Tuesday, January 15, 2008

Nursing woes

I wish my nurses today would just freaking work together. We had a triage nurse basically refuse to escort (or find someone to escort) the patient from triage to the OBS unit. This is a problem, 'cause getting to OBS, and not Fast Track, can be kind of tricky. And, when the patient ends up in Fast Track by accident, it delays care by hours and hours. When she refused the first time, my OBS nurse very correctly called down to triage to address the problem. No heat from her side - she just wanted to make sure it didn't happen again.

The triage nurse threw a hissy fit. And ya know what? The second patient she sent up got lost too. Not as lost, and not for nearly as long (we suspected triage might do something dumb again), but still. I really shouldn't have to get involved in this sh!t. If the nurse manager hadn't been on vacation this week, I wouldn't have had to stick my nose into the situation. Grr...

Sunday, January 13, 2008

Upcoming vacation!

I know I missed my last Saturday post (yesterday) and I'm hereby announcing that I'm likely gonna miss next Saturday as well. Why, you ask? I'm going on vacation! Where, you ask? My favorite place on earth, Steamboat Springs Colorado. And it's been snowing for two weeks straight - powder powder powder time, baby.

I'm a pretty good skier. I like to think I'm as good as anyone could be given:
- three weeks a year on skis from 3 years - 12 years
- two weeks a year from 12 - 18 years old
- one week a year most, but not all, years thereafter.

I can get down anything. I enjoy getting down most everything. But I'm only graceful about 70% of the time. I haven't been in Steamboat during a true powder dump since I was 18. I can't wait I can't wait I can't wait. With my luck, though, the snow will stop two days prior to my arrival and a warm snap will arrive one day before I get there.

Grr.

Cross yer fingers for snow, baby!

Friday, January 11, 2008

Godf*ckingdamnbastardtraffic@ssholes!

Goal: To enjoy the company of my friends at a birthday party, leave early enough to get home in time to have a final beer, wind down a little by myself AND get 6.5 - 7 hours of sleep.

What got in my way... Oh, that would be signage. Or rather, the lack thereof. There are about three ways to get back from my friend's house. Why so many options? He lives in bumfuck. Yes, it's a very nice section of bumfuck. And yes, it's a very nice house in a very nice section of bumfuck, but it's still bumfuck! And when you're so far away, there are almost always multiple routes. (Yes Karla, I'm talking about your brother. Seriously, does he really need to live 25.6 miles from the Montrose?)

One route - the northern one - would have been fine. That's the route the lovely Tom Tom gave us on the way out. Given how well things went, and given that the trip back was sans husband, I thought using the Tom Tom directions a second time would be swell.

Yeah, well, it would have been if the Tom Tom had been consistent. But nooooooooooo on the way back it sent me south. Which, since I was sans husband, I didn't realize until I was well on my way. Without the sun, I'm helpless at finding north.

So the Tom Tom sent me south to 10 and HW-6. Straight into construction. Bumper to bumper traffic at 1030p on a Friday. Grumpy much? Yeah, that would be me.

Thursday, January 10, 2008

MacGyver!

I've somehow conned my husband into watching DVDs of the second season of MacGyver with me. It's great. Although season three is better. But whatever! I'm getting my young and mulleted Richard Dean Anderson fix.

On another note - I've rediscovered the StudentDoctor.net forums. The emergency medicine forum in particular is hilarious. Some of the threads are boooooring. I really couldn't care about the residency match anymore. Nor do I care about 3rd year (medschool) clerkships. But the 'Things I Learn From My Patients" threads, part one and two, are great. So are the haikus.

Just go check it out.

Wednesday, January 09, 2008

Hair

I finally got my hair cut. It's now shoulder length.

Tomorrow, we'll see how well I like it.

Tuesday, January 08, 2008

Chaos

Doctors never get sick. At least that's the illusion. The best part is we, as physicians, buy into this one ourselves. And even though I intellectually disagree with the ironman mentality... I discovered today that I'm definitely a card-carrying member of the MD hardass society.

One of the other doctors in my emergency medicine group called in sick today. She couldn't work her shift. She said. And even though I didn't talk to her, I did overhear conversations between her and my boss.

She wasn't that sick. She wasn't going to the ER, or her doctor, or whatever. She just wasn't going to work.

Meanwhile, the rest of us were scrambling to cover the ER. I was covering two areas... and one of the two areas decided to turn into a burning cesspit of sickness. Patient number 1 had a hemoglobin level of 4; which would be one third of normal. One third of normal isn't good. She was a kind of pale I hadn't seen in a while. Patient number 2 had a gi-normus mass on her right neck involving her airway. Oh, and by the way, the child had an oxygen saturation of 85% (normal = 100%) because the stupid thing had started to grow.

Fabulous!

Now, on a good day, I like taking care of sick people. That is, after all, the whole point of becoming a doctor. But when I'm being pulled in five million different directions and I'm taking care of patients in two totally different geographic locations... at that point I'd really like to just be taking care of simple stuff, thanks. Airway impingement? Not so much.

The good news is that everyone made it out of the ER okay; the ICU players went to the ICU, the floor patients went to the floor, and everyone else stayed in the waiting room. 'Cause they weren't sick enough to get seen while I was there. So they made it out of the ER without being seen to go to their PRIMARY CARE DOCTOR tomorrow. Which was where they belonged, thankssomuch.

Monday, January 07, 2008

Scrub hierarchy

There is a scrub hierarchy that only those in medicine knows. Furthermore, I'm not sure that non-doctors fully understand all of the class connotations of the scrub pyramid.

Lowest on the pyramid are the sales reps. These dudes try to mimic doctor scrubs, but always get the color wrong. Furthermore, their scrubs always fit too well, which is an immediate give-away.

Next are the orderlies, also known as PCAs. PCA stands for patient care associate. They basically take vital signs, clean up the messes, weigh poopy diapers and do other unpleasant tasks. Identifiable by their store bought scrubs and lack of stethoscopes, these poor folks are the bottom of the medical staffing structure.

I'm going to skip over respiratory techs and radiology techs. Their uniform is a lot like the PCA outfit, with slightly more medical knowledge. Which, of course, makes them more dangerous.

Nurses are the easiest creature to identify in the medical world. They always buy cutsy futsy scrubs. Frequently, their scrubs have been pressed. Never, every are their scrubs hospital green. Never, ever are their scrubs stained. Frequently, their scrubs have extra pockets, especially in the pants. Sometimes, those nurses even spring for elastic waistbands.

Just for contrast, MDs never buy their scrubs. We feel that we've paid the hospital enough in time and sweat that free scrub tops and bottoms are the least it owes us. Extra pockets? Who needs them! We've got the white coat. Elastic waistbands are for wussies, and cutsie pattern would make us look like nurses.

Basically, no culturally literate, self respecting doctor will ever find him or herself in store bought scrubs. If it ain't hospital style stolen, it ain't worth it!

Sunday, January 06, 2008

Hockey!

Hockey is a sport I thoroughly enjoy but don't really understand. I've had the basics explained to me, but I just get all confuzzled while I'm watching the game. It doesn't help that I've had the most exposure to American Hockey League and college hockey - basically the equivalent to triple and double A baseball. Which makes the hockey... sloppy. Hockey is an imprecise sport to begin with, so development league games are messy like a two year old eating chocolate cream pie.

My local team is the Aeros. We've been to one game so far this season, and we're going to a second this afternoon. I like watching them play, but sometimes I feel like the venue doesn't actually want us there. Aeros fans only get Bud Lite and similar; Rockets fans get a choice of barley-based libations. Yes, I know, Rockets games bring the venue much much more money. I don't care! I don't go to Rockets games. I want my bock beer, damn it! None of the nicer food joints are open for Aeros games, just burgers and such. Sometimes I think they would close some of the bathrooms if they could get away with it. Stoopid Toyota Center. Stoopid South for not supporting hockey. Pbbt!

Saturday, January 05, 2008

Wild-card Games

What the fuck happened to Rothlisberger? Three interceptions in the first half? Is he out of his mind? So the Steelers are losing; as I write this, the halftime show is blathering away. Is there any use to the post-season halftime show? I don't think so. Every day during the playoffs, there are at most 2 games. I don't really need to hear 20 minutes of recap. Nor do I need to hear recap of the game I'm already watching.

Halftime shows are just annoying. I'd rather watch a marching band or maybe some pretty cheerleaders. Even Janet Jackson's boob is preferable.

Really, it's still yesterday

Or at least as far as I'm concerned - I haven't been to bed yet.

Today I treated the PWT Award Winner. These poor white trash folks really just never had any chance. Great grandma had a face that had been around the block so many times that 'roadmap' was an understatement. Grandma was MIA. Mom was, at the MOST, 16 years old. However, the award winner for the family was Dad. Or better stated, the baby daddy - since all he did was donate the sperm.

Babydaddy, like the child, has seizures... maybe. According to the Mom, "The dad says he has seizures, but his dad (ie Dad's dad) says that he only has fits when he's doing cocaine."

Oh snap, now that's a good family tree. This kid is already done for - PWT, a Dad with substance abuse issues, and a mother that probably won't finish high school. Good luck and good night!

Thursday, January 03, 2008

Don't drop yer baby

I'm just saying. 'Cause if you do, I'll call CPS on your ass. Especially if the 'dropping the baby' story doesn't match with the two skull fractures, one older than the other. Again, I'm just saying.

In other news, hubbie and I are finally sitting down to do something we haven't done in days and days and days: watch our DVR! Mythbusters is at our fingertips, along with Bionic Woman, Torchwood, Dirty Jobs, Good Eats, Eureka and Top Gear. So far, we've tackled a Bionic Woman and we're midway through Mythbustuers.

Wednesday, January 02, 2008

Holidays

Mad props to folks who can blog every day through the holidays. I have proven that I can't. We had a crazy good time, though. Our annual New Year's Eve bash was a success. Most of the guests did, in fact, show up in formal wear. Our food came off well, even if the filet mignon was saltier than I'd usually like. We didn't run out of booze, which had been an initial fear. Best of all, even though I got drunk, I didn't get totally sloppy, pass out or puke. Go me!

Usually, when we through a party, I do well through the first 2/3rds of the night... but then during the last hours of the party I usually lose all control, slam the drinky-drinks and get shit-faced. Shit-faced then leads to passing out, which leads to hubbie staying up until all of the guests leave followed by shafting him with most of the cleaning. Not very cool.

This year, I stayed up until the fat lady sang. One number: 5. The party lasted until 5am. Holy crap! According to hubbie, most of our parties last that long. People, that's 11 hours of party. Yeesh. Who knew we were such animals?

Thursday, December 27, 2007

Destruction of a tree

So I took down the Chridma tree today. Hubbie was sad, since he didn't get to participate. I was sad because I like having the tree up. I learned several things while dismantling the tree:
  • there's always a missing ornament.
  • no matter how well I think I'm wrapping the lights, I'll still have a mess to unwrap next year. And yeah, this year I thought I'd wrapped things pretty well.
  • the tree is always lighter on the way out.
  • the tree is always messier on the way out. How many needles does a noble fir have? Ask my floor.
  • the water in the tree stand? Yeah, it's nasty. And smelly. Beware.
Next up is New Year's Eve. We're throwing a formal, black tie, sit down dinner. Unfortunately, a large portion of our friends haven't GROWN UP and learned how to be on time. So they get punished - no filet mignon for them! (If any of them are reading this, I'm serious. You late, you no get the meat.)

Wednesday, December 26, 2007

People are dumb

I worked a 12 hour shift yesterday. Here's a list of what constitutes a "pediatric emergency" on Christmas day:
  • Fever - I had lots of these. Only about 1 in 5 of these children were actually sick.
  • Constipation - Again, are people stupid?
  • Congestion - Just blow the damn kid's nose.
  • "My butt hurts" - This one eneded up being real, but only because the child developed intractable vomiting while waiting to see me. Her butt was fine.
  • "Spider bite" - These are almost always real, since in H-town a 'spider bite' is actually an abscess. And I can fix those.
  • Broken arm - I can't fix those myself, but I can give your kid the good drugs while the orthopod fixes it.

The first three made up the bulk of my patients, took up the bulk of my time and made me renew my confidence that most people are, truly, stupid.

Monday, December 24, 2007

Dailies

So I'm not doing so well on this daily posting bit, am I? I'm sure all the other daily bloggers are just as busy as I am, and they seem to do just fine. Dave, however, does have the unfair advantage of an iPhone; the handy device allows him to post from anywhere. Then again, he was a daily poster long before his beloved Apple gizmo was invented. So no excuses for me!

Today I finally finished by Chridma shopping. Chridma consists of all of the commercial and social aspects of Christmas without any of the Godly bits. Carols are fine... as long as they couldn't also pass as hymms. Decorations are fine... as long as the baby Jesus is no where to be found. Big lavish family meals are fine... as long as no one says grace. Gifts are freakin' great... as long as I don't have to 'give thanks to God' for my booty. I'll happily give thanks to the gift giver, instead. Usually in form of smooches, since the gift giver is almost always my hubbie.

He does such a good job with 'dem presents. I'm staring at a stack of them right now and I can't WAIT!

Friday, December 21, 2007

Sorry

So I missed yesterday. Shoot me. We had the annual office party yesterday, and fun was had by all. It was, however, a very strange party. I always see all of these people in scrubs or at least white coats. Party clothes made everyone almost unrecognizable. One of my buddies commented, "If I hadn't seen you, I would have thought I was at the wrong party."

Other strange things:
  • The boss didn't show up - at all. What's up with that? The boss doesn't show up to the department party - that's weird.
  • Child Life can boogy down. I mean, seriously, the girl has moves.
  • Research assistants + orderlies = near sex on the dance floor... at an office party. Can we say, not good for the career?
  • Drunk doctors are funny. 'Nuff said.
  • Drunk nurses are even funnier. It's like a college frat party, only better, 'cause the floors aren't sticky.

Thursday, December 20, 2007

EMSTAT

I don' t know how clear I've been in the past about where I work; I actually have two job sites. I work at the Big House and the Community Hospital. The Big House is a large tertiary care children's hospital while the Community Hospital is a tax payer funded county hospital. On days like today, where I worked yesterday at the Community Hospital and today at Big House, the differences seem pretty stark.

Yesterday - porn computer. Today - the system that helps us track patient location went down. Of course, our system outage coincided with a huge bed crunch and flood of new patients. It was like everyone wanted to get his kid checked out before Christmas, but didn't want to see the pediatrician during shopping hours. Very frustrating.

Wednesday, December 19, 2007

ComPuterMachine

I could have sworn that I'd blogged about this before, but I can't find the post. And I'm too lazy to keep on looking. So there's this computer at work - henceforth known as the porn computer - with no firewall protection. Which is good, 'cause the firewall protection at the community hospital is so strict as to be debilitating, but bad, because, well, no firewall = no protection. I always feel like I've having sex without a condom when I use that thing.

Recently, I've noticed the porn computer getting slower and buggier. So I stopped checking any accounts that need a password from that machine. But I didn't stop using it for patient data. Inconsistent much? I think so.

I feel pretty stupid, since I didn't catch my own inconsistency until tonight. Then I ask myself if I would be comfortable having my personal health information accessed from the porn computer. The answer is clearly no.

But there isn't much I can do about the porn computer. The hospital IT department has tried to replace it several times, but the doctors working the ER will literally sacrifice body and soul to keep the thing around. We all know that if it gets fixed, we won't have access to YouTube, NBC.com programming, the pediatric clinical adviser, or any of the other stuff we've come to rely on. So what to do?

I dunno, but I've decided I'm not using the thing at all. At least that way I'll be consistent.

Monday, December 17, 2007

Daily Posting

I've decided I'm an all or nothing kinda gal. Either I never post (as any reader will have experienced) or I post all of the time. (again... as any reader...)

So I'm going to attempt to post daily. What will I write? I have no clue. The slant of the blog may end up medical, it may end up personal, or it may be a recipe a day. I kinda hope it ends up being a-recipe-a-day blog - that would mean I'm cooking most days. Which would be good.

Or I could just talk about the TV series Heroes. DVR is a beautiful thing - we're
only just now catching up. Hiro rules, Peter rules, Adam... not so much. Screen Writers Guide strike must end so I can see how this tangle ends! So say we all.

Sunday, December 16, 2007

St. Louis Food

Amazingly enough, I've been more impressed by St. Louis food than Houston food. And I think I know why. Houston doesn't have many one-off, unique and mid-priced restaurants. Sure, we have multiple cheap, ethnic joints. Sure, we have tons and TONS of mid-priced regional chains: Pappas, Landry's and Goode Company. But how many restaurants like Benjy's? Not that many, and really not that many inside the Loop.

In contrast, I went to three fantastic, mid-priced yet geographically close restaurants during my recent trip to the Gateway to the West. One, Remy's, has been around forever. Farotto's has the best pizza ever, and I've been going there since I was born. The quality has never wagered, and I swear half of the teenage population of Kirkwood has worked there. And then there was Acero. Acero is in a region that used to be known as "Maple-hood" instead of Maplewood. Acero serves the best risotto I've ever had outside of Italy. Acero served three people three courses including a NICE bottle of wine for about $100.

Oh yeah, I ate well in St. Louis.

If it weren't for Tapatia Taqueria, I'd be sad to be home.