the night of ingestion.

INGESTION PART ONE


Sweet kind 85 year old man walks in cute as can be. When asked to state his complaint he
says he thinks he swallowed his dentures. He said he went to bed and when he woke up his
teeth were missing and his throat was sore. After the initial shock of hearing the story
i sent him to xray to see if we can see his teeth. I'm thinking to myself " how the hell?"
but nonetheless, he went to xray. As we waited for the xray results we chatted. This man was so cute. He was kind and had a gentle demeanor. I asked him what medications he takes at home and he pulled out a crumpled old piece of paper from 1952. He broke my heart,so i took his list and went over to the computer and typed it up for him and cut it to wallet size.He was SO appreciative, it made my night. So....we wait for
the xray results and much to my surprise (sarcasm)...there were no dentures in his throat,
abdomen or intestines. All clear! I told him they were not in his body and you know what he said?

"I had a feeling I hadn't swallowed them, I think i know what happened to them."
"What do you think?" I asked.

"Well,my wife died 4 years ago and she was always playing pranks on me so I figure she probably stole them in the middle of the night and is laughing at me from up in heaven".
I died. I literally felt my heart open up and swallow this lovely man.
I told him I agreed and thought that this was her best prank yet. He winked at me ;)


INGESTION #2


to hate yourself so much that you'd swallow a handful of razor blades

i can't imagine.

to be screaming in pain at something you inflicted upon yourself.

That is a kind of hatred i can't wrap my mind around.

The ct scan literally showed 5 razor blades at various stages of digestion
just destroying her insides. The screams coming from the room resonated all night long and
we, here in the ER, are left to contemplate our own self confidence, self assurance and sense
of value. I know now, after seeing and hearing this patient, that I love and value myself and
that nothing would make me inflict that kind of harm on my body. Our bodies are so sacred. Why
must people torture and neglect them. Whether it be drugs or razor blades....there is no difference.
One day their bodies will shut down, and in those final moments, I know for a fact that they will
wish they had another chance to make the right decision. I know that because I see them here night
after night, dying right infront of me. They look at you with those wide eyes and your heart aches. You know they did it to themselves,but that doesn't change the outcome. Death is inevitable.

Life lesson of the night: love yourself enough to take care of your body, mind and spirit.
AND....always hide your dentures when you take them out, or the tooth fairy might just grab em ;)

"my ass fell out of my ass"

Emma....you have a new patient.....she's in the room waiting for you....

What is her stated complaint?

She says her ass fell out of her ass.

I'm not following you?

Her ass literally fell out of her ass.

Hi there...my name is Emma and i'm going to be your nurse here in the ER. What exactly happened?

I had a baby 2 days ago. I didn't use any medicine, no epidural, nothing. I pushed really hard everything was okay until tonight. I was laying in bed and i felt my ass fall out. It hurts so bad. Its on the outside of my body. I can't move, can't poop. My husband said my butt fell out.



this is what i see:

I call the doc in and we ask the woman to roll over so we can figure out what exactly she is talking about. She rolls over and .....................

brace yourself.........

seriously.......................


............................





........................................you're sure you wanna see this?

no her ass did not fall out of her ass. She has hemmorhoids. Really really large ones that were internal and were pushed out by childbirth.

hemorrhoidsplural of hem·or·rhoid

Noun:

A swollen vein or group of veins in the region of the anus They can be internal and external and can either go away with some cream or can be cut off. Usually a small incision is made and they disappear. NOT in this case! We had to call in a surgeon and prep her for surgery. Poor thing. She was so stressed about the next time she has to poop. I can't even imagine how much that is gonna hurt. Ouchhhhhhhhhhhhhhhhhhhhhhhhhhh. LIFE LESSSON: think twice about having kids ;) or at least have a c section lol.

MY SHIFT ...start to finish....

I love my job. I am feeling more and more comfortable with my day to day (or night to night ) responsibilities and definately don't feel overwhelmed anymore. Everyday there are at least ten new things i learn but I feel like the knowledge is stacking up in my brain and becoming easier to absorb.

For my friends and family that ask what my usual routine is:

6:45 pm arrive at the hospital and put my stuff away in my locker in the breakroom.

6:55 pm meet with the other nurses and paramedics to discuss our nights events. Things to look out for, new procedures etc. Listen the the charge nurses' pep talk!

7:00 head out to the ER floor to find out what area i'm working in that night and who I need to get report from.There are a few different areas I could be in. AREA 1 and AREA 2 are adult rooms and usually the most critical patients go there (including all the codes and trauma). FAST TRACK is where the quick in and out patients go and anyone who is pregnant and having vaginal bleeding(This area does a lot of pelvic exams and obgyn type stuff). PEDS means you are in the pediatric ER and you share the patient load with the other PEDS nurse. You don't really have  patients to yourself, you both just trade off and help each other out. I PRAY EVERY NIGHT TO BE ON THE ADULT SIDE. I am trained in both adult and pediatric emergency medicine but I can't seem to get used to needles and IV's in little screaming sick babies. And if they aren't getting needles they are just sneezing or barfing on you. I hate it. The parents are crazed, the kids are miserable and I can't find a damn vein to save my life. I was told i'm good with the kids but i definately think they are talking about when they are about 10 years and up. I love the teens, I  relate well with them...but the lil ones...no maaaaam.

7:05 I find my area and find the day nurse that's in it. I walk with her from room to room and find out who's in the room, how long they've been there, what their diagnosis is, what was done and what still needs to be done. In a perfect world...the documentation is complete, the labs and blood are drawn and sent and the patient has been medicated. It's awful to arrive at work and have to catch up on someone elses slow pace. Plus, you don't even know these patients, their story, their pain. I introduce myself while double checking that all the rooms are stocked with suction (in case of a breathing issue) and ambu bags (in case I need to be someone's lungs for them).

7:10 I rock and roll. I know that if i get behind now, i'm screwed for the rest of the night. I say hey to the docs and check the giant board to see what is flashing red that needs to be done STAT. I put on my rollerskates and start hustlin. It's always a good indication of how the night is going to go depending on which doc is on. Some love to order every test in the book which slowsssssssssssss you down a lot, while some just use their knowledge and assessment skills to determine the prognosis. The less labs = the less medicine = early discharge home. The sooner I can fix them and send them home the better.....for everyone involved.

7:15-2:30 am Work Work Work, Patients will come, get treated, sign the paperwork and leave, you will clean the room turn the corner and see another patient coming right towards you...its an endless cycle but as long as you are fast, smart and take things in stride, you won't lose your cool or your mind :)

3:00am EAT LUNCH + red bull

3:30am-7:00 continue with patient care, do some online coursework the hospital delegates we do and usually laugh hysterically. The ER slows down "sometimes" at this time and the nurses, techs and docs have a grand old time pranking each other, telling geeky stories and releasing some of the stress of the night. As i said, it usually slows down, that is not always. Some days its none stop and your feet and legs are throbbing come 7 am but other days you can chill for a bit and actually sit down!

7:05am give report to the day shift, clean all your rooms, finish any documentation you may not have finished and smile a lot cause sleep is coming soon.

7:10 head upstairs to the hospital Medical Surgical/telemetry or ICU Floors to visit any patients I may have admitted to stay over night. The patients are always surprised to see their ER nurse visiting and it makes them feel good to be remembered. I think this is a cool thing. It's exhausting to walk all over the hospital after 12 hours on the clock but wouldn't you want someone to come visit you?

7:20 Drive home fast, pee finally and sleeeeeeeeeeeeep.

That's my 12 hours in the ER. It is a long shift and it doesn't involve a lot of sitting but damn, I am so blessed to be in the field i'm in. Emergency Medicine is fascinating, fast paced and everchanging. I work with people who i not only consider my coworkers but some of my best friends. I will be falling behind and be running (literally) into a room to draw blood only to find my buddy in there doing it for me. Then i'll head next door to give a med and i'll see my friend walking towards me with the meds already ready for me to give. These nurses are amazing and every time one of them helps me, it makes me want to pay it forward. It has created this cycle of incredible teamwork and comraderie. I KNOW it's not like this everywhere. I am truly happy with where I am in my career thus far and I cannot wait to see what the future is going to bring.

Here's to loving where you work........Onward and upward..................

I am a World Champion!

I spent the week in Dayton,Ohio for the Winter Guard International World Championships. I was fortunate enough with my job to be able to leave for week with no problems. That's the great thing about being a nurse...you work sun, mon,tues and don't have to work again till the next week wed, thurs, fri. What a sweet deal.

Soooooo..... Flanagan was amazing. Simply unreal. I knew they were ready, I knew they were prepared and I knew they wanted it. But I had no idea what was about to happen. I didn't know that it was possible to have that much fire at such a young age. They showed up and made the arena take notice. They were a class act from start to finish and made me so proud to stand next to and infront of them.

I felt honestly, like i was living a dream. Oh wait.....I am. 
Teaching these kids is a gift I cherish everyday. Saying goodbye to these seniors is something I keep pushing out of my mind. I feel so connected to each and every one of them. The journey to this championship was long but damn was it fun. They all poured their hearts into this product and believed in us as instructors. We said jump and they said how high, we said give more and they did. I don't believe its like that everywhere. I always think to myself...i wish other instructors could get a chance to teach these kids for a year...hell...for a day. They would NEVER want to leave. 

It's always so hard coming home from WGI. I'm pretty sure everyone involved gets the blues. It's a crazy feeling to get home, full of pride, medals and trophies and have to go back to your real life. Tonight I walked into the hospital and suddenly i'm just Emma the nurse. It's emotional in it's own way. I want the rejoicing and celebrations to continue. But they stop. But then I realized something. The reason color guard is so special to me now is BECAUSE it is not all I have. I use it as an outlet. A creative and spiritual release. I used to only have color guard in my life and while i loved it so much, it didn't feel like it does now. It is so much more now. I can't even explain it. Leaving the hospital after a weary shift...and walking into that gymnasium filled with smiling, silly teenagers is the greatest feeling. They are an instant "pick me up" and a perfect start or end to any day.

I absolutely thought that once I became a nurse that would be it. My teaching would be over. But one thing I've learned over the last few years is that NOTHING is impossible.

If you want to do things, do them.
If you want to change careers, change it.
If you want to win a world championship, win it.


NEVER UNDERESTIMATE YOURSELF. YOU CAN DO ANYTHING AND WILL DO ANYTHING AS LONG AS YOU JUST PUT ONE FOOT IN FRONT OF THE OTHER AND BEGIN...ONE STEP AT A TIME. DEMAND GREATNESS AND GREATNESS WILL COME.

Thank you to my Flanagan family for giving me the most amazing years of my life. For making me a better person just by association and for always demanding the best from me. I hope I've given you guys half as much as you've given me.

Let's do this again next year ;)
Emma

One liners............

Lines of the night.....


me: "take your medicine with food"
them: "what kind of food?"
me: "any type of food, breakfast lunch or dinner"
them: "what should i cook for the week, i need suggestions"
me :(what i really said ) " cook some meat, veggies and rice"
me: (what i wanted to say) "i'm not your f#$^$$# personal chef, i don't f#$$^$ care you lazy dumbass".


me: "how many drinks did you have tonight, you seem intoxicated"?
patient: " i got my disability check and bought some vodka"
me: what did you mix with it?
patient: "i don't understand"
me: "what did you mix the vodka with"?
patient: "more vodka".
me: "perfect".

patient : "i keep vomicking"
me: "you keep what?!!"
patient: "vomicking...you know vomicking all over the place"
me: "ohhhhhh vomiting......"
patient: " ya......thats what i said nurse, vomicking".


me:"maam, the doctor and I have to perform a pelvic exam"
patient: " listen honey...if that doctor wants to play little house on the prairie, then he at least needs to buy me groceries first."
me: (excused myself from the room laughing)

another night in heaven :)
Emma RN

bananas anyone?

Case #1

the stats: Eat a big meal, severe stomach pain, obese, female
the diagnosis: pancreatitis caused by gallstones

Gallstones

Cholelithiasis; Gallbladder attack; Biliary colic; Gallstone attack; Biliary calculus

Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball. They form for a variety of reasons but usually due to a fatty diet. An attack almost always happens after a huge greasy meal. The gallbladder and pancreas share the same duct or canal so when the gallstone blocks the passageway, both the pancreas and gallbladder get backed up and inflammed. It hurts like hell! Soooo......moral of the story: eat salad.

Case #2

the stats: 65 yr old male, presents with severe abdominal pain, back pain and shoulder pain. Severely low blood pressure and pulse. White faced and lethargic. Shoulder and back pain are significant and pointed us in the right direction.
the diagnosis: Dissecting Aortic Aneurysm

Aortic dissection occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall of the aorta and force the layers apart. The dissection typically extends anterograde, but can extend retrograde from the site of the intimal (lining) tear. Aortic dissection is a medical emergency and can quickly lead to death, even with optimal treatment. If the dissection tears the aorta completely open (through all three layers), massive and rapid blood loss occurs. Aortic dissections resulting in rupture have an 80% mortality rate, and 50% of patients die before they even reach the hospital. All acute ascending aortic dissections require emergency surgery to prevent rupture and death.

Pt was transferred to a heart hospital and directly into surgery. They need to stop the bleed before he bleeds out completely. His survival rate is approximately 5 %. We told him to call his family. He said he hasn't spoken to his kids in years. We told him now would be a good time to start. Moral of this story: you will ALWAYS need your family. Never stray far from them.

Case #3

WARNING...DO NOT READ IF YOU ARE GONNA BE OFFENDED OR PUKE EASILY.
WARNING
WARNING
WARNING
WARNING


the stats: 36 year old male, severe pain upon urination. Swollen penis and testicles. Super embarrassed.
the suspected diagnosis: an STD
the ACTUAL diagnosis: Broken Penis

A penile fracture is an injury caused by tunica albuginea, which envelops the corpus cavernosum penis. It is most often caused by a blunt trauma to an erect penis. Usually from intercourse with the male ontop penetrating the partner from behind.

 

Penile Fracture

A popping or cracking sound, significant pain, immediate flaccidity, and skin hematoma of various sizes are commonly associated with the event. These symptoms are similar to a common bruising or contusion of the penis.

Moral of THIS story: This guy should NEVER have sex again.

 And may you never look at bananas the same way again.

till next time, Emma

the night of a thousand smells....and vagina's

Imagine wet garbage, covered in horse crap, coated with skunk, drizzled in urine and topped with boiling hot vomit. THAT is what my night smelled like. I cannot get the smell out of my nose. I literally have rubbing alcohol swabs stuffed up my nostrils right now and besides from the fact that i'm high from the fumes...i can still smell the stench. I don't understand how people cannot smell themselves. When my perfume is fading i think i smell. Some of these people have not only not showered...ever.....they have infections down under that are bubbling over. Tonight I saw (and smelled) more vagina's than a frat boy in college and if I never see another in my lifetime, it would be too soon. I had one patient after another that just wouldn't pee in a cup for me. I explained time and time again, "if you don't pee in a cup, i have to insert a foley catheter". The pretty much just said "okay." Are they crazy? I literally gave one woman about 100 gallons of water to pee and still...not a drop. So....i dove in.....and believe me I held my breath.

That's all for now. I have to go disinfect my nostrils. good night