http://profiles.blogdrive.com/dochendrickson
|
|
Oct 7, 2005
Corrections and Emergency
I'm new to corrections by 6 months. Love the job, but didn't see the poop on my shoe until last week. The setting is County jail, one nurse-me. 37 YO male is booked on Friday night with BAC 0.39. No one calls me cause he's no trouble, sleeps the whole weekend until 0300am Monday. He starts withdrawals. Hallucinations... according to the officers who call me at 0520 a.m. I'm already on my way at that point. When I get there, he's diaphoretic, trembling, severe difficulty walking and talking, yet he tells me.... I know there's no blue letters in here but it's hard not to flinch when it looks like something's flying at your face. Our doctor was in England by the way. So I give him a loading dose of Librium, 50mg PO at 0630am and make him eat all his breakfast, drink all his milk and encourage water. By 0745 he's greatly improved. No tremors, no sweating, denies visual hallucinations but still weak and he goes back to sleep. By 1100 he's had a 2nd dose of Librium 25mg. He eats all his lunch and is ready for a shower. Later that afternoon he's in court and takes care of business. He has to stay in jail awhile. By 1400 he tells the officers he has a little dog in his room and it progresses from there. I keep him on the Librium detoxification schedule. Wednesday am 0630 I find out from the officers he became aggressive in the night and they had to take him down, in fact they had to Taser him twice and he's in the restraint chair. This is his 3rd day of detoxification and he had already improved and didn't become a problem until after court, so we think it's all behavioral. I get them to let him up and discover he's as nutty as ever. No withdrawal type symptoms, but really nuts. A&O x1. Tries to feed the wall his meal. So I call our Mental Health agency to come for an evaluation and get him out of there. Well she's got all kinds of excuses and basically gave me the run around. I call the local ER and they say, "Don't bother to send him here, we'll send him right back. So, I call the main hospital and the ER DOC says "Don't send him here, we can't handle that and it sounds like you have a real problem", Yada-Yada. By 1600 I was ready to throw myself on the floor and scream. So.... I told the Commander, "Take him to the 3rd ER and drop him off in the door" That's what we did. I did not call them ahead of time as I had already learned my lesson. How in the world can a nurse get help for somebody if they all say no? It was probably the worst experience I've ever had in healthcare and was ashamed of my own profession because I couldn't come through. We have since obtained a new mental health provider, so we'll see. When our doctor got back he said it sounded like the patient had a psychotic episode due to the severe withdrawal event, that it's not likely he was going through withdrawals again after such an improvement. Sorry this is so long, I have been beating myself up over this. That is the most outrageous response I have encountered.
Posted at 09:37 am by dochendrickson
Permalink
Sep 14, 2005
Yesterday a girl came if because the ACRYLIC nail had cracked. It was just starting to get into her real nail, no pain. Next thing you know they will be coming in for pedicures!!!
And, where I used to work we had a female take an ambulance to the emergency room for belly pain. The examination was done - finding was negative, she suddenly felt better, stated she was hungry, was fed and several hours later walked a short distance to the cinema in time for the movie to start. That's what you can do if you don't have cab fare for both ways I guess.
~Crystal Ball
Posted at 12:59 pm by dochendrickson
Permalink
Jun 17, 2005
This is not emergent but what the heck, here goes.....There was a young girl (maybe 12 or 13) who kept visiting the nurses office every morning. She was always nauseaus.
Well, the nurse finally asked her if she ever had sex. She then asked her when her last period was etc. Finally, in confirming her pregnancy, the girl's shocked reply was "I can't possibly be pregnant, we used saran wrap!"
The nurse wanted to know whose idea was it to use saran wrap. She said her boyfriend (also maybe 13 or 14) told her it was safe.
Posted at 01:46 pm by dochendrickson
Permalink
Jun 2, 2005
The classics we get are the males (I can't call them men) between 20 and 40 who come in with: vomited x 1 - 8 hrs ago, nausea (as they sit there with their coke and chips), rash, and various aches and pains. The one thing they all have in common is that they are single, have recently moved here to work or go to school and Mommy is back home in what ever town they came from. It's also very hard to "encourage" these guys to go to a clinic instead, they would rather sit in the ER waiting room for 8 hrs with lots of complaints of course. Rain at night brings the regulars that normally sleep in doorways, it's amazing how knowledgeable they are about how triage works and they know which complaints will get them a stretcher right away.
On the opposite end of the list are the people who are dragged into the ER by wives or husbands in the midst of an MI or stroke, "Oh come on dear its just a little indigestion!"
Posted at 10:07 am by dochendrickson
Permalink
I had a lady come in to ER because she "hid" a hundred dollar bill in her rectum. Needless to say, she couldn't get it out. She said that she had unsuccessfully tried to "dig" it out. The MD did a rectal exam but refused to get an anoscope to go searching for something that would come out on it's own. The patient got panicked and cried until he gave her a bottle of magnesium citrate and sent her back out onto the streets. Apparently, she was mad because she wanted a fix and wanted it out that second. Just think about that the next time you use money!
Posted at 10:06 am by dochendrickson
Permalink
I have my own story on this...
Years ago, when I was a student nurse I decided to try tanning. I am a very fair skinned Canadian, so I should have been very cautious. New to tanning I didn't know just what would happen, I tanned for a 'mere' 10 minutes.
I was pink that night, pink and itchy and sore. The discomfort grew and escalated as I went to bed. I applied lotion, it was soothing and felt good when fresh on, but dried and the discomfort was there all the more, it seemed. I took a bath around midnight, my skin craved coolness, water was soothing. I was getting panicky as I had clinical in the morning and needed some rest. There was some Tylenol in my personal care supplies so I took some, bathed again, and applied lotion yet again. The lotion was drying and the effect not lasting so I applied it yet again and wrapped my limbs and chest and back in saran wrap (was getting desperate for sleep).
It was around 2:30 am, still no sleep and ran out of ideas to gain comfort I walked on over to the Emerg (was living in Nurses Residence at the hospital that I trained at). Fortunately they were not busy so I didn't have to feel too guilty for coming with overexposure from a tanning bed. The doc gave me some T3's and sent me off to sleep and told me to not tan anymore or reduce my time way down as my skin did not take well to it.
I did sleep after taking the Tylenol with codeine's.
Posted at 10:04 am by dochendrickson
Permalink
Apr 27, 2005
One time, when my nephew was 2 years old, he was crying uncontrollably.
My sister being a new mom freaked out. She assumed the worst and called the ambulance. I tried to console her the best I could, but it was no use. After he was examined he was diagnosed with a temper tantrum.
Posted at 10:36 am by dochendrickson
Permalink
My one health teacher told me of people using preservatives thinking it could be used as birth control jeeze!
I know when I was an infant my mom couldn't get a peice of hair that some how wrapped around my big toe. It actually turneed blue and she could not get it off so she took me to the ER and they got the hair out!
Also my dad a C.O.P.D.'er I'm discovering is a HUGE freaking out can't breath person!!! Can't blame him but he was allways hyper and now that he's having respiratory problems he's NUTS! Ok, not over the top but anyway every now and then but more frequent he'll get bronchitis or I think it's more an exacberation of C.O.P.D. that he needs antibiotics. Anyway, he was sent home with Zithromax and took the one pill that day and at home our power went out. We only have electical administered O2 because he only needs it occasionally not that much at all although he probably should wear it at night anyway. He was CRAZED because he had Levaquin before and that worked faster. No matter what i told him that all these are pills and takes some time to work he was a nervous wreck and was insistant he needed Levaquin. Then his lips were blue and no o2 from no power so he ended up in the ER. I work on med surg at the hospital and yeah I was concerned he was blue but there probably wasn't much to do but he wouldn't listen. So the ER doctor came and my dad is freakin out,"I need levaquin this isn't working" so they gave him Levaquin and then a prescription for some and sent him home. I was a little embaressed but you know they admit people with less severe symptoms so I don't know. I know one time his doctor for the same condition wanted him admitted and he did not want too. Probably didn't want to face up he's really sick. Yes he still smokes. I'm telling you all he has tried so many times. His pulmonoligist even tells me at work he's never met a patient so guity about it and trying so hard but won't kick it.
Anyway, these stories are interesting! Although agravating at least it makes you smile! I had a psych patient faking seizures on med surg and it just drove me bonkers because the md didn't know WHAT to do with her every test was negative then suggest to go to psych and she freaks "I"m NOT crazy!" Oh boy but I have to smile! She was screaming at me then the next day writing notes to me and apolagizing for the way she acted! It was so fustrating but I find myself smiling right now and just shaking my head!
I always love to hear about funky ways people got cellulitis although I mean not that crazy but like if some one's cat bit them, dog bite, and once a poor guy vacationing in like the bahamas and stepped on a conch chell and got a NASTY infection then had to come home early, ew!
Posted at 10:34 am by dochendrickson
Permalink
Mar 29, 2005
I had an old alcoholic man one night with lots of tattoos, across each butt cheek he had one word "The End ". I was also told by other staff he had a tattoo on his manhood.
I made it my goal for the night to NOT know what that tattoo was! I sure hope ever who his tattoo artist was, he was well paid.
Posted at 07:37 am by dochendrickson
Permalink
Mar 25, 2005
About 0430 am Mom obviously trashed along with friend who drove them to our ER brings in 5 y/o with complaint of nausea & vomiting (dried vomited on child’s night shirt). Understand they drove to us from a near by city with plenty of hospitals. The kicker they wanted a prescription yah you heard me for Tylenol. We did a work up on the kid and she was fine PO challenge included. We’ll I couldn’t let the child get back into a car with a drunks one passed out on the stretcher with the kid. The other passed out in the waiting room. I pressed for time by telling Mom that Tylenol was so strong we couldn’t keep it in the ER, and we had to wait for pharmacy to bring it to us. Meanwhile I did the only thing I could and police were on there way. We they arrived they kicked the stretcher several times to wake Mom finally when she woke up very surprised I must add they ran her info. A couple minutes later she was cuffed and heading for jail for several outstanding warrants. They waited outside for the driver to get into his car when they arrested him for DWI. I kept the kid until Grandma arrived to pick her up.
All over a prescription for Tylenol.
Posted at 11:24 am by dochendrickson
Permalink
|
|
|
