Saturday, June 09, 2007

Ceci était ma cour de jeu, or: You Can't Go Home Again....

This used to be my playground,

This used to be my childhood dream,

This used to be the place I ran to,

Whenever I was in need of a friend,

Why did it have to end?

And why do they always say don't look back...


("This Used To Be My Playground", Madonna)


Lately it rains every five minutes. I haven't seen a dang cow on it's feet in three weeks.

In addition, there's other aggravations. Patients keep lying to me, I had to fire another secretary (because she stated that she "couldn't remember if she had punched holes in some documents" or not), and I missed the 10:15 am deadline for ordering the Deluxe Breakfast at McDonalds.

(When that secretary made that statement, I will tell you here and now that I was VERY proud of myself for not YELLING the following phrase, simply stating it in a relatively calm voice, asking acidly: "Couldn't you have just LOOKED at the piece of paper to SEE if you'd punched the holes in it or not?" )

(You think I'm kidding but I'm not. She REALLY told me that. Don't worry---she's not out of a job. The company owners simply "reassigned" her to a simpler job in one of their other businesses because she's part of the owners' large family since she's living with Jane-Anne's brother, who also works for the owners' family...)

(Lord Jesus.....20 years old and "couldn't remember" if she'd punched holes in a document or not!!.....)

And now I need a new secretary.

Okay. There. I got my "whining" out.

I feel better now.

Anyway, I'm as stressed out as a long-tailed cat in a room full of rocking chairs. I've got problems galore and so I'm doing as I usually do when I'm stressed out---I knit, I cuss, I fret, and I bug the Mockingbird Family, whose dang eggs are sitting in their little nest, snugly nestled there like blue-with-brown-spot jewels, teasing me to death by not hatching. (See Mama Birdie sitting there? Broodin' away......) (I can only get these "brooding" pictures by hiding on my living room floor, shooting the pics from a crouched position behind the couch, through the balcony door's glass...)

Anyway, one of my ongoing problems is that my patients sometimes don't do certain things which they're supposed to do---like informing us nurses of Important Details--- and then it lands them in the hospital, which is bad for them for two reasons:

1)* It's always bad to be in the hospital because it means you're really sick. And they do uncomfortable things to patients in the hospital --- like not allowing them to eat the things their doctors tell them they're not supposed to eat. And the TV clickers don't always work in our piddly little town hospital. And they can't get any sleep because the night nurses wake them up at 3am to take their vital signs, who are then followed by the lab techs who arrive at 4:00 am to draw the morning bloods. Oh yes, and also, they can't get Moon Pies, buttermilk, and other Texan delicacies in the hospital.

and the second reason:

2)* I live right across the street and so I will frequently show up, striding into their rooms wearing my biker jacket to sanctimoniously say : "I told you so, dammit."

Anyhoo, I've got two patients in the hospital this weekend. One because she indirectly (and reluctantly) FINALLY confessed to me what was going on with her.

The other one didn't tell me that her doctor had sent her to the hospital---- but I found out anyway. (Small town, ya know? And hell---what did she think---- that she could "hide" it from me?")

(I'll deal with her later....)

The first incident happened Friday afternoon when a patient called me with that tell-tale guilty and defensive sound in her voice. She stated: "I just don't know why my son won't leave me alone. He keeps wanting me to go to the hospital for some reason. But I'm telling you, Nurse---that I just CAN'T leave this house for any reason. My 16-year old granddaughter lives with me and I've got to keep an eye on her. There's no telling WHAT naughty things she'd do if I were gone."

After a little careful questioning (in which I can frequently descend into a mode of hardcore criminal interrogation which sounds more like the mean cops on the "Law & Order" television show), I dragged it out of her that she had gone to the hospital's lab to have a Holter monitor removed--- which is the end part of a test in which her doctor had ordered that she wear a heart monitor continuously, while at home for 24 hours, in order to see what was going on with her heart. And I was pissed off because I hadn't even know that she'd been ordered to have the dang Holter test in the FIRST damn place....

"WHY on earth did you have a Holter monitor test and WHY didn't you tell our nurse about it when she was there the other day?" I grilled.

"Well....uh....I didn't really think it was important," she hedged. "I mean, these know how they are.......always ordering tests. Ummm... he only did it to see why I was getting dizzy every now and then....and...well, I might have had some palpitations or something last week..."

"Do WHAT? You get dizzy now and then?!?" I thundered. "And palpitations??? You never told us that! What in the hell is going on that you didn't us something important like that? Geez-oh-Man, next you're going to tell me that you haven't taken your diuretic pill like you're supposed to."

"Well, I can't take that Lasix pill before I go to Walmart!" she explained in an irritated voice. "Public bathrooms are always so dirty----and that horrible pill makes me have to pee every 5 minutes! And sometimes I can't make it to the bathroom! The last time I took that stupid pill on shopping day I accidentally made a big pee-puddle right in the middle of the Baggies aisle! I was utterly mortified!"

After a little more of my questioning, she admitted that her son was repeatedly instructing her to "go to the hospital".

"Why would your son tell you to go to the hospital?" I asked.

This story was getting stranger and stranger. Because it sounded suspiciously like the kind of stories my patients tell me in a roundabout way to "confess" something that they knew darn well that they should have told me two days ago.

Or three weeks ago.

And my patients do frequently experience "guilty conscience" attacks which cause them to eventually (and reluctantly) confess everything, albeit in their own sometimes humourous ways--- and sometimes dangerously late for the problem at hand. Podunk lies deep within the Bible Belt, and so I guess the closer it gets to Sunday (like on a Friday afternoon) , the more it causes them to get the urge to get the truth out so that they don't have to sit in front of the preacher on Sunday morning knowing full well that they are "hiding" something from Nurse Bo, whose wrath is sometimes worse than that of any fire and brimstone preacher...)

"Um...I don't know..." she wavered at my questioning. "He may have....uh...talked to the doctor this morning. But we won't know till next week because the doctor's office closes at noon on Friday. So there's nothing to worry about right now as it's way past noon. And I told you, I don't want to leave my granddaughter in the house alone over a weekend..."

"Hang up right now," I told her in an ominous tone. "I'm calling the damn doctor to see for MYSELF what in the hell is going on...."

"I TOLD you that his office closes at noon on Fridays," she stated defiantly. I knew she thought she was "safe" simply because the doctor's office was closed.

"I know his office closes at noon on Fridays," I told her with a definite smugness in my voice. "But don't worry---because I am the Doctor-Finder. I can find a white-coated doctor in the dark during a snowstorm. I can find a doctor if he's stuck in a crevice on top of Mount Everest. I can find a doctor no matter WHAT time of day, no matter WHAT time of night, no matter WHAT the circumstances...."

"Okay, call the damn doctor then," she stated resolutely, knowing it was useless to argue with me.

(Ask me sometime about how I "found" a doctor in the Men's Bathroom of a Psychiatric Hospital---it's a good story, and that doctor learned to never avoid me again. I did get "counseled" by my superiors for running in a hospital corridor, but by God, when I want a chart signed, I WANT THE CHART SIGNED.)

Anyway, this is how I find doctors in Podunk:

I called Beulah, the hospital's telephone switchboard operator.

"Beulah," I said. "Would you find Doctor Milton for me, please? Tell him it's me--- and tell him that it's about Mrs. Dimsy."

In 3 minutes the phone rang and it was Doctor Milton. He didn't even allow me to explain before launching into an angry diatribe.

"Goddammit, where the hell is that woman?" he demanded. "I'm up here making rounds at the hospital and I've been waiting for her. She had a Holter that showed rapid a-fib, SVT, and God knows what else. This morning I told her son to get her up here as fast as he could."

And then he added, in a smaller voice:

"And Bo, um.....send her through the ER, okay? But whatever you do, don't tell the dang ER doc that I said that. Just pretend that you sent her because of palpitations or something. They'll call me when she gets here anyway."

"I won't tell," I said, laughing inwardly to myself.

And I wouldn't tell on him---because I know how grouchy that ER doctor is. If the ER doctor found out that Dr. Milton had sent a patient through the ER (unnecessarily adding to the ER doc's patient load) when he could have simply "directly admitted her" to a bed in the hospital, bypassing the ER altogether, that ER doctor would throw a hissy fit the likes of which we'd never hear the end of for about 4 days. It irks our ER doctor to death that the local docs' favorite phrase is "Send her to the ER..."

So I called the patient back. I told her I was sending her to the hospital---but that I was going to insist she go by ambulance. She lives out in ranch country, 45 minutes away from the hospital, is a fairly ill woman, and I was very worried about her newly discovered heart condition. And I didn't trust her son to drive her because he is a known drug/alcohol user and has been known to pass out, drunk as a skunk, in the neighbors' front yards.

"Pack you an overnight bag and get ready for the paramedics to arrive," I told her. "I'm sending them in a minute. And I know you're worried to death about leaving your granddaughter alone while you're in the hospital. So put her on the phone. I want to talk to her."

I knew that this patient's worrying about the possible consequences of leaving her mischevious 16-year old granddaughter to her own devices for a few days while she was in the hospital could likely put her into a worse heart rhythm simply from her anxiety and worrying.

The granddaughter got on the phone but before I could even begin a lecture, she said in one long, breathless, lightning-quick sentence:


Now then, does that sound like a typical 16-year old who's thrilled at the chance to have the house to herself for a few days? It did to me. So I immediately wrote myself a note to have our nurses do a "surprise" visit and knock on that door every single day during the time Mrs. Dimsy is in the hospital in order to see what the hell is going on over there....

"Right," I told the girl. "And NO BOYS, NO BOOZE---or anything else that you know you're not supposed to be doing, okay? I want you to help her pack an overnight bag. And make sure she's got her hairbrush and false teeth stuff in it. Take off all her valuable jewelry and have her leave it at home. Put plenty of clean panties in there for her. Now hang up, cuz I'm calling the medics."

So I sent the patient to the hospital via the paramedics. I called the ER to tell them I was sending them a patient and I faxed them the patient's medication list and other pertinent details. And I did as the doctor asked and never admitted to them that it was a "set up". They thought that I was sending the patient on my own---- and so Dr. Milton was safe from the wrath of the ER doctor.

Then I called one of our home health aides, a girl who also moonlights at the hospital as a nurse's aide on the weekends.

"Jenna?" I asked on the phone. "Mrs. Dimsy's coming in. Would you do me a favor and check on her over the weekend for me? She's nervous about her granddaughter as usual."

"Sure, Bo," Jenna replied. "And oh---- did you know that Mrs. Janeway's here, too? Got here yesterday, and she's in room 214."

"Get the F___ out of town!" I hollered in shock and surprise.

(Little apology and defense of my bad language here: Usually when something shocks and surprises me, I use the phrase: "Get out of town!" But when something REALLY shocks and surprises me, especially on a Friday afternoon, and especially if it's about a sick patient who was supposed to tell me she went to the hospital but DIDN'T----well, then I'm likely to add the F-word, okay? Bad habit, I know, but sometimes my ex-biker chick habits pop out involuntarily when I'm hit with a surprise piece of bad news....)

(Ok, I've been known to get so mad that I said: "Get the F___ing F____out of town!" but that was only once and it was a REALLY bad day---and I told you before that Texans will frequently heap extra words into a cussin' sentence when it's called for......)

(Hey, at least I admit my sins and apologize for them, right?)

So now I have two patients in the hospital.

And it's Saturday.......

So guess where I'm going in about an hour, after I've showered and then bugged the Mockingbird Family for one picture? Yep----I'll be going up to the hospital to check on the two patients. (And I can't wait to see the look on Mrs. Janeway's face when I stroll into her room with a big grin on my own face....)

(She's probably sitting there in all her glory, thinking she's "safely hidden", happily munching on a banana-nut muffin that she bugged the nurses to get her from the hospital's new lobby "snack bar", thinking smugly to herself that she's pulled a fast one on me by not telling us that she's in the hospital.)

(I've actually had patients who went to their doctor, got admitted to the hospital, came home two days later--- and NEVER SAID A WORD to our nurses about it. In these cases, I not only have a hissy fit to the patient for "sneaking", but then I do my Doctor Finder behavior and have a word with him for forgetting to inform our company that he had hospitalized one of the patients. I usually ask him sassily: "How would you feel if I 'forgot' to inform YOU that something serious was going on with one of the patients?")

(Unfortunately, the doctors are not afraid of me and simply humor me by saying: "Oh, I'm so sorry Bo, I TOLD my office nurse to tell you---but she must have forgotten......")

(I don't believe everything doctors say....)

Anyhoo, I then went out to bug the Mockingbird Family just once, quickly, by taking one picture of those eggs. I am trying to leave them alone while mama birdie broods on her eggs, but it is taking FOREVER for them to hatch. God, I'm like an expectant mother myself waiting for those dang eggs to hatch! Because the way I figure, by my count it will probably be the end of next week before they start hatching.....which seems like FOREVER!!!!

Here's "Day 6 Since The Discovery of The Eggs":

I'm so impatient about these damn eggs that I actually tried distracting myself by cranking up the old knitting machine. It's an ancient "Incredible Sweater Machine" (which is the old version of the more modern "Ultimate Sweater Machine" ) and I threaded the thing up to knit a "camouflage" yarn blanket to match the camouflage sweater I knitted for Jane-Anne's future baby. I used Bernat "camouflage" yarn so that it would be machine washable/dryable.

To my utter surprise, the infrequently used, rusty thing worked--- although I had to do most of the first 3 rows by hand manipulation. So I sanded a "joint" in the middle of the machine (because I've put extensions on the machine to make it longer) and that seemed to help---but mostly I suspect that I need a new carriage because it "sits too low" and the needles are catching on it. I think I can order one from Knitting Today. But it worked alright after a somewhat rough beginning.

Note that the "wrong" side of the knitting fabric is in the front.

So I climbed up under the table to snap this pic of the "right" side of the knitting. I think it's knitting out into an acceptable "camo spots" pattern. (You knitters know that sometimes these varigated camouflage yarns don't "do right" and knit out too "stripe-y" rather than in camo "spots".) But I think I lucked out with this particular project.

I'll hand-crochet a border for the blanket when it's finished.

Oh yes....

Here's a newspaper clipping of a friend that 911Doc over at M.D.O.D. requested to see. (He likes cheerleaders, so I'm indulging him just this one time...)



911DOC said...

MAN IN THE BOAT OVERBOARD! HOLY COW! I AM DEFINITELY CHEERING FOR THIS TEAM. Thank you BHR for posting a picture of your friend.

Anonymous said...

Can you send someone out to check on that 16 year old tonight?!

Here's hoping your patients are both out of that hospital soon ... and ornery as ever!

Anonymous said...

"Anyway, I'm as stressed out as a long-tailed cat in a room full of rocking chairs." OMG, that is SO GREAT. I'm going to start using that quote. Ha ha ha!

Anonymous said...

I am glad I discovered this blog! This post was too funny - and from my experience as a nurse, all too true.

Oh, and I really want to hear the "mens room" story.

Deacon Barry said...

The 16 year old granddaughter probably knows you're coming. Something would be amiss if nobody turned up to check on her. Anyway, this is her chance to show she can be mature and look after the house while her gran's away.
While I am not a knitter (and I have tried to learn) my wife loves knitting baby clothes. Because they're small, she can knock one up in a few days. But she has made vague murmerings about knitting machines. Cats and rocking chairs sums up my reaction. Where would we put the darn thing?
Lately, I've been telling a junior colleague that when telling a patient that they must position face down after retinal surgery, she should find her 'inner Hattie Jacques' (she played Matron in all the 'Carry On medical comedies)
Now, I have an alternate role model - the fire & brimstone preacher!

poody said...

Bo is that you in the cheerleader outfit? So cute!

Janet said...

Thanks for the comment on my old blog. Did you get the email I sent you about my blogging situation? I'm still out there, just under a different name.

Cyndy said...

Dang, Bo! I've got to find more time to read blogs. I just jumped over here for a quick look, and I'm still here ages later... and I haven't finished yet....

"long-tailed cat in a room full of rocking chairs.."; I'm still laughing over that one.

Please don't change, Bo. ;o)