Didn't Make It And A Burger

I came back from my break and my coworker told me that my patient "didn't make it." I just stared at her, totally confused. The patient was fine earlier and I hadn't heard a code called. It didn't make any sense. What could have happened while I was gone?

What happened was that she didn't make any pee. After I was done laughing, I explained to my coworker what it means when someone doesn't make it.

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A coworker and I were discussing doing an "in and out" on a patient. This is a type of catheterization where we leave the tube in until the bladder is drained and then remove it. I overheard another coworker telling someone that she was craving an in and out. I turned, looked at her and asked, "You want to be catheterized?"

When she was done laughing, she said that she wanted an In-N-Out burger.

Catheterizing The Neighbor Lady

With growing suspicion darkening her tone, the patient asked, "Why are you putting gloves on?" I knew what she was worried about, I had threatened her earlier that if she didn't void, she would be catheterized. That's not why I was putting the gloves on, though. I just wanted to get rid of her blood tubing.

The absolutely last thing I wanted to do was catheterize her. Not that I enjoy doing that to anyone, but her especially, I did not want to do. It was nothing personal, I liked her just fine, she didn't smell or anything like that; the problem was that she was my former neighbor. It was just too awkward and embarrassing and I'm sure that she felt the same way about me. It's much easier to handle the genitals of strangers than of acquaintances.

It was near the end of my shift, but instead of applying the thumbscrews like I normally do to get people to agree to be catheterized, I gave her an easy out. I reminded her that as a competent adult, she had the right to refuse. That left a door open for her to refuse and she jumped at the chance. Problem solved.

I did feel a little guilty about dumping a possible catheterization on the next shift, but it turned out okay. She later voided during the next shift.

So, do you find it easier to handle the genitals of strangers or acquaintances? ( No, don't answer that. I'm joking.)

Dog Pride

This photo is of an orange and green Murphy surrounded by orange lillies, soaking in a green pond.

Murph's back legs are becoming a little weak, but he still enjoys his walks everyday. I've been walking all three dogs at once, which I thought would be disastrous but has worked out fine. I thought that Kelsey and Tommy would take off like race horses and drag us down the sidewalk, but they are perfectly happy to walk at Murphy's slow pace. They know that he's sick and patiently walk either behind or alongside of him.

Getting out the front door is a nightmare, though. The door isn't wide enough for all three dogs to get out at the same time, so they all squeeze and push each other to try and get out first. They then run around my legs, tying me up in their leads. After that, they're fine.

Murph no longer lifts his leg to pee, except on walks when there are people around. At home, he squats, but his pride won't allow him to do that in front of others. On walks, if he sees anyone else outside, he proudly lifts his leg. He has way too much pride to let others see him squat like a girl. I think it's cute that even dogs want to maintain their dignity.

The Good Doctor

It was near the end of the shift and I was saying to my coworker in frustration that I wished a good doctor would step in. She answered that four doctors had already seen the patient, but I again emphasized that we needed a good doctor.

When we had begun our shift, the patient was already circling the drain. He was a healthy guy who had joint replacement surgery earlier that day. Now he was blue, drifting in and out of consciousness, thrashing about, disoriented and no matter how much oxygen we gave him, it wasn't enough.

Day shift had called the anesthesiologist and his solution was to use a type of oxygen mask that would supply more oxygen. Later he gave narcan to reverse the morphine without effect. There was a good reason that his interventions didn't work, the patient was not overdosed. Yes, I know that we frequently overdose our patients, but this time the symptoms didn't quite fit.

When my coworker took over the care of the patient, I insisted that his surgeon be called. I figured that he would want to know that his patient was in serious trouble. The surgeon just asked us to call the on-call doctor to see him.

She came up and ordered tests to determine if he had a PE (pulmonary embolus). That's what we figured had happened to him, but she didn't see any reason to transfer him to a higher level of care, such as ICU. I don't like unstable patients on my floor because it's not a safe place for them to be, so I told the supervisor. She cringed when I told her about the patient's condition and that the doctor didn't want to order a transfer, but she didn't intervene.

The doctors then had a change of shift and the next on-call doctor took over. He was so sure that it was a PE that he ordered us to start a heparin drip. By this time, the patient had developed a wet cough and was wheezing, when he wasn't unconscious.

It was a surprise when the CT showed no blood clot in the lungs. The doctor cancelled the heparin and started treating the patient for pneumonia. There was nothing wrong with treating the symptoms, but after that, the doctor left. He was no longer trying to find out why the patient's lungs had suddenly filled with fluid. Pneumonia doesn't come on that quickly.

The patient was steadily deteriorating and I really wanted him off my floor. It was then that I was complaining that I wanted a good doctor. Then the phone rang. The surgeon wanted to know how his patient was. His nurse described what had happened and the surgeon said that it sounded like the patient had a fat embolism in the lungs. A CT scan wouldn't show that. He then hung up. I was astonished. Why doesn't anyone do something?

The phone then rang again. It was the on-call doctor ordering us to transfer the patient to ICU. The surgeon had called him and intervened. It turned out that we had a good doctor after all.

I don't know how the patient is. The last patient we had with that problem died, but at least now he is in the best place for him and receiving appropriate treatment.

Out-foxed

When you are in big trouble, just stare straight ahead and pretend that everything is fine.



Thanks, Sarah.

What Did She Ever Do To Them?

The patient had come from a nursing home. The gangrene in her feet had worked it's way into her bloodstream and she was in septic shock. She was intubated, put on a ventilator and aggressively treated. Once stable, she came to my floor for a few days.

This poor lady was extremely elderly and was in such an advanced stage of dementia, she could no longer recognize her family. She spent her days staring off into space, sometimes moaning. Not being able to eat, she was fed through a tube in her nose. Her arms and legs were badly contracted and she needed frequent turning. The facility where she normally vegetated hadn't turned her often enough, resulting in pressure ulcers going down to the bone across her buttocks. Her legs had poor circulation and were dark and cold from the knees down. Her feet needed to be amputated because of the gangrene.

Her family had been approached about making her a DNR (do not resuscitate). They refused and wanted us to continue doing everything in our power to keep her alive (and suffering) as long as possible.

Not wanting to end up like that, I've considered wearing a DNR sticker taped to my abdomen. I tried it and it was a bit scratchy, so I'm considering making underwear with a DNR print. It wouldn't be sexy, but it would deliver a strong message, I hope. Perhaps I should go into the business of selling DNR underwear. Any takers?

(Despite appearances, that photo is not of an adolescent boy. It is of a 50 year old woman, me.)

Violence, Sex And Chases

This is either an example of someone's artwork, or the owner of the car knows someone with a grudge against him. Five pick-axes left impaled in someone's car, makes an effective message. I'm not sure what the message is, but it would sure get my attention.

Interspecies dating doesn't have to be a bad thing. That's a sweet , although slightly embarrassed looking couple below. You don't suppose the Audi driver got caught in a similiar predicament?
It looks like it's time to go back to the clubhouse and have a drink, but don't run, he'll only give chase and bears can outrun golfers.
Normally I take the side of the dog in disputes, but I suspect the the dog must have done something to cause the horse to take chase. I hope that dogs can outrun horses.

Nasty Nose Borer

My patient of note today was admitted with a nose bleed, a bad one. Before the doctors figured out a way to stop the bleeding, he lost so much blood that we had to give him two units. So, what caused his nose bleed? Aggressive nose picking.

While I was busy with another patient, he used his call light, which another nurse answered. She came and got me, telling me that he was in respiratory distress and needed a respiratory therapist. She didn't know him as well as I did. I walked into his room and told him to breathe through his mouth. Frantically he said, "I must breathe through my nose." His wife was pleading with me to call the doctor. At the very least, he wanted some gauze so that he could clean out his nose.

We discussed why that wasn't a good idea given what had happened earlier. While cleaning one nostril, he had ruptured a blood vessel. Now, he wanted to work on his remaining unbandaged nostril. Reluctantly, I suggested that he very gently blow only his good nostril. He did and a wad of snot came out. Success.

Later, he complained that he wanted someone to turn down the temperature. It had been a hot day and with our lousy air conditioners, the room was hot and stuffy. Since he was wrapped in a blanket, the first thing I did was pull it off of him. He snapped, "What are you doing, I'm freezing." I replied that he said he wanted the temperature turned down. He said, "Yes I want the temperature turned down, I'm cold." Rather than argue about what the statement means, I got a bunch of blankets and covered up the old coot. Geeez!

No Backbones

I don't know about you, but I'm not built like this. If somehow I did get in this position, it would be permanent.

Can't Fool The Nurse

This was sitting on a patient's table. It's not what it looks like, assuming that you think it looks like a jug of urine.

I had given the patient a pitcher of water, a cup and a urinal container. I threatened him that if he didn't pee soon, I would have to catheterize him. He put the container between his legs and I left him alone to work on his assignment.

Checking back later, I found what is shown in the photo. It was clear, colorless and odorless. I may be blonde, but I can tell water from urine and that was water.

I gave him another chance , but he couldn't produce anything that was urine-like, so he got catheterized. I got over a liter of yellow, pungent liquid. I feel for the guy, though, he must have been desperate to try a trick like that. I have a suggestion for the future, have a family member pee in the container, then the nurse won't know.

Projectiles

The patient was wearing a diaper, but whenever he felt the need, he would pull down the diaper and while lying flat on his back, urinate. Of course the bed would get soaked and everything within a couple of feet of the bed would get splashed. We couldn't get him to stop it, so we just had to keep cleaning him up. We called it projectile pee.

As annoying as that was, it was much better than the patient the night before who kept spewing projectile black vomit. It wasn't his fault. He had an upper GI bleed and every container we gave him to puke in failed to contain the volcanic-like eruptions. In case you're curious, vomit travels at a much higher velocity than pee and spews further. Even the curtains weren't safe.

Last night, my self-described easy going patient, projected wrath. Still unhappy about the dressing on her leg, she complained that it was "inhumane" to expect her to endure that dressing for another 7 days. She wanted it off and didn't care that every doctor who was called in refused to remove it for fear of being sued for malpractice. There was talk about getting someone to write a waiver for her to sign, but finally, after a full day of yelling negotiations, it was agreed to put a lighter dressing on.

Afterwards, she was able to wiggle two toes, which improved her mood. If I had known that what she needed to be happy was to be able to wiggle two toes, I would have cut them free myself. A shrink who was called in to evaluate her, described her as being attention seeking. That's a diplomatic way of putting it. I would have said that she was a bitch.

Given a choice between patients projecting bodily fluids or projecting wrath, I would choose bodily fluids any day. That's a major reason why I left law. Dealing with people's anger sucks the life out of me. What would you prefer to have projected at you, bodily fluids or wrath?

Miss Easy Going

The patient had been a nightmare. She was irritable, demanding and anxious. Anyone who failed to do exactly what she wanted when she wanted it got reported to management.

A doctor who refused her demand for a catheter was reported. The nurses who overheard the exchange said that he was nice and explained that he didn't want her to risk an infection and that she didn't need one since she was already able to void just fine. She said he was arrogant and didn't want him ever to see her again.

Another doctor was reported because he refused to remove the dressing and splint on her leg. He has a great bedside demeanor and told her that he could not remove the dressing without her risking a massive infection. She reported him too. Management told him to go back and try and reason with her again. He did so and again refused , nicely, to remove the dressing. She wanted it removed because her leg was itchy.

Her response was to bang her leg against the bed, over and over again. Soon she was crying because her leg hurt so bad, so she was put on a morphine pump.

She is not confused and although she has "issues", is not insane. These are just a couple of examples of her behavior. She was a terror with the nurses as well and reported people left and right for no good reason.

Last night it was my turn to endure her. When the previous nurse introduced me to her, the patient told me that she was "very easy going." The other nurse and I managed to make it out of the room before exploding in laughter.

And just in case you were wondering, I managed to get through the shift without enraging her, but if she thinks she is easy going, I would hate to see what she thinks difficult is.

Superman Is Like Us

Notice that paunch above Superman's belt? Apparently, Superman sucks it in when the cameras are rolling and relaxes his abs during breaks. I'm sure glad that I don't have to work in a leotard. I would have the same problem.

Food Labels And A Script

I noticed some nurses from another unit eating from containers stamped with patient's names. This was homemade food in Tupperware containers. I couldn't imagine why they would want to eat food from a patient's home, even if it was offered to them.

I asked why they were eating patient food and they answered that it was their food. I asked about the name stamp and they said they did that so they could keep the food in the patient's refridgerator.

Let me explain why that it so brilliant. There is a health department rule that employees cannot keep their food in a patient refridgerator. If caught, the food is thrown out along with the container. Depending on who does the catching, we could also be cited. By stamping a patient's name on their food, it passes for being patient's food and won't be thrown out.

We do have our own employee refridgerator, but it is down the hall and not as convenient. I love creative solutions like that.

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We have been handed a script to follow when giving change of shift report. One of the questions we are supposed to ask is, "What are some goals that you would like to accomplish for this shift?" The next question is, "Can you please teach back these goals to me?"

I have just one question. What the hell does that mean?

Assuming that a patient could give me a goal it would probably be something like, "I want to get some sleep. I haven't been able to sleep since I got here."According to the script, my reply would be, "Can you please teach back this goal to me? "

Huh?!!! Why does management want us to sound like idiots?

Street Scenes

These are just some shots of villages that we passed through while driving around Ireland.

Below is a village that is the backdrop for some Irish TV program. It has become famous, although it meant nothing to me other being the only place where I was able to buy just one stamp. I can't figure out why one house was painted one color in front and another color in back.

When the streets were designed, no one was thinking about cars. Even a cart drawn by a horse would have a problem on some of the streets. This street wasn't too bad.
I liked the brightly painted doors that so many houses had. Sarah was joking with a cab driver and asked him if men walking home from the pub can tell which house is theirs by the color of the door. The driver said no, you can tell by the wife who is behind the door.
This was just another almost impassable street. Even though it was a one way street, people parked on both sides of the road leaving little room for cars to get through.
Many of the homes have lace curtains, which I liked. I've heard of lace curtain Irish, but have no idea what it means. Does anyone know?

Hot Chocolate

I guess I should have turned the air conditioner on. It was a little on the hot side, but tolerable, I thought. It wasn't until my father opened a box of chocolate covered cherries that I realized my error in judgment. The chocolates were all melted.

The directions with the chocolates said not to leave them in the sun or a hot car, so I didn't. They were on top of the piano, next to an interior wall far away from any windows. I guess the directions should also have said to keep them in an air conditioned room. Maybe it didn't occur to them that anyone would allow their house to get so hot.

There are two reasons that I hate to turn the air conditioner on. One reason is that I'm cheap. The other reason is that I like all of the windows and doors wide open. I like the feeling of bringing the outdoors inside and the feel of fresh breezes. For the same reason, my house is freezing in the winter.

On the bright side, I didn't fall down today, not even once. We won't talk about the number of times I tripped.

Nine Misadventures

For a beautiful day off, it sure sucked. It started out okay, a little on the hot side, but within my heat tolerance level. Then things started going downhill.

1) First, ants had invaded my kitchen. I couldn't deal with this before I had my first cup of tea, so while I was busy with the tea preparation, ants were climbing my legs. The entire floor was swarming with them. I would brush them off and up my legs they climbed again. Those little bastards can run fast. They are dead now and more have taken their place.

2) I wondered why fruit flies were swarming around the kitchen. They were after a squishy pineapple that went from green to rotten without any stage in between.

3) For breakfast, along with the tea, I had a mango and peanuts in the shell. Walking into the kitchen with the empty peanut shells, I noticed a big puddle of water from Murphy's earlier pond dip. I stepped carefully, knowing that the floor is like ice when wet, and felt one leg slip away from me. The next thing I knew, I was lying on the floor with peanut shells scattered across the floor. At least one good thing resulted from my figure skating lessons, I'm good at falling and not getting hurt. My only injury was annoyance.

4) Next I decided to wash the sheets on my bed. When I woke up this morning I noticed some brown streaks on my pillow. Kelsey has his own pillow, but he likes to sit on mine. While removing them, I stepped on a pillow and fell down again. I hadn't been drinking, honest.

5) My parents are coming over for dinner tomorrow and I planned on making salmon topped with prawns cooked in garlic butter. That required a trip to Costco. I got everything I needed, came home and discovered that the salmon never made it home. Checking the receipt, I saw that I had paid for the salmon. Not being able to deal with Costco again on a Saturday afternoon, I went to Vons.

6) While in the Costco, someone told me that that I still had the tags on my shorts. It was the glued on strip that gives the size, in big print, about a dozen times down the length of the garment. If it had been my usual size, it wouldn't have been so bad, but these shorts ran small and I was wearing a bigger size. I'm not making that excuse up. If you don't believe me, check my closet, my clothes really are smaller.

7) Feeding the fish, I noticed that Sunny, my big metallic yellow koi, was floating on his side. He was staring off into space and looked dead. I nudged him and he swam away. I had forgotten that fish don't blink, but still, fish don't swim on their side. I jumped in the car and bought some koi products for sick fish. I wished that I could take him to the vet, but the vets around here only treat land creatures. I dumped the stuff in the pond, but he failed to respond. Within a half hour he was dead. A burial service and two beers followed. He was a member of the family and deserved a wake, okay?

8) Murphy was green again from the pond, so I gave him a bath. While I was at it, I washed all of the dogs. Tommy, in the photo, is still mad at me. My gift of a pig's ear did nothing to improve his mood. I swear, I think he is part cat. Right after Murph got his bath, he climbed back into the pond.

9) Walking back into the kitchen, I slipped again and fell down.

Head Bonk And Shredding Allergy

The patient had slid down in bed, again, and needed to be pulled up. This was complicated by her substantial size and unconscious status. Although not dead, she was dead weight. So that we wouldn't be fighting gravity, we positioned her bed so that her feet were a couple of feet higher than her head. Four of us grabbed the sheet under her and on the count of three, yanked her up. A loud bonking sound was the next thing we heard. That was the sound of her head hitting the headboard.

They really need to give us beds with padded headboards. This isn't the first time this has happened. (They were going to give her another MRI of the brain anyway. I hope there aren't any changes.)

Another patient had shredded coconut listed as an allergy in the chart. Since it specified shredded coconut, is it okay to give the patient sliced or ground coconut? What about coconut milk or oil?

Isn't that like saying someone is allergic to sliced bread or diced eggs?

Beauty Queen Talk

What inspires you to go to work everyday? Asking a room full of nurses that question evokes sobbing. Pretty strange, huh? At a meeting, the nurses had to take turns answering what inspires them to go to work everyday. People replied with beauty pageant-type answers about wanting to help people and then progressed to ramblings about a higher calling and being part of God's plan and how God knows what is best for them. This is when the mass sobbing began.

I wasn't at this meeting, but heard that these were not tears of joy, but of sadness. This makes no sense to me. I would love to believe that I'm part of some master plan and have a pre-ordained purpose in life. If I believed that I would be laughing in joy.

It's a good thing that I wasn't at that meeting. With dry eyes I would have answered that what inspires me to go to work is money. What inspires you to go to work?

Escapee, Pumpless And The Strangling Nurse

Arriving on my floor yesterday, I got off the elevator and was met by a frantic coworker.

"Did you see an old man?", she asked.

On the way in I had passed dozens of old men, women too. This is a hospital, that's mostly what we see.

I answered "no" and kept walking. End of conversation. (I hadn't paid attention to anyone when walking in, so a description wouldn't have helped. I was aware of other people's presence, but hadn't really seen anyone.)

Later, when I saw her back on the floor, I asked if she had found the man that she was looking for. She had, but it didn't do any good. He had gotten fed up and left, without even signing a waiver. He refused to come back. I can understand how he must have felt. There are times when I want to take off as well, but then I would have to look for a new job.

Last night, we had a shortage of IV pumps so we had to decide who needed them more and run the other, less critical, IVs by gravity. We're not allowed to run IVs by gravity, but what choice did we have? They don't want to buy more equipment because it is so expensive, but then, so are lawsuits. If something goes wrong, a lucky lawyer is going to have fun in court with how we triage the equipment.

The nurse who strangled an aide awhile back floated to my floor. It was her first day back after a three month leave of absence. I don't know if it was voluntary or punitive and wasn't about to ask. She didn't strangle anyone tonight, but we also didn't have any aides working, so it wasn't a good test.

I bet the night nurse who took over from her wanted to strangle her. As usual, she left a pile of unfinished tasks for the next nurse. I told the strangler that before she left, she needed to re-start the IVs that came out and catheterize the patients who couldn't pee, but she didn't. She can be charming and has fooled some people high up in the organization. They think that she can do no wrong and has been ganged up against. I'm patient, though. I think that it's just a matter of time before she screws up again big-time. Just give her time.

Cabbage Time

My cabbage did well this year, at least the green cabbage did. The tiny, red cabbage is in my hand. It would be fun to leave the cabbage and see how much bigger it gets, but more tomatoes need to go in and there is no other place to put them.

Anyone have some good cabbage recipes to share?

Pulsing Quiet

Saturday morning at seven, I woke up to the sound of a chain saw in my next door neighbor's yard. That's a tad bit early for me. I work evenings and rarely get to bed before 1:30. I closed the window, turned on the fan, wrapped a pillow around my head, but the sound kept penetrating through. Soon, a wood chipper joined in. When I left for work a little after 2 pm, they were still at it. It was one of the few days when I was eager to go to work.

This morning I woke to the sound of a jackhammer and tile saw. The only way to escape the noise was to leave the house and do errands.

I started thinking about Ireland. We stayed for a week in a cottage that was surrounded by peat bogs. It was so isolated and quiet that I thought I was going to go crazy. The only sound I could hear sometimes was the blood pulsing in my ears. The only place to walk was across the peat bog.

Ever try walking across a peat bog? They're squishy and disgusting.
Above is our cottage. It is 190 years old and has been restored. The original floor was dirt, but had been covered in concrete to make it more acceptable by modern day standards. The place was cute with it's thatched roof.

This is the view from the cottage. There were three sheep that wandered around the property. This is the infamous peat bog. When you took a step, sometimes all went fine and other times a shoe got stuck and would have to be retrieved. There was no way to predict what each step would bring. The squishy, sucking sounds were also annoying.

The lake was the final destination and then it was back across the bog to the cottage.

After listening to all of the equipment lately, the bog doesn't seem so bad.

Satan's Bite

My bug bite is getting worse. It's now four inches in diameter, plus it's starting to hurt. The bite happened on 6/6/06, causing me to wonder if Satan had anything to do with it. I never saw what got me; perhaps he nipped me when I wasn't looking.

Yesterday seemed like it was time to see a doctor. I asked my supervisor if I could go downstairs to the urgent care clinic, but she thought that a hydrocortisone cream would take care of it. She said that I could go today if it didn't work. Well, it didn't work, but today she thought that it looked better, so she said to just take a benadryl tonight. She said that if the house doctor happened to come to my floor, I could show it to him. (She just didn't want a nurse to leave the floor.)

My favorite doctor was the house doctor tonight and he did come visit. It was embarrassing, but I opened up my top so that he could see the boob bite. Finally, I got some action. Oh, that didn't come out quite right. What I meant was that he did something. He got on the phone and called in a prescription for an antibiotic. If it doesn't get better in two days, I'll need IV antibiotics. It's cellulitis.

The doctor did say one annoying thing, the infection could be caused by an ingrown hair on my chest. Just so you know, I do not have chest hair.There were two small holes where each tiny fang entered my skin. Chest hair, indeed! A tiny bit of peach fuzz, maybe, but not hair.

We're So Sorry That We Were Caught

A few months ago, my employer got caught in an embarrassing scandal. What happened is that one of our sister hospitals hired a taxi to drop off a homeless person in downtown Los Angeles. She was disoriented and wearing nothing but a hospital gown, socks and name band. Someone in a nearby shelter noticed her wandering down the street and brought her in. The name band identified where she came from. The media was alerted and it became an ugly scandal with tons of bad publicity.

To make sure that never happens again, some new protocols were enacted. From now on, social workers, discharge planners and supervisors will all be involved in discharging homeless patients. Hopefully, they will be able to come up with better discharge plans, but just in case they don't, we have additional instructions. Homeless people must be discharged in real clothes, not a hospital gown. I suppose that someone walking down a public street wearing a backless gown is too conspicuous. We are encouraged to donate clothes as an "opportunity for public service."

Last but not least, we must cut off the name band before the homeless patient leaves. I'm guessing that is just in case we do dump another patient on the street, it won't be traced back to us. I can't think of another reason to remove the band, can you?

Octoberfest In April

Airline security has become tough to get through, without laughing. It's illegal to joke about bombs on airplanes, which presents an enormous challenge. When I'm checking into a German airline and see the pictures of forbidden weapons with the title of "explosive stoffe", how can I not laugh and make jokes? I so wanted to tell Sarah to take the hand grenades out of her purse and hand them over to security so that they would be too distracted to notice the rocket launcher inside my coat.

I hope that it's not illegal to joke about it in a blog. In case it is, my official story is that I'm not joking. I really did have a rocket launcher in my coat. There, is that better?

I don't know why, but we had to fly to Germany in order to get to Ireland. Talk about frustrating. We flew directly over Ireland. The least they could have done was drop a little in altitude and let us jump with parachutes.

I did enjoy flying on Lufthansa. Had it been October, I would have thought for sure that it was Octoberfest. The booze was flowing like water, all of it free.

My guess is that Lufthansa has the same philosophy for taking care of passengers that nurses have towards patients. Keep them drugged and happy. Whether it's booze or morphine, the effect is the same. Sedation makes for less work, whether you are a nurse or a flight attendant.

It nearly killed me to turn down all of that free German beer, wine and mixed drinks, but alcohol and long flights aren't a good idea. Stoically, I accepted water, orange juice and sodas, plus I fed off of the candy bar platter.

I do have one complaint, though. It was the flight attendants. They were just too gorgous. Most of them were even taller than me with thin, perfect bodies. They were all young and several of them had long, blonde hair. Don't they know that I like to be the only tall, long-haired blonde in a room? It was also strange to be around so many German people. I never realized before how German I look. I guess my German genes won out over the English, Irish, Scottish, French, Dutch and Indian genes.

Chasing Victor

A nurse came running through our unit faster than I've ever seen before. It was Victor. He escaped out the door and disappeared down the stairs. Hot on his trail was a patient with her bare bottom exposed. Hot on her trail was a nurse from our sister unit across the hall.

The patient was yelling for Victor, but it was too late, he was gone. She started searching the other patient's rooms, which we really frown on, then she noticed the door. She took off, dragging the tiny nurse who was trying to corral her back in. An orderly joined in the fray and brought a wheelchair to try and retrieve the patient in.

The patient was strong as an ox and believed that she was fighting for her life. She had to get out of the hospital and was not going to get in the chair. When the patient took a swing at the nurse, we called security.

It just so happened that a security guard was making his rounds at the time and came across the escalating situation. So, what did he do? He hid around the corner and took occasional peeks.

Being the biggest and strongest person present, I decided to step in. I sneaked behind her, grabbed her gown and pulled her down into the chair. Wrapping a blanket around her and tying it in the back, kept her from hitting us. The orderly tried to push the wheelchair, but she wrapped her feet around the wheels. I grabbed her feet, lifted her legs off the ground and the orderly wheeled her while I walked along carrying her feet. We dumped her in her room where she was tied down.

A good ten minutes later, the security crew arrived. It was only then that the first security guard came out of hiding. It's a good thing that we were just dealing with a nearly naked, unarmed woman. I hate to think what would happen if we had a real emergency.

Later I found out why Victor was being chased. According to the patient, he was the only one who knew the way out. If that were true, I would have been chasing Victor too.

Alarming Letter And A Boob Bug

A shocking letter arrived in the mail. AARP wants me to join. ME?! I'm not old enough to join some old folks organization. How dare they send me such a letter. It turns out, though, that I am old enough. It's open to fifty year olds. How depressing.

Last night, I felt an itchy bump on my boob. It looked like a bug had bitten me. This morning I woke up with what looked like a third nipple. Just what I need. There will be no photos of this. It's just too embarrassing. It's going to be awhile before I can wear tank tops again.

Garden Surprise

Thank goodness I was wearing latex gloves and shoes. While digging and moving plants around in the garden, I noticed a squished rat on the lawn next to my feet. It had burst open and guts were lying across the lawn. Excuse me a second...AAAUUGGGGHHH....Anyway, I don't know if it was already dead or if I accidently killed it with the shovel.

It's a good thing that I found it as I was finishing up my project, because it's going to be a long time before I dig around in the garden again. My project was to do something about the big mud hole that the dogs run through on their way from the lawn to the house. Since the dogs want a path there, there is no point in fighting it. I laid down some flagstone in the path that they follow and planted bog plants bordering it because it's too wet and gooey for anything else to grow there.

I'll wait and see how this goes. I'm getting desperate. My house is starting to look like I have a dirt floor, dirt furniture and dirt bed.

Driving Fool And Diabetic Fool

I was stopped at a red light behind another car. When the light turned green, the car in front started to drive and then abruptly stopped. I stopped and looked around. There were no cars, people, pets or anything else in the way. The car then took off again only to slam on the brakes a second later. I stopped in time, but I'm convinced that the driver was trying to get me to crash into him. He was probably trying to earn a little extra cash through insurance fraud. I'm glad that I keep a good distance between me and other cars.

At work, I took a message concerning an admission we were receiving and wrote down the information and gave it to the secretary. The secretary read the note and said, "What is the patient's diagnosis?" I thought that it was a strange diagnosis too, "diabetic foot", but it seemed obvious what it meant. It's a dying, decaying foot.

That wasn't the secretary's problem, though. She wondered why we were getting a diabetic fool. I had forgotten to cross the T, so the foot looked like a fool. We get quite a few diabetic fools and non-diabetic fools through here, but it would be unusual to so bluntly label them.

Fairymount Farm

I think that Sarah's favorite part of the trip was visiting Fairymount farm. It is a working farm on over 400 acres with pastures full of sheep and horses. Walking through the pastures was a challenge. I really wished that I had accepted the owner's offer to borrow boots. Sheep seem to do nothing but eat and...uh, well, you know.

We walked up to the top of a hill that had a gorgeous view. Sheep don't like humans, probably for good reason. They can probably smell lamb on humans' breath. They stayed away from us.

Of course it was cold and, off in the distance, raining.
There was a list of rules for visiting the farm. It was a short list, easy to remember and seemed reasonable. One of the rules was, "Do not touch the horses." So, what does Sarah do? Well, look at the picture below and see for yourself.

Exploding Flowers

My garden has exploded with flowers. Considering how much I neglected it this winter, I didn't really expect much for the spring. I've been wandering around my garden in a dazed sense of contentment with the warm sunshine and long days calming me. I've loved cold Ireland, but it is so nice to just walk outside in shorts, T shirt and barefeet and bask in the warmth. I'm lucky to live where I do and have this garden just outside my door. Sometimes life doesn't entirely suck.


The red roses below are suckers that I didn't get around to removing from a white rose bush. It's not often that laziness is rewarded so richly.



The picture below was taken on my fiftieth birthday. It was a good day. I'm proud of my age.

The Big Five-0

A half century ago today, in a tiny English village bordering the North Sea, my father and brothers went to see a western at a nearby theater. I was born during the movie. In my dad's defense, the doctor did say that it was going to be awhile before I was born.

That's how things were done in those days. Today, I wonder how a woman would react if she was in labor and her husband decided to go see a movie.

Anyway, this is the big day and despite turning fifty, I feel only one day older than I did yesterday. Maybe it's time to act my age and stop wearing low-rider jeans and bikinis. Naw. I can't help being older, but that doesn't mean I have to act older.

Canceling Christmas

In order to stay fully accredited, we must endure inspections by JCAHO every three years. This is our year. We know that it's going to happen, but not when. Because JCAHO has been inspecting our sister hospitals the last few weeks, it's safe to assume that our turn is coming up fast.

Personally, I don't really care, but management is going bonkers. They've gone from just being nervous to practically psychotic. Management has gone so far over the edge that they threw away all of our Christmas decorations stored in boxes in the closet. We have been accumulating these decorations for a number of years and have been through numerous JCAHO inspections without anyone commenting on or caring about our decorations before. And, why would JCAHO care? They are only interested in safety issues, like cleanliness and the safe administration of drugs. What possible threat to safety can Christmas ornaments in a closet present?

If management wants to impress JCAHO, maybe they should clean this pigsty of a hospital. The carpet is filthy, paint is peeling off the walls, the counters are dusty and the IV poles are specked with dried blood.

Maybe I'm the crazy one here, but I think that JCAHO would be more impressed by a clean hospital than a dirty one with no Christmas decorations in the closet. We are all quite angry right now and have decided that there will be no Christmas this year. Perhaps we can just post a sign at Christmas that says, "Ask management why we didn't decorate for Christmas this year."

Medical Examinations

Someone sent me this. These may be old jokes, rather than true stories. Hope you enjoy them anyway.


1. A man comes into the ER and yells, "My wife's going to have her baby in the cab!" I grabbed my stuff, rushed out to the cab, lifted the lady's dress, and began to take off her underwear. Suddenly I noticed that there were several cabs -and I was in the wrong one.

Submitted by Dr. Mark MacDonald, San Antonio, TX.

3. One day I had to be the bearer of bad news when I told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, I heard her reporting to the rest of the family that he had died of a "massive internal fart."

Submitted by Dr. Susan Steinberg, Manitoba, Canada

4. During a patient's two week follow-up appointment with his cardiologist, he informed me, his doctor, that he was having trouble with one of his medications. "Which one?" I asked. "The patch. The nurse told me to put on a new one every six hours and now I'm running out of places to put it!" I had him quickly undress and discovered what I hoped I wouldn't see.

Yes, the man had over fifty patches on his body!

Now, the instructions include removal of the old patch before applying a new one.

Submitted by Dr. Rebecca St. Clair, Norfolk, VA

7. A nurse was on duty in the Emergency Room, when a young woman with purple hair styled into a punk rocker Mohawk, sporting a variety of tattoos, and wearing strange clothing, entered. It was quickly determined that the patient had acute appendicitis, so she was scheduled for immediate surgery. When she was completely disrobed on the operating table, the staff noticed that her pubic hair had been dyed green, and above it there was a tattoo that read, "Keep off the grass."Once the surgery was completed, the surgeon wrote a short note on the patient's dressing, which said, "Sorry, had to mow the lawn."

Submitted by RN no name AND FINALLY!!!................

8. As a new, young MD doing his residency in OB, I was quite embarrassed when performing female pelvic exams. To cover my embarrassment I had unconsciously formed a habit of whistling softly. The middle-aged lady upon whom I was performing this exam suddenly burst out laughing and further embarrassing me. I looked up from my work and sheepishly said, "I'm sorry. Was I tickling you?" She replied, "No doctor, but the song you were whistling was, "I wish I was an Oscar Meyer Wiener".

Driving Drama

The yellow reserve light for my gas tank was lit up. It had come on a couple of miles earlier, so with only another mile to go to the gas station, there would be no problem reaching it. Why didn't my car know that? Sputtering and jerking, I wasn't sure if my car was going to make it. The gas station was within site when my car started losing power. Putting the pedal to the metal did nothing, but at least the car was still moving. I only had a couple hundred feet to go.

Two red lights on my dash were lit. Without my glasses, I couldn't read what they were, but from past experience, I knew that it is always bad when a red light on the dash lights up. Two red lights had to me double trouble.

As I came to the bottom of the hill, the green arrow light was lit for me, so I went straight into my U turn to the gas station. I do mean literally, that I went straight. The steering wheel was locked. I yanked it with all of my strength and barely made the turn. My car then coasted to a stop about 15 feet from the pump. Close, but not close enough.

It was only then that it occurred to me that my engine had quit. With the radio on and coasting down a hill, I thought that the engine was still running, although poorly. The red lights on the dash were trying to say, "Hey blondie, you're engine stalled. Start her up again."

Holding my breath and with shaking hands, I turned the key and the engine started right up. I drove a feet few feet to the pump and filled 'er up. No more problems after that. There must be gunk in the bottom of my gas tank. For now on, I fill up at a quarter of a tank. I don't need this kind of drama in my life.