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spotangel MSN, RN

ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds

Content by spotangel

  1. spotangel

    I Have to Go to Work!

    Friday the 16th of August was a busy day in the clinic. I was on triage duty. Mr Grainer had signed in for shortness of breath and near syncope. I called him in and observed him walking in breathing normally. As he sat down, I noted that he was neatly dressed in summer clothes; shorts and cotton shirt with a straw colored hat that he removed displaying his salt and pepper hair. His ankles didn't have any edema and he did not look like he was in any acute distress. I sat across him observing him as I spoke to him quietly. "Good Afternoon Mr. Grainer! My name is Nurse Annie and I am the triage nurse in the clinic today. How are you doing?" "I am good! Can't complain. Please call me Carl!" "Thank you Carl. Why did you come today?" " Nurse, something's not right." "You seem worried. What do you mean by something's not right?" "I am normally pretty healthy and can walk four miles a day but for the last two weeks, I feel like I am going to pass out after walking one block." 'Is this something new? " "Yes. I never felt like this way before." "Do you get short of breath? " "Yes! Just in the last two weeks." My mind went into overdrive as I scanned through his chart. He was a diabetic and hypertensive. In my mind I always equated shortness of breath with the heart in a diabetic until proven otherwise. Just in case, I asked him questions to rule out a Pulmonary emboli. He had no risk factors, no travel, no smoking or recent prolonged immobilization. I took his pulse manually and immediately figured out what was wrong. His vitals all were great except for one. He had a heart rate of 38 bpm. Probably a heart block but totally asymptomatic! "I have some good news and bad news Carl! Which one do you want first?" "The good news " "I figured out what is wrong with you and why you feel this way." "Why?" It's your heart. It's beating really slow and any activity puts a huge strain on it." "What do you mean?" "For some reason your heart is beating very slow and that is causing your symptoms. I need to send you to the ER right now ." " Nurse! What about work? I have to go to work tonight!" I realized that he did not grasp the seriousness of the situation. I had to give him a verbal jolt and be honest. After all we nurses are known to be the most trusted profession! "Carl, let me be very frank. I am surprised that you made it into the clinic after walking four blocks from home. It's only a matter of time before something happens to your heart. Do you think your work will care if you drop dead? At this time you need to take care of you!" He stared at me and saw the truth in my eyes. "Nurse you are right. OK, I will go. What happens next?" "Just relax. You are safe here. Let me make a few calls." I called for an ambulance ALS team, informed the front desk and lobby about their impending arrival, printed out his paperwork and informed his doctor that I was sending him. She agreed 100 percent with the plan. I then called our main hospital and gave report to the ED charge nurse who was named Carl too! I informed Carl what to expect in the ED; Labs, line, EKG, portable chest, being hooked to a monitor, no food and possibly a cardiology fellow visit and a recommendation of putting in a pacemaker. The ambulance crew came and whisked him away to our main hospital. In three hours he went through all that was discussed and was taken to the cardiac cath lab with a second degree heart block and a pacemaker was placed. He went home on Saturday with no complications. I followed up with him via phone on Monday and got him an appointment for a follow up with a provider the same week and in two weeks with his own PMD. When he came for his first visit, I was out sick and he went around the clinic looking for me. One of my nurses told me. Yesterday, I saw him in the clinic for his two week follow up waiting in a room for his doctor. He jumped out of the room and hugged me and kept thanking me. I went into the exam room, sat down and caught up with the latest in his health. He showed me the dual pacemaker site and I noted that the skin was healing well. "Nurse Annie, thank you. Thank God you were there that day." "Carl, lets give all glory and thanks to God! He put me in your path that day and I am glad that I was able to help you." 'Nurse, I want to treat you to dinner!" "Thank you Carl! That is very sweet but not necessary! " "Nurse! I want to do something for you!" "Just say a prayer for my family and do something good for someone else and pass it on!" I left the room feeling grateful and feeling appreciated. It is not often that one gets appreciated in our profession. I reflected how my years of experience kicked in when needed but more than that I marveled at the way our skills are utilized to help others in the grand plan of our lives and in the lives of others. Each person is created in God's image and likeness but we have been given strengths and weaknesses that together as a human race fit together perfectly like pieces of a puzzle. It is wonderful to be a nurse! I have a question for the readers. Can you share your stories where you felt that you made a difference in a person's life in and out of work? These stories need to be shared with each other and the world!
  2. spotangel

    Spouse of nurse

    This year marks 25 years of married life. All through out, I have earned more but it has been a non issue for us. My husband used to have hangups about making less and it took a lot of convincing for him to trust that I was more into him than into money. At home we have a policy. Home is a safe place and we are a family and not our titles. We have one account. He is better at managing money, so he manages it. We trust each other and speak frankly if the other spouse is doing something that may be an issue. Be honest with each other and ask what you can do as a team to manage expenses. Comforts and bank balances does not provide security and happiness in the long term. Don't lose a marriage but look for opportunities to make your spouse feel loved and cared for. This is the one you promised to stay with through richness,poverty,health and sickness. Tough but doable.At the end of your life how much comfort will money bring you? Thirty years is nothing to sneeze at. God bless! All luck. Take one day at a time, trust in God's providence! I will be praying for you. Peace!
  3. spotangel

    September 2019 Caption Contest

    Time for the Flu shot before the grim reaper and the invisibles take you says the overworked robotic nurse!
  4. spotangel

    But, she was fine this morning!

    1.20 PM The red phone rang in the ER. This was the EMS line when they called with an incoming emergency. "South side ER. This is Nurse Annie. May I help you?" "Nurse Annie, Brian from EMS unit 134. We have a two year old female, found unresponsive at home; CPR in progress, ETA (estimated time of arrival) 4 minutes." "Thank you Brian. See you in 4.Over." I hung up and quietly announced,"Peds code, 2 year old female, CPR in progress, ETA 4minutes." The team quickly swung into action. The code cart was pulled right to the stretcher. The suction, defibrillator and cardiac monitor turned on and ready, 2 nurses with IO/IV kits, NG, Foleys and emergency med box ready, and the registration clerk with her portable computer. The team gathered by the bedside as the doors swung open and the EMS team came through and was directed to Stretcher A1. The next hour passed as a blur and the team worked hard to save the young child's life. The dad was allowed to sit at the side and sat quietly in a chair, tears coursing down his face as he clasped his hands convulsively and prayed. The monitor never picked up a rhythm throughout and after an hour the code was called off. The father was in a daze and kept repeating, "But she was fine this morning. How did this happen?" The rest of the family was in the waiting room waiting for the mother who was at school and had been notified. I triaged the child Sara as a tier 1(unresponsive, pulseless,) code and noticed that she had been in our ER the night before for cough, vomiting and fever. She had been given IV fluids, labs had been sent, CXR negative, urine negative, tolerated po and had been sent home at 5 am with a prescription for antibiotics as the white blood count was 14. The discharge note from the nurse read" Sara noted to be smiling, skipping up and down the hallways, tolerated apple juice and sent home with grandmother with discharge instructions on a BRAT (Banana, Rice, Apple sauce, Toast) diet with prescription for antibiotics. Grandmother verbalized understanding of discharge instructions". EMS reported that the child was taken home after the ER visit and was fine and fell asleep on the sofa nursing on a bottle of milk around 12 noon. Mother had gone to school and grandma checked her around 1 pm and found her unresponsive. There was no one else at home. Dad was at work and came straight to the ER when grandma notified him. The mother was enroute to the hospital now. So what happened? This was definitely an ME (Medical Examiner) case. Sara's body was moved to our isolation room where the family could grieve in private. It was almost 3 hours since she had been pronounced. The family came in quietly 2 by 2 as it was a very small room that fit a stretcher and 2 chairs only. All of a sudden the double doors swung open and I heard a scream. It was the mother and she was out of control. Screaming, cursing, crying hysterically and sweeping everything in her path. She grabbed a vase of flowers that a grateful patient had brought the staff and smashed it on the floor, then picked up a computer monitor that was on the nurses' station and pulled it down. At no point did she go to the room where her daughter's body was. By then, security came in and she was escorted out of the ER along with the rest of the family. No one was allowed back into the ED from that family. Luckily no one got hurt even though the ED was crowded. Sara's body was sent to the morgue. The staff were all down emotionally as we were unable to save her and a child's death always shook the most hardened ER RN'S armor. We pored through the chart looking for any signs that we missed from her previous visit but it looked like gastroenteritis and a slightly elevated white count without a known source. The only comfort we took was that we had tried our hardest to save Sara's life even though she had been a DOA (dead on arrival). It was 10pm. One more hour, and my shift would end. I was sitting in my office going through the schedule when I got a call. The entire family was back; around 40 of them and they wanted to see Sara. As the evening ED manager, I had to handle this situation. Saying an internal prayer, I walked into the registration room and scoped the waiting room through the glass to gauge the mood. The family was subdued and I saw the parents. I called the security supervisor and asked him to have a few security guards inside the ED for easy access to the waiting room in case anything erupted. I went out to the waiting room and 40 pair of eyes swung my way. I went straight to the parents. The father recognized me. I introduced myself calmly and asked them how I could help them. The mother looked at me with tears in her eyes and whispered, "I want to see Sara. Please!" I told them, "I am so sorry you lost your daughter! She was taken to the morgue. She is not in the ER anymore." "Can we go to the morgue?" "No. No one is allowed as per hospital policy. I am so sorry" They were distraught and kept begging me. Right next to the parents were the two grandmothers and would not take no for an answer. Finally I told them to have a seat and that I would come back. I then discussed with the Evening Nursing Supervisor and the Security Supervisor who basically told me to make the call and that they would support me. I went with the security supervisor and another guard to the morgue, put on gloves and mask. I pulled the drawer with the child out and unwrapped the head. Sara looked like she was sleeping. We then went back to the ED and I went back into the waiting room. I called the parents and grandmothers and told them that I would take the four of them only to the morgue. The rest of the family could not come. I told them straight up that I was putting my job on the line as the policy strictly prohibited visitors. I told them that they had to contain themselves as the morgue was in the sub-basement which was pretty far away from the ED in case anyone fainted or fell. They promised that they would not create any issues and we went down to the morgue accompanied by 4 security officers. The next 20 minutes was very hard to watch as they knelt by her drawer and cried and kissed her. I held back my sobs though tears ran down my cheeks as I watched that mother's heart rending pain as she hugged her child in the drawer. A couple of times I thought that the grandmothers might faint and prayed earnestly that nothing happened. After half hour we shepherded them out and they waited as we closed the morgue door and wrapped her body and slid the drawer closed before joining them. As we walked back to the ED waiting room, the mother apologized for trashing the ED. The father thanked me and asked me to thank the staff for working hard to save their child. The entire family left and I thanked the security officers and huddled with the staff and informed them. Sara's body was transported to the ME's office by his team. I left around 12.30am and reached home around 1 am and went straight to the shower. Later in bed, I hugged my two year old daughter's warm body and watched her breath in and out and thanked God for her life. I knew that even though this was one of the hardest days in my life as a Nurse Manager, I had done the right thing. As I mother, how could I refuse a mother's plea? As a nurse, I could see beyond the anger to the grief of a loving mother who completely lost it when she heard that her daughter was dead. I got in big trouble for breaking the rules with the Medical Director and got a discipline for not following rules. It honestly did not change me in anyway as I would have done it again if needed (I didn't tell them that!). My gut and my heart has always steered me in the right direction and it taught me to take a stand even if it is unpopular. The Medical Examiner's report was that Sara had aspirated on the milk she drank while sleeping. Going to the morgue, seeing dead bodies and handling them was one of my biggest fears and I had to pray and ask God to take those images off my head. Recently, when my then two year old, now 11 year old daughter hugged me, I thought of little Sara who would have been the same age . I hope her family has regained some measure of peace after 9 years. I hugged my daughter back extra tightly for Sara's mom.
  5. spotangel

    Your most bonehead moment in nursing. Or 2. Or 3.

    The ER was very busy with an unusual amount of pediatric patients, a few of them wailing infants. As I focused on getting a line into an old lady with spider veins, she whispered "Nurse Annie, check your scrubs". I look down to see 2 big wet patches. I had started to leak with the "let down effect" listening to all those infants crying! I felt like diary queen, smelt of milk and was mortified! Luckily I kept extra scrubs in my locker----!
  6. Annie! Your break is over! They are sending up a patient from the ER to this bed!
  7. spotangel

    An Ode to Hospice Nursing

    Beautiful post! Thank you for your article. Being there for a family when they are at their most vulnerable and the emotions are on their sleeves is hard and will take a toll on you. You have to replenish every day! God Bless! Keep writing!
  8. To me, 30 years as a nurse passed like a fleeting dream at night, but every day brings something new! I go in like a rookie every day wondering what the day will bring and I am never disappointed! Since graduation, I worked a host of jobs in acute care, long term care, school health, teaching, home care, community health nurse and administration. For the last four years, I have been working in a primary care clinic. When I first walked in, I thought, "How hard can this be?" After all, all I would be doing was vital signs and have the patient wait for the doctor. Right? Wrong! Let me take you through a clinic day at my job. I work as a Chronic Care Nurse Coordinator in a busy clinic in an economically disadvantaged area, in a busy city, in the United States. My patients are mostly Medicaid funded with major medical issues, chronic problems and innumerable social issues including homelessness, poverty, broken homes, inadequate food, access issues, transportation issues, illiteracy, and minimal social support. Let's meet some of my patients. Jose, a former gang member with skull and cross tattoos on both arms is a forty years old diabetic, hypertensive with depression and alcohol dependence who reads at a fourth-grade level. His biggest supporter is his mother who is battling depression herself. His HbA1C is fourteen and he doesn't understand why I am so concerned. My Diabetic teaching 15 minutes visit stretches to 40 minutes as I ask if he ever sleeps with his front door open at night. Scratching his head he says "No!" "Why not Jose?", I calmly ask. "Nurse, that is plain stupid! Anyone can come in! I could get robbed!" "Jose, you are already doing that!" "What do you mean Nurse Annie?" "When you don't take your medications and ignore your diabetes, you leave the door open to infections, high sugars, kidney problems, heart attacks. They are like rival gang members!" "Oh! I see!" the penny drops as he understands. "What should I do?" "Well, Jose! You are a smart man. You need to close your door by taking meds. Let's talk about them----!" I have him hooked now as it makes sense to him and he is ready to listen and learn how to protect himself. After all, that's what he has been doing ever since he was a kid! The last time I saw him, he was back on his medications and his HbA1C had come down to 13! Jose was back on track. Tanya, 36 years old with a history of CHF, flash pulmonary edema and an ejection fraction of 15%, a frequent flier to the hospital looks bloated as I pass her in the waiting room. I stop to say hello. She smiles at me as I sit next to her in the waiting room. "Who are you seeing today? " "The Medicaid worker. I just dropped my papers. My insurance won't start back for two weeks". She looks worried and is short of breath. I inwardly curse as I suspect she has run out of medications. "Tanya, when is the last time you took your Lasix? " "3 days ago, nurse. I called the clinic and told them to ask Nurse Annie to call me back, please. It's urgent. I tried calling them again but no one picked up. Didn't they tell you?" I had never got that message as it was the weekend, the call center had taken the message but the clinic was closed. Tanya could not remember the on-call number. I gave her my personal cell number again for emergencies. I turned to the front desk clerk John and requested that he put her on my panel and took her into an exam room even though, I had 3 other patients waiting. Just like I suspected, she had put on 4 lbs and I could hear crackles at the base of her lungs. She did not want to go to the hospital for admission and we had to negotiate! I got her a same day appointment with one of our providers who titrated her Lasix and scheduled her for a followup and weight check in two days with me. As I left the room after giving a warm handoff to the provider, she called out after me, "Thanks! Nurse! You are an angel!" I smiled at her and walked away to my waiting patients. Sam looked grumpy when I found him in the waiting room. "What took you so long nurse?" "Sorry Sam, I had an emergency." "Did you bring all your medications?" "Yes, nurse". He pulled out 3 bags! I inwardly groaned as I painstakingly went over his medications. He was taking Metoprolol that had been discontinued, had not picked up his Lisinopril, was taking over the counter garlic pills with his blood thinner Coumadin and had left his inhalers and insulin pens at home---. I called his pharmacy, updated them, educated him about the dangers of bleeding by mixing a blood thinner with garlic pills, turmeric pills alongside his aspirin 81mg and ibuprofen for pain! I made another appointment for him to come back with the rest of his medication and eye drops in one week. I was running over every 15-minute visit on my panel today. I went to my office as my next patient was in an hour. I had 12 messages waiting in my inbox in our EMR for a callback, 7 forms waiting to be filled, staff schedules for the next week to be reviewed and was covering my partner that was on lunch for all triage calls. I got through 2 forms and 3 calls before I had to go and triage an asthmatic that walked into our clinic requesting to be seen. I started the 18-year-old on a Combivent treatment and found an empty slot with a provider and asked the provider to put in the order. It was time for my next patient. My next patient was from West Africa, spoke only French, was 21 pregnant and had a six-year-old child. The translator phone service put me on hold twice for 20 minutes each till I got fed up and went looking for the video translator in the clinic. I found it in the 12th room I checked and did a prenatal visit asking her a whole bunch of preset questions and taught her about breastfeeding and how to prevent and manage nausea in pregnancy. I wished my visit slots were at least 30 minutes instead of the fifteen a sure setup for not keeping time. I had to then, call a complex care patient who was paraplegic, and who self catheterized. He was running out of supplies as his prior authorization for supplies was not approved and now I was on the phone trying to get him approval----left messages for his care coordinator and the durable medical equipment store that had an automated system. All throughout the day, I was paged multiple times when the front desk had questions, the LPN needed help, the doctor needed me to call a 14-year-old with abnormal results (positive STD) and a new order for medications that needed to be picked up by the patient and started. I called the 14-year-old patient and her mother picked up the phone-------could not tell her. Told her to have her daughter call back the doctor or me, fielded and avoided giving specific answers to the mother's questions and sent a private message via the patient portal to call the clinic and ask for me or the doctor. Documented all conversations in the chart. I then had to call a hospital discharge patient and get a Spanish translator on the phone to ask our lengthy hospital discharge questions about her CHF management and coordinate calls between her primary care provider, the cardiologist and myself and work around her schedule as she was watching her grandkids while her daughter worked. I was unsure if she knew what medications to take and asked her to come in for a med reconciliation. The earliest she could come was a week later on her daughter's day off. I sent a note to her doctor. It was almost time to go home. The rest of the work would have to wait for tomorrow. I sat down and said a quick prayer of thanks. At the beginning of the day, I had sent someone who was short of breath and fatigued via 911 to the nearest hospital. I was pretty sure he was having some kind of blockage in his heart. I called the hospital to find out and finally was transferred to the ICU. Turns out he had a 100% block in his LAD and had been taken straight to the cath lab and stented. He was stable and in the ICU being monitored. I left work feeling good! My years in the telemetry and ED had helped me spot that pt and also Tanya's CHF exacerbation. My home care training had prepared me for the discharge calls, the med reconciliation and many of the triage calls. My teaching and long term care experience helped me with grumpy Sam and Jose my ex-gang patient! Every day of my nursing experience has been put to use in this job. I feel privileged to be a front line worker making a difference. I might not be recognized for my work and sincerity to my job, by a manager or coworker but in my heart, I know, I make a difference every day in someone's life. I have been blessed by my patients a thousand times over like many of you who work tirelessly no matter what the odds stacked against us! We are blessed to be nurses and have a special mission on earth! It is to touch lives from birth to death and be there for our patients and one another when no one else does! If no one has thanked you for being a nurse, let me say thank you! I am blessed and proud to be a nurse!
  9. spotangel

    Any nurses that love nursing and love their job??

    30 years this month and absolutely love being a nurse! Read the articles I have written for the why part. I am very humbled to be part of a pt’s life and be a person they trust. Many a time my venting after a hard day sounds like bitc—ing and mourning! I don’t hate my job, I just need to vent! If you work with a good team you are all set and even better if you have a great boss!All luck! It is a hard but satisfying profession . As a Christian. I always say. “Here I am lord! Let me do your will. Let me be your comfort and strength to anyone in need!” He puts me to good use every day and I go in wondering who He will send to me each day, patient, staff or colleagues! This is my ministry of caring , not just a job!
  10. Sounds like my clinic. No med Tecs but 4 PCTs, around 25 LPNs and 3 RNs . Around 30 providers including family medicine, ObGyn, Psycologist, psychiatrists, podiatrist , cardiologist, Dermatology NP, nutritionist, social workers, Health educators etc. We offer many services!
  11. It is frustrating on most days but you touch many lives and after a while we are part of their family----! I would rather a new grad that I could train but that will happen only i f you have input into the hiring process!
  12. spotangel

    Nurse in Germany Convicted of Killing Patients

    Report him to the BON and let them know about the camera. I happened to walk in during rounds as a nursing supervisor into a room in a pediatric long term care facility and heard crying behind a curtain. I peeked and saw the a new LPN on her last day of orientation, roughly handling a peds kids with Cerebral Palsy. I had her relieved of her duties and wait downstairs in the lobby while I called my boss the Chief Nursing Office at 8pm. We send her home suspended and she was let go the next day. I never regretted speaking up and thanked God, I walked into that situation. I am not one to make you lose your job but abuse should not be tolerated. Period.
  13. Thank you Kooky Korky! Will definitely tighten up as I know you all have good intentions.I honestly do not give my number to every patient, just 1 in 3000! Lol! Did not mean to exhaust you with details of a clinic day but you are right. It is understaffed as even the management that runs the place do not get what the nurses do! Most people have this "all they do is vital signs attitude "and I am guilty of that too before I started working in a clinic.I guess, when you don't work in a place, you don't realize the details whether it be inpatient or outpatient.
  14. Wow! That's a lot you are doing super nurse! Thank you for helping your patients in spite of all the work they throw your way! I have to stand my ground and ask them to put patients on my schedule if they want me to see them that day. I am not afraid to say no. I say it nicely though! When I am scheduled to attend interviews for new staff and they put pts on my schedule, I skip the interview as I can only be at one place at one time.It is a tough job but I am glad I can make a difference. Don't underestimate the good you can do where ever you are. It does sound like a lot for one LPN. We don't have access all the time and sometimes I send pts to the ED or Urgent care the same day. If they can wait for one more day safely, I put them on the next available slot. Sometimes I speak to the doctor and overbook them if it is urgent but does not warrant an ED visit or is unstable for Urgent care like an asthma exacerbation.
  15. So true.It is like a PE! If you are not looking, you may miss the boat! You hit the ground running and most days are fast paced. You also have to know what to do and how to stabilize a patient while waiting for 911. I once had a patient on Coumadin with a non healing foot ulcer and a tendency to bleed. He went to the bathroom and turned his wheelchair hitting his foot against something and bleed like crazy. Luckily he pulled the emergency cord and we went in to a blood bath and called 911! Between the doc and I, we tied a tourniquet, lifted his leg up and put an IV in, all in the bathroom. I walked out of the bathroom feeling like I was in a murder scene! Lol! Later he came back and thanked us as they transfused him with 2 units in the ED! I joked with him that I was a blood relative at this point!
  16. Thank you! I love my job! You are spot on especially about the extra work(lol)! More than anything else, the phone number inspired trust and decreased anxiety. I remember, as the evening nurse manager , a patient in the ED, call me once as he was threatening to leave AMA and was desperately ill. I talked him into staying, spoke to his nurse and expedited his admission to the ICU----turns out he needed a CABG , got one and walked out of the hospital a week later--alive.Once you gain a patient's trust, they will walk with you and you can walk them off the cliff edge to safety! Like I said, I rarely got calls! Sometimes you have to walk your own path away from the conventional method of caring for patients to the road less traveled.
  17. Thanks . I respect your opinion.The funny thing is they rarely call! It’s a security blanket for my patients. The patients are very respectful of our time and privacy. I hear your concerns and normally give my work number to the patients not private cell. She is desperately ill and beginning to go downhill and is a mother to 5 kids,the youngest being 6. She has had a few close calls recently and I am her point person. She has yet to call me!
  18. Wuzzie ! You are worth your weight in gold. In the clinic you always have to be on high alert not knowing what will come through your door!
  19. Thank you! It is not easy being a clinic nurse. However, it is very rewarding. I wish administration would understand how much work is involved and stop piling on more work and responsibilities that I have not mentioned in the article like being the champion to a chronic disease, being in committees, covering your partner's on their day off and seeing their patients (as well as your own). That is just the tip of the iceberg---
  20. spotangel

    Primary Care Is Dead. Long Live Primary Care!

    Primary care is definitely staying and is the way to go. Trust and consistency are 2 big factors when we assist our patients.Prevention is the name of the game and the nurses are in the forefront.
  21. spotangel

    Celebrate Nurses Article Contest

    Good Morning! I submitted an article for review and the competition.Thanks!
  22. spotangel

    February 2019 Caption Contest: Win $100!

    When the C Diff/Melena smell follows me home after an "Of course we have this under control"shift in my insane ER!
  23. spotangel

    Clinical Coordinator

    Hi, I am a Care Coordinator working in a clinic. I coordinate care for complex cases, see pts for education on chronic care issues like DM,HTN,Asthma, Obesity etc. I manage coumadin dosing for pts, triage pts, fill forms and trouble shoot any issues etc etc
  24. Green eggs and ham will make you give up those coins you were hiding!