Monday, December 31, 2007

From these humble beginnings...
Came these...
and these...a deserving group of doctors, nurses, and EMTs got to knosh on still warm doughnuts we fried up on new years. Happy New Years to all ER workers! You deserve the best!

Thursday, December 20, 2007

Check out my buns!

Check out my beautiful french buns! As you know, it's been raining in LA and I have felt the need for coziness. So I needed to bake! I found a recipe for french buns that didn't take four days to make (although they may have been better if they had). These beautiful buns are the result. I got the recipe from "The Practical Encyclopedia of Baking". Sounds boring but has some wonderful recipes. Baking is just like cooking. You need to try it out one time, then tweak the recipe for your own taste.

The recipe said to put a "roasting pan" in the oven and then preheat to 450 degrees. It then said to add a cup of water to the roasting pan when I am ready to put the buns in the oven. I asked Noah to help me and gave him the job of pouring the water in the roasting pan. As soon as he started pouring in the water, the glass Pyrex shattered into a thousand pieces! Holy shit! We were both standing in the line of fire and I'm surprised one of us didn't end up in the ER with shrapnel injuries! After a long oven clean out, we started over and had success! I think the roasting pan with the water made the oven have more moisture as the bread baked thereby creating a more moist inside with a nice crispy crust.

Noah made a pan seared Lake Superior whitefish with pan sauteed brussel sprouts, radishes, and bacon. We watched "The Order of the Phoenix" and then he made roasted lamb loin with baby heirloom carrots and quinoa with hen-of-the-wood mushrooms. He is such a sweet guy. He loves to cook and has rarely made the same dish twice since we started our relationship. If I offer my help he will put me to work picking parsley or peeling vegetables. Otherwise he lets me sit at the computer sipping wine while he cooks. I feel bad because I rarely have the chance to reciprocate my knowledge for his. Sure, I've steri-stripped his surf induced foot lacerations and disinfected and bandaged many a burn. But he provides his gift to me on a daily basis. It's interesting that we both chose careers in the service industry.

If you have suggestion on how I could have made my buns a little lighter and fluffier, let me know. I would love to be able to bake better than my husband!

Wednesday, December 19, 2007

LA living...

It rained all day in Los Angeles today. That doesn't happen often. The ER was pretty slow, people don't like to come in when the weather is crummy (although I like it!), so only REAL patients came in.

A patient came in who had been visiting someone at the hospital. He dropped his car off at the valet (yes, a hospital with a valet) and decided to grab something out of the back seat. The valet driver was unaware of this and started to pull away, thereby running over the (now) patient's foot. Luckily it wasn't broken and the horrified valet driver came in to check on the patient. "Where'd you learn to drive? Britney Spears?" I asked him when we knew the patient was okay. Luckily, he thought that was funny, too.

A gentlemen in his 60's was brought in complaining of elbow and hip pain after a traffic accident. It seems this guy was on his motorcycle (imagine white haired, overweight dude finally living the dream of his youth) and had pulled into a parking lot. He came to a stop behind another car that had stopped as well. He looked behind him and saw an SUV pulling in behind him. He realized that the driver of the SUV was on her cell phone and was not looking his way. He panicked and tried to pull away but she hit him anyway and he "spilled" his bike and landed hard on the pavement. We discovered he had broken his elbow AND his pelvis! Ouch! The woman that hit him? Three words: Hit and Run. She took off without even bothering to see if he was okay. He was so shaken he didn't even have time to get her license plate. Puh-lease, people! If you drive an SUV, I'm sure you have insurance! Where is your regard for other humans??

Another young man came in after being in a four car pile up on the 405 freeway at rush hour. (Rush "hour" is from 4 to 7pm.) He told us that he had been in the fast lane going about 20mph (hee hee!) when the accident happened. No one was seriously hurt so all the drivers did the responsible thing and pulled off the freeway (instead of snarling up traffic while waiting for the cops to show up). They exchanged numbers and info and went their separate ways. For our patient, this meant calling a tow truck since his car was barely drivable. His friend drove him to a nearby police station so he could file a report. The police told him they would not take a report since he "could be filing a false report to scam his insurance company". Okay, okay, I'm sure many people have done this before (!). By now he is feeling the consequences of the impact and comes to us to inventory his bodily damage. We hear his story and immediately get on the phone to file a report to the police. Now, obviously, in LA, there are many different jurisdictions. The first number I call is to the West LAPD. They tell me that because he was on the actual freeway and not on an exit it is not their jurisdiction. They tell me to call the CHP (CHiPs, as in Ponch and John), otherwise known as the California Highway Patrol. I call the number and get a recording saying that if I have an emergency I should call 911, otherwise, have a nice day. The phone disconnects. What? So I call West LAPD again and tell the front desk officer what happened. He tells me, "The CHP hold banker's hours. They're closed by now". What? This officer was nice enough though and promised to call me back with another number. Fifteen minutes later he calls and gives me a new number. I dial it and it rings.. and rings.. and rings. No answer, no recording, nothing. What? I call back and someone finally answers. She sounds stressed and pissed. I explain the situation and she lets out a big sigh and asks, "They didn't call the police when it happened?". I tell her why they didn't and she takes my number and says she will call me back. She never called back. Luckily, this guy was not seriously hurt. A little whip lash of course. We discharged him with the number I had been given by West LAPD. I hope he was finally able to file a report. Having trouble getting a hold of the police is nothing new here. I've had several people tell me that when they dialed 911 they got a busy signal!

A young man came in after falling while walking dogs. (His profession!). His middle and ring fingers of his right hand were severely deformed. His fingers were dislocated. Imagine your fingers, in their normal position, and then twist the middle knuckles to exactly the opposite of where they should be. It's hard for me to explain without a picture. Look at your fingers on your right hand now and try to imagine the middle and ring fingers pointing 45 degrees to the right. Grossly out of place. Amazingly, this man was in good spirits, although complaining of pain. He received morphine intramuscularly and the physician's assistant did a nerve block before she "reduced" the dislocation. The funny thing is that he and his companion smelt overpoweringly of really good marijuana. Probably the reason why he was not freaked out. A good bong hit can make any major body deformity seem not so bad. I remarked to the physician that we should ask him where he got his supply because it was "the dank".

A young woman came in complaining of severe chest and back pain for the last two months. She had been seen by a GI (gastroenterologist) who prescribed her medications for gastric reflux with no relief. This girl was sick, you could just tell. (Before I had met her I happened to be walking behind her in the hallway and thought she was an old woman, the way she was hunched over.) Once she was in our exam room I hurried in to start an IV after the doc had seen her. Her husband was at the bedside, very nice people. She was in obvious distress. I started a 20 gauge in her arm and drew blood samples. I started an IV drip and gave her anti nausea meds and morphine. She was finally able to relax enough to lean back on the gurney. I was gathering up all my garbage and was headed out the door with her blood samples when my foot shot forward and I almost fell. I looked down and realized I had just skidded through a big pile of vomit! I have slipped in urine, blood, and shit so this only completed my nursing resume. Always the professional, I quickly recovered and, after disinfecting my nurse shoes and calling a janitor, I sent her blood specimens to the lab. Meanwhile, I'm laughing because it is pretty funny. After several more tests we finally discovered she was passing gall stones. Very painful! At this point, she was comfortable and ready to be sent home. As I was taking out her IV, I told her what had happened. She was embarrassed until I told her, what was only the truth, "Don't feel bad. It was the biggest laugh of my day!".

I love my job the most when people who are truly in need of medical help come in to the ER. I'm frustrated by bullshit complaints. It's hard to take someone seriously when they ask for a handicap sign (to hang in your car to be eligible to park in a handicap spot) for a broken toe. I sometimes wonder if some people have never been injured before. I try not to be hard hearted. I know a lot of emergency room workers have a reputation for being callous. But, I'm sorry, a broken pinky toe, while painful, should not warrant the request of a handicap placard. But, some people think it is necessary, or owed to them.
It's probably not just LA, but I know we have a special group of people here that expect (demand) a certain type of service. For me, the more you expect special treatment, the less likely you are going to get it (unless you are TRULY sick or hurt).

Rainy day in LA. Valet parking, hit and runs, 911 busy signals...everything you have heard about LA and more...

Friday, December 14, 2007

Where are your kids right now??

Had a day of rememberance on December 12th. Eighteen years ago (! Its been that long?!) I was in a car accident that really f*cked me up. And sometimes I feel like I should get over it and not think about it anymore. In fact, one year, with my sister, I declared I would not "celebrate" the anniversary anymore. It has been too long. But I can't not think about it. Granted, I'm not obsessed about it and blame all my shortcomings and problems on it. However, everyday, when I step out of the shower and catch a glimpse of my body in the mirror, I think about it. When I buy new clothes I think about it. When I wear a bikini in public, I think about it. When my back aches for no good reason, I think about it. It is a part of my life, who I am, who I've become. It shaped how my life turned out. It is why I became a nurse. It is why I can't help but cry when a patient is upset over an injury or a diagnosis. I feel blessed (not a big fan of that word but for now it fits) that it did happen to me because I like who I have become, regardless of certain quirks and behaviors I know have stemmed from it. What would I have become if not for it?

And I must give props to my poor family who endured this horrible time with me. My little sister, who was 8 years old, and no one really explained to her, properly, what was happening. My parents, who must have blamed themselves for it happening. And then to have to care for me, for almost a year, doing the job of nurses, while I recuperated. My big brother, who perhaps thought that he, as well, could have prevented it from happening. My older sister, who flew away from her newfound life, to sleep on the floor in my hospital room. I ask myself, what is worse? The physical injury or the emotional one?

The wonderful thing is that I can walk (and snowboard and exercise and dance and give my nieces broken-down-bronco-bruce-rides), I can eat (anything I want, is it surprising I married a chef?), and I can shit like a normal person (may seem like a trivial thing but it is not). I learned compassion and empathy. I learned pain and hunger. I learned disability and perseverance.

So I think I will continue to celebrate my anniversary, year after year, no matter how many years have passed. Because it reminds me of what I have overcome, what I have gained, and what I have to be thankful for.

Sunday, December 9, 2007

Took some time off..

So I took some time off from the NaBloPoMo. I loved to blog every day but it's also nice to have a few days off.

Had a crazy situation the other day.. We had a 21 month old come in with the complaint of vomiting for three days. This patient should never have come to us, it's not "Fast Track". Fast track means in and out. Not someone who is so sick they may need to be admitted to the hospital. But sometimes it happens. The doctor was upset that this patient came to us, especially because we are not a pediatric hospital. When we get pediatrics that are sick enough to be admitted we have to transfer them to a pediatric hospital. But it is hard to be a community hospital because people don't know this, they take their sick child to the closest hospital they can find. I don't blame them.

We had to start an IV on the poor little guy. Starting an IV on a child is always difficult. We have to basically hold them down while we stick a needle in their arm. They don't understand why we are hurting them. We are under the constant scrutiny of their parents who pay strict attention to everything we do.

A nurse from the ER who had experience in pediatrics came over to start the IV. At the bedside was the little guys mom and his 18 year old sister. We asked them to help. We told mom to stay near his face to talk and reassure him. We asked the sister to hold his legs so he wouldn't kick us. We have the kids arm and are attempting to access a vein. The poor kid is howling and twisting away from us. (I don't blame him). The nurse gets blood return from her needle and all of a sudden, the other nurse helping yells, "She's going down! She's going down!" I'm not really sure what she means and I turn my head just in time to watch the 18 year old sister faint. She falls backwards from the guerney and hits her head so hard on the floor that I'm still haunted by it.

I immediately crouch next to the sister (I find out later her name is Anna) and try to assess the situation. I stand up and open the door and yell, "We need some help in here!" I crouch back down and realize that she's not really breathing, the color of her face is yellowish/gray. I start rubbing her sternum with my knuckles. It's called a "sternal rub" and it's very painful. (Try to rub your sternum now. It's painful. I was digging into her.) One of the physician assistants came in and crouches down with me. Anna's color comes back in her face and her eyes open. She's confused and tries to sit up. We look at the back of her head and see a gigantic lump forming. Meanwhile, her mother is freaking out. "Ayyayeeayaayeeyayyeee!" Unfortunately, we still haven't gained IV access to the kid.

I grab a gurney and push it into the room. The other nurses get Anna up and into the guerney. She complains of a headache (I don't blame her). We order a head CT and give her pain meds and an ice pack for her goose egg. I can relate to her predicament, I fainted the day after Easter and ended up with a huge hematoma on my head. I know it hurts. I have to push the doc to give her stronger pain meds. He had originally ordered Advil until I pushed for something stronger. Sometimes I think doctors have never been hurt before.

We finally gain IV access to the little kid and get a CT on his sister. Nothing wrong with her except the hematoma on her head. We eventually sent the kid home after we gave him fluids and anti emetics. We sent the girl home as well.

Amazing what the body can do after seeing something crazy. I'm very careful now about making the family member sit down if we need to do something. These poor people, this is going to go down as one of the worst days of their lives...