Monday, January 31, 2011

The Things you Learn at Work

  For reasons unknown to me two coworkers were having a debate over whether cinnamon was an aphrodisiac or not. An intrepid CRNA listening into the conversation googled the matter on his iPhone. He almost immediately discovered a list of supposed culinary aphrodisiacs. Oysters were there of course, as well as chocolate. Honey and almonds were listed, so a bowl of Honey Bunches of Oats in the morning could possibly have some interesting consequences. There were certainly some surprises, at least for me. Asparagus was on the list, said by a 17th century herbalist to "stir up passion in both man and woman".  Avocados were also listed. Apparently the Aztecs called avocado trees "testicle trees" due to the  testicular appearance of the pairs of avocados hanging from the branches. In fact, avocados were banned by Spanish Catholic priests due to their sexual nature. I thought garlic was an interesting, odorous choice, but apparently it has the ability to vasodilate and increase blood flow. Bananas, figs, and basil were also on the list, but no cinnamon.  I suggested alcohol, but nobody paid any attention to me.

Thursday, January 20, 2011


Headline on

"Merck Clot Preventer Linked to Bleeding Risk"
No way!!!! Really!?!?

Monday, January 17, 2011

Nurse loses license for 20 years over sex with hospice patient |

Nurse loses license for 20 years over sex with hospice patient |

Wow. Never been tempted to have sex with one of my patients. Of course often they have been elderly, toothless, stinky, drunk, on drugs, or all of the above. Anybody ever have any issues with this? I don't know what this gentleman looked like, but I suppose that is really irrelevant. He was a patient, a married patient. The nurse is stating the sexual contact occurred after he was no longer a patient. Do you think that makes a difference? I guess I don't often think about dying hospice patients even still functioning sexually, which is biased on my part. What are your opinions on this article and the nurse's situation?

Friday, January 14, 2011

Random Musings Again

I saw a ten year patient in for a minor orthopedic procedure the other day who had just gotten over Pertussis (Whooping Cough) after months of illness. The parents still do not believe in vaccines. I know it can be scary to subject your newborn infant to a bunch of immunizations, but if you don't get your child vaccinated by the time they are ten...that just seems ridiculous.

I had an elderly patient the other night who was plesantly confused. She knew who she was and who her family members were. However, time and place were nebulous concepts for her. She vacillated between it being "two thousand something" and sometime when Lyndon Johnson was president. She usually knew what city she was in, but not which hospital or exactly why she was there. Her family noted that she had agreed to stop driving several years ago and they had sold her car at that time. She refused, however, to get rid of her guns. Apparently Grandma still has a 38 caliber pistol next to her bed and a shotgun in her closet. I totally support our second amendment rights, but WOW!

Why are the online programs for filling out incident reports so complicated? If an incident has occurred, you are already traumatized, pissed off, worried, embarassed, annoyed or all of the above. It makes it worse when it is next to impossible and practically takes a committee of nurses to figure out how to complete the report.

I met a 54 year old patient who had just had his third child (he was getting a vasectomy). I also met a 57 year old woman who had several great grandchildren.

I was in phase II recovery getting a patient ready to go home. One of the things we do is make sure they can tolerate liquids by mouth. This lady was not interested in the usual hospital beverages, juice, ginger ale, or generic cola. She had missed her morning coffee and wanted to get some caffeine into her system immediately. Understandable. So I asked her how she liked her coffee. Did she take sugar, Splenda, creamer? "Creamer" she replied. Did she like it light or dark? "Oh" she said "About Barack Obama".

One of the great things about being a nurse is getting to know your patients and learning from them, right? Last week I met a patient who told me all about their former occupation, meth lab owner. I learned about all the steps of making meth. Fascinating. This gentleman had recently been forced to close down his operation after he lost his home to forclosure. "Damn bank" he said.

Tuesday, January 11, 2011

Piano Students and Astronauts

   I had the pleasure right before Christmas of going to my two daughters' first piano recital. They hadn't been taking lessons long. I had just picked up our $250 piano off Craig's List in October, so they were still newbies. A large audience of parents and friends watched as kids ranging in age from roughly 5 to 15 with various skill levels approached the stage in the modest, old church and sat down to play their music. Towards the end of the recital, a student named Shirley was announced. I thought "Shirley... Hmmm you don't see many kids named Shirley these days". It turned out Shirley was in fact not a kid. Shirley looked to be at least well into her 50's and she played a beginner/early intermediate piece very nicely. I noticed some of the audience members kind of smirked at the older student. However, as I thought back on the recital later that night, I realized that I was pretty impressed. It takes courage and initiative to learn a new skill as an adult, especially in front of an audience.
   A little over a year ago when I was still working in the ER, I had a patient on New Year's Eve who had been hurt badly in a fall. She was a local college student who, while attempting to climb from one 3rd floor balcony to another in the dorms (apparently a common activity), fell onto the concrete below. She had not been drinking, later confirmed with a negative serum ETOH. We'll call her Jane. Jane had multiple fractures in her left arm and left lower leg. Her head CT amazingly showed no damage. She had several lacerations, only one of which needed suturing. Her vital signs were stable. An orthopedic surgeon was called in to fix her fractures up. A general surgeon was to evaluate her as well for any possible internal injuries. My other patients were all waiting on rooms at that time, so I actually had a chance to talk to Jane and get to know her a little bit while she waited for the OR. She told me that she was in the Navy ROTC at the college. She wanted to be a fighter pilot and maybe even an astronaut. She was concerned because she said the orthopedic surgeon wanted to fix her limbs with metal hardware and apparently fighter pilots can't have metal in their bodies. She told me that the surgeon mentioned she may be able to get the hardware removed at a later date, so that she could be eligible to be a pilot. Soon she was whisked off to Preop and the OR. The last I heard of her she was going back into surgery for a lacerated spleen and then up to the ICU. With all the orthopedic surgery and the possibility of a splenectomy, I assumed her dream of being a Navy pilot and astronaut was over.
   Fast forward to this past week. I was in Phase II Recovery with one other nurse. I had just discharged a patient and was tidying up the bay. Through the curtain I could hear a conversation between the nurse next to me and her patient, who was getting ready to be discharged. As I was listening to them talk, I realized the patient was Jane. I mean how many young female patients do we get who had a bad accident and want to be Navy pilots? At my hospital at least, not that many. I peeked around the curtain, and there was Jane. I introduced myself. Of course she did not remember me...I had given her a fair amount of morphine in the ER. She told me that she had been in surgery that day to remove the last of the hardware in her body. She was eligible to meet the physical requirements to pursue her dream career. The general surgeon had been able to repair her spleen without removing it. She was currently training for a 5k. Unbelievable.
    Now bear with me here...I know a middle aged woman learning how to play the piano and a college senior wanting to join the Navy don't seem to have a lot in common. However, these women both struck me as being very courageous in their own ways. They were not content with simply maintaining their status quo. I'm over in my little corner of the world wondering if I should go back for my long overdue BSN or if it's too late, too hard, too expensive, etc. When I look at Shirley and Jane, I wish I were more like them. I want to go out on a limb, but am scared to venture out of my treehouse.

Saturday, January 8, 2011

War Stories

Twice this week I encountered patients whose medical issues stemmed from the US government's use of Agent Orange in the 1960's and early 1970's. The United States military used the herbicide/defoliant, Agent Orange during the Vietnam War, spraying it on many of the region's heavily forested areas in order to deprive the guerilla enemy fighters of cover. However, the chemical, nicknamed for the orange barrels in which it was transported, eneded up being extremely toxic and had other unfortunate effects on the soldiers and the Vietnamese civilians. Agent Orange has caused various cancers, neurological and skin disorders, and devastating birth defects.
One of my patients was a Vietnam veteran who was having major cancer surgery. He did great. The surgeon thought he got all of it out, so chemo will be minimal if even necessary.
The other patient was actually the grown son of a Vietnam veteran. He had been born with a relatively mild form of spina bifida, as well as some pretty serious urological problems. At almost 40, he is still undergoing procedures due to these issues.
Amazing how a policy decision about a chemical decades ago is still affecting these veterans and their families.

On a lighter note, one of our neurosurgeons tends to mumble. He is from the deep south, so with the drawl and the mumbling sometimes he is tough to understand. He rolls his eyes and says "You girls" (the nurses are always "you girls") when we ask him to repeat himself. I love to read his H & P's, though, because he often includes interesting little personal details about his patients. I was looking at one yesterday and realized the dictation voice recognition software might have been thrown off by the doctor's manner of speaking. It read

"Patient is a World War Two veteran. He suffered multiple injuries while invading Iceland in the Pacific"

Now my historical and geographical knowledge isn't the best, but something about that just isn't right.

Tuesday, January 4, 2011


    Apparently I showed an aptitude for nursing at an early age. I found a preschool progress report from when I was 4 that stated I liked to "play nurse" and "fix the other kids' boo boos".  In kindergarten I proudly drew a picture of a stick figure nurse witha big white cap adorned with a red cross when asked about what I wanted to be when I grew up. Plus, I grew up on fabulous reruns of the 1970's TV show Emergency! (the exclamation point is crucial), where I was introduced to the lovely Nurse Dixie, shown above.  Nurse Dixie always remained calm and cool, no matter what the situation, even when the hospital was burning down! I'm sure Nurse Dixie knew RACE and PASS. Hell, maybe she invented them! I did not have beautiful blonde hair like Nurse Dixie, but I thought maybe, just maybe I could grow up and work with cool, good looking paramedics and ER doctors like she did. I did end up being an ER nurse, however, I have still not managed to get my mascara to ever look as good as hers did.  What the heck?
   Also in my youth one of my brothers brought me home a box of Cherry Ames books from a used bookstore.
 The Cherry Ames series started out by introducing Cherry, a wholesome, Iowa born World War II era student nurse. The books follow her through nursing school to graduation and on to her various jobs, including flight nurse, jungle nurse, dude ranch nurse, army nurse, rural nurse, rest home nurse, boarding school nurse, veterans' nurse, and pictured above, cruise ship nurse. Geez, did Cherry have trouble holding down a job or what? In her off time Cherry solved mysteries and had all kinds of wacky hijinks and adventures with her really sweet, perfect friends. There was never any mention of bedpans or blood in the books, however, so I'm not sure how much work Cherry actually did. Maybe she just had really awesome techs who did all her dirty work. Of course I have not yet become a dude ranch nurse or a department store nurse, but there is still time. Jungle nursing, here I come!

Who or what inspired you to pursue your career?

Saturday, January 1, 2011

Happy New Year

South Florida is definitely the first area in which I have worked where a surgical team was called out on New Year's Day to fix a fractured hip, injured while the patient was intoxicated and water skiing.

Happy New Year! I hope it is a healthy and peaceful one.