It's Not a Freaking Spider Bite

When I first started in the ER, I was surprised at how many patients came in every shift with "spider bites". These bites seemed to have a special affinity for the buttock, breast, and armpit areas and tended to be teeming with pus. The patients usually insisted that a brown recluse spider had bitten them. Eventually I figured out that these were not in fact spider bites. They were abscesses caused by a staph infection, usually MRSA. The doctor or nurse practitioner would cut open the abscess and push, prod and dig until all the visible pus was evacuated. I learned how to properly irrigate, pack, and dress the ensuing wound, then hand the patient their prescription for Bactrim.
After a while as I became a more jaded RN, I started to get annoyed with the patients who were adamant that they had been bitten by a spider and were often quite offended and insulted at the insinuation that they actually had a staph infection. Apparently other staffers were getting tired of it too. One of our docs (my favorite) copied a news article and tacked it up in the wating room. It was about the geographic location of the brown recluse spider, ie. nowhere near where we were. Patients would still leave shaking their heads and insisting that the doctor had misdiagnosed them and their "spider bite".
Now I am out of the ER and in the surgical area. I assumed there would be no more spider bites. However, now patients coming in for an I and D of their abscess under anesthesia are telling me about their spider bites preoperatively, as I start their IV Vancomycin.
I had to roll my eyes the other day as my family was watching the show Dr. G on Discovery Health. Dr. G, a Medical Examiner in Orlando, Fl was describing the events leading to the death of her next subject. As soon as I heard the words "he was concerned about a spider bite on his back", I was like "For God's sake, Dr. G. You don't even have to do an autopsy. he died of MRSA". My kids were so impressed when the report of autopsy backed up my hypothesis :) The young man had neglected to see a doctor for his fever and malaise, not linking these symptoms with his "spider bite". The poor guy died of a treatable infection.
I hope I don't sound too much like a bi%$#, but just a little vent.

Man's Best Friend

Ok. This is not about my usual passions, nursing and food. This is another love of mine, dogs. I have a dachshund who is a spoiled princess, no not even a princess...she is the queen. I lost my beloved German Shepherd a year ago and still miss having a big dog around. A coworker who knows my love of big dogs offered me a dog she rescued 5 months ago. This nurse is moving into an urban apartment in another part of the country and is getting rid of both of her dogs :(  This dog is roughly 6 months old,  housetrained, up to date on shots, loves other dogs and kids, travels well, knows basic obedience, and loves to go on walks. She is also very cute. Perfect, right? Well, I'm not sure. I have a small child, and this dog is possibly a pure bred Pit Bull. I have heard all the stories of kids being mauled by Pit Bulls. I have also met people whose Pit Bulls would lay down their lives for the children of the family. I am very confused.
When I worked in ER and Urgent Care, I took care of many patients with dog bites. I never took care of any mauled by Pit Bulls. Maybe because they were in the morgue already? Sorry that is bad nurse humor. I met many people bitten by Chihuahuas. Seriously. The worst bites I ever saw were from a Golden Retriever of all things. Of course the lady waited a few days before seeking treatment, so the wounds were grossly infected, needing debridement and packing of pretty much her entire leg.
I really need some input on this. I have met the dog before, who seems very gentle and sweet. Is the backlash against these dogs justified? I would certainly get her spayed and never subject her to cruelty or dogfighting. Please tell me your thoughts.

A Weighty Matter

No offense meant to anyone, but as long as obesity, especially morbid obesity, is common, I will always have a job. I am the first to admit that my body is not perfect. I could stand to lose 5 to 10 pounds. I often eat too much sugar and processed foods and get too little exercise. However, it is the population that is 100 or more pounds overweight to whom I am referring. We have had to acquire special hospital beds for the morbidly obese, special wheelchairs, special operating room tables. We have one orthopedic surgeon who has literally made a fortune providing knee replacements to obese patients. We take care of so many people having toes feet, legs amputated because of obesity related diabetes. I am fortunate to have only gotten a few aches and strains from lifting/maneuvering obese patients. I have had coworkers develop severe and chronic back, neck, shoulder, and elbow problems from assisting super heavy patients. Many of these patients are on Medicaid, so everyone else is collectively footing the bill for their numerous medical procedures and quite extensive care. These patients are getting younger and younger. The other day I had a 24 year old female patient who literally could not wipe her own butt. When I asked her what she did about it at home, she replied that her husband did it for her. I have seen ICU patients with trachs for an inability to maintain their own airway and breathe solely due to their morbid obesity. My uber conservative husband makes statements like "Oh, just cut off their food stamps". Somehow I don't think that would get the job done. I don’t know what the solution is. Do you?

Food History

If I were a 1950's woman, would this look appetizing to me? Would I be recommending it as a healthy meal choice? My 75 year old Dad loves Veg All.

Cool

Things like this reinforce my belief in a higher power. It was the middle of the night in Recovery . We had 2 nurses tending to a patient who had just come out of a complicated emergency bowel resection and was going south very quickly. She was feverish and having respiratory distress. Of course not being able to breathe well was scaring the patient. Adding to the anxiety was the fact that she did not understand the English being spoken to her. She was a native of Haiti and spoke only Creole. No one could locate a patient rep who spoke Creole. Her family had gone home to rest. She was crying, making her struggle to breathe even worse. The Respiratory Therapist was setting up a ventilator. The anesthesiologist was preparing to start a central line.
 A housekeeping supervisor interrupted the chaos, politely asking if we would be there much longer- the floor needed waxing- and if we had any additional needs for housekeeping to address. This man had light brown skin but no trace of any accent. One of the nurses looked up from the gasping patient.
“You don’t happen to speak Creole, do you?” she asked in a semi sarcastic tone.
“As a matter of fact, I do” he replied.
Holy crap! We had a translator dropped into our laps. He spoke to the patient in soothing tones. She lit up upon hearing her native language. He explained to her what we were doing and why. She immediately calmed down and her oxygen saturation went up several points. When her anxiety lessened, her breathing improved. No vent needed after all. The central line was put in, and she was taken to the ICU.
Cool.

My New Favorite Book

I have not had a chance to read this book, but it is obviously awesome.

Earphone

OUCH!!!!! Wouldn't a Bluetooth be easier?