperation,
the running joke of “save a life today?” plays out every time I start an IV
for a migraine or a toothache and the junkies line up to have their abscesses drained
without pain medication because even if I could find a vein, anything the doctors could give them isn’t nearly as strong as the heroin they injected with their dirty needles. I don’t
expect to walk into a room after a particularly bad drainage, blood and pus all over
the floor, scrawny junkie whimpering on the bed, and feel anything but the usual
businesslike disgust of caring for yet another slow suicide.
But I surprise myself, and I start crying. Not terribly good patient care, I
suppose, but there you go. And as I finish taping the gauze over the hole
in his flesh, the junkie grabs my wrist with his other hand and says “thank you”
and promises to get clean. I look him straight in the eye, tell him he's lying, dare him
to prove me wrong
Guess it doesn’t matter what he said after that, because a week or a month
or a year from now, it’ll be his body on the gurney the medics bring in,
CPR in progress, his eyes fixed and staring, code called after five minutes of
definitive care in the hospital.
My friend Luke wrote me last night from work: “One of my patients just passed. . .what
a strange job we have. . .time goes so fast you know and there is just no way
to go back. . .sometimes I wonder what the hell I am doing. . .am I leaving
the world better than I found it. . .”
And I remember, again, “did you save a life today?” and the code we had
last week, 76 year old guy in town to celebrate his 50th wedding anniversary with
his family. . . I did compressions for 10 minutes, sweat pouring down my face and back, while the doctor pushed every possible drug and the man’s wife waited in a wheelchair
in the lobby
I looked at his face. . .what was I thinking, I never do that, dangerous when you’re breaking someone’s ribs trying to push their blood to the rest of their body, dangerous
to think of them as a person instead of a collection of cells and blood and systems
that all need to work together to be a life. . .it haunted me, his face did, but I don’t
know now if I could tell you what he looked like.
and I’m wondering, really, if I’m saving anybody’s life but mine
Friday, August 17, 2007
you know it's a good day in the ER when you have to change your pants
huh. That didn't sound quite right.
Just about the only thing that bugs me anymore is smell. I mean, I can handle the sight of blood, guts, gore, dangly adipose tissue, broken bones, poop, pee, puke, appendages dangling by a tendon, abcesses, nasty infected holes in people's legs. . .but smell. . .well.
it's not so bad when you can prepare; rub some vicks under your nose or inside a mask, then head into a room. But when you're walking down the hallway to start an IV, swinging the IV caddy jauntily, minding your own business, singing a little song to yourself, and a head injury patient projectile vomits directly into your path, and it's loud and voluminous and very, very colorful, and it splats on the curtain and the bed and the floor, and you've just gotten back from dinner. . .
that's not so great.
Just about the only thing that bugs me anymore is smell. I mean, I can handle the sight of blood, guts, gore, dangly adipose tissue, broken bones, poop, pee, puke, appendages dangling by a tendon, abcesses, nasty infected holes in people's legs. . .but smell. . .well.
it's not so bad when you can prepare; rub some vicks under your nose or inside a mask, then head into a room. But when you're walking down the hallway to start an IV, swinging the IV caddy jauntily, minding your own business, singing a little song to yourself, and a head injury patient projectile vomits directly into your path, and it's loud and voluminous and very, very colorful, and it splats on the curtain and the bed and the floor, and you've just gotten back from dinner. . .
that's not so great.
Wednesday, August 8, 2007
greetings from another planet
I may have mentioned that I come from a large family. A large, Mormon family. I have four siblings, all older than I. They, unlike me, have managed to remain married to their spouses, and produce several children in wedlock. I have 22 nieces and nephews, and 3 grand-nephews, in fact. All good, wholesome folk. Plus my parents. In my brother's mansion. Me, my kids, and a bunch of non-drinkin' non-smokin' non-swearin anti-liberal pro-life over-educated over-populated over-whelming people. 25 of them, in fact. Yep. I fit right in.
Sooooooo. Sunday. Noonish. Get the kids in the car, on the road. We've just hit Brownsville when Miss Diva asks for the first, but not the last, time, "how much longer?" I grit my teeth. I have a goodie bag of new books and coloring stuff in the front seat. I figure if we can hold out until Portland, I can dish out the goodies and we'll be set until we hit my brother's house, where the shindig's happening.
We barely make it to Portland before I start doling out the books, the coloring markers, the notebooks, the clipboards. The kids make it to Vancouver before they finish the books and start telling me they're bored.
Vancouver, Washington. Not BC. Vancouver-across-the-bridge-from-Portland. By Castle Rock, they're bashing each other over the head with the clipboards.
But we made it, albeit six hours later. And we ate some dinner, and then woke up the next morning and ate and played in the go carts and one nephew had his Eagle Scout celebration and then we were weirdos around the campfire, my sister and I dancing around to "Father Abraham" and today we went to the aquarium and Pike Place and the little magic shop is still there and we jumped on the trampoline and yelled and screamed and fought like families do.
Granted, when I wake up I'm slightly bleary, and my whole family laughs loudly as I stumble to my car and drive to Starbucks, and they tease me about my coffee addiction. And I do occasionally have to hide in a closet and whisper all the curse words I can think of just so I don't accidently let one slip in polite company. But I am one smartypants loudmouth among many, here. . .I mean, I had to get it from somewhere, right? It's just my smartass comments are occasionally sprinkled with naughty words. ahem.
My sisters and I all snort with laughter, my brother and I mush hamburger patties together in lumps when his wife isn't looking, and earn ourselves a lecture; I watch my sister and her husband leave black streaks of rubber on my brother's race-track driveway trying to run each other off. And I watch my favorite nephew, who does great accents and has the best one-liners, try very hard to hide the fact that he is gay. Or maybe he doesn't hide it, really, and I'm the only one who notices it.
He'll be a good role model for MixMan, who recently told me he'd rather be a girl. When I asked him why, he looked at me like I was stupid and said, "girls get all the best dresses!" And he rolled his eyes and walked away. Well, duh.
Sooooooo. Sunday. Noonish. Get the kids in the car, on the road. We've just hit Brownsville when Miss Diva asks for the first, but not the last, time, "how much longer?" I grit my teeth. I have a goodie bag of new books and coloring stuff in the front seat. I figure if we can hold out until Portland, I can dish out the goodies and we'll be set until we hit my brother's house, where the shindig's happening.
We barely make it to Portland before I start doling out the books, the coloring markers, the notebooks, the clipboards. The kids make it to Vancouver before they finish the books and start telling me they're bored.
Vancouver, Washington. Not BC. Vancouver-across-the-bridge-from-Portland. By Castle Rock, they're bashing each other over the head with the clipboards.
But we made it, albeit six hours later. And we ate some dinner, and then woke up the next morning and ate and played in the go carts and one nephew had his Eagle Scout celebration and then we were weirdos around the campfire, my sister and I dancing around to "Father Abraham" and today we went to the aquarium and Pike Place and the little magic shop is still there and we jumped on the trampoline and yelled and screamed and fought like families do.
Granted, when I wake up I'm slightly bleary, and my whole family laughs loudly as I stumble to my car and drive to Starbucks, and they tease me about my coffee addiction. And I do occasionally have to hide in a closet and whisper all the curse words I can think of just so I don't accidently let one slip in polite company. But I am one smartypants loudmouth among many, here. . .I mean, I had to get it from somewhere, right? It's just my smartass comments are occasionally sprinkled with naughty words. ahem.
My sisters and I all snort with laughter, my brother and I mush hamburger patties together in lumps when his wife isn't looking, and earn ourselves a lecture; I watch my sister and her husband leave black streaks of rubber on my brother's race-track driveway trying to run each other off. And I watch my favorite nephew, who does great accents and has the best one-liners, try very hard to hide the fact that he is gay. Or maybe he doesn't hide it, really, and I'm the only one who notices it.
He'll be a good role model for MixMan, who recently told me he'd rather be a girl. When I asked him why, he looked at me like I was stupid and said, "girls get all the best dresses!" And he rolled his eyes and walked away. Well, duh.
Tuesday, July 31, 2007
here's an excuse for shopping at victoria's secret
Just worked five twelves in a row, and the freaks really do come out during the full moon. So do the gardening injuries, the drunk drivers, the broken arms (5 sugar tong splints in two days!! Geez!!), the heart patients, and the stroke victims. Had two brain tumors diagnosed in the ER that night. My favorite nurse looked at me, waggled his eyebrows, and said, "see, firefighter girl? Nurses can put in 18g IVs, too." I told him I woulda shot a 16.
It's somewhat sobering to see these patients in the ICU a couple of days later, though, knocked out from propofol, tubes in every orifice. Particularly when you saw them talking, or trying to talk, 48 hours earlier.
We had one woman who had been in an MVA earlier in the day. Medics got called to her home; they boarded her just to get her out, since she could barely walk. Doc cleared her C-spine, and he and I rolled her up on her side with the standard "give yourself a hug!" Apparently, my eyes widened rather comically when she flailed her arms around and one of her hands landed square on my tuckus and then held on for dear life, because Doc started laughing. However, her hand remained, and Doc took it upon himself to ask her if she had developed a fondness for me. She released her iron grip, patted my butt, and apologized. I have a feeling I'll be hearing about that one for a while.
Was having one of those days. You know. Where everything you pick up, you fumble, or drop; when the saline flush falls out of the lock right before you set the IV; when tape sticks to your gloved fingers, when the velcro on the knee immobilizer attaches to everything but what it's supposed to, when the underwire on your favorite bra snaps right at the curve, and you suddenly feel a sharp pain and an amazing lack of support. Then you get home, try to read before falling into a dead sleep, and your glasses snap right at the bridge. Seems like a sign. You know. Like maybe it's time for a little R and R.
It's somewhat sobering to see these patients in the ICU a couple of days later, though, knocked out from propofol, tubes in every orifice. Particularly when you saw them talking, or trying to talk, 48 hours earlier.
We had one woman who had been in an MVA earlier in the day. Medics got called to her home; they boarded her just to get her out, since she could barely walk. Doc cleared her C-spine, and he and I rolled her up on her side with the standard "give yourself a hug!" Apparently, my eyes widened rather comically when she flailed her arms around and one of her hands landed square on my tuckus and then held on for dear life, because Doc started laughing. However, her hand remained, and Doc took it upon himself to ask her if she had developed a fondness for me. She released her iron grip, patted my butt, and apologized. I have a feeling I'll be hearing about that one for a while.
Was having one of those days. You know. Where everything you pick up, you fumble, or drop; when the saline flush falls out of the lock right before you set the IV; when tape sticks to your gloved fingers, when the velcro on the knee immobilizer attaches to everything but what it's supposed to, when the underwire on your favorite bra snaps right at the curve, and you suddenly feel a sharp pain and an amazing lack of support. Then you get home, try to read before falling into a dead sleep, and your glasses snap right at the bridge. Seems like a sign. You know. Like maybe it's time for a little R and R.
Saturday, July 14, 2007
mixman gets a splinter
This morning, I sat outside on my back patio, enjoying the shade, my coffee, and a great book. It's been a while since I could sit out there- the cherry tree has decided to make cherries this year, and they are small and dark and hurt like hell when they come pelting down and smack you on the head, or foot, or leg. Plus they leave a really attractive reddish purple stain which the children decided looks a lot like blood, and have taken to smearing all over their faces and stomachs, and then chasing mom around the yard making spooky, goulish monster noises.
Anyway, judging by the number of cherries on the ground and smooshed all over the inside of my house, I felt it was safe to sit outside. There honestly could not be any left in that tree. I had just gotten to the best part in the book when I felt something warm and icky spooge on my shoulder and down my arm. Cherry colored bird poop. Yum. So. No more sitting on the back patio for me.
MixMan has developed the oddly disturbing (to his father) and rather funny (to me) habit of passing out at the slightest hint of blood or injury. School friend's loose, wiggly tooth? MixMan, down on the ground. Miss Diva's broken foot blister? Whump, MixMan flat on his back. So when he came to tell me he'd gotten a splinter and needed a bandaid, and I got out the tweezers and he ran from me, screaming, I didn't bother to chase him. I saw how pale his face was. I knew I needed only to wait for the inevitable vagal response before I could dig that sucker out.
Worked an extra shift at Meth Central Med Center this week. I started out covering for the unit secretary at her command post, and briefly entertained fantasies of running and hiding in the supply room, under all the IV supplies. I managed to hold it together until she got back from her class. I'm not sure if all the Unit Secs scowl that way all the time, or if it's just at me. Whatever. I left the nurses' station and made myself happy by sticking several people with 18g IV caths in the hand, just because I could. Oh, yeah, and because they needed 'em. Then I realized it's been over a week since I missed an IV, and I probably just cursed myself by saying that. Whoopsie. But I have floor nurses call and ask for me by name now when they have a tough stick. The last time was the med floor; they had some 300 lb cantankerous old lady cursing like a sailor who needed an IV, and they were all somewhat frightened of her, I think. So I get in there, introduce myself, and she says, and I quote, "I don't give a rat's ass where you come from or who you are; shut up or I'll shove a sock down your throat."
Well.
The nurses all made clucking noises. I looked at the lady, who cocked one eyebrow and dared me to respond. I grabbed her hand, swiped it with alcohol, and said, "you and my mother agree on something, then," slid a 20g in and taped it down. Her jaw dropped so far I coulda shoved a couple socks in, but the thought didn't even cross my mind. Honest. And that whole part about my mama isn't true, either. But it's good this lady didn't have my work socks on hand after a long shift-- I usually tuck those into a biohazard ziplock bag when I get off work, which in my humble opinion is the best place for them.
A couple of medics brought in a Charles Manson lookalike last week, and we put him in the psych room. He was a bit antsy, and hospital security wasn't cutting it, so we called the cops. One of the two officers who showed up is almost always good for a laugh, so I hovered outside the door and listened.
Officer Friendly: What's going on, sir? Why can't you do what these nice people ask you to do? They're just trying to help you.
Charles Manson: I can't, my--
OF: (sighing)you know, I was just sitting down to my coffee and doughnuts. I love doughnuts. I'm very hungry right now, and I was really looking forward to eating my sugar sprinkles.
CM: (squeaking)you want to eat me?
OF: (roaring)do you look like a doughnut? Do you have chocolate frosting and little rainbow sprinkles? No!! But if you did, I might eat you up.
Charles faints. Or maybe the Ativan kicked in.
Anyway, judging by the number of cherries on the ground and smooshed all over the inside of my house, I felt it was safe to sit outside. There honestly could not be any left in that tree. I had just gotten to the best part in the book when I felt something warm and icky spooge on my shoulder and down my arm. Cherry colored bird poop. Yum. So. No more sitting on the back patio for me.
MixMan has developed the oddly disturbing (to his father) and rather funny (to me) habit of passing out at the slightest hint of blood or injury. School friend's loose, wiggly tooth? MixMan, down on the ground. Miss Diva's broken foot blister? Whump, MixMan flat on his back. So when he came to tell me he'd gotten a splinter and needed a bandaid, and I got out the tweezers and he ran from me, screaming, I didn't bother to chase him. I saw how pale his face was. I knew I needed only to wait for the inevitable vagal response before I could dig that sucker out.
Worked an extra shift at Meth Central Med Center this week. I started out covering for the unit secretary at her command post, and briefly entertained fantasies of running and hiding in the supply room, under all the IV supplies. I managed to hold it together until she got back from her class. I'm not sure if all the Unit Secs scowl that way all the time, or if it's just at me. Whatever. I left the nurses' station and made myself happy by sticking several people with 18g IV caths in the hand, just because I could. Oh, yeah, and because they needed 'em. Then I realized it's been over a week since I missed an IV, and I probably just cursed myself by saying that. Whoopsie. But I have floor nurses call and ask for me by name now when they have a tough stick. The last time was the med floor; they had some 300 lb cantankerous old lady cursing like a sailor who needed an IV, and they were all somewhat frightened of her, I think. So I get in there, introduce myself, and she says, and I quote, "I don't give a rat's ass where you come from or who you are; shut up or I'll shove a sock down your throat."
Well.
The nurses all made clucking noises. I looked at the lady, who cocked one eyebrow and dared me to respond. I grabbed her hand, swiped it with alcohol, and said, "you and my mother agree on something, then," slid a 20g in and taped it down. Her jaw dropped so far I coulda shoved a couple socks in, but the thought didn't even cross my mind. Honest. And that whole part about my mama isn't true, either. But it's good this lady didn't have my work socks on hand after a long shift-- I usually tuck those into a biohazard ziplock bag when I get off work, which in my humble opinion is the best place for them.
A couple of medics brought in a Charles Manson lookalike last week, and we put him in the psych room. He was a bit antsy, and hospital security wasn't cutting it, so we called the cops. One of the two officers who showed up is almost always good for a laugh, so I hovered outside the door and listened.
Officer Friendly: What's going on, sir? Why can't you do what these nice people ask you to do? They're just trying to help you.
Charles Manson: I can't, my--
OF: (sighing)
CM: (squeaking)
OF: (roaring)
Charles faints. Or maybe the Ativan kicked in.
Wednesday, July 11, 2007
Tuesday, June 5, 2007
a little excursion
short shift last night; only 8 hours. In that time, two alcohol poisonings, two intentional ODs (tubed one of 'em), three little kids who got into their parents' aspirin and/or tylenol. Three years in EMS and I've never seen activated charcoal used, but the black goop was flying last night, I tell ya.
Had to take a run to imaging to restart an IV for a woman undergoing an MRI. I got in there and unloaded all my metal medic paraphernalia--trauma shears, clamps, name badge and key, retractable lanyard, watch, spiral ER pocket guide. Got next to the MRI and felt my Who hair ponytails vwoom toward it. Shit! Bobby pins! About 5o of them! No way was I taking all of them out. So I made the tech stand between me and the imager while I got a nice little IV in the patient's upper arm. It was a beauty.
Today, my daughter and I took a walk in the neighborhood. I am trying to make up for my inattention during the last three years of school and work, when I spent the days I wasn't commuting two hours to the coast for twenty-four hour shifts recovering from those 24 hour shifts. I am also trying to make up for the shoddiness of our neighborhood, the sheltered indoor life we seem to lead most of the time. We turned out our driveway, went east instead of west because the shooting last month was in the cul de sac to the west, and walked the sidewalks to get to the playground nestled in between several other duplexes. I almost cried when I saw the empty playground; broken glass covered the decrepit tennis court, and all that was left of the swing set was a rusty slide with bolts sticking out of it. The rings and the swings were gone, stolen or broken, and had never been replaced. I looked around at all the backyard fences, saw gang tags on every one. I don't know when this happened.
Nervous about the three men circling us on bicycles, I convinced Miss Diva to walk home with me sooner than we planned, promising we'd make a list of all the things we'll do this week. "Yeah," she said, "like go to Disneyland!" I held her hand tightly, my other hand locked around my phone in the front pocket of my hoodie zip-up. As we walked, I noticed the garbage stacked in front of houses, under bushes, spilling out of cardboard boxes. I noticed the peeling paint on the duplexes, the worthless cars in yards, parked haphazardly across overgrown grass; stray bedraggled cats missing chunks of fur. Here and there I noticed little secret gardens, plants and flowers in pots, and I wondered at the absurdity of it all, wondered why we even bother, when hell and poverty are closing in all around us.
Some days, I don't know how I do this. I don't know how I manage as a single parent with two children and four cats in this shit hole neighborhood, where my attempts at a flower garden seem pointless, where I can hear the sirens and the music booming in cars and babies crying and people screaming at all hours, even through my double paned windows, even with the doors double locked and curtains closed against the sound. Some days, I don't know how I do it. Some days, I don't know why I bother. But I do bother, and I do it, every day, because gardening and mothering are my little attempts at revolution. I wake up and I try to smile at the kids, even before coffee, which is no small feat. I pour their milk and cereal. I drink my coffee. And every day turns out okay in the end.
Had to take a run to imaging to restart an IV for a woman undergoing an MRI. I got in there and unloaded all my metal medic paraphernalia--trauma shears, clamps, name badge and key, retractable lanyard, watch, spiral ER pocket guide. Got next to the MRI and felt my Who hair ponytails vwoom toward it. Shit! Bobby pins! About 5o of them! No way was I taking all of them out. So I made the tech stand between me and the imager while I got a nice little IV in the patient's upper arm. It was a beauty.
Today, my daughter and I took a walk in the neighborhood. I am trying to make up for my inattention during the last three years of school and work, when I spent the days I wasn't commuting two hours to the coast for twenty-four hour shifts recovering from those 24 hour shifts. I am also trying to make up for the shoddiness of our neighborhood, the sheltered indoor life we seem to lead most of the time. We turned out our driveway, went east instead of west because the shooting last month was in the cul de sac to the west, and walked the sidewalks to get to the playground nestled in between several other duplexes. I almost cried when I saw the empty playground; broken glass covered the decrepit tennis court, and all that was left of the swing set was a rusty slide with bolts sticking out of it. The rings and the swings were gone, stolen or broken, and had never been replaced. I looked around at all the backyard fences, saw gang tags on every one. I don't know when this happened.
Nervous about the three men circling us on bicycles, I convinced Miss Diva to walk home with me sooner than we planned, promising we'd make a list of all the things we'll do this week. "Yeah," she said, "like go to Disneyland!" I held her hand tightly, my other hand locked around my phone in the front pocket of my hoodie zip-up. As we walked, I noticed the garbage stacked in front of houses, under bushes, spilling out of cardboard boxes. I noticed the peeling paint on the duplexes, the worthless cars in yards, parked haphazardly across overgrown grass; stray bedraggled cats missing chunks of fur. Here and there I noticed little secret gardens, plants and flowers in pots, and I wondered at the absurdity of it all, wondered why we even bother, when hell and poverty are closing in all around us.
Some days, I don't know how I do this. I don't know how I manage as a single parent with two children and four cats in this shit hole neighborhood, where my attempts at a flower garden seem pointless, where I can hear the sirens and the music booming in cars and babies crying and people screaming at all hours, even through my double paned windows, even with the doors double locked and curtains closed against the sound. Some days, I don't know how I do it. Some days, I don't know why I bother. But I do bother, and I do it, every day, because gardening and mothering are my little attempts at revolution. I wake up and I try to smile at the kids, even before coffee, which is no small feat. I pour their milk and cereal. I drink my coffee. And every day turns out okay in the end.
Saturday, May 19, 2007
firefighter girl 1, snails 100 and counting
It's early Saturday morning. I'm sitting on my back patio in the cold, damp air, drinking gnarly coffee. I make it strong, anyway, but there was just a little bit extra in the bottom of the bag, so I dumped it in. . .maybe a bit too much, even for me. But at least I'm awake. The kids are inside, playing monkeys and monsters. I'm not quite sure what the rules are, but they're giggling wildly, so it must be fun--either that, or the game is just a cover for kitty corralling. Anyway, they're so high energy it makes me tired; fueled by youth and a breakfast of three kinds of cereal, dumped together in the same bowl, that, when mixed with milk, looks a lot like cat vomit. But they seem to find it delicious.
I don't usually have both of them on Saturday, but MixMan's daddy went out last night to celebrate his birthday, and Miss Diva's daddy had a Salsa dancing lesson last night. So yesterday we played hard, ran through the sprinkler, built, painted, and planted a window box, and stayed up late watching Toonsylvania. I checked this morning to see if the snails had eaten any of the new plants. Only two casualties, but this is becoming a serious problem. I don't like killing anything, and apparently news has spread in the neighborhood that my yard is a snail sanctuary, with tasty plants to boot.
This is war. Time for the heavy artillery. Beer. In shallow dishes. Snails love it, or so I hear. And yeah, they die, but at least they die drunk and happy. But I'm not behind this idea one hundred percent; I mean, it seems like a lot of work. I'll have to check itty bitty snail IDs, limit entry to snails at least 21 days old. Still, it's probably easier than my nightly snail chucking, when I toss snails into the grass and hope that at least some of them make their way to the neighbors' yards instead of back into mine. I dunno. I'll keep you posted.
Yesterday, MixMan's school had a first grade performance of music from around the world. I loved watching him sign the words, singing quietly with his sweet voice. Afterwards, one of the parents said to her kid, "Let's get a picture of you with the little deaf boy!"
WTF?!! I am so glad that MixMan didn't hear that. There are benefits, I suppose, to being deaf. On the way home, to channel my anger into something constructive, I turned up the stereo in the car, bass thumping so MixMan could feel it. We sang along to one of my favorite songs, the Black Eyed Peas' "My Style." It starts out with an a capella round "Lord have mercy, Lord have mercy," except I swear they're singing, "Lord have MRSA, Lord have MRSA." And why not? Everybody else does.
I don't usually have both of them on Saturday, but MixMan's daddy went out last night to celebrate his birthday, and Miss Diva's daddy had a Salsa dancing lesson last night. So yesterday we played hard, ran through the sprinkler, built, painted, and planted a window box, and stayed up late watching Toonsylvania. I checked this morning to see if the snails had eaten any of the new plants. Only two casualties, but this is becoming a serious problem. I don't like killing anything, and apparently news has spread in the neighborhood that my yard is a snail sanctuary, with tasty plants to boot.
This is war. Time for the heavy artillery. Beer. In shallow dishes. Snails love it, or so I hear. And yeah, they die, but at least they die drunk and happy. But I'm not behind this idea one hundred percent; I mean, it seems like a lot of work. I'll have to check itty bitty snail IDs, limit entry to snails at least 21 days old. Still, it's probably easier than my nightly snail chucking, when I toss snails into the grass and hope that at least some of them make their way to the neighbors' yards instead of back into mine. I dunno. I'll keep you posted.
Yesterday, MixMan's school had a first grade performance of music from around the world. I loved watching him sign the words, singing quietly with his sweet voice. Afterwards, one of the parents said to her kid, "Let's get a picture of you with the little deaf boy!"
WTF?!! I am so glad that MixMan didn't hear that. There are benefits, I suppose, to being deaf. On the way home, to channel my anger into something constructive, I turned up the stereo in the car, bass thumping so MixMan could feel it. We sang along to one of my favorite songs, the Black Eyed Peas' "My Style." It starts out with an a capella round "Lord have mercy, Lord have mercy," except I swear they're singing, "Lord have MRSA, Lord have MRSA." And why not? Everybody else does.
Friday, May 11, 2007
drama system entries
The poem in the previous posting seems particularly applicable this past week. Two kids, 10 and 16, were shot through their sliding glass door in the next cul-de-sac over from mine last week. This makes me feel angry, and helpless. And it doesn't matter, really, that it was the result of some ongoing family feud that most likely involved drugs. All that matters is that the work I've done on my garden, my home, my sanctuary pales in comparison with the need for safety for my children. I decided, of course, that I needed to move immediately, but then realized that anyplace I could afford would have the same problems, but at least here, I know my neighbors, and we take care of each other. So I dig in the dirt, plant flowers and seeds with a little prayer for peace.
I've had this feeling, lately, that I should be doing something productive for posterity. I mean, I've got the school and career thing under my belt, I think I've got a handle on parenting (although just when I'm congratulating myself on being a fabulous mom, Miss Diva shatters the illusion with a zinger like this: "Mommy, remember when you said I'd have to live outside until I was 8?" but before you get all up in arms and call DHS, I should mention that I would have provided her with food and water and blankets. Really.) Anyway, maybe I should buy a house (yeah, right, that's gonna happen anytime soon) or work on my paintings or publish a book. So I sit down to write the great american novel and what comes out is. . .nothing.
Well, not really nothing. I mean, I type, and words come out on the screen, but what it really is is moose puke. Or yak butter. Yum. So maybe the great american novel isn't my style, and I should stick with poetry that will never, ever see the light of day.
Anyway.
I just finished up the TNCC (Trauma Nursing Core Course) that I'm required to take for my ER job. It was great to be in class again, but I didn't even open the book, because the lecture and the subject material seemed mostly like the second term of paramedic school. I breezed through the practicals (airway, spinal immobilization, trauma patient assessment) and watched with some amusement as the ICU nurses struggled with some of the biggies: Cushings, Becks, IOs, the rehydration formula for burns. I have the greatest respect for ICU nurses- the amount of information they retain is enormous- but it was interesting to see the tables turned, however briefly.
I've been working mostly night shifts, lately- 1545-0415- which makes day care much cheaper and is easier for the dads' work schedule. Plus, some very interesting patients come in at o'dark hundred. The ones who come in retching and wailing with pain, the cries a doppler effect as they're led past the nurses' station, then abruptly stop on entrance to the room, but the loud retching mysteriously starts up again when the patient hears footsteps outside the doorway, kinda like Pavlov's dog salivating to the dinging of the bell. After initial treatment of IV, meds, and a warm blanket, the nurse and I sit and engage in some mild black humor. "aaaaaeeeeeeerrrrrrkkkk," I gag quietly, mimicking our loud and proud un-puker, and the nurse laughs. "Drama alert!! Drama alert!!" she whispers. Doc D glances at us. "Heartless, absolutely heartless! Where is your compassion, people?" But before you take him too seriously, remember the time one of the other doctors saw a carpenter ant and raaaaaaan down the hall in the other direction, and Doc D jumped up on one of the rolling stools, waved his arms, and squealed, "a bug! a bug!" before sedately resuming his dictation. Compassion, my tuckus. Fun as night shift is, I'm discovering that my preference lies with the day shift nurses and doctors. Just the other day, we were so busy, and I was running back and forth starting IVs and cleaning wounds (it was a good day for heart attacks and table saws, apparently) when a guy came in with a bloody towel wrapped around his thumb. This is rarely a good thing. He didn't speak much English, which made things even more difficult. How do you say "bone rongers" in Spanish? Because that's what the doctor called for when he saw the guy's thumb. Or what was left of it. And rongers look like they're for exactly what they're for. Bone crunching.
Watching is bad enough. The sound is worse. Snip, snip, snip. Clank when the bone hits the stainless steel bowl. Blech. The patient pales, but remains stoic. I clean him up after the stitching, gently wash his little thumb nub, then apply a liberal coating of bacitracin, adaptic, and enough tube gauze to give him a Looney Tunes mega-thumb.
After I'm finished, he sits and ponders everything but the thumb. The nurse is trying to arrange for a ride home for the guy, and when she finally gets ahold of the taxi company, she calls for the interpreter, who is nowhere to be found. So she gets the guy's attention, and gives him a big smile and a jaunty thumbs up.
Whoopsie.
I've had this feeling, lately, that I should be doing something productive for posterity. I mean, I've got the school and career thing under my belt, I think I've got a handle on parenting (although just when I'm congratulating myself on being a fabulous mom, Miss Diva shatters the illusion with a zinger like this: "Mommy, remember when you said I'd have to live outside until I was 8?" but before you get all up in arms and call DHS, I should mention that I would have provided her with food and water and blankets. Really.) Anyway, maybe I should buy a house (yeah, right, that's gonna happen anytime soon) or work on my paintings or publish a book. So I sit down to write the great american novel and what comes out is. . .nothing.
Well, not really nothing. I mean, I type, and words come out on the screen, but what it really is is moose puke. Or yak butter. Yum. So maybe the great american novel isn't my style, and I should stick with poetry that will never, ever see the light of day.
Anyway.
I just finished up the TNCC (Trauma Nursing Core Course) that I'm required to take for my ER job. It was great to be in class again, but I didn't even open the book, because the lecture and the subject material seemed mostly like the second term of paramedic school. I breezed through the practicals (airway, spinal immobilization, trauma patient assessment) and watched with some amusement as the ICU nurses struggled with some of the biggies: Cushings, Becks, IOs, the rehydration formula for burns. I have the greatest respect for ICU nurses- the amount of information they retain is enormous- but it was interesting to see the tables turned, however briefly.
I've been working mostly night shifts, lately- 1545-0415- which makes day care much cheaper and is easier for the dads' work schedule. Plus, some very interesting patients come in at o'dark hundred. The ones who come in retching and wailing with pain, the cries a doppler effect as they're led past the nurses' station, then abruptly stop on entrance to the room, but the loud retching mysteriously starts up again when the patient hears footsteps outside the doorway, kinda like Pavlov's dog salivating to the dinging of the bell. After initial treatment of IV, meds, and a warm blanket, the nurse and I sit and engage in some mild black humor. "aaaaaeeeeeeerrrrrrkkkk," I gag quietly, mimicking our loud and proud un-puker, and the nurse laughs. "Drama alert!! Drama alert!!" she whispers. Doc D glances at us. "Heartless, absolutely heartless! Where is your compassion, people?" But before you take him too seriously, remember the time one of the other doctors saw a carpenter ant and raaaaaaan down the hall in the other direction, and Doc D jumped up on one of the rolling stools, waved his arms, and squealed, "a bug! a bug!" before sedately resuming his dictation. Compassion, my tuckus. Fun as night shift is, I'm discovering that my preference lies with the day shift nurses and doctors. Just the other day, we were so busy, and I was running back and forth starting IVs and cleaning wounds (it was a good day for heart attacks and table saws, apparently) when a guy came in with a bloody towel wrapped around his thumb. This is rarely a good thing. He didn't speak much English, which made things even more difficult. How do you say "bone rongers" in Spanish? Because that's what the doctor called for when he saw the guy's thumb. Or what was left of it. And rongers look like they're for exactly what they're for. Bone crunching.
Watching is bad enough. The sound is worse. Snip, snip, snip. Clank when the bone hits the stainless steel bowl. Blech. The patient pales, but remains stoic. I clean him up after the stitching, gently wash his little thumb nub, then apply a liberal coating of bacitracin, adaptic, and enough tube gauze to give him a Looney Tunes mega-thumb.
After I'm finished, he sits and ponders everything but the thumb. The nurse is trying to arrange for a ride home for the guy, and when she finally gets ahold of the taxi company, she calls for the interpreter, who is nowhere to be found. So she gets the guy's attention, and gives him a big smile and a jaunty thumbs up.
Whoopsie.
Sunday, April 22, 2007
any day's a good day for poetry. most days are good for god, too.
Occasionally, I find a book I like to read over and over again. Most of Anne Lamott's books are like that for me- she's got the tattered Christianity over the previously messed up life that seems to fit me quite well, too. And this poem by W. S. Merwin was the epigram in one of her books. No matter how many times I read this, it speaks to something visceral in me, and touches deeper every time.
Listen
with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
standing by the windows looking out
in our directions
back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you
over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on the stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you
with the animals dying around us
taking our feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
thank you we are saying and waving
dark though it is
W. S. Merwin
printed from "Travelling Mercies" by Anne Lamott, Anchor Books, a Division of Random House.
Listen
with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
standing by the windows looking out
in our directions
back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you
over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on the stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you
with the animals dying around us
taking our feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
thank you we are saying and waving
dark though it is
W. S. Merwin
printed from "Travelling Mercies" by Anne Lamott, Anchor Books, a Division of Random House.
off-gassing on earth day
I woke up at 0700 yesterday, after only two hours of sleep. I’d gotten off a 12 hour shift at 0415, and getting out of bed was sheer torture—until I remembered why I was doing it. We have a burn to learn scheduled. I drag my sorry tuckus into the shower and out to the car, slam a few shots of coffee, and make my way to station 1, where we pow wow and team up.
We drive up to the burn site in the Rescue just as Leapfrog Towing was dragging—er, towing—the last of the three mobile homes into place. “Mobile home” in the most literal and also most generous sense of the phrase, because these three structures hadn’t been decent living spaces for some time. I vaguely remember going on a chest pain call in one of them a couple of years ago; you know, the typical 300 lb patient naked in the very back bedroom, hallway barely big enough to walk through even before it was stuffed full of tchotchkes and National Geographics.
It’s a small crew today; five teams of two or three folks each, and then Incident Command, who has brought his lawn chair, two engineers, the Safety Officer, and the usual light team, who will also act as team leaders inside, since only a couple of us going in have our FFI certs. I’m partnered with a kid I’ll call DogBoy, since his official nickname is BeastMaster for reasons we won’t go into now. DB’s dad is a career firefighter, DB has been a volunteer for a while, he’s a good kid with a good heart and a great sense of humor. He looks dubiously at the third mobile home, a hulking brown mass of metal held up by wood blocks and tires that have been so flat for so long the rims are half-circles. He clears his throat. “That one makes me a little nervous. Why can’t we burn houses instead of mobile homes?” he complains. I point out that 1) we are in Deliverance country, or at least the Northwest version of Deliverance country, and there aren’t any houses out here, and 2) at least we are getting rid of some of the mobile homes. Three in one day, actually. He concedes, and quits whining. Briefly.
We start setting up, laying lines and filling the porta-tank, locating the cooler and the potty, identifying exposures. DB and I are first on exposures, so we get to hose down a couple of tall, moss-covered trees and a beat up old fence with foam that looks like drippy flocking on a Christmas tree. My feet and hose line get tangled in a Judas limb hanging over the side of the fence, and down I go. One thing I love about being a firefighter, though, aside from the fact that I get to squirt lots of water at big fires, is that everyone is klutzy in turnouts, and while I might fall down a bit more often than most, it’s nothing out of the ordinary. And unless you can see the back of my helmet, nobody knows it’s me. (Although on a different fire, I did hear somebody ask where I was, and Chief said, “Look for the firefighter who fell on her butt. That’s Firefighter Girl.” So maybe turnouts aren’t as anonymous as I’d like to think. . .) Anyway, one of the firefighters on RIT, or Rapid Intervention Team, whose only purpose is to rescue downed firefighters, came at me and the tree branch with his axe raised. Rescuing a firefighter downed by a renegade tree branch may have been stretching his job description a tad, but he rose to the occasion, and the branch was kindling after a few whacks.
DogBoy takes this opportunity to tell me that he had a small bout of diarrhea this morning. I’m not quite sure why he feels the need to share this with me. I ask him if he’s nervous, and he gets that guy thing going—you know, the squared shoulders, the look of disbelief and aloofness on his face. As if. By this time, it’s our turn for attack team, and I’m kind enough to let DogBoy have the nozzle for the first couple of attacks, and he’s new enough to not realize that later lights have better fire. Heh heh heh.
The teams managed a couple rotations each through the first mobile home, and then the second, which I would describe more as a hovel, had four lights before our turn comes up again. Captain Snappy and Chief lit the second of the two rooms, and Dog Boy and I sat and waited to go in. I watched our three-person back up team check each others’ gear, and nudged DB. They looked like nothing more than a bunch of chimps in a line, grooming each other. DB started laughing. I started having doubts about their competency. But then DB started poking around my mask and hood, under my helmet, and I made him promise to eat any bugs he found. He crossed his heart, hoped to die, and stuffed my errant ponytail down into my coat. Then we sat, and watched the light take hold.
A usual training light is nothing special. Maybe a couch or a pile of pallets on fire, lots of smoke, some good, controlled flames. But Captain Snappy knew it had been a while since I’d seen fire. And he also knew I’d let DogBoy have the nozzle the first few lights. I was about to head in, and Snappy held his arm across the doorway. “Oh, no, FFG. Wait.” So we watched as flames climbed the walls, and smoke billowed out the vents and windows. “Now?” I asked. Snappy shook his head. Flames started rolling over on the ceiling. “Now?” I asked. Snappy shook his head again. We backed away from the heat of the doorway, flames poured out the top, and Snappy said, “Take it whenever you want, FFG.” Whoot whoot!! And I got it. I got it all, and then they let the whole thing burn.
Afterwards, sitting in rehab, sipping on a Gatorade and munching on M&Ms that had only slightly melted in my turnout coat pocket, DB finally got it, finally realized that perhaps good things come to those who wait; ie, better fire. I promise him the nozzle for all the lights in the hulking brown thing. They’ve just started lighting it, and it goes faster than the other two—burning mobile homes is like starting a fire in a big metal box. They burn hard and fast once they catch. DB gets one good light, we’re rotating teams like nobody’s business, and we’re on backup just getting ready to go back in when the tones go off for a severe respiratory distress up valley.
IC points out an engineer—120mph—and DogBoy and I to take the call. We drop our helmets, coats, masks, packs, and gloves, race to the Rescue, climb in, and then race back to the packs to turn off the air and bleed them. Then back to the Rescue, me behind the wheel, 120mph in the officer’s seat, DB in the back. We go enroute, and this is much easier than driving an ambulance code 3 on the coast highway, but 120mph is asserting his testosterone and comments on my cornering. I bite my tongue to keep from mentioning the bucking sawhorse he ran over with the engine last year, or the fact that he tipped the engine into a ditch once. I look down at my mud-splotched, ash-streaked arms, the flotsam coating my turnouts. I slow the Rescue to appease 120mph, see DogBoy in the back with the paperwork, getting our gloves ready. And I feel a sudden flush of comraderie, that feeling you get at family reunion campouts after you’ve been bickering with your relatives all day but then you look at them in the light of the campfire and see how big their hearts are.
We pull in to the residence, grab the gear, and tromp in. Our patient is sitting in his LazyBoy watching his big screen TV. His new caregiver hovers nervously. I recognize this guy, seen him in the ER a couple of times, and he turns, looks at me, points his finger like a gun and winks like he’s some kind of dapper Rico Suave instead of an overweight, chronic respiratory train wreck. The caregiver may have exaggerated slightly when she called 911. I laugh, bat my mud speckled eyelashes at the patient, and get his vital signs. We chat until the Meth Central medics get there.
Once we wrap things up, we head back to the burn. DB seems anxious, and I ask him if three lights wasn’t enough for him. But he’s more concerned about missing lunch, and we pull up just in time for fried chicken, potato salad, and cookies with little tiny m&ms in them. It wasn’t just a good day; it was a great day, and even after two hours of clean up back at the station, when I knew exactly where my body would be aching the next day, and I knew I’d need 14 hours of sleep, 6 advil and a whole tube of BenGay to even move the next morning, I wouldn’t have changed a dang thing.
We drive up to the burn site in the Rescue just as Leapfrog Towing was dragging—er, towing—the last of the three mobile homes into place. “Mobile home” in the most literal and also most generous sense of the phrase, because these three structures hadn’t been decent living spaces for some time. I vaguely remember going on a chest pain call in one of them a couple of years ago; you know, the typical 300 lb patient naked in the very back bedroom, hallway barely big enough to walk through even before it was stuffed full of tchotchkes and National Geographics.
It’s a small crew today; five teams of two or three folks each, and then Incident Command, who has brought his lawn chair, two engineers, the Safety Officer, and the usual light team, who will also act as team leaders inside, since only a couple of us going in have our FFI certs. I’m partnered with a kid I’ll call DogBoy, since his official nickname is BeastMaster for reasons we won’t go into now. DB’s dad is a career firefighter, DB has been a volunteer for a while, he’s a good kid with a good heart and a great sense of humor. He looks dubiously at the third mobile home, a hulking brown mass of metal held up by wood blocks and tires that have been so flat for so long the rims are half-circles. He clears his throat. “That one makes me a little nervous. Why can’t we burn houses instead of mobile homes?” he complains. I point out that 1) we are in Deliverance country, or at least the Northwest version of Deliverance country, and there aren’t any houses out here, and 2) at least we are getting rid of some of the mobile homes. Three in one day, actually. He concedes, and quits whining. Briefly.
We start setting up, laying lines and filling the porta-tank, locating the cooler and the potty, identifying exposures. DB and I are first on exposures, so we get to hose down a couple of tall, moss-covered trees and a beat up old fence with foam that looks like drippy flocking on a Christmas tree. My feet and hose line get tangled in a Judas limb hanging over the side of the fence, and down I go. One thing I love about being a firefighter, though, aside from the fact that I get to squirt lots of water at big fires, is that everyone is klutzy in turnouts, and while I might fall down a bit more often than most, it’s nothing out of the ordinary. And unless you can see the back of my helmet, nobody knows it’s me. (Although on a different fire, I did hear somebody ask where I was, and Chief said, “Look for the firefighter who fell on her butt. That’s Firefighter Girl.” So maybe turnouts aren’t as anonymous as I’d like to think. . .) Anyway, one of the firefighters on RIT, or Rapid Intervention Team, whose only purpose is to rescue downed firefighters, came at me and the tree branch with his axe raised. Rescuing a firefighter downed by a renegade tree branch may have been stretching his job description a tad, but he rose to the occasion, and the branch was kindling after a few whacks.
DogBoy takes this opportunity to tell me that he had a small bout of diarrhea this morning. I’m not quite sure why he feels the need to share this with me. I ask him if he’s nervous, and he gets that guy thing going—you know, the squared shoulders, the look of disbelief and aloofness on his face. As if. By this time, it’s our turn for attack team, and I’m kind enough to let DogBoy have the nozzle for the first couple of attacks, and he’s new enough to not realize that later lights have better fire. Heh heh heh.
The teams managed a couple rotations each through the first mobile home, and then the second, which I would describe more as a hovel, had four lights before our turn comes up again. Captain Snappy and Chief lit the second of the two rooms, and Dog Boy and I sat and waited to go in. I watched our three-person back up team check each others’ gear, and nudged DB. They looked like nothing more than a bunch of chimps in a line, grooming each other. DB started laughing. I started having doubts about their competency. But then DB started poking around my mask and hood, under my helmet, and I made him promise to eat any bugs he found. He crossed his heart, hoped to die, and stuffed my errant ponytail down into my coat. Then we sat, and watched the light take hold.
A usual training light is nothing special. Maybe a couch or a pile of pallets on fire, lots of smoke, some good, controlled flames. But Captain Snappy knew it had been a while since I’d seen fire. And he also knew I’d let DogBoy have the nozzle the first few lights. I was about to head in, and Snappy held his arm across the doorway. “Oh, no, FFG. Wait.” So we watched as flames climbed the walls, and smoke billowed out the vents and windows. “Now?” I asked. Snappy shook his head. Flames started rolling over on the ceiling. “Now?” I asked. Snappy shook his head again. We backed away from the heat of the doorway, flames poured out the top, and Snappy said, “Take it whenever you want, FFG.” Whoot whoot!! And I got it. I got it all, and then they let the whole thing burn.
Afterwards, sitting in rehab, sipping on a Gatorade and munching on M&Ms that had only slightly melted in my turnout coat pocket, DB finally got it, finally realized that perhaps good things come to those who wait; ie, better fire. I promise him the nozzle for all the lights in the hulking brown thing. They’ve just started lighting it, and it goes faster than the other two—burning mobile homes is like starting a fire in a big metal box. They burn hard and fast once they catch. DB gets one good light, we’re rotating teams like nobody’s business, and we’re on backup just getting ready to go back in when the tones go off for a severe respiratory distress up valley.
IC points out an engineer—120mph—and DogBoy and I to take the call. We drop our helmets, coats, masks, packs, and gloves, race to the Rescue, climb in, and then race back to the packs to turn off the air and bleed them. Then back to the Rescue, me behind the wheel, 120mph in the officer’s seat, DB in the back. We go enroute, and this is much easier than driving an ambulance code 3 on the coast highway, but 120mph is asserting his testosterone and comments on my cornering. I bite my tongue to keep from mentioning the bucking sawhorse he ran over with the engine last year, or the fact that he tipped the engine into a ditch once. I look down at my mud-splotched, ash-streaked arms, the flotsam coating my turnouts. I slow the Rescue to appease 120mph, see DogBoy in the back with the paperwork, getting our gloves ready. And I feel a sudden flush of comraderie, that feeling you get at family reunion campouts after you’ve been bickering with your relatives all day but then you look at them in the light of the campfire and see how big their hearts are.
We pull in to the residence, grab the gear, and tromp in. Our patient is sitting in his LazyBoy watching his big screen TV. His new caregiver hovers nervously. I recognize this guy, seen him in the ER a couple of times, and he turns, looks at me, points his finger like a gun and winks like he’s some kind of dapper Rico Suave instead of an overweight, chronic respiratory train wreck. The caregiver may have exaggerated slightly when she called 911. I laugh, bat my mud speckled eyelashes at the patient, and get his vital signs. We chat until the Meth Central medics get there.
Once we wrap things up, we head back to the burn. DB seems anxious, and I ask him if three lights wasn’t enough for him. But he’s more concerned about missing lunch, and we pull up just in time for fried chicken, potato salad, and cookies with little tiny m&ms in them. It wasn’t just a good day; it was a great day, and even after two hours of clean up back at the station, when I knew exactly where my body would be aching the next day, and I knew I’d need 14 hours of sleep, 6 advil and a whole tube of BenGay to even move the next morning, I wouldn’t have changed a dang thing.
Tuesday, April 17, 2007
not really my idea of a great date. . .
I came off a 16 hour shift at 0415 this morning, driving to pick up my son with my head hanging out the window in the rain so I wouldn't fall asleep. Busy, busy for the first few hours, then steady the rest of the shift. A dozen IVs, and I only missed one, and that was because the patient's PCP was bedside, and I get performance anxiety. But I got it on the second try, although I cheated and went AC with an 18g. But, yeah. A sixteen hour shift.
What was I thinking?
Oh, yeah. I was thinking about paying rent, and insurance, and car; fuel, power, phone, and that one slightly important thing for little ol' hypoglycemic me. Food.
Of note to male hospital patients (I think I'm going to type this up and hand it out when I put op sites on IVs): While starting an IV and drawing blood are, by their very nature, intimate, just because I'm sticking you with a very big needle doesn't mean I'm coming on to you.
Repeat after me: IVS ARE NOT FOREPLAY.
On the other hand, I think one of the reasons I love my job is it allows me so much human contact. I used to be such a touchy feely person, but somewhere along the way, even hugs from friends started making me uncomfortable. In any case, the contact of another human, even through purple nitrile gloves, is nothing to sneeze at. We all need it. And patients appreciate the human aspect of a caregiver who is willing to touch them, hold their hand, offer support more compassionate than empty words. I've watched medics, nurses, and doctors with patients, and the ones who have the greatest rapport with people are the ones who are willing to touch.
Near the end of the 16 hour shift, when an ambulance brought in a patient for nausea, vomiting, and diarrhea after eating at Taco Bell, the charge nurse made a small, snide comment about the slightly expanding waistlines of some of the older medics. One of said medics, in the middle of ordering a tasty breakfast sandwich from the night kitchen, who actually bikes 40 miles a week, and who obviously has lost no hearing whatsoever from almost two decades of sirens, abruptly hung up the phone. He glanced at me. I glanced at the charge nurse. She and I snickered. The medic shook his head, then shook his finger at me, and said, "You be a good girl, now."
There must be some sort of blue light special lately for comments on my behavior. Which is, I might add, always good.
What was I thinking?
Oh, yeah. I was thinking about paying rent, and insurance, and car; fuel, power, phone, and that one slightly important thing for little ol' hypoglycemic me. Food.
Of note to male hospital patients (I think I'm going to type this up and hand it out when I put op sites on IVs): While starting an IV and drawing blood are, by their very nature, intimate, just because I'm sticking you with a very big needle doesn't mean I'm coming on to you.
Repeat after me: IVS ARE NOT FOREPLAY.
On the other hand, I think one of the reasons I love my job is it allows me so much human contact. I used to be such a touchy feely person, but somewhere along the way, even hugs from friends started making me uncomfortable. In any case, the contact of another human, even through purple nitrile gloves, is nothing to sneeze at. We all need it. And patients appreciate the human aspect of a caregiver who is willing to touch them, hold their hand, offer support more compassionate than empty words. I've watched medics, nurses, and doctors with patients, and the ones who have the greatest rapport with people are the ones who are willing to touch.
Near the end of the 16 hour shift, when an ambulance brought in a patient for nausea, vomiting, and diarrhea after eating at Taco Bell, the charge nurse made a small, snide comment about the slightly expanding waistlines of some of the older medics. One of said medics, in the middle of ordering a tasty breakfast sandwich from the night kitchen, who actually bikes 40 miles a week, and who obviously has lost no hearing whatsoever from almost two decades of sirens, abruptly hung up the phone. He glanced at me. I glanced at the charge nurse. She and I snickered. The medic shook his head, then shook his finger at me, and said, "You be a good girl, now."
There must be some sort of blue light special lately for comments on my behavior. Which is, I might add, always good.
Thursday, April 12, 2007
sisyphus in my own back yard
Yesterday, the angst that has been building all week came to a head. When I get angsty, I need to get outside and dig in the dirt, plant flowers, turn compost, whatever. The day showed promise early on; you know, sun breaking through the clouds and all that. I lingered over coffee, finished a book, headed out to the garage for my gardening tools. As soon as I unlocked the garage door, thunder crashed and a wall of rain hit the pavement.
Okay, it wasn't quite that dramatic, but it might as well have been. So I sighed one of those long-suffering sighs and headed back in. I decided to be optimistic about the whole thing, and poured another cup of coffee. The sun came out. I headed outside. See above. Rinse. Repeat.
Back to the whole angst thing. Like I said, it's been building all week. The kids and I have been working in the back yard, building raised beds for an herb garden, digging into the hill to lay a patio. The wheelbarrow perched precariously on the hill no matter which way I tilted it, and so for every successful load of dirt carted to the compost pile, another tiiiiiiiiips back into the hole with a boomcrash. Just like Sisyphus, only my rock is a flippin' wheelbarrow. Anyway, that's what I'm working on, shovel in hand, sweat pouring off me, when I hear the sound of 4 boys, all around 12 years old, giggling and saying, "heeeeeere, kitty kitty." I look up and see them crouched around a car, rocks and very large sticks in hand. I should mention that I don't lose my temper often. But the few things that make me see red involve bullying and cruelty to animals and children. I charged up the hill with shovel in hand, screaming at the top of my lungs, red faced and, quite likely, frightening to look at. MixMan and Miss Diva paused briefly in their playing and stared, gape mouthed. The boys and cat scattered in opposite directions. There was a brief moment of silence, and then Miss Diva said, "Mama. You said the f-word."
Whoopsie.
So when I found the pet rat dead on my front porch yesterday morning, I just assumed the little 12 year old punks had left it there, even after the neighbor who disposed of it declared the predator must have been a hawk. Miss Diva and I headed to the garden center to buy some flowers to cheer us up, and came away successful. The day was brightening, at least until I bent to get into the car and smacked my head on the roof. My immediate reaction was to jerk away, and I bonked the other temple on the door. I showed great restraint in the language I spewed at full volume there in the parking lot, you'll be happy to know. I double checked with Miss Diva, and she confirmed I hadn't cursed once. Good thing I've been practicing with make-up, because I have a positively stellar bruise on the side of my forehead.
Firefighter Girl, thy middle name is Grace.
Miss Diva is adept at conversation. So much so that I forget sometimes she's only 4. She sang in the shower this morning, some made up song with the refrain, "I'm a grumpy old soul, yeah, yeah!!" I shake my head in wonder. She is so demonstrative, too- huge hugs, sloppy lip-gloss kisses. Sometimes, she comes up behind me, pats my tuckus rather hard, and says affectionately, "I love your great big butt!"
Ohh. Thank you.
So we wait for the rain to pass. The kids play Plinko behind the futon with the round wooden coasters; MixMan builds impossible block towers and reads Dr. Seuss out loud, vrooms his cars and trains on the floors and up the walls. Miss Diva flounces around in her princess dresses and crooked crowns. She declares today a blue day, and will wear only clothing items in shades of blue. I write poetry, listen to music, clean muddy footprints and puddles of water from the doorways, sneak bites of chocolate from my hidden stash while the kids aren't looking.
On the Meth Central Med Center front- my IV skills are getting better, and I've managed a couple of tough ones on the maternity and surgical wards. I was congratulating myself on a tough foot stick in the ER- this guy had one, and I mean only one, vein, and it was sitting there on his foot, and I stuck it with no hesitation with a 22g, got a great flash, advanced, it was in, I was ready to tape it down, and he started screaming. Whoa. I wasn't even touching the damn thing at that point. There was a reason he didn't have any other veins, and I'm pretty sure he was hoping for some pain drugs, and I let him know that this was his one chance for IV meds, and he told me to f--- off and get it out. So I calmly removed the catheter, smiled politely, and left him there.
My new car is finally growing on me. Well, not really, because that would be kind of bumpy and make jeans even harder to wear. But I'm learning its moods, when it doesn't like starting, what makes it happy.
Going really, really fast makes my car happy.
Itemized list of things found behind the futon while vacuuming today:
2 slightly battered wooden coasters
1 catnip mouse
feather collection (I thought the pillows were feeling a bit less plump)
1 gameboy game (Yoshi's Egg, I believe, and it found its way behind the couch rather forcibly when MixMan got frustrated with it)
2 markers in colors very similar to the fresh markings on the wall of the stairwell
1 very frightened cat
2 hairballs
Guess what? The sun just came out. I think I'll sneak up on the garage, see if I can get some digging done in the back yard.
Firefighter Girl. Digger of hills, champion of stray cats and snails.
Okay, it wasn't quite that dramatic, but it might as well have been. So I sighed one of those long-suffering sighs and headed back in. I decided to be optimistic about the whole thing, and poured another cup of coffee. The sun came out. I headed outside. See above. Rinse. Repeat.
Back to the whole angst thing. Like I said, it's been building all week. The kids and I have been working in the back yard, building raised beds for an herb garden, digging into the hill to lay a patio. The wheelbarrow perched precariously on the hill no matter which way I tilted it, and so for every successful load of dirt carted to the compost pile, another tiiiiiiiiips back into the hole with a boomcrash. Just like Sisyphus, only my rock is a flippin' wheelbarrow. Anyway, that's what I'm working on, shovel in hand, sweat pouring off me, when I hear the sound of 4 boys, all around 12 years old, giggling and saying, "heeeeeere, kitty kitty." I look up and see them crouched around a car, rocks and very large sticks in hand. I should mention that I don't lose my temper often. But the few things that make me see red involve bullying and cruelty to animals and children. I charged up the hill with shovel in hand, screaming at the top of my lungs, red faced and, quite likely, frightening to look at. MixMan and Miss Diva paused briefly in their playing and stared, gape mouthed. The boys and cat scattered in opposite directions. There was a brief moment of silence, and then Miss Diva said, "Mama. You said the f-word."
Whoopsie.
So when I found the pet rat dead on my front porch yesterday morning, I just assumed the little 12 year old punks had left it there, even after the neighbor who disposed of it declared the predator must have been a hawk. Miss Diva and I headed to the garden center to buy some flowers to cheer us up, and came away successful. The day was brightening, at least until I bent to get into the car and smacked my head on the roof. My immediate reaction was to jerk away, and I bonked the other temple on the door. I showed great restraint in the language I spewed at full volume there in the parking lot, you'll be happy to know. I double checked with Miss Diva, and she confirmed I hadn't cursed once. Good thing I've been practicing with make-up, because I have a positively stellar bruise on the side of my forehead.
Firefighter Girl, thy middle name is Grace.
Miss Diva is adept at conversation. So much so that I forget sometimes she's only 4. She sang in the shower this morning, some made up song with the refrain, "I'm a grumpy old soul, yeah, yeah!!" I shake my head in wonder. She is so demonstrative, too- huge hugs, sloppy lip-gloss kisses. Sometimes, she comes up behind me, pats my tuckus rather hard, and says affectionately, "I love your great big butt!"
Ohh. Thank you.
So we wait for the rain to pass. The kids play Plinko behind the futon with the round wooden coasters; MixMan builds impossible block towers and reads Dr. Seuss out loud, vrooms his cars and trains on the floors and up the walls. Miss Diva flounces around in her princess dresses and crooked crowns. She declares today a blue day, and will wear only clothing items in shades of blue. I write poetry, listen to music, clean muddy footprints and puddles of water from the doorways, sneak bites of chocolate from my hidden stash while the kids aren't looking.
On the Meth Central Med Center front- my IV skills are getting better, and I've managed a couple of tough ones on the maternity and surgical wards. I was congratulating myself on a tough foot stick in the ER- this guy had one, and I mean only one, vein, and it was sitting there on his foot, and I stuck it with no hesitation with a 22g, got a great flash, advanced, it was in, I was ready to tape it down, and he started screaming. Whoa. I wasn't even touching the damn thing at that point. There was a reason he didn't have any other veins, and I'm pretty sure he was hoping for some pain drugs, and I let him know that this was his one chance for IV meds, and he told me to f--- off and get it out. So I calmly removed the catheter, smiled politely, and left him there.
My new car is finally growing on me. Well, not really, because that would be kind of bumpy and make jeans even harder to wear. But I'm learning its moods, when it doesn't like starting, what makes it happy.
Going really, really fast makes my car happy.
Itemized list of things found behind the futon while vacuuming today:
2 slightly battered wooden coasters
1 catnip mouse
feather collection (I thought the pillows were feeling a bit less plump)
1 gameboy game (Yoshi's Egg, I believe, and it found its way behind the couch rather forcibly when MixMan got frustrated with it)
2 markers in colors very similar to the fresh markings on the wall of the stairwell
1 very frightened cat
2 hairballs
Guess what? The sun just came out. I think I'll sneak up on the garage, see if I can get some digging done in the back yard.
Firefighter Girl. Digger of hills, champion of stray cats and snails.
Friday, March 30, 2007
quaking in my boots. . .er, um, sensible shoes
Sorry my posts are so erratic, folks. Had to cancel my home phone, and with it my dial-up. Yes, dial-up. In any case, this is a loooooong one, so grab a beverage of choice, put up your feet, and enjoy the story.
Last week, my first preceptor came in with a patient. (Long story short, she and I had a serious personality conflict, although I still haven't figured out why. Luckily, I was moved to a different preceptor for the end of my internship, and I did fine.) I didn't know she was even in the ER until the fine hairs on the back of my neck stood straight up, and I sensed EEEEEEEEEVVVVVVVIIIILLLLL. I turned around, caught a glimpse of her, started shaking, did a quick soft shoe routine behind a curtain, and made like a stack of laundry. Or equipment cart. Anything to avoid her. But she caught up with me in the cafeteria, damn it all. Our exchange was very. . .um. . .polite.
Cleaning beds after an ER rush, one of the new nurses asked me where to dispose of bio waste. I pointed mutely at the large red garbage can in the corner. She giggled. "Whoops. Guess my blond is showing." I asked if the streak of blond framing her face in otherwise brunette hair was like a blondometer that increased in width when she was having a blond moment. (I can't help it. Sometimes these things just shoot out of my mouth.) She looked at me and then laughed. A deep, long belly laugh that shook her from her blond roots all the way to her toes.
thank goodness.
I did CPR for the very first time last week, and was sore for days after. Pt was a 36 yo female found down in a field. The entire code team and half the ER nurses were in there, but I shoved my way to the bedside, climbed up on the stool, and started compressions. That craaaaaack as her ribs separated from her sternum was one I was expecting, but it felt icky. Weird icky. Not at all like the dummies we practice on. Damn good upper body and ab workout, though. Maybe I'll get to add it to my regimen.
Only had two marriage proposals in my last few shifts. It's been a slow week. Maybe it has something to do with my self-tanning moisturizer accident. You know, the stuff that is supposed to be fool-proof. Apply it like lotion, it builds up color gradually. Somehow, I managed to get streaky, anyway. I wonder if I'll ever get the hang of this girl thing.
My parents came to visit this week. My mother apparently had an issue wiping with kleenex instead of Charmin (ahem. . .I'm a bit low on funds lately), because on the second morning of their visit, they showed up with a Mack truck sized package of toilet paper. It doesn't fit under any of the sinks, so for now, it's taking up valuable shoe space on the floor of my closet. I think Mom is hoping that it'll last until their visit next year.
Patient highlight of the week (aside from amusing myself with conversations with little old ladies who have been given Morphine. . .what a hoot!!) was the girl who came in POV after a fight with her boyfriend. They'd been discussing breaking up while they were driving on the freeway, and she decided the discussion was over, opened the door, and jumped out of the car.
Ouch.
Damage incurred: broken shoulder, cracked T1, several abrasions, and a deep, messy lac extending from her right eyebrow all the way to a hematomato in her hairline. The surgeon stepped in to take a look, and his only comment (he's a man of few words) was, "Oh, damn."
Last Monday was a great day. RevMedic brought a patient over from the coast, and stopped by my house after the drop off. I'm pretty sure I squealed like a girl when I saw him, I was so excited. Oh, wait. I am a girl. It's a good thing he wasn't hungry, because all I had to offer was my trademark chewy coffee, but hey, he drank it without complaint. We got caught up on work stuff ("how's everybody?" "same as usual." "The ocean?" "Still there.") and headed briefly into the personal, and then he told me all about his trip to Baltimore. I sighed wistfully a few times. I'm proud to call RevMedic family, and honored to have been his trainee. Of all the folks from that job, it's him I miss the most. Now if he'd just send me that employee movie. . .
They headed out after a bit more conversation. RevMedic rolled down the window and waved. "Be safe!!" I yelled. He grinned, wiggled his eyebrows like Groucho, and yelled back, "be good!"
I have absolutely no idea what he was referring to. I'm always good.
Don't look at me like that.
Last week, my first preceptor came in with a patient. (Long story short, she and I had a serious personality conflict, although I still haven't figured out why. Luckily, I was moved to a different preceptor for the end of my internship, and I did fine.) I didn't know she was even in the ER until the fine hairs on the back of my neck stood straight up, and I sensed EEEEEEEEEVVVVVVVIIIILLLLL. I turned around, caught a glimpse of her, started shaking, did a quick soft shoe routine behind a curtain, and made like a stack of laundry. Or equipment cart. Anything to avoid her. But she caught up with me in the cafeteria, damn it all. Our exchange was very. . .um. . .polite.
Cleaning beds after an ER rush, one of the new nurses asked me where to dispose of bio waste. I pointed mutely at the large red garbage can in the corner. She giggled. "Whoops. Guess my blond is showing." I asked if the streak of blond framing her face in otherwise brunette hair was like a blondometer that increased in width when she was having a blond moment. (I can't help it. Sometimes these things just shoot out of my mouth.) She looked at me and then laughed. A deep, long belly laugh that shook her from her blond roots all the way to her toes.
thank goodness.
I did CPR for the very first time last week, and was sore for days after. Pt was a 36 yo female found down in a field. The entire code team and half the ER nurses were in there, but I shoved my way to the bedside, climbed up on the stool, and started compressions. That craaaaaack as her ribs separated from her sternum was one I was expecting, but it felt icky. Weird icky. Not at all like the dummies we practice on. Damn good upper body and ab workout, though. Maybe I'll get to add it to my regimen.
Only had two marriage proposals in my last few shifts. It's been a slow week. Maybe it has something to do with my self-tanning moisturizer accident. You know, the stuff that is supposed to be fool-proof. Apply it like lotion, it builds up color gradually. Somehow, I managed to get streaky, anyway. I wonder if I'll ever get the hang of this girl thing.
My parents came to visit this week. My mother apparently had an issue wiping with kleenex instead of Charmin (ahem. . .I'm a bit low on funds lately), because on the second morning of their visit, they showed up with a Mack truck sized package of toilet paper. It doesn't fit under any of the sinks, so for now, it's taking up valuable shoe space on the floor of my closet. I think Mom is hoping that it'll last until their visit next year.
Patient highlight of the week (aside from amusing myself with conversations with little old ladies who have been given Morphine. . .what a hoot!!) was the girl who came in POV after a fight with her boyfriend. They'd been discussing breaking up while they were driving on the freeway, and she decided the discussion was over, opened the door, and jumped out of the car.
Ouch.
Damage incurred: broken shoulder, cracked T1, several abrasions, and a deep, messy lac extending from her right eyebrow all the way to a hematomato in her hairline. The surgeon stepped in to take a look, and his only comment (he's a man of few words) was, "Oh, damn."
Last Monday was a great day. RevMedic brought a patient over from the coast, and stopped by my house after the drop off. I'm pretty sure I squealed like a girl when I saw him, I was so excited. Oh, wait. I am a girl. It's a good thing he wasn't hungry, because all I had to offer was my trademark chewy coffee, but hey, he drank it without complaint. We got caught up on work stuff ("how's everybody?" "same as usual." "The ocean?" "Still there.") and headed briefly into the personal, and then he told me all about his trip to Baltimore. I sighed wistfully a few times. I'm proud to call RevMedic family, and honored to have been his trainee. Of all the folks from that job, it's him I miss the most. Now if he'd just send me that employee movie. . .
They headed out after a bit more conversation. RevMedic rolled down the window and waved. "Be safe!!" I yelled. He grinned, wiggled his eyebrows like Groucho, and yelled back, "be good!"
I have absolutely no idea what he was referring to. I'm always good.
Don't look at me like that.
Monday, March 19, 2007
the sweet smell of singed flesh
yesterday's 12 hour shift started out like any other. Night folk meet in the break room before the shift change, we all tease each other, DT attempts to show me various pressure points on my wrist and behind my ears. "Does it hurt? Does it hurt? Huh does it?" And I have flashbacks to my older brother doing the same dang thing right before he broke my wrist. I slap DT on the shoulder and give him a quick jab to the ribs, and that's the end of that. We saunter out to the triage desk (if it's possible to saunter in ill-fitting scrubs and sensible shoes) and check the board. Busy, busy day. My first patient is a twentysomething female with a "3 inch vertical lac to forehead." Easy. She shuffles back to the bed, holding a blood-smudged towel to her forehead, boyfriend in tow. I get her settled and she pulls away the towel to show me a thick gash that goes from her hairline down to the bridge of her nose. I nod, impressed. Then-- flop flop-- the skin on both sides of the lac sort of slip, revealing a lovely, smooth, blood slicked expanse of skull. Spurt spurt go various blood vessels onto my clean scrub shirt. I hastily replace the towel with a lot of 4x4s, report to the RN and the doc, and get the lac tray and sutures ready. The doc meets me back at the bed with the cautery gun.
Oh, horrors.
Brief digression:
Last week, it was a warm sunny day. I'd used up most of the energy from my caffeine and Boomi Bar (it's hippie food, and that's all you need to know) chasing my best friend's cat around the front yard, into the neighbor's back yard, and into a tree, which I then climbed to perform a five o'clock newsworthy rescue. I got to work still a bit out of breath and sweaty from the chase, and headed to the back bed to help out the MD with the suturing of a dangly, hanging-by-a-thread finger of a squirmy, screaming, pissed off 18 month old boy. I'm helping hold the patient. Mom has the kiddo on her lap. They're both crying, we're all sweaty, the heat from the spotlight is almost unbearable. We're all doing remarkably well until the doc pulls out the cautery gun and burns two holes in that itty, bitty fingernail. The smell was bad enough, but then I realized the doc was using the fingernail like a lacing card, and sewing up through the holes.
Ewwww. Grody.
Suddenly, the smell of the. . .and the idea of the. . .and the squirming and the sweating and the screaming and the hot light and the lack of carbs all became a bit much. My vision narrowed, my ears started buzzing, and I informed the doctor in a very pleasant voice that I needed to leave post haste. He took one look at me and ordered me out of the room, and I didn't hear the end of it for the next two shifts.
How embarrassing.
End of digression.
Imagine my dismay when I saw that cautery gun. But I mostly held direct pressure with one hand and fanned the stinky smoke back at the doctor with the other, and we all came out of it just fine.
The holy spirit came in again, this time with the story of how she lost all three of her children when the sun imploded in Jesus' chest earlier in the day. God told her to come to the ER to get some rest, and that's exactly what she did. There was some mention of spaceships and demons, and she wouldn't stop fidgeting until we told her none of it was her fault. After that, she slept easy.
I guess sometimes, it's just nice to have somebody tell you everything's going to be okay.
Oh, horrors.
Brief digression:
Last week, it was a warm sunny day. I'd used up most of the energy from my caffeine and Boomi Bar (it's hippie food, and that's all you need to know) chasing my best friend's cat around the front yard, into the neighbor's back yard, and into a tree, which I then climbed to perform a five o'clock newsworthy rescue. I got to work still a bit out of breath and sweaty from the chase, and headed to the back bed to help out the MD with the suturing of a dangly, hanging-by-a-thread finger of a squirmy, screaming, pissed off 18 month old boy. I'm helping hold the patient. Mom has the kiddo on her lap. They're both crying, we're all sweaty, the heat from the spotlight is almost unbearable. We're all doing remarkably well until the doc pulls out the cautery gun and burns two holes in that itty, bitty fingernail. The smell was bad enough, but then I realized the doc was using the fingernail like a lacing card, and sewing up through the holes.
Ewwww. Grody.
Suddenly, the smell of the. . .and the idea of the. . .and the squirming and the sweating and the screaming and the hot light and the lack of carbs all became a bit much. My vision narrowed, my ears started buzzing, and I informed the doctor in a very pleasant voice that I needed to leave post haste. He took one look at me and ordered me out of the room, and I didn't hear the end of it for the next two shifts.
How embarrassing.
End of digression.
Imagine my dismay when I saw that cautery gun. But I mostly held direct pressure with one hand and fanned the stinky smoke back at the doctor with the other, and we all came out of it just fine.
The holy spirit came in again, this time with the story of how she lost all three of her children when the sun imploded in Jesus' chest earlier in the day. God told her to come to the ER to get some rest, and that's exactly what she did. There was some mention of spaceships and demons, and she wouldn't stop fidgeting until we told her none of it was her fault. After that, she slept easy.
I guess sometimes, it's just nice to have somebody tell you everything's going to be okay.
Wednesday, March 7, 2007
from hippie chick to firefighter girl
I was a bookwormish tomboy growing up. Bonafide, dyed in the wool, jeans, tennies, and t-shirt kind of tomboy. I did have waist length red hair, but always kept it up in two tight pigtails. The dusting of freckles across my nose and deep tan during summertime completed the picture. Granted, the jeans were hand-me-down bell bottoms with flowers embroidered around the bells, but they did have respectably worn knees. I announced to the world (at the tender age of 7) that I wanted to be a firefighter when I grew up. Grown ups smiled, and several boys in the neighborhood told me, in no uncertain terms, that I couldn't be a fireman, because I was a girl. Whatever. My mother, to her credit, allowed me my overflowing bookcases, Hot Wheels, cap guns, tree houses, and shunning of the color pink, but insisted that I wear a dress each week on one day in addition to sunday so I wouldn't forget I was a girl.
Ha! As if.
I did like playing dress up, and had a fairly large collection of cast-off makeup from my three older sisters. I never quite got the hang of it, though, and so my essential makeup kit as I went through my teen years consisted of mascara, powder, and lip gloss. Sundays, I wore dresses and flats, but went defiantly bare-legged, which my mother pretended not to notice.
She cringed and almost cried when she saw my first tattoo. I was in no hurry to tell her that I had a couple of others hidden under my clothes. By the time she noticed my pierced tongue, all she could do was cluck hers and shake her head. I think by that time, she realized I probably wasn't going to turn out quite like her other daughters. Late teens and early twenties, I slipped into hippie chick mode; I never did wear patchouli or tie dye, but I was big on the no makeup/no high heels/all cotton wardrobe. At the age of 24, I got a job as co-manager of a clothing store. My parents were ecstatic- Firefighter Girl picks a career! In a female dominated field! Doing girl things! But that only lasted a few months.
After I went through academy and my first year of school, I was still hell-bent on being a paramedic/firefighter. Interestingly enough, the more time I spend in this field, the more girly I get. I now own 5 pink shirts (yes, I do). I have a few pairs of high heels, and as mentioned in a previous post, I can even walk in them. I'm still getting the hang of this whole girl grooming thing, though. I make Miss Diva say the waxing mantra with me in between screams as I peel strips of hair off my legs: "Beauty is Pain! Beauty is Pain!" She laughs at me, but she's girly-girl all the way through- I don't think she has a single shirt in her dresser that isn't pink. She'll be begging for a razor and wax strips by the time she's 10. Heck, she already paints her nails, and it's not really her fault when half the purple nail polish ends up on the carpet. She's only 4, after all.
I think I figured out how to pluck my eyebrows symmetrically. That was a big milestone a couple of years ago. Hair styling beyond shampoo, conditioner, and a sloppy bun still eludes me, which is why I frequently look like an unbraided Pippi Longstocking. My staple cosmetics are still mascara and lip gloss, although for a special occasion (and if I have the time to putz around in front of the bathroom mirror) I'll put on lipstick and foundation, and if I'm feeling really brave, I'll try eyeshadow. Like this morning.
Here's how it went. I got a girl magazine (no, you pervs, not a girl-y magazine-- it was Allure, one of those magazines filled with advice for girly-girls-- makeup, fashion, tricks and tips for everything from faking a fabulous tan to horoscopes for you and your guy). In said girl magazine was this season's hottest new looks for eyes. I spread the magazine on the bathroom counter, prepared my arsenal, and set to work.
I look like I have two black eyes. Seeeeeeexxxxxxxyyyy.
Ha! As if.
I did like playing dress up, and had a fairly large collection of cast-off makeup from my three older sisters. I never quite got the hang of it, though, and so my essential makeup kit as I went through my teen years consisted of mascara, powder, and lip gloss. Sundays, I wore dresses and flats, but went defiantly bare-legged, which my mother pretended not to notice.
She cringed and almost cried when she saw my first tattoo. I was in no hurry to tell her that I had a couple of others hidden under my clothes. By the time she noticed my pierced tongue, all she could do was cluck hers and shake her head. I think by that time, she realized I probably wasn't going to turn out quite like her other daughters. Late teens and early twenties, I slipped into hippie chick mode; I never did wear patchouli or tie dye, but I was big on the no makeup/no high heels/all cotton wardrobe. At the age of 24, I got a job as co-manager of a clothing store. My parents were ecstatic- Firefighter Girl picks a career! In a female dominated field! Doing girl things! But that only lasted a few months.
After I went through academy and my first year of school, I was still hell-bent on being a paramedic/firefighter. Interestingly enough, the more time I spend in this field, the more girly I get. I now own 5 pink shirts (yes, I do). I have a few pairs of high heels, and as mentioned in a previous post, I can even walk in them. I'm still getting the hang of this whole girl grooming thing, though. I make Miss Diva say the waxing mantra with me in between screams as I peel strips of hair off my legs: "Beauty is Pain! Beauty is Pain!" She laughs at me, but she's girly-girl all the way through- I don't think she has a single shirt in her dresser that isn't pink. She'll be begging for a razor and wax strips by the time she's 10. Heck, she already paints her nails, and it's not really her fault when half the purple nail polish ends up on the carpet. She's only 4, after all.
I think I figured out how to pluck my eyebrows symmetrically. That was a big milestone a couple of years ago. Hair styling beyond shampoo, conditioner, and a sloppy bun still eludes me, which is why I frequently look like an unbraided Pippi Longstocking. My staple cosmetics are still mascara and lip gloss, although for a special occasion (and if I have the time to putz around in front of the bathroom mirror) I'll put on lipstick and foundation, and if I'm feeling really brave, I'll try eyeshadow. Like this morning.
Here's how it went. I got a girl magazine (no, you pervs, not a girl-y magazine-- it was Allure, one of those magazines filled with advice for girly-girls-- makeup, fashion, tricks and tips for everything from faking a fabulous tan to horoscopes for you and your guy). In said girl magazine was this season's hottest new looks for eyes. I spread the magazine on the bathroom counter, prepared my arsenal, and set to work.
I look like I have two black eyes. Seeeeeeexxxxxxxyyyy.
Tuesday, March 6, 2007
my dogs are barkin
12 hour shifts, 4 days in a row. Awake at 2 a.m. takes some getting used to. . .but at least I only have a 10 minute commute instead of the 2 hour commute of my recent past. 45 IVs started, one pneumothorax chest tap, one pretty dang impressive hemothorax. . .2 1/2 liters drained. I was assisting the doc, and we both watched in amazement at the solid red stream that filled the first, and then the second, and then the third evac bottle.
Had a stubborn a-fib that didn't answer to the cardizem, or the two doses of lopressor, so the doc told me to get ready for a cardiovert. Never done one of those before. . .but the doc said, "hey, why don't you do this one!" so I did. Twice. There was a tense 7 seconds of asystole after the first 50j, 7 seconds while we all held our breath, and at about 6 seconds, the doc and I looked at each other and he kind of cleared his throat and chewed his lip, and the relief in the room was palpable as the first q r s complex blipped across the screen, even though the rate was still at 150. We got him again at 120j, but the man's heart just wouldn't stop its atrial twitter.
Saw a six day old baby that was healthy as a horse. Mom was a bit. . .off. Was very concerned about some of the things baby was doing. Mom looked at me, lower lip quivering. "When she sleeps, her legs twitch." And a big fat tear rolled down her cheek. I was loathe to wake the baby with the rectal thermometer, but I sighed and lubed up the tip, and bit my tongue. I refrained from mentioning that Mom's legs probably twitched when she slept, too.
The usual junkies, migraines, NSO abdominal pains. Two aortic aneurysms in as many days. The patient who came in with a belly the size of a bowling ball from burst divurticuli was very pleasant, smiling and talking to us while we took her blood pressure. . .a couple of times, because the 55/20 measurement was somewhat difficult to believe. But no, it was right. Yikes. Three IVs, 3 L of NaCl, and Trendelenberg for you, ma'am. And she didn't even mess up her lipstick.
My favorite was the patient who showed up insisting she was the Holy Spirit. She kept addressing the numerous imaginary children in her belly and some person in the exam room only she could see. She called him Dad. It took a while to figure out she meant God. Kinda spooky. . .I have no doubt she was seeing and hearing something, but the only thing she had to say to any of us was, "gimme an IV!! My babies are thirsty and Dad says you have to!" And we were trying, but damn if her veins were filled with anything but holy water, because no matter how hard any of us tried, we couldn't get that dark red flash in the cath chamber.
Where the hell do these people come from?
Had a stubborn a-fib that didn't answer to the cardizem, or the two doses of lopressor, so the doc told me to get ready for a cardiovert. Never done one of those before. . .but the doc said, "hey, why don't you do this one!" so I did. Twice. There was a tense 7 seconds of asystole after the first 50j, 7 seconds while we all held our breath, and at about 6 seconds, the doc and I looked at each other and he kind of cleared his throat and chewed his lip, and the relief in the room was palpable as the first q r s complex blipped across the screen, even though the rate was still at 150. We got him again at 120j, but the man's heart just wouldn't stop its atrial twitter.
Saw a six day old baby that was healthy as a horse. Mom was a bit. . .off. Was very concerned about some of the things baby was doing. Mom looked at me, lower lip quivering. "When she sleeps, her legs twitch." And a big fat tear rolled down her cheek. I was loathe to wake the baby with the rectal thermometer, but I sighed and lubed up the tip, and bit my tongue. I refrained from mentioning that Mom's legs probably twitched when she slept, too.
The usual junkies, migraines, NSO abdominal pains. Two aortic aneurysms in as many days. The patient who came in with a belly the size of a bowling ball from burst divurticuli was very pleasant, smiling and talking to us while we took her blood pressure. . .a couple of times, because the 55/20 measurement was somewhat difficult to believe. But no, it was right. Yikes. Three IVs, 3 L of NaCl, and Trendelenberg for you, ma'am. And she didn't even mess up her lipstick.
My favorite was the patient who showed up insisting she was the Holy Spirit. She kept addressing the numerous imaginary children in her belly and some person in the exam room only she could see. She called him Dad. It took a while to figure out she meant God. Kinda spooky. . .I have no doubt she was seeing and hearing something, but the only thing she had to say to any of us was, "gimme an IV!! My babies are thirsty and Dad says you have to!" And we were trying, but damn if her veins were filled with anything but holy water, because no matter how hard any of us tried, we couldn't get that dark red flash in the cath chamber.
Where the hell do these people come from?
Wednesday, February 28, 2007
the agony and the ecstasy
I'd almost forgotten what a 12 hour shift in the middle of the night feels like. It started off like any first shift at a new job, although it's nice that I know the employees, and the equipment, and the layout of most of the rooms. But just enough has changed that I feel I'm in some slightly skewed alternate ER- the beds have been renumbered, the crash carts have been reorganized, the charts have been shuffled. At first I contributed my mild confusion to the early a.m. pre-coffee haze, but then realized that this time, it wasn't entirely me.
first IV of the day is an EJ. No, I didn't get to do it, although I could have- the patient had ropes for veins. With the EJ came a marriage proposal from the patient, my first of two for the shift. DeepThroat, my Medic trainer, teases me a little. I tell him it's a little different in the back of an ambulance, where it's just me, the patient, and a bunch of 14 g needles. That combination tends to curb the flirtation a bit.
With DT hovering over my attempts on the next several patients, I botch 4 out of 5 IVs. Grrrr. Granted, I haven't started an IV in a couple of months, and each patient greeted me with "I'm a tough stick," but still. After lunch, DT decided to leave me be, and hovered outside the room instead of over my shoulder and- ba da bing ba da boom- I'm 7 for 7 the rest of the shift, with only one AC. Hallelujah, the tingle is back in the fingertips.
The cops showed up in the early a.m. with a meth head. The guy had been pounding on his sister/cousin/girlfriend's car at 5 a.m (he wasn't terribly clear on this, so take your pick- although since this is meth central, one person could actually be all three). The guy is barefoot, dirty and bloodstained, with blackened burn blisters at both corners of his mouth from sucking on a hot pipe. He is also about 6 feet of wirey, sinewy muscle. Not an ounce of fat on this guy. The night nurses give him Haldol and Ativan, and we calm him enough to get him to a bed. He's definitely high as a kite, but I think he was less violent than terrified of the cuffs, the bright lights, the restraints in the back of the cop car.
Later in the day, an ambo brings in a homeless guy who is somewhat disagreeable. He was drunk, and got in a fight, and doesn't really want to be here. I am amazed at the disgust his nurse shows him, how rude she is. DT says she's old school, and doesn't like change. Whatever. I can understand getting burned out and sick of the so-called human trash- I live in the middle of it. But I also know that most humans, if given the opportunity, will rise to the occasion when treated like humans instead of pond scum. The guy was lying on the bed, shivering, soaked through from the rain, and his nurse hadn't even given him a sheet. I put my hand on his shoulder, introduced myself. He lowered his arm from his eyes, told me his name. Smiled. I covered him with a couple of dry, warm blankets. He thanked me. The doc shows up, gives the guy a once over, orders dinner for him. Treats him like a human being. Thank god for that doc. I wanted to fwap the nurse over the head with a purple nitrile glove- fwap fwap fwap. But that may not have been my most excellent idea, considering it was only my first day.
I can't think of one employee that I don't actually like at Meth Central ER. Most are good people with high standards and excellent training. The nurses generally fall into one of three categories- the ones who appreciate the medics and view us as colleagues, the ones who view us as nothing more than housekeeping with IV skills, and the ones who resent the hell out of us. Luckily, the nurses in the first category far outnumber the other two, but I am only now realizing the intricacies of politics in the hospital setting- the docs are treated with kid gloves, but nudged along by the nurses, who seem to think the docs have no idea what they're doing. The docs tolerate this because, well, it's best to humor the nurses, don't you think?
first IV of the day is an EJ. No, I didn't get to do it, although I could have- the patient had ropes for veins. With the EJ came a marriage proposal from the patient, my first of two for the shift. DeepThroat, my Medic trainer, teases me a little. I tell him it's a little different in the back of an ambulance, where it's just me, the patient, and a bunch of 14 g needles. That combination tends to curb the flirtation a bit.
With DT hovering over my attempts on the next several patients, I botch 4 out of 5 IVs. Grrrr. Granted, I haven't started an IV in a couple of months, and each patient greeted me with "I'm a tough stick," but still. After lunch, DT decided to leave me be, and hovered outside the room instead of over my shoulder and- ba da bing ba da boom- I'm 7 for 7 the rest of the shift, with only one AC. Hallelujah, the tingle is back in the fingertips.
The cops showed up in the early a.m. with a meth head. The guy had been pounding on his sister/cousin/girlfriend's car at 5 a.m (he wasn't terribly clear on this, so take your pick- although since this is meth central, one person could actually be all three). The guy is barefoot, dirty and bloodstained, with blackened burn blisters at both corners of his mouth from sucking on a hot pipe. He is also about 6 feet of wirey, sinewy muscle. Not an ounce of fat on this guy. The night nurses give him Haldol and Ativan, and we calm him enough to get him to a bed. He's definitely high as a kite, but I think he was less violent than terrified of the cuffs, the bright lights, the restraints in the back of the cop car.
Later in the day, an ambo brings in a homeless guy who is somewhat disagreeable. He was drunk, and got in a fight, and doesn't really want to be here. I am amazed at the disgust his nurse shows him, how rude she is. DT says she's old school, and doesn't like change. Whatever. I can understand getting burned out and sick of the so-called human trash- I live in the middle of it. But I also know that most humans, if given the opportunity, will rise to the occasion when treated like humans instead of pond scum. The guy was lying on the bed, shivering, soaked through from the rain, and his nurse hadn't even given him a sheet. I put my hand on his shoulder, introduced myself. He lowered his arm from his eyes, told me his name. Smiled. I covered him with a couple of dry, warm blankets. He thanked me. The doc shows up, gives the guy a once over, orders dinner for him. Treats him like a human being. Thank god for that doc. I wanted to fwap the nurse over the head with a purple nitrile glove- fwap fwap fwap. But that may not have been my most excellent idea, considering it was only my first day.
I can't think of one employee that I don't actually like at Meth Central ER. Most are good people with high standards and excellent training. The nurses generally fall into one of three categories- the ones who appreciate the medics and view us as colleagues, the ones who view us as nothing more than housekeeping with IV skills, and the ones who resent the hell out of us. Luckily, the nurses in the first category far outnumber the other two, but I am only now realizing the intricacies of politics in the hospital setting- the docs are treated with kid gloves, but nudged along by the nurses, who seem to think the docs have no idea what they're doing. The docs tolerate this because, well, it's best to humor the nurses, don't you think?
Tuesday, February 20, 2007
it's a miles davis kind of day
you know, one of those cloudy rainy cold kind of blue days. Give me some Miles, give me some Coltrane, give me something that resonates with the mood of my restless, broken heart.
I'm a single mom, which in many ways is a good thing, although it can be difficult at times. MixMan and Miss Diva are lucky (and by default, I am also lucky) that The Dads (always referred to collectively) are so much a part of their lives. Both I and my two children are truly blessed, in so many different ways.
My son is turning 7 next month. He was born ten days early in Y2K after 23 hours of drug-free labor, 13 of it very, very hard. Nuchal cord, mild distress. Five pounds, 13 ounces. The first few weeks, when he would get colicky, I'd put music on the stereo (he liked just about anything, but jazz, particularly Thelonious Monk and Coltrane, soothed him the most) and we'd dance around my tiny apartment, MixMan tight against my chest. He hated the harmonica, though. My sister tried to play for him (and she's rather good) and he would scream like he was being pinched. Hard. Every single time.
When MixMan was 4 1/2 months old, I noticed a sudden loss in his responsiveness to the sound of my voice. I'd walk into a room and he wouldn't turn his head; he no longer smiled when I sang to him. But it didn't happen all the time, and his dad and I convinced ourselves it was nothing to worry about. But by 8 months, when the random noises he made should have been shaping themselves into vowels and recognizable sounds, he was still shrieking. He got hearing aids 2 months later.
My son is one of the sweetest, most loving little boys in the world. He has a deep, abiding love for animals and his people. He is generous to a fault, although not in ways you might recognize. He terrorizes his little sister, just like any good brother should. He also has autism spectrum disorder.
Watching my little boy collapse in a frantic pile of writhing limbs, screaming the same thing over and over, saying his throat hurts from all the screaming but being unable to stop, and finally covering his own ears because the sound of his own screaming is unbearable. . . it breaks my heart. So I do what any mother would: I sit down beside him. Pull him into my lap. Take out his hearing aids. Press his head against my chest and hum a riff from Miles so he can feel the vibration in his own body. Rock gently. And it's almost like the first few weeks after he was born.
Almost.
I'm a single mom, which in many ways is a good thing, although it can be difficult at times. MixMan and Miss Diva are lucky (and by default, I am also lucky) that The Dads (always referred to collectively) are so much a part of their lives. Both I and my two children are truly blessed, in so many different ways.
My son is turning 7 next month. He was born ten days early in Y2K after 23 hours of drug-free labor, 13 of it very, very hard. Nuchal cord, mild distress. Five pounds, 13 ounces. The first few weeks, when he would get colicky, I'd put music on the stereo (he liked just about anything, but jazz, particularly Thelonious Monk and Coltrane, soothed him the most) and we'd dance around my tiny apartment, MixMan tight against my chest. He hated the harmonica, though. My sister tried to play for him (and she's rather good) and he would scream like he was being pinched. Hard. Every single time.
When MixMan was 4 1/2 months old, I noticed a sudden loss in his responsiveness to the sound of my voice. I'd walk into a room and he wouldn't turn his head; he no longer smiled when I sang to him. But it didn't happen all the time, and his dad and I convinced ourselves it was nothing to worry about. But by 8 months, when the random noises he made should have been shaping themselves into vowels and recognizable sounds, he was still shrieking. He got hearing aids 2 months later.
My son is one of the sweetest, most loving little boys in the world. He has a deep, abiding love for animals and his people. He is generous to a fault, although not in ways you might recognize. He terrorizes his little sister, just like any good brother should. He also has autism spectrum disorder.
Watching my little boy collapse in a frantic pile of writhing limbs, screaming the same thing over and over, saying his throat hurts from all the screaming but being unable to stop, and finally covering his own ears because the sound of his own screaming is unbearable. . . it breaks my heart. So I do what any mother would: I sit down beside him. Pull him into my lap. Take out his hearing aids. Press his head against my chest and hum a riff from Miles so he can feel the vibration in his own body. Rock gently. And it's almost like the first few weeks after he was born.
Almost.
Monday, February 19, 2007
call FUBAR #1
I wish I'd started writing this while I was actually working on my training. Of course, it's the calls that I screwed up on that stick with me, and it's easy to forget the ones that went well. I figure, though, that as long as I can learn from them and not make the same mistake twice I'm okay. RevMedic reminded me frequently that mistakes like this are the reason it is called "practicing" medicine, because we constantly learn and grow with each experience.
It had been a fairly slow day for The Rev and I early in my training. The call came in as cx pn, the address way out in the boonies- took us over 10 minutes to get there, even going c-3. We find a man lying on his bed, barely responsive; a single firefighter has responded and a family member stands by, says his only previous hx is chronic pn, but he'd been in to the clinic for a long-lasting cold a few days before. I ask him the standard OPQRST, but he's unable to answer; I ask him to point out where the pn is, and his hand moves to his right side, hovering over the lower part of his ribcage. I ask him if it gets worse when he breathes in or out. No answer. Lung sounds are clear. No fever. SPO2 is around 90 on the O2 that FD has placed. BP isn't great, but isn't alarmingly low, either. 12 lead shows a controlled A-fib. CBG is fine. My mind is racing. I'm thinking pneumonia with that "long-lasting cold," but all I've got is my gut to go on. The Rev mentions the man's slightly puffy legs; considers furosemide. . .but that just doesn't sit right with me for some reason. RevMedic's searching the house for meds, finds an awful lot of empty methadone bottles. Of course! Pupils are constricted but not pinpoint, but I'm so relieved to find something to treat that my awareness goes out the window. I dig for an IV, can't get one. The Rev gets one in the hand, finally, and I push 0.5 mg of Narcan, standard for this company and most others, although things were a tad different during my internship. SPO2 rises a gratifying percentage. We're in the process of figuring out how to move this short, stout man from his bed to the gurney when I hear a noise. It doesn't register, at first-- I'm so focused on the task at hand-- until The Rev taps me on the shoulder. "Your patient is snoring." He hands me an NPA. And as I lube it and push it into the patient's nose with absolutely no response, the jumble of puzzle pieces that had been falling into place rearrange themselves. This can't be. . .if his SPO2 is rising, his mentation should be improving. If the call wasn't FUBAR before this, it's definitely heading in that direction now, and at an alarming speed. I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug. We move him with no grace or fanfare to the gurney, strap him in, and wheel him out to the bus. The firefighter says he'd come with us but he's the only one covering his district today. We head out c-3. Halfway in, my patient starts frothing. It is thick, and yellow, and not at all attractive. I knock on the partition, tell The Rev we need to intubate. He pulls over, heads into the back. I try to open my patient's mouth with the standard finger pry and his teeth snap shut, narrowly missing my thumb. I try again, and his jaw is clamped so tight I probably couldn't get it open with a hammer and a prybar. I am not at all impressed with my performance from this point on. I completely blanked on my sux dosage, almost forgot the Versed, and missed both tube attempts. I am sweating and close to crying, because I still cannot figure out what is wrong with this patient. Rev gets him tubed and on the vent, and we continue on. My radio report is remarkably coherent. My mind is not. The ambulance looks like a war zone. My pt starts frothing up the tube. I'm scrabbling through suction caths, the vent is beeping, and now he's bucking the tube. The vec falls out of my hand and goes skittering under the gurney. I go to get the vent on the portable O2 and realize it's empty. ER staff pulls out the gurney, they get him into a room, they take over. The Rev and I clean up. My written report finished, we head back home. Two days later, our physician advisor skins us upside and down. He insists this pt needed Lasix. I do not concur. We check with the ICU, discover the patient had an atypical pneumonia, had almost developed ARDS. Pt received 2 L of fluid in the ER, another 2 in the ICU. Lasix would have been catastrophic.
The list of things I learned from this call numbers in the hundreds. Seriously. I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition. I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia. The Rev taught me a way to prepare meds for an RSI that would prevent vials and syringes from slipping out of my butterfingers. My chart had been shoddily written, with some important things left out- the fact that our pt had trismus, and needed RSI instead of a basic intubation, the fact that the other medic unit was on another call, and could not assist, the fact that the FD had only one available person and was unable to ride along. A glaring typo in the vec dosage.
I forget, sometimes, that every new medic goes through a crisis of faith/education/whatever. But most new medics have something that I missed- that initial feeling of being unstoppable, the paragod factor that allows them the illusion of self-confidence while they build up the real thing. Self-doubt and perfectionism can both be crippling, and in my time, I've had scads of both.
It had been a fairly slow day for The Rev and I early in my training. The call came in as cx pn, the address way out in the boonies- took us over 10 minutes to get there, even going c-3. We find a man lying on his bed, barely responsive; a single firefighter has responded and a family member stands by, says his only previous hx is chronic pn, but he'd been in to the clinic for a long-lasting cold a few days before. I ask him the standard OPQRST, but he's unable to answer; I ask him to point out where the pn is, and his hand moves to his right side, hovering over the lower part of his ribcage. I ask him if it gets worse when he breathes in or out. No answer. Lung sounds are clear. No fever. SPO2 is around 90 on the O2 that FD has placed. BP isn't great, but isn't alarmingly low, either. 12 lead shows a controlled A-fib. CBG is fine. My mind is racing. I'm thinking pneumonia with that "long-lasting cold," but all I've got is my gut to go on. The Rev mentions the man's slightly puffy legs; considers furosemide. . .but that just doesn't sit right with me for some reason. RevMedic's searching the house for meds, finds an awful lot of empty methadone bottles. Of course! Pupils are constricted but not pinpoint, but I'm so relieved to find something to treat that my awareness goes out the window. I dig for an IV, can't get one. The Rev gets one in the hand, finally, and I push 0.5 mg of Narcan, standard for this company and most others, although things were a tad different during my internship. SPO2 rises a gratifying percentage. We're in the process of figuring out how to move this short, stout man from his bed to the gurney when I hear a noise. It doesn't register, at first-- I'm so focused on the task at hand-- until The Rev taps me on the shoulder. "Your patient is snoring." He hands me an NPA. And as I lube it and push it into the patient's nose with absolutely no response, the jumble of puzzle pieces that had been falling into place rearrange themselves. This can't be. . .if his SPO2 is rising, his mentation should be improving. If the call wasn't FUBAR before this, it's definitely heading in that direction now, and at an alarming speed. I revert back to my internship, where a full 2mg of Narcan submentally (yes, submentally) injected was the norm, and push the remaining meds. My patient crumps. So much for Narcan being a relatively innocuous drug. We move him with no grace or fanfare to the gurney, strap him in, and wheel him out to the bus. The firefighter says he'd come with us but he's the only one covering his district today. We head out c-3. Halfway in, my patient starts frothing. It is thick, and yellow, and not at all attractive. I knock on the partition, tell The Rev we need to intubate. He pulls over, heads into the back. I try to open my patient's mouth with the standard finger pry and his teeth snap shut, narrowly missing my thumb. I try again, and his jaw is clamped so tight I probably couldn't get it open with a hammer and a prybar. I am not at all impressed with my performance from this point on. I completely blanked on my sux dosage, almost forgot the Versed, and missed both tube attempts. I am sweating and close to crying, because I still cannot figure out what is wrong with this patient. Rev gets him tubed and on the vent, and we continue on. My radio report is remarkably coherent. My mind is not. The ambulance looks like a war zone. My pt starts frothing up the tube. I'm scrabbling through suction caths, the vent is beeping, and now he's bucking the tube. The vec falls out of my hand and goes skittering under the gurney. I go to get the vent on the portable O2 and realize it's empty. ER staff pulls out the gurney, they get him into a room, they take over. The Rev and I clean up. My written report finished, we head back home. Two days later, our physician advisor skins us upside and down. He insists this pt needed Lasix. I do not concur. We check with the ICU, discover the patient had an atypical pneumonia, had almost developed ARDS. Pt received 2 L of fluid in the ER, another 2 in the ICU. Lasix would have been catastrophic.
The list of things I learned from this call numbers in the hundreds. Seriously. I do not push Narcan lightly now, particularly if the patient has an underlying pulmonary condition. I spent much time afterwards fondling various suction catheters, blades, and laryngoscopes, staring at the vent, going over in my head dosages, techniques, indications and contraindications. I read everything I could about naloxone, chronic pain, and types of pneumonia. The Rev taught me a way to prepare meds for an RSI that would prevent vials and syringes from slipping out of my butterfingers. My chart had been shoddily written, with some important things left out- the fact that our pt had trismus, and needed RSI instead of a basic intubation, the fact that the other medic unit was on another call, and could not assist, the fact that the FD had only one available person and was unable to ride along. A glaring typo in the vec dosage.
I forget, sometimes, that every new medic goes through a crisis of faith/education/whatever. But most new medics have something that I missed- that initial feeling of being unstoppable, the paragod factor that allows them the illusion of self-confidence while they build up the real thing. Self-doubt and perfectionism can both be crippling, and in my time, I've had scads of both.
Wednesday, February 14, 2007
hungry hungry HIPAAs
Second day of orientation at MethCentral MedCenter. Had to go in a tad early for a chest x-ray since I had a positive skin test in 2004 (well, not really; it turns out the damn stuff was contaminated and what was initially thought to be a positive result bump got very painful and red and swollen and kept growing until it finally erupted in a slew of pus-ish goo about 4 months later. I still have the scar!!). In any case, I no longer get the skin tests. I get chest x-rays.
Ahem. So the radiologist calls my name, and I follow him into the dark hallways of radiology. He's a little bit gawky, still kind of looks like he hasn't grown into his nose and limbs yet. He turns around and looks at me, clears his throat. "So, are you wearing a bra and all that?"
Well. Let me see. I know I haven't got the biggest boobs in the world, and I happen to live in a hippie mecca, but I don't dress like a hippie, and I don't stink of patchouli, and there are more than token bumps under my shirt, so yes, chances are, I'm wearing a bra. But what the hell does he mean by "all that"? A corset? Push-ups? Nipple clamps? I decide not to ask. He instructs me on the use of a hospital gown (?!), tells me that if I have a problem tying it he'd be happy to do it for me.
Yeah, right.
Orientation is another long day of sitting and listening. My brain is swimming in its CSF, drowning in all this information, paperwork, check here sign here answer these questions true false multiple choice. HIPAA, patient safety, disaster protocols. We learned all the code codes (code blue, red, evac, 10, etc). I'm downing coffee like it's water, and my eyelids are still drooping.
Finally, a break, and I head to the ER for a brief reprieve. I talk to the charge nurse, find out I still don't get on the schedule until I finish with the RN orientation this week and next. Three more days of sitting, three more days I don't get to stick anyone with needles. But I find out the three medics I'll be training with are my three favorite medics in the department-- there's DeepThroat, the one who has kept me in the loop this whole time about possible job openings (he'd call and leave whispered messages on my machine every now and again: "psssst. Firefighter Girl. There's something you should know. . ." but I think he only did it so he'd get a bonus when I got hired. Then there's the RN Paragod, who has been around for ages, but is at the end of nursing school and will be leaving the department for a different one when he graduates. And then there's Stu. Good old Stu.
He's young, Stu is. Been a medic for only a couple of years. We bonded during my ER clinicals over a truly remarkable code brown (that one's not in the orientation curriculum, but if you don't know what it is. . .guess). When the stream first hit the floor with a splat and the panicked doc called for help, Stu just shook his head and grabbed the Vicks, rubbed some under my nose, and we rolled up our scrubs sleeves (so to speak) and dove in, log-rolling the bariatric patient toward us to avoid the spray. Yup. I tell ya. There's a lot you can learn about a person in a situation like that.
So. A couple more weeks before I can get my (gloved) hands bloody and dirty again, but it's going to be worth the wait.
Ahem. So the radiologist calls my name, and I follow him into the dark hallways of radiology. He's a little bit gawky, still kind of looks like he hasn't grown into his nose and limbs yet. He turns around and looks at me, clears his throat. "So, are you wearing a bra and all that?"
Well. Let me see. I know I haven't got the biggest boobs in the world, and I happen to live in a hippie mecca, but I don't dress like a hippie, and I don't stink of patchouli, and there are more than token bumps under my shirt, so yes, chances are, I'm wearing a bra. But what the hell does he mean by "all that"? A corset? Push-ups? Nipple clamps? I decide not to ask. He instructs me on the use of a hospital gown (?!), tells me that if I have a problem tying it he'd be happy to do it for me.
Yeah, right.
Orientation is another long day of sitting and listening. My brain is swimming in its CSF, drowning in all this information, paperwork, check here sign here answer these questions true false multiple choice. HIPAA, patient safety, disaster protocols. We learned all the code codes (code blue, red, evac, 10, etc). I'm downing coffee like it's water, and my eyelids are still drooping.
Finally, a break, and I head to the ER for a brief reprieve. I talk to the charge nurse, find out I still don't get on the schedule until I finish with the RN orientation this week and next. Three more days of sitting, three more days I don't get to stick anyone with needles. But I find out the three medics I'll be training with are my three favorite medics in the department-- there's DeepThroat, the one who has kept me in the loop this whole time about possible job openings (he'd call and leave whispered messages on my machine every now and again: "psssst. Firefighter Girl. There's something you should know. . ." but I think he only did it so he'd get a bonus when I got hired. Then there's the RN Paragod, who has been around for ages, but is at the end of nursing school and will be leaving the department for a different one when he graduates. And then there's Stu. Good old Stu.
He's young, Stu is. Been a medic for only a couple of years. We bonded during my ER clinicals over a truly remarkable code brown (that one's not in the orientation curriculum, but if you don't know what it is. . .guess). When the stream first hit the floor with a splat and the panicked doc called for help, Stu just shook his head and grabbed the Vicks, rubbed some under my nose, and we rolled up our scrubs sleeves (so to speak) and dove in, log-rolling the bariatric patient toward us to avoid the spray. Yup. I tell ya. There's a lot you can learn about a person in a situation like that.
So. A couple more weeks before I can get my (gloved) hands bloody and dirty again, but it's going to be worth the wait.
Saturday, February 10, 2007
search and rescue, country style
I love drill day. I especially love drill day when the drill is in a crappy little mobile home that I know we get to burn in a few weeks. This drill, though, is SAR- search and rescue-to help Captain Snappy, the training officer, train all the newbies. The mission: Find and remove from harm our victim, Rescue Randy.
Let me set the stage:
The mobile home is set on a hill of dirt. The only vegetation is dead blackberry brambles, each stalk as thick as a rope. The carpet on the inside of this place is soaked with what I'm hoping is water, as opposed to some other unpleasant substance. There's also a large bag of Krusteaz Buttermilk pancake mix torn open in the middle of the floor, and a layer of flour coats everything. There's quite a paste forming on the carpet of the living room. There are toys and cast off things everywhere; cabinets torn from hinges, holes in the floor. You can see the ground several feet below.
I'm engineering (if you can call it that) so that the newbies get some experience with the officers on SAR. About 25 minutes left of drill time, and Captain Snappy decides he wants the last two senior firefighters (that would be myself and Ms. J, the only other female on the department) to do a run through. We mask up and head in, faces covered with our hoods so we can't see. I have the nozzle and the halligan, Ms. J has the radio. We head right, a quick search through the kitchen, and continue down the hall, pausing at each doorway. I leave Ms. J and the nozzle at the door, and take the halligan in, sweeping it with my left arm while keeping my right foot or hand in contact with the wall all the time. On one broad sweep, my halligan hits something. It makes a very loud noise. The noise it makes as it falls on me is even louder, and the noise I make as it lands on me takes the cake, particularly since I have my amplifier turned on. I'm flat on the floor on my stomach, spread eagle under a damn door. I'm laughing so hard I know I'm sucking air. . .I hear Ms. J at the door of the room screaming "Firefighter Girl! Can you hear me!!" And the most I can get out between guffaws is "collapse!" "collapse!" And all the firefighters watching me from outside do just that. In fact, they are so entertained that they decide to come in and follow us through the rest of our initial search. I can hear their little comments and shuffling bunker boots behind me as I crawl through the hallway.
The next doorway, it turns out, leads to the bathroom. I know this because when my Krusteaz coated gloves hit the linoleum, I shoot right over the nozzle and don't stop until my halligan hits the base of the counter 4 feet away. I've still got the hose with my foot, thank goodness, and I've definitely maintained contact with the wall. I search the cabinets and the little closet, and then. . .I've found our victim, Randy, in the bathtub.
He's a heavy bastard, 175 lbs of dead weight, missing a forearm from an escapade a certain firefighter had with him last year that may have involved a long chain, the staff rig, and a gravel road, although I could be wrong. More likely, the arm came off from somebody yarding on it during a different SAR drill (you know the firefighter motto. . .if it doesn't work, force it. . .). In any case, the easiest way to get this sexy beast out of the tub is with webbing. I loop my webbing under his armpits, and then get Ms. J's done up the same way. About then is when I realize there's a toilet between the bathtub and the doorway. I know this because I smacked my head on it when I tried to get at Randy's feet.
Victim removal is not a tidy thing. It's not particularly gentle, either, and in zero visibility, frankly, you're going to run into things. I accept this. Chances are, your victim's going to end up with some bruises. I accept this, as well. Ms. J is on the other side of the toilet, and can't get much purchase, so it's pretty much up to me. I grab onto the webbing, we count to three, and I feel Randy lift over the edge of the tub. The last thing I want is him wedged between the toilet and the tub, so I keep pulling. I've got both feet propped against the edge of the tub, and I'm pulling, up and over, up and over. And there's a scraaaaaaape craaaaaash boom spray and water everywhere. I check the bale of my nozzle, which has somehow miraculously remained closed during the fray. I hear Ms. J on the other side of the toilet, her voice more muffled than usual. The sound of water flowing is getting louder, and I hear someone from the audience start laughing. (thank you. thank you very much.) And it turns out that I took off the lid, seat, and tank cover from the toilet, pulled part of the tank away from the wall, and managed to turn on the bathtub faucet. As I said, victim removal is not a tidy thing. But Randy's out, although he's now on top of me.
From there, we're pretty much home free, just have to get him outside. There was a small incident with Ms. J mistaking me for Randy, yanking on my boot and screaming "I've got him! I've got him!" While I was trying desperately to maintain my hold on Randy's leg. When what she thought was Randy started kicking her, she re-evaluated her decision. By this time, she's trying to give a report to command on what her hold up is (she wisely decided not to mention that the two of us were now wedged into the doorway, weak with laughter. She did manage to tell command that we were planning an exit through the back door, although I'm not sure how much of that was understood by command because Ms. J was snorting so loudly.) The actual exit was uneventful but less than graceful, because I fell out the back door over two steep stairs, and Randy landed on his head next to me.
Guess what? Mission accomplished. Our victim is most likely now a paraplegic, but hey. . .details.
Let me set the stage:
The mobile home is set on a hill of dirt. The only vegetation is dead blackberry brambles, each stalk as thick as a rope. The carpet on the inside of this place is soaked with what I'm hoping is water, as opposed to some other unpleasant substance. There's also a large bag of Krusteaz Buttermilk pancake mix torn open in the middle of the floor, and a layer of flour coats everything. There's quite a paste forming on the carpet of the living room. There are toys and cast off things everywhere; cabinets torn from hinges, holes in the floor. You can see the ground several feet below.
I'm engineering (if you can call it that) so that the newbies get some experience with the officers on SAR. About 25 minutes left of drill time, and Captain Snappy decides he wants the last two senior firefighters (that would be myself and Ms. J, the only other female on the department) to do a run through. We mask up and head in, faces covered with our hoods so we can't see. I have the nozzle and the halligan, Ms. J has the radio. We head right, a quick search through the kitchen, and continue down the hall, pausing at each doorway. I leave Ms. J and the nozzle at the door, and take the halligan in, sweeping it with my left arm while keeping my right foot or hand in contact with the wall all the time. On one broad sweep, my halligan hits something. It makes a very loud noise. The noise it makes as it falls on me is even louder, and the noise I make as it lands on me takes the cake, particularly since I have my amplifier turned on. I'm flat on the floor on my stomach, spread eagle under a damn door. I'm laughing so hard I know I'm sucking air. . .I hear Ms. J at the door of the room screaming "Firefighter Girl! Can you hear me!!" And the most I can get out between guffaws is "collapse!" "collapse!" And all the firefighters watching me from outside do just that. In fact, they are so entertained that they decide to come in and follow us through the rest of our initial search. I can hear their little comments and shuffling bunker boots behind me as I crawl through the hallway.
The next doorway, it turns out, leads to the bathroom. I know this because when my Krusteaz coated gloves hit the linoleum, I shoot right over the nozzle and don't stop until my halligan hits the base of the counter 4 feet away. I've still got the hose with my foot, thank goodness, and I've definitely maintained contact with the wall. I search the cabinets and the little closet, and then. . .I've found our victim, Randy, in the bathtub.
He's a heavy bastard, 175 lbs of dead weight, missing a forearm from an escapade a certain firefighter had with him last year that may have involved a long chain, the staff rig, and a gravel road, although I could be wrong. More likely, the arm came off from somebody yarding on it during a different SAR drill (you know the firefighter motto. . .if it doesn't work, force it. . .). In any case, the easiest way to get this sexy beast out of the tub is with webbing. I loop my webbing under his armpits, and then get Ms. J's done up the same way. About then is when I realize there's a toilet between the bathtub and the doorway. I know this because I smacked my head on it when I tried to get at Randy's feet.
Victim removal is not a tidy thing. It's not particularly gentle, either, and in zero visibility, frankly, you're going to run into things. I accept this. Chances are, your victim's going to end up with some bruises. I accept this, as well. Ms. J is on the other side of the toilet, and can't get much purchase, so it's pretty much up to me. I grab onto the webbing, we count to three, and I feel Randy lift over the edge of the tub. The last thing I want is him wedged between the toilet and the tub, so I keep pulling. I've got both feet propped against the edge of the tub, and I'm pulling, up and over, up and over. And there's a scraaaaaaape craaaaaash boom spray and water everywhere. I check the bale of my nozzle, which has somehow miraculously remained closed during the fray. I hear Ms. J on the other side of the toilet, her voice more muffled than usual. The sound of water flowing is getting louder, and I hear someone from the audience start laughing. (thank you. thank you very much.) And it turns out that I took off the lid, seat, and tank cover from the toilet, pulled part of the tank away from the wall, and managed to turn on the bathtub faucet. As I said, victim removal is not a tidy thing. But Randy's out, although he's now on top of me.
From there, we're pretty much home free, just have to get him outside. There was a small incident with Ms. J mistaking me for Randy, yanking on my boot and screaming "I've got him! I've got him!" While I was trying desperately to maintain my hold on Randy's leg. When what she thought was Randy started kicking her, she re-evaluated her decision. By this time, she's trying to give a report to command on what her hold up is (she wisely decided not to mention that the two of us were now wedged into the doorway, weak with laughter. She did manage to tell command that we were planning an exit through the back door, although I'm not sure how much of that was understood by command because Ms. J was snorting so loudly.) The actual exit was uneventful but less than graceful, because I fell out the back door over two steep stairs, and Randy landed on his head next to me.
Guess what? Mission accomplished. Our victim is most likely now a paraplegic, but hey. . .details.
pitchfork, trident
I have, on my left wrist, a tattoo. This tattoo happens to be from the poem "Spel Against Demons" by Gary Snyder. Perhaps my brothers (the firefighting ones, as I only have one actual male sibling) are somewhat ignorant because I've had this tattoo for ten years now, and frankly, the first time anyone ever really commented on it was when my training officer at the fire station informed me that it looked like two pitchforks f***ing. I have since been asked by at least two other firefighters just what the heck the pitchforks are doing on my wrist. So. A brief lesson in a) garden tools and b)anatomy and physiology. We'll save c) poetry for a completely different time.
A pitchfork, if I may be so bold as to state, generally has 4 tines, similar to (gasp) a fork. It is used for pitching hay, turning compost, and the like. A trident was Poseidon's scepter of choice; "tri-" meaning, of course, three, as it has three prongs.
As far as I am aware (although one never really knows what happens in the tool shed while everyone is sleeping), neither the trident nor the pitchfork have the sentience or the . . . uh. . . equipment to do the deed.
My tattoo, although not pitchfork or trident, most closely resembles the latter.
I hope this clears things up. For any of you still confused about the issue, I have pictures of both for comparison.
A pitchfork, if I may be so bold as to state, generally has 4 tines, similar to (gasp) a fork. It is used for pitching hay, turning compost, and the like. A trident was Poseidon's scepter of choice; "tri-" meaning, of course, three, as it has three prongs.
As far as I am aware (although one never really knows what happens in the tool shed while everyone is sleeping), neither the trident nor the pitchfork have the sentience or the . . . uh. . . equipment to do the deed.
My tattoo, although not pitchfork or trident, most closely resembles the latter.
I hope this clears things up. For any of you still confused about the issue, I have pictures of both for comparison.
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