Florid Psychosis

Yesterday my partner and I did the nursing intake assessment on a new patient to the adult unit. The nurse's advice? "Be CAREFUL girls! Don't let him get between you and the door, he's got a history of violent outbursts, isn't medicated, and is bigger than you".

Because that's going to make us feel REALLY comfortable.

So we sat down, carefully, and began our assessment. "You two are students?" he asked. "Yep!" I replied, knowing that Truthfulness Is Important, "GET OUT WHILE YOU STILL CAN" he said, admirably demonstrating pressured speech and delusional ideation. "THEY MAKE YOU KILL PEOPLE!!! AND THEY GIVE YOU MEDICATION THAT MAKES YOU NOT LIVE FOREVER WE CAN ALL LIVE FOREVER YOU KNOW" he said, at the top of his lungs.

A few minutes later, we were done, worried, and sent to keep the rest of the ward from hurting each other.

It's quite a rotation...

Over My Dead Body

Today we are learning, in Trends and Professional Nursing class, about how IMPORTANT it is that we practice "Consumer Centered Care", where the "client determines quality". Man, SCREW THAT. Ive had plenty of patients whose idea of "quality" would be higher thread-count sheets, perrier water, and me, running to cater to their every whim no matter how sick my fellow patients were. This should determine my practice? MY practice is based on providing safe and effective care to my patients, with their physical wellbeing placed FAR above any stupid ideas of customer satisfaction. You may hate me for not giving you water, but I dont care- if you're fluid restricted, you are not getting extra water. You may WANT it, you may DESIRE it, but you could go into a CHF crisis. The consumer is not always right, and pretending that the patient should run our units is dangerous and unsafe.

Just my student opinion, but it feels WRONG.

Its the Pandemic, Stupid!

Today I learned that a colleague on the campus EMT squad pulled an 18 hour shift last night with what is almost certainly an active case of H1N1. Without a mask. She was running a 103 degree fever this morning, according to her. She said "i didn't want to get people mad by calling out of my shift". Oh I'm mad as HELL now! She exposed another medic (one of our FIVE current drivers, due to how long our training program for driving is) AND her probie AND her observer/student to H1N1. If they catch it they'll ALL be unable to pull duty.

I am SO pissed at this! I'm stuck here with bronchitis, unable to think clearly for longer than 10 minutes at a time, and she's out there making people sick, and I can't STOP her without exposing MORE people to this bug! GAAAH!

Please people- if you're sick, dont hurt other people. Find an excuse to wear a mask if nothing else. Really. Just...wear a mask. This winter is going to be hellish enough for a HEALTHY squad- and we're dropping like flies here.

It's Bronchitis

I still don't feel terribly sick, but my mother (rather overprotective), convinced me to go over to the Health Services building to get checked out. As expected, it's bronchitis. As far as I'm concerned, it's probably viral (for chrissakes, most things ARE) but because of the asthma, they wanted me to take antibiotics, "so you dont wait too long to go to the ER, which you KNOW you will, while claiming it's "not really that bad". I guess they do have a point. It sounds like something I'd do.

So no Halloween for me. Trick or treat???

Hi, I'm Unresponsive!

Last night, in spite of (ok BECAUSE of) The Cough, I acted as a spare victim for the EMT class on campus. My friend Meg was assisting with teaching, and needed a person upon which to demonstrate a Rapid Trauma Assessment. As I cannot currently run away, that person was me.

The RTA involves touching just about everywhere quite rapidly on a person, palpating and skimming to look for "DCAP-BTLS"- deformitites, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling. Essentially, it's summed up as "well THATS not good". Meg is a rockstar, and was demonstrating to these VERY nervous students how you can do a complete assessment without your victim feeling sexually harassed. It helps that they dont make the students strip the mock victims, although one girl was HORRIFIED to learn that we strip ALL trauma patients. He he he he he!

I only vaguely remember being that green. The problem with those of us who are nursing students as well as EMTs is that we keep adding to our field assessments- no longer is it "lungs clear and equal bilaterally", its "lungs CTA, decreased at the bases, suspect atalectasis from stasis"

I Dont *YET* Have The Flu

But I do have some sort of violent cough- mild, almost unnoticable congestion in the nose, just mostly a VIOLENT (sounds much worse than it is) cough. For the past three days. At this point I'm pretty damn sure it's NOT the flu, but the looks people are giving me are pretty awful. I mean, ive been asked 5-6 times if i have "The Flu", though i'm not actually that sick. Two people bucked the trend, and notified me that I could have walking Pneumonia.

It's getting to the point where I'm almost tempted to go to the Student Health Center so that they can TELL me I dont have anything wrong with me, and write it on a slip of paper...last year people would have asked me if I had a cold. This year they think I'm Typhoid Mary.

Go figure.

Dear God The Exhaustion (Part 2)

Last night I worked as Standby Crew for a campus event to kick off the basketball season, and that is always followed by a brief musical performance (usually by someone we've never heard of). "Oh! This will be easy!" I thought. After all, the event started at 7pm, and would be over by 10! What could POSSIBLY go wrong???

We were there for FIVE MINUTES before we had TWO patients, both found in the bathrooms puking their guts up (thank heaven for small favors- they made it to the bathrooms) because THESE geniuses thought that aggressive drinking was the best way to attend a basketball event. The irony is, they were so sick, and so drunk within the first FIVE MINUTES (ie. before anything had HAPPENED at the event) that they missed the whole thing. Local Hospital was being EVIL and on full diversion (we're not sure why...we think it's because they dont like us) so our Duty Crew (the people who were on the actual night shift) were taking two patients at a time to a farther hospital, which turned the whole thing into a Mass Casualty Incident.

The thing about MCIs is that you have one as soon as your number of patients overwhelms your resources and personnel. We were at that point about 15 minutes into the event- public safety officers were scouring the building for sick or drunk people, and kept calling us. We had 7 EMTS, working in 3 teams (3 on the rig, two pairs with a jump-kit each)...there WAS another crew, a paid professional squad, but they were technically on call only for the athletes and the entertainment, NOT for the students. As a result, they wouldn't transport for us, leaving us at several points with patients stacked up waiting for rides to the hospital.

By 10 pm we had upward of 12 patients, and 7 VERY testy EMTs. I'm exhausted, and I just slept for 8 hours. Ugh. I hate hate HATE drunk students.