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Okay, I know this is a bit of a chronological jump, considering I was last writing about my recent odyssey. I'll get back to that soon. I am back at work now, and since returning I have encountered an unusually-long parade of ER patients who have displayed, shall we say, less-than-sound judgment with regard to the way they chose to conduct themselves in ER Triage. I am a man of great forbearance and restraint. I have never told any patient that he/she was a slack-jawed, mouth-breathing idiot before- even when the patient's actions clearly proved such to be the case....

The deep, exhausted sleep into which I initially fell proved to be woefully short-lived. I was jolted awake around 1AM by the simple act of rolling over. My left great toe, which I had injured the previous morning when I struck it against a heavy chair in Susanville, was proving itself to be in far worse condition than I originally thought. I did not detect any deformation at the time of injury, and I could bend the joint fairly well. I had done everything that we would have done in the emergency department for this type of injury, and had...

Fallon, Nevada to Kingman, Arizona:I have been all over the world, and have seen some interesting terrain in my travels. But the landscape of western Nevada was just, well... eerie. The outside temperature was 110 degrees and rising, and it was only mid-morning. I had cast a lot of glances out of the side windows for the first 100 miles of this leg, but as the environment became more barren and forbidding, and the atmosphere thinner and drier, I found myself retreating inward with a strange sense of isolation and vulnerability. And that only caused me to become more aware...

Hello, FRemales. This is a purely informal and non-scientific question for the sole purpose of gaining some insight into your perspective of the current election to-do. Since Barack Obama has chosen to dispatch a group of Democrat women to counter the nomination of Alaska Governor Sarah Palin, I have become highly curious about how women might respond. My "research" questions are as follows: (1) With whom do you identify more: Hillary Clinton, Michelle Obama, Janet Napolitano, other Democrat women sent out to respond to the Palin nomination (name your pick), or Gov. Sarah Palin? (2) Why do you identify with...

Day two, 0500: I had not slept so well and so deeply in years. It was the kind of deep and dreamless Rip van Winkle sleep from which one awakens with the impression that no time had passed at all. The first objective data to the contrary was presented by the merciless blaring of the alarm clock in my hotel room. My eyes snapped open and I fumbled hastily across the unfamiliar, darkened room with a single-minded determination to stop that damned bleating instrument of chaos and evil. It was during this effort that I encountered the second (and far...

I rose in the very early morning for my much-anticipated trip to San Diego with a sense of excitement and my three good companions: A cooler full of snack, my souped-up 2007 Ford Mustang named Baby-san, and the open road. Fully-prepped for the trip, waxed, and buffed until her fireglow scarlet paint took on a fathomless gleam, Baby-san communicated her eagerness to boogie with a throaty, crackling snarl as I fired her up and blipped the accelerator. I throttled up, released the clutch and let 320 horses out of the corral. With a saucy chirp from the Pirellis, we lunged...

Once again, the media has released a "nature is out to kill us all" article. Source: Comcast News. The writer of the article was, to be quite blunt, pretty damned irresponsible in selecting the information with which the reader is presented. Go figure. I will break this down point by point and fill in the blanks after each article snippet. My comments are in boldface: Para.1: More than 10,000 people per year are hospitalized with Clostridium difficile. Response: 10,000 people is about 0.00003% of the population of the United States. This hardly constitutes a widespread epidemic. Para. 2: The germ...

Once again, the media has released a "nature is out to kill us all" article. Source: Comcast News. The writer of the article was, to be quite blunt, pretty damned irresponsible in selecting the information with which the reader is presented. Go figure. I will break this down point by point and fill in the blanks after each article snippet. My comments are in boldface: Para.1: More than 10,000 people per year are hospitalized with Clostridium difficile.Response: 10,000 people is about 0.00003% of the population of the United States. Hardly a widespread epidemic. Para. 2: The germ is resistant to...

It's been two years since I have had a break. It wasn't that I didn't have the opportunity; it's just that I never really thought about it. But a coming event has provided the opportunity for me to take a much-needed (and eagerly-anticipated) break from the trenches. What's the event? Well, dear friend, I am glad to tell you: One of my older sisters is graduating from nursing school down in Southern California. (Can I tell you all how proud I am of her? I am just busting at the seams. She's a good one, she is. And she has...

If the public ever stopped to think for themselves, the 'eco-friendly' hybrid would be banned from our highways. They are not 'green.' They are, in fact, blacker than Hitler's bastard heart. Do any of these bunny-hugging, sign-waving morons stop to think about what it takes to make just one of those big-assed batteries? Come to think of it, do any of these idiots stop to think about what it takes to recycle one- which is necessary every five years!? Of course not. And you can bet your sweet ass that none of the proponents of these toxic deathtraps is about...

I have been thinking about this since nursing school. It was always a matter of the right motives, but the wrong time. Well, I have been talking to the Assistant Gunner (My bride of 19 years) and she agrees that the time is right. So I contacted my good friend who is a medical recruiter for the US Navy. He has laid out the whole shooting match for me, good and bad. I relayed this to my wife. She says, "God will guide us and whatever happens, He'll take care of us. Do what you know is right." So I...

He was sick, sick, sick. I inherited him at the change of shift. He was completely with it, but his body was failing him fast. The offgoing nurse offhandedly reported that the patient was a bomber pilot because his wife of nearly sixty years had mentioned it. (Sixty years! Can you imagine being married that long?) This man was the only person I had at the beginning of my shift. I signed off on the report and, after reviewing the chart, went into the room to introduce myself as the oncoming nurse. The patient was asleep, so I spoke with...

Okay. At the suggestion of many a reader (and I sincerely thank you all), I have begun a book. Sort of. It's a toss-up. I am torn between a non-fiction compilation of my experiences (which is fraught with legal hassles) and a fictional work based on my experiences with a third-person character taking on my persona. I'll be the first to admit this: it's one thing sharing my stories with you; it's entirely another when I have to sit down and figure out what I'm supposed to write, make the reader empathize, and all that stuff. Frankly, I do not...

It was about 4PM on a Sunday. The waiting area was packed with malingering whiney-baws, harried soccer moms and their bruised, violent hooligans, armchair football warriors who tripped over their coffee tables and sacked themselves- right into the TV-, and the "Bucket Brigade" (seasonal GI bug sufferers). I was float RN and I was covering the Charge RN for a lunch break when the Charge RN's phone rang; I picked it up. On the other end was the Triage RN. Her rather hushed tone was laden with, oh, I don't know... a strange, pressured awkwardness, I suppose. (I am here...

I was recently shadowed by a high school senior during a couple of shifts. She was considering becoming a nurse and had an interest in Emergency Nursing. She followed me as I provided care for patients with a broad spectrum of problems- from a known narcotic seeker who demanded (read: screamed) that we address his pain, to a homeless patient with a peritonsilar abscess and no access to continuity of care, to a nonogenarian woman who suffered cardiac arrest and whose family had kept her on "full code" (all measures to maintain life) status because they could not let her...

Here's a quick guide to preventing the transmission and contraction of the "new" (as of 1955) strain of adenovirus. 1: Cover your coughs and sneezes. Nobody wants to share what's in your snot. I don't care if you are wearing an angora sweater from Niemann-Marcus. Deposit your snot on your sleeve so I don't have to share your private hell. 2: Wash your hands. We've gone there. See my previous post. 3: When in doubt, mask up. They do it in China. Ever wonder why they have so many Chinese?

Okay, my friends. For the last week or so, the media have gotten Americans all worked up into a froth about this "deadly new bacteria" called MRSA. My ER is now inundated with frantic phone calls from people who have no idea what they are looking at, or what the disease really is. One charming woman (who clearly smoked wayyyyyyyy too much) called amid the throes of a panic attack because she found a pimple and was convinced beyond all attempts to reason with her that she was "gonna die of Melissa." "Ah, you mean MRSA." I corrected the hyperventilating...

I saw a woman at the store near my house last Wednesday morning after I got off work. The moment I saw the woman, I knew she was on Meth. Her face was covered with black sores; she was pale, scrawny, dirty, and absolutely wild-eyed. She was practically dancing in place. Her speech was a jumble of pressured and confused babble; her movements were grandiose and repetitive. She constantly rearranged the items she placed on the checkout counter. At one point she looked right at me. Her expression was chilling. She managed to pay for her groceries, but then loitered...

I had spent the first half of my shift in the "Fast Track" section of the Emergency Department. Cases that are a level 4 and 5 on the 5-point triage scale are sent to Fast Track in order to make room for the more acute cases in the main ER. Cases that rate a 4 or 5 are cuts, sprains, bumps, bruises, series antibiotics, migraines, the mother who brings her six kids in because the ER is her family clinic, and such. (I am a fervent proponent of "Fast Track." It keeps the patients suffering from non life-threatening ailments from...

The shift had been an exciting one from the time I arrived. I had some very challenging and complex patients for the first half; all but one of them ended up in our ICU. The one exception was sent over to a higher-level trauma center for his injuries. That patient was a teenaged Homo jackassii who had attempted to car surf and had managed to get up to somewhere around 30MPH when the car reached an intersection and the dufus kid's "friend" slammed on the brakes. The kid shattered both of his ankles, nearly tore one of his feet completely...