Goofball

Our ICU is totally open, 24 hours a day. Cots can go in the big rooms, not the small rooms, but family member can spend a night in a chair if they want to. We just took away the intercoms, no calling to ask persmission to enter anymore. They were all just walking in and out anyhow. Who cares? It totally frees you up from the stress of trying to control everyone's entry. Only thing we get huffy about is if the room curtain is closed, how dare they walk around it. Then we kick them to the wait room. No standing outside rooms or in hallways allowed, due to Pt. privacy laws...They can either be visiting inside a room, or they can be in waiting room, but no hall loitering. Works for us.

How about, "Hey, the more you make, the more they take! (as in taxes)" Or sometimes I just say, "I never discuss my salary" and cut the subject off abruptly. If they persist, I may say, "It's none of anyone else's business". Or if I am trying to be nicer about it, I say, "I make a decent salary, but it has been at great sacrifice to my family and myself to get to this point, and I put my personal health and safety at risk every time I work."

Never heard of it; but I have noted that if a pt. is becoming bradycardic, and they are on high-dose propofol, cutting the propofol down will quickly reverse the bradycardia.

We are not allowed to restrict visitors at any time from being in the rooms in our ICU, except maybe for cleaning up stool and even then sometimes they refuse to leave. Most refuse to even use the intercom and they get mad if you say something. Most visitors are anxious and slow you down, but I know they have a need to be there so that's ok. The only time I realllllly hate it, is when they are there around 1730-1930, because that's end of shift then report time, and they are always poking and prodding the pt, insisiting Do you have pain Mom? Do you have pain? You have pain, don't you? My mother has pain! She needs something right now for pain! (or nausea, or wants to be repositioned yet again). Sometimes I think the pt agrees they have whatever need it is, just to make the visitor happy.

There's a place called Sassy Scrubs online that will let you pick out the material, and then sew up a scrub top for you. Their sizes run quite large. I usually wear S, so I ordered Xs, and it was still the size of a medium.

METOO! I'm a scrubaholic, because I'm a fabric-aholic too. I'm always on the search for really unique material that calls out and grabs me. OCD's run rampant in nurses, and this is mine. First I thought maybe it was a craving attention. But I think it is also because we want to wrap ourselves in things that remind us of favorite hobbies, places, themes...feel-good stuff that feels happy or calming. Maybe it's also sort of an artistic expression. What's wrong with that? Anyway, my patients like them, and besides, the scrubs are partly tax deductible!

We had a patient named Larry Lobster.

little asian man found down at home, E.R. reported suctioning maggots out of nose and NGTube and Et Tube. I was almost sick myself seeing it; until his family came in and reported he had eaten a huge bowl of rice just before coding at home.

Our Per Diem nurses have that option, to refuse to go to certain floors. If we accept them to come and work in the unit for 12 hours, then at 3PM we end up overstaffed - and one of the 8-hour floors are short for 3-11....then one of us ICU 'regulars' gets to float from 3PM to the end of our shift at 7PM. Also, you can be floated to one unit for 4 to 8 hours, then told to float again to some other unit for the rest of your shift. It Stinks!!!!

I got a young R/O MI pt from ER end-shift yesterday. I was rummy from lack of sleep over the past 5 days. I kept having to move his hands from his chest -he kept tangling his EKg leads in his fingers (too obese to fit in the gowns we had on hand, and didn't want to wear one anyway)and entangling his hands in the IV lines (on nitro, heparin, cardizem drips, I was focusing on trying to keep adjusting and resetting alarms). I also had to keep moving his feet/legs back onto the bed. I noticed his hands and feet had a pale yellow-orange stain on them, like they had recently been painted with a light coat of betadyne. I asked him what procedures the ER had been doing that his hands and legs/feet were that color. He said, "Oh,that's from the diarrhea I've had for the last 2 weeks; I havent been able to take a shower yet." That's when I noticed he was a bit jaundiced, and that the bilirubin poopstains and other crud were all up under his long fingernails and toenails too; The day I don't smell and recognize poop, and even worse, didn't have gloves on several times that I touched him, I know my brains were too scrambled to be working!

Must have been good eatin's up there! But what doe "NH" mean?

I confess I have eaten it myself when desperate and no time for a lunch break, and the patient was made NPO and couldn't have it. But it does look kind of like something that came from a wound that wouldn't heal.

I think what's kind of freaky about a deceased pt. is the way their blood settles. When you turn them to push the morgue bag under them, it's all purpley.

Today one of our pulmonologists introduced a new MD just hired into their group. He said, "Meet Dr. Azfal." Well, you know what I thought I heard. I had to look at the guy's name on his coat to see if that other Dr. was kidding. (Try saying the name softly, or quickly - it sounds like Dr. A--hole!) I was relieved to see it wasn't what I thought, but I can't wait to hear him paged overhead; they had better enunciate verrrry clearly!

We have an intensivist/pulmonologist by the name of Dr. Shragg. The other day, one of the new RNs in E.R. heard his name incorrectly, and was having the operator page him overhead as Dr. Shrekk. We were all just busting a gut laughing, because he can really be such an ogre sometimes!