Sunday, September 17, 2006

Three Flags Over Podunk (or "A Road Nurse's Day Off"...)

* * *
The cattle are prowlin' and the coyotes are howlin', way out where the dogies bawl, where spurs are a-jinglin' a cowboy is singin' this lonesome cattle call.... ("Cattle Call", sung by lots of folks, like Eddy Arnold and LeAnn Rimes...)
I had a nightmare on Friday night. Nightmares are a frequent thing for me, but it sure gets old. Usually I dream about nursing stuff--and usually it's a frightening flashback type of deal where I'm re-living one of the godawful shifts from when I used to work in emergency rooms. This was one of those times. I had dreamed about the last night that I had worked in an emergency room.

I used to work at a trauma center about 4 hours away from here. I finally quit, nearly two years ago, swearing for the umpteenth time that I will NEVER, and I repeat NEVER, work an ER again. I had sworn this same oath on numerous occasions before in years gone by, leaving the ER in disgust--yet always returning to the ER after a brief absence into some other area of nursing-- working a few more years then leaving the ER again in disgust....etc, etc.

But this time, two years ago, I MEANT IT. My philosophy these days is : "Let the younger-- and stupider-- girls go for it. My glory days are officially OVER. I'm too tired and worn out to fight that soul-sapping, losing battle anymore....."

So far it's been a good philosphy, exept for the problem of nightmares. They haunt last night.

The last night I worked in the trauma center, it was a horrible--yet typical--shift. I worked what we called the "hell shift"-- which was Friday, Saturday and Sunday evenings.

The paramedics galloped into my section and practically flung a 6-year old boy onto the nearest stretcher. The boy was in full tonic-clonic seizures, violently twisting and flopping his tiny body, slobbering at the mouth with his eyes rolled up into the back of his head. He had peed and pooped on himself. His young, barely-out-of-her-teens, mother came trailing behind the medics, white as a ghost with fear, looking bewildered and panicked. There was no father.

"What's going on?" I asked the medics.

"Status epilepticus," they replied, hurriedly unhooking the child from their portable monitors in order to transfer him to the ones in the room. I scanned the monitor screen to see the child's vital signs--and noticed thankfully that the boy was still breathing. I hollered for a doctor. Then the medics gave me the bad news. "Couldn't get an IV line to stay in," they told me ruefully. "He jerked out the only one we managed to get into him. Sorry, but you'll have to re-start your own line cuz we gotta go."

Just then the ER doctor rushed in as I frantically finished hooking the kid up to our ER monitors and oxygen. But the child kept knocking his oxygen mask off due to the violent spasms of his seizures. The doctor quicly scanned the medics' paperwork to check for allergies. He scribbled some orders for anti-seizure medicines to be given, intravenously, and then dashed out to see his next patient.

"Hey!" I hollered after him. "I don't have a line yet!"

"So get one," he snapped. "I'm going to transfer him via helicopter to the children's hospital in Arkansas..." He disappeared down the crowded hall. I turned and begged the departing paramedics to help me.

"Sorry, but we've gotta go," they told me. "Five car smash-up on the Interstate---good luck!" and they were gone.

I hollered for help several more times but nobody came. So I knew I was on my own. Cussing loudly, I grabbed an IV kit from the cabinet. I knew that getting an IV line into a 6-year old's small veins while he was thrashing around in the throes of a full blown seizure was a next to impossible task for one person, so I flipped on the emergency intercom on the wall by the stretcher.

"What?" the Ward Clerk answered, sounding annoyed.

"I need someone in here to help me hold this kid down so I can get an IV into him!" I screamed at the wall speaker, frantically lobbing the IV supplies I would need onto a bedside tray. "Get somebody in here to help me STAT!!!!"

"No can do," she replied nonchalantly. "There ain't nobody available--you know damn well it's a zoo out here. But I did call the helicopter and they're on their way. But you better hope they can land when they get here--because there's four other birds on the way and there's only one copter platform...."

I looked at the child and truly felt panic. Because I knew that as long as there was no IV in this kid, I wouldn't be able to inject the anti-seizure medicine into him. And I knew that the longer he stayed in this prolonged seizure, the more likely he would be to suffer brain damage from lack of oxygen--or simply die...

A tech rushed in and threw a bag of anti-seizure medicine onto the stretcher. "There's your meds....gotta go!"

Dismally, I did the only thing I could do. I LAYED DOWN ON TOP OF THE KID in order to stop his legs and one arm from thrashing. Then, while lying on top of the child, I looked right into his mother's frightened eyeballs and said as serious and FIRMLY as I possibly could: "Ma'am--you need to HOLD HIS OTHER ARM AS STILL AS POSSIBLE SO THAT I CAN GET THIS IV INTO HIM--and I mean, DON'T LET HIS ARM MOVE EVEN ONE INCH, do you hear me????"

She nodded in understanding and held his arm down as I strapped two tourniquets on--I wanted to make DAMN sure that a viable vein popped up. But I only found one vein that looked even vaguely possible for a stick....and it was between his 2nd and 3rd finger. So I aimed...and I PRAYED the nurse's prayer...and then I STUCK.

And I got lucky. It was a good line....

I got the IV started and shoved in the medicine. I watched carefully, hoping the medicine would work. And in a few seconds the child's spasms started slowing....slower and slower....and then they stopped. I checked the monitor and saw that the child's heart was still beating--and his oxygen level was good. And he was breathing....thank God.

I kept working on the kid for the next couple of hours trying to stabilize him and get him ready for the flight to the children's hospital, getting in another IV, putting in a catheter, drawing blood for labwork, reassuring his mother, getting his paperwork prepared for the transfer--and giving him more anti-seizure medicine every time the seizures began again, which they did about every half hour. The doctor checked on him frequently, cursing at the delay in the helicopter.

Finally, I called the Ward Clerk again to check on the helicopter's arrival.

"They just got here but they're having to circle," she replied. "They can't land because the helicopter before them is still on the pad. I don't know what's taking them so long to get out of here because they already dropped off the patient they brought us--a guy from a truck accident."

I ran down the hall and found the Charge Nurse. "Listen here," I yelled. "My bird is circling but can't land---what's the hold up on the pad?"

The Charge Nurse looked out over the sea of faces in the crowded halls and noticed the errant helicopter's flight crew standing in a hall chatting with some medics. "YO! FLIGHT CREW! GET OFF THE DAMN ROOF!" she shrieked at them. They looked up in shock, realized what she was asking, and ran to do as she asked.

I ran back to my patient, and waited. Sure enough, the children's hospital copter was finally able to land--and its flight crew came running in. They were all in flight suits, a flight doctor, a medic, and a flight nurse. They helped me load up the child, transferring him from my monitors to their portable monitors, as I gave a fast verbal report. The Ward Clerk came running in to thrust a packet containing the child's X-Rays, blood work reports, and other paperwork at the flight crew -- and we were ready to go.

We madly rolled the child's stretcher down the busy halls as fast as we could, practically knocking over everybody in our path, and took the special elevator up to the flight pad, which was one hundred and fifty dizzying feet up into the air. We then raced out to the waiting copter and performed a "hot load", which means the copter's blades are whirling in full gear, ready for take-off.

I helped the flight crew load the child onto the bird. I thanked them heartily, glad that the child was still in stable shape. Suddenly I noticed the flight doctor's flight pin--which was kind of automatic to me... because it is a little-known fact that ER nurses "collect" medical helicopter flight pins for some crazy reason. We never ask for them--but if given one by an appreciative flight crew, we will wear it proudly on our ER badges. Although I was already wearing two other helicopter services' flight pins, I couldn't help wistfully gazing at the children's copter pin, for it was beautiful...and I didn't have one. Their flight pin was blue and had gold wings. It was labled "Angel One".

The doctor noticed my look--and so I quickly looked away, embarassed. Then to my astonishment, he quickly took off his pin and handed it to me.

And they closed the helicopter's doors...and flew off into the night.

* * * * *

I woke up Saturday morning, mumbling to myself groggily: "There's no place like home.... there's no place like home....."

and realized---it was going to be a great day. I shook off my nightmare because I realized that I had hit the lucky jackpot. Because it was the day that my family was going to take me to the PodunkVille Livestock Show & Carnival after a birthday lunch. We were celebrating several birthdays: mine, my 18-year old niece's, and that of a friend of my father's.

Here's my birthday badge, the one that my sister assigned to me when I walked into the door:

You have to understand, my sister is like Clark Griswold in the "Vacation" movies. She's the type that will set up everything "just so", decorations and all, for Christmas, Easter, New Years, birthdays or whatever the occasion is--and she'll tell you: "We are going to have a nice family birthday (Christmas/ Easter/ New Years, etc.) celebration and you're going to have fun or I'LL KILL YA!" So you do as she directs, by golly. Which means wearing "Birthday Girl" Badges, Birthday Girl Mardi-Gras Necklaces, Birthday Girl Flashing-Light Birthday Girl Tiara's, etc., no matter how old you are.

So we birthday-people donned our badges, our necklaces and our tiaras..... (Sometimes she deviates from the above sentence and says something like: "You're going to have fun IF I HAVE TO BREAK EVERY BONE IN YOUR BODY!"---you get the picture.) Fortunately, my sister is always as good as her word -- about the having fun part ( not the killin' part or the breakin' bones part, that is) because we always have a rootin'-tootin' good time. And this time was no exception.

First we had what my sister calls: "The Birthday Lunch, with the Birthday Cake, and The Present-Opening Ceremony".

We had my favorite dish, my mother's Chicken Enchiladas with Mexican Spoonbread, for lunch. Then we had my cake favorite, my mother's Coconut Cake With Bananas Under the 7-Minute Frosting. (LOVE THAT STUFF....) Then we opened presents. I cleaned up like a bandit. I got subscriptions to two of my favorite knitting magazines from my niece-- is that COOL or what? And I got a purse, some computer speakers with a sub-woofer, a rechargeable wireless computer Mouse, a new mouse pad, a vaccuum cleaner (with a one-year service contract...yeah!), a set of bed sheets, and a gift certificate to Walmart---Yay!!!! (Everybody knows Walmart is my most favorite store in the world. It also happens to be the ONLY store in the town I live, ergo, a gift certificate from there is a Double-Yay!) My niece cleaned up, too. She got a video I-Pod to go with her regular I-Pod, a Coach purse, gift certificates to her favorite stores (Victoria's Secret, Aeropostale and Forever Twenty-One), jewelry and... GET THIS..... a snazzy little hand-held device which will enable her to download her classroom notes to her laptop without having to take her laptop to class---she just has to take the little hand-held device to class... Uh....would somebody puh-leeze CLUE ME IN, here???? I mean, I knew that college kids nowadays have it easier than we did in the dark ages....but I thought it ended at the laptop computer, ya know? But it goes further than that now...because they DON'T EVEN HAVE TO TAKE THE LAPTOP TO CLASS!!!!????? Did I miss something????? (Like a decade or two?)

(Sigh....I'm getting old....) After they explained the whole thing to me, I still HAD TO ASK the inevitable "Old Aunt Who Doesn't Know Squat" question: "So what do the kids who can't afford laptop computers do for their notes?" The answer was: "They use the classroom computers." Okay. Now I know. (Dumb Aunt, Dumb Aunt....) (But I will admit here that I'm left wondering what in the hell has happened since I went to college? I mean, I just can't understand how they suddenly got so "computerized"--and WIRELESS even--in college! And absolutely EVERYBODY seems to be in the swing of it. I am visualizing classrooms that look like sets from "The Jetsons" or something. Oh well, what do I know? It's been eons since I went to college. I guess I need to accept that things are just flat out different now. But still, it's scary, you know?)

(Do people even still watch "The Jetsons" anymore????) Anyhoo, then we went to the PondunkVille Livestock Show and Carnival. And let me tell you, as my mother said, you better enjoy these old fashioned, small town livestock shows and carnivals now-- because the way they are disappearing, they probably won't exist much longer....which will be a total shame.

Because to me, it's the last place anymore that you can find that old-fashioned, hometown, safe, Good-Clean, Uncomplicated, as American as Applie Pie, rip-roarin', rootin'-tootin', laughing-till-your-sides-hurt, fun---anymore.... And it was fun as hell. (And in honor of the occasion, I wore my "Bronco-Bustin'" hat to protect myself from the blazing Texas sun....) First we headed to the cattle barn where my co-worker, a nurse named Geena-Lou, was helping her kids "show" their hefers. The hefer showings were running all day, with hundreds of kids from various school district chapters of the Future Farmers of America showing the results of their hard work all summer long.

First, we tromped through 85 cattle stalls filled with various sized & breed of cattle, looking for Geena-Lou and her kids. We elbowed our way through throngs of humans and cows, stepping in umpteen cow pies, asking everybody where Geena-Lou's brood was, to no avail. Finally, the lightbulb went on over my head. "The cell phone!" I exclaimed. "I'll call her to find out where they are!"

I stabbed the numbers out on my cell phone, stopping up my free ear with a finger so that I could hear any reply. It rang and rang...but she finally answered. "Hello?" "Geena-Lou? This is Road Nurse 007. Where in the hell are you? I'm here in the cattle barn and I cain't find ya." (Translation in hickese: "Cain't" equals "can't".) "Where are you?" she asked. "We're by a bunch of Brahmin cows---but there's a bunch of Herefords to the left and a few Angus'es over to the right." "No, silly....not what KIND of cows, but WHOSE cows are you by?" she continued. "How the hell do I know?" I railed. "I don't recognize anybody." "Look at the brands," she continued, patiently. "The brands on the cattle. Look on the COWS' BUTTS and you'll know who you're by! And hurry UP--one of my kids is in the Show Ring NOW!" Okay. So I looked on the cows' butts to check which brands were on them. I saw all kinds of brands. And I figured something out---which is that ranchers don't put their brands onto their cows' butts very neatly. They stick them on there all which-a-way. Some of the brands are sideways, some are perpendicular, some are catywompus, and some of them are just flat out higgledy-piggledy. But I told Geena-Lou where I was.... "I'm by the cattle with brands that look like a bunch of upside-down J's next to a West Coast Chopper symbol", I told her triumphantly. "You idjit!" she laughed. "There's no West Coast Chopper cattle brands! That's probably the J-Cross Ranch. I know where you are, now-- I'll come get ya." She came and got us, and then hurriedly herded us back through the barn to the Show Ring, where one of her boys was showing his prize hefer. I stepped on some more cow pies in the process and my mother was startled by a black hefer who bawled loudly right in her face.

"Mom, that cow is talking to you," I said.

"Oh very funy," she replied sarcastically. The Show Ring was exciting as heck, where all the young people who belong to Future Farmers of America showed the various cattle they've been raising. These kids work very hard all year long to raise these cattle. (And if you want my opinion, kids raising cattle during summer vacation is a good healthy activity-- and a dang site better than some of the other stuff kids can be tempted to get into in these modern times, if you know what I mean....)

The atmosphere was charged with excitement, with the young people showing their cattle in various events, their familes cheering them on, and the usual devil-may-care attitude of "Western Folks" out having a good ole time.

We arrived at the Show Ring just in time to see the judge start down the line to decide on some hefers of a particular breed and age group. Here's a pic of him ( the big ole guy in the suit & tie cum cowboy hat) starting down the line for the first "Look-See". The kids are usually really excited at this time, hoping like heck to win a ribbon, and they just stand there nervous as cats, hoping to high heavens that their cow doesn't chose this moment to er....drop a cow pie. The families stand by, keeping their fingers crossed, waiting for the judging.

And then....after all the judging results came in....guess what? Geena-Lou's kid had won SECOND PRIZE! YAY! He got a ribbon! Which thrilled him because his brother had won a 4th Prize Ribbon earlier in the day. So each of the boys each won ribbons, which is a testament to the hard work they've done. Here's the famous hefers and their ribbons:

Then we all went to the carnival side of the show. And THAT was truly cool. I haven't been to a carnival in a long time. And there it was....just like I remembered it: the rides, the cotton candy, the food booths, the "games" on the midway---and we had the most FANTABULOUS time.

But I was handicapped this time. I had made the GIANT mistake of watching the movie "Final Destination 3" just last week. (WHY oh WHY did I do that before going to a carnival where there were rides? I ask you--WHY?)

But I had. And so I made my big announcement to my crestfallen niece: "I ain't riding no rides that look like that humongous, dangerous roller coast ride in Final Destination 3," I told her firmly. "No way, Jose. The kids in the movie rode that ride--OR ALMOST DID-- and just look what happened to them! Nope...not me! No way, Jose, that's for sure!"

And then my niece showed me the rides....

"Um....look, Auntie Road Nurse," she said gently. "These rides are different...."

And sure Stupid Old Auntie Road Nurse took a second look at the rides--she noticed that INDEED they WERE DIFFERENT than the roller coaster ride in "Final Destination 3".....

They were harmless rides. Family rides. Rides which couldn't POSSIBLY cause the sort of thing that had happened in "Final Destination 3".

Um....there was the tea-cup ride, only instead of tea-cups there were big Strawberry-shaped cages--it was called "The Berry Go-Round". There was the Ferris Wheel, which didn't go any higher than the local Walmart roof. There was the "Flying Helicopters" ride, which looked like the Dumbo Ride in Disneyland only with helicopters instead of elephants with big ears. And there was the... er....roller coaster....which was really just a little choo-choo train painted like a big green caterpillar--and it never left its tracks which were firmly on the ground.....

"Okay, okay," I told my niece, embarassed about my "Final Destination 3" tirade. "I get the picture--these rides aren't very dangerous. Ok, so I'll ride....."

And so me and my niece rode the rides.

(And I had a really great time except for the mistake I made by riding "The Himalaya". Lord, that damnable ride..... I almost squashed my niece from being flung into her by the centrifugal force, and it just about twirled me right into the stratosphere over the dang carnival grounds. So let me tell you--I don't care HOW un-dangerous it looks, don't ever make the mistake of riding the damn "Himalaya". )

Then we played the games on the midway. Now THAT was fun. If you ever want to win prizes in those games, which are notoriously "rigged" so that you can't win even the smallest prize until you've spent about $78, just go with a gaggle of screaming, laughing Road Nurse Family females--because we laugh so loudly and horse around so crazily that the "carnies" who run the games usually end up giving up trying to "con" us and simply GIVE us all kinds of free, extra "chances"---until we end up winning the big prizes!!!

First, we played the "Throw The Ping-Pong Balls Into The Vases Filled With Gold-Fish" game, where you throw ping-pong balls into vases whose mouths are too small for the ping-pong balls to fit into. If you get one in you win the goldfish swimming around in there. The guy running the game ended up giving us all kinds of free, extra ping-pong balls--probably to get us to shut up. But it backfired on him because we simply drove him to distraction by laughing and playing hysterically--while he surely believed that we didn't have a CHANCE IN HELL of getting any of those stupid ping-pong ball into those too-small vases--and his poor ears were probably bursting from listening to my sister and me each shouting "I WANNA GOLDFISH! I WANNA GOLDFISH! I WANNA GOLDFISH!"--and so the poor guy kept giving us "extra" ping-pong balls for no charge as we cackled like crazed chickens and laughed like hyenas--until I suddenly won three silly goldfish in a row, bam bam bam! Yahoo!

Lord, you would have thought I'd just reeled in a 250-pound off the Caribbean coast.....

"I CAUGHT A GOLDFISH! I CAUGHT A GOLDFISH!" I screamed. Even the carnie guy looked happy for me. He gave me three Fishie-Tokens, which you keep till you go home. Then you stop by an redeem them for the real goldfish just before you leave the carnival. Here's my Fishie Tokens (which I have instead of goldfish because I forgot to go redeem them when we left the carnival....) (Cute little suckers, aren't they?) (Easier to keep, too...) :

Then we headed for the next game. We argued back and forth--should it be a "tossing" game or should it be a "dart" game? Hmmm....... And I was on a roll.....and wanted to keep winning prizes.

And then I won again-- at the "Throw the Steak Into The Tiger's Mouth" game. It was easy. The object of the game was to take your "chance" of throwing 6 steaks into the Tiger's Mouth. You'd get a little plastic toy for a "prize" if you got all 6 steaks into the Tiger's Mouth. Then to win a small stuffed animal you had to get 6 MORE steaks into the Tiger's Mouth--and then 6 MORE steaks--at $5 per "chance" of 6 steaks....

My mother finally dragged me away when I had won a "big" stuffed Tiger for about $127.00 worth of "chances". (I was trying for the gigantic, life-sized, Tiger--but I'm happy with the one I got.)

By then, we were thirsty, so we went looking for some lemonade.

"Where do we get the lemonade?" I asked, looking at the menus on various food vendor signs.

"Gee, I don't know," my sister said sarcastically, staring pointedly at a nearby kiosk which was shapped like a giant yellow lemon.

"Oh hush, you Smart-Aleck!" I laughed---gladly realizing that we were standing outside The Lemonade-of-All-Lemonade Stands.

I ordered lemonades for everybody and we watched, fasinated, as the carnies made the lemonade. Using their grubby, unwashed hands, they grabbed real lemons, halfed them with a communal knife, squeezed the juice out of them with a juice-grinder, poured the juice into huge cups, dumped a dollop of pure cane sugar into the cups, poured ice into the cups-- and them shook the cups hard for a few minutes like they were making martinis--winding up the whole shebang by placing lids and straws onto the tops, and then handing them to us with a flourish....

and when we sipped the lemonade we thought we'd DIED AND GONE TO HEAVEN....because it was the BEST DANG LEMONADE we'd ever tasted in our lives!

Aaaaaahh....... nothing like good ole lemonade on a burning hot Texan day at the carnival, eh?

Here's a pic of my Tiger prize, along with the rest of my Birthday Girl loot--the Birthday Girl Badge, my Birthday Girl Mardi-Gras Necklaces, my Birthday Girl Flashing-Lights Tiara, my Bronco-Bustin' hat-- ALL of which I wore to the Lifestock Show and the carnival---and my Lemonade Made With Real Lemons By Dirty Carnie Hands But Was The Best Tasting Lemonade I've Ever Had In My Entire Life Cup, and my Unclaimed Fishie-Tokens:

And a Good Time Was Had By All.......

I was kind of tired that night and so I didn't sleep very good. I tossed and turned. And I had nightmares again.....

This time, the nightmare started out as an old nightmare I used to have when I worked in Miami. The hospital I worked at was on the bay and had a boat dock to receive patients from cruise ships. We used to see dolphins swimming out there sometimes. I used to tease the other nurses that I "saw dolphins in my IV bags". Sometimes I still dream that there's dolphins in my IV bags.

This was one of those nights where I dreamed about dolphins in my IV bags. But on this particular night there was a twist on the usual scenario....

* * * * * * * *


Anonymous said...

Thanks once again for a wonderful post :) I cried and laughed too!!!

Cheers Eva

Anonymous said...

Thanks once again for a wonderful post :) I cried and laughed too!!!

Cheers Eva

flajol said...

I always look forward to your posts. You hit just the right note. Hope the nightmares ease off, especially those involving aquatic cows... ;o)

Dorothy said...

My son has been one of those kids, more than once, and I'm always thankful for the nurses and doctors who are around. And the short 45 minute flight to the childrens hospital!
So, even though there is no chance our paths will ever cross, thank you so much for all you do in your profession!

Anonymous said...

With "day/nightmares" like that, you NEED a fabulous birthday celebration. When I turn 60 next year I'm using your celebration as the standard...Wait a minute, is this the same person who pitched a fit at the fast-food place because the kid put sprinkles on a sundae with bare hands??? But dirty carnie hands making lemonade is just an acceptable risk, right? Right. Your post makes me want to go hang out at the county fair. Today I WILL go watch a "sorghum syrup" making because it's a fleeting thing and no one will remember how to do it before long (hey, have you ever eaten that stuff?..may be a good thing!). Thanks again for a wonderful post. The heart-wrenching is balanced with joy. You are very, very good at that.

flajol said...

Oh, I just had to add: I've never heard anyone sing "Cattle Call", but whenever I check in for new posts and see that verse, in my head it's sung along to Meatloaf's "Bat Out of Hell"...

The sirens are screaming and the fires are howling
Way down in the valley tonight
There's a man in the shadows with a gun in his eye
And a blade shining oh so bright

Same metre... ;)

Unknown said...

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