Posts Tagged Funny

The Hockey Season Cometh

Overheard in Fast Track:

Grandmother: (pointing to hat on child with a Canadiens emblem) Who are they? Who’s your favourite hockey team?

3-year-old child: Habs!

Some other patient: Losers!

I tell you, she had some nerve, that child. In Toronto, no less.

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I Cannot Write This Blog Without the Love and Support of My Husband

A short farce of two lines.

Me: (excited) Hey, my blog post just got tweeted by the American Journal of Nursing.

Spouse: They told you to knock it off?

(Curtain.)

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Sex, Vampires and Dentistry

Not a combination you would normally put together yourself, but I have to admit, it made me laugh.

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The Eternal Flame

Scenes from a dissipated childhood, courtesy of 15 and Falling, an anti-smoking campaign aimed at adolescents brought out by the Nova Scotia Department of Health and Wellness.

I have to admit, I laughed my ass off when I saw this. Who doesn’t like a good flatus joke, after all?

[Via.]

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“What You Don’t Want to Hear Me Say at Triage”

[A rerun. I will be back tomorrow. Really. Slightly modified; first posted 27/01/2010.]

“Let me see if I can find a bed for you right away.”

“You look a bit unwell.”

“Your blood pressure is a little low — let’s get a wheelchair.”

“Let’s do an ECG right away.”

“Can I get a stretcher at Triage, stat?”

“Call a code.”

“Your wife can register you while I bring you in.”

“Wait here while I find an oxygen tank.”

“Let’s put a few more abd pads over that cut.”

“How long have you had the black stools?”

“Did the drainage start after you hit your head?”

“At what time exactly did the chest pain start?”

“At what time exactly did you notice the right arm weakness?”

“Can you page the RT?”

“Can you page the doc to the Resus Room?”

The words “ST elevation”, “shock”, “distress”, “hypotension”, “precode”, “neurological deficits”, “CTAS 1“, “actively bleeding” and “new onset” in any context.

If, on the other hand, I tell you it’s going to be a longish wait and send you to the waiting room with a urine specimen bottle, you should be grateful, happy and relieved: you aren’t likely to die.

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“Monkey, Monkey”

[A rerun while I’m away. Originally posted 17/10/2009.]

The Observation Room.  Eight beds, separated by curtains, which gives the illusion of privacy, but of course any conversation can be heard clear across the room.  My colleague Karla is in Bed 5 helping a patient on the pan; I’m next door in 6 with a 40 year-old post-op hyster who’s come in with wound dehiscence.  She has a very doting family, who have supplied flowers, chocolates and also very cute stuffed monkey, which the patient has placed by her pillow.

Dr. Jove, her surgeon and generally a lovely man, comes bustling in, all bluff good cheer and exuding a well-fed happiness and concern.

Do you want the family to leave so you can examine the patient? I ask.

Oh, no, says Dr. Jove. Not to worry. I’ll tent, I’ll tent.  By which he means he will examine at the patient by making a tent of the blankets, and looking underneath. Voila! Patient modesty is preserved and the family can feel like it’s part of the health care team.

And so, like a magician, Dr. Jove makes a tent, and examines (from the bottom up) the patient, sighing and making tsk-tsk noises.

He looks up at the patient.

“Nice monkey,” he says, meaning the stuffed animal.

A pause, then a small, plaintive voice from the other side of the curtain. Karla has been listening.

“He didn’t really call it a monkey, did he?”

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Some Days You Just Gotta Post Links Vol. 5

When Pumpkins Drink

Okay, so I posted this photo last year. But most of you weren’t around last year; laziness is the fall-back position today anyway, so what the hell. It’s still funny, if, um, vulgar.

I also figured it was a day for links: looking back over the past few weeks, there’s been a lot of substantial writing. In short: tired brain. So without further ado:

  • Do dogs enjoy dressing up for Hallowe’en? Short answer, no: “To put raiments on a dog is to blithely ignore his essential dogness.”
  • Findings shared with Nursing Times reveal that members of the public, who were interviewed in 81 research sessions, commonly described nurses as overworked, underpaid, patient, stoic, put upon, unambitious and passive.”

Per Capita Health Spending And 15-Year Survival For 45-Year-Old Women, United States And 12 Comparison Countries, 1975 And 2005

  • Yet another reason to be cheerful. Why do I think our descendants (if, in fact, we have any) will view our stupidity with the same distaste, shame and smugness (if truth be known) we view the Inquisition, burning at the stake, the Thirty Years War, the slave trade in the 17th, 18th and 19th Centuries, or the Opium War?

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Lift and Separate

Okay, I lied about posting. I saw this picture this afternoon, and thought, hey, we all need a laugh to start the holiday weekend.

The trouble is, I think if I ever see some guy wearing these, say, in a trauma, I’m going to get an irreversible case of the giggles. I’m giggling, in fact, as I write this. Also, why do I think guys who would parse their underwear would have these?

Available, if you’re interested, through Marks & Spencer.

[via Sabina Becker and Roger Ebert]

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Can’t Breathe Through the Foley

At five-thirty in the morning, any laughter you might hear in the Emergency Department is the laughter of the damned: damned by in-and-out sheets that refuse to add up, damned by orders signed off but not actually done, damned by having to herd exhausted physicians to needy patients, and damned by lack of sleep and general befuddlement and lack of coffee. Five-thirty in the morning is crap. Five-thirty in the morning is not the best time to get critically ill patients in the emerg.

Of course, the nature of the beast is that critically ill patients frequently and alarmingly roll in at the hour we’re least able to take care of them, psychologically at least. But I was in the resus room the other night, working with Brad, who is cool, friendly and fazed by nothing at all, actually having for once a happy-smiley night, a couple of nothing chest pains and a CHFer who got bipaped, foley’d and Lasix’d and up to the ICU before we could even finish the MARs.

Life in the emergency department, I fear, is all about the fulfillment of karma. Cause and effect, the accumulation of past deeds and actions resulting in present consequences, operating in the micro and macro-levels of existence: do you need to tell you what happened next?

At 0517 EMS brought us a violently sick, obtunded, Kussmaul-respiring, ketones-emitting 24 year-old non-compliant insulin dependent diabetic in DKA, who also happened to have a seizure disorder.

Kids, don’t try this at home. It’s very bad joss, and will really, really fuck you up.

How sick? Glad you asked. For you health care types, her pH was 6.97. For the rest of you, that’s a number not compatible with life.

And since the patient hadn’t taken her carbamazepine in nine months, continuous seizures started almost immediately.

Secretly, this is what we live for. Remember: airway, breathing, circulation. Always ABCs. Life and death with a nasty twist. Bring it on! Roll out the adrenalin, pump it out, baby, we’re goin’ in.

But not at 0530.

So after three IVs, fluid boluses, two blood draws, an ECGs, a central line, an arterial line, and insulin drip, status epilepticus, intubation, sedation, a dose of Dilantin, it was 0647. It was nearly shift change. But we were missing something — and my eye caught sight of the foley catheter set-up on the bedside table.

“We need to put in the foley,” I said to Brad. He was sorting out the multiple IV lines, labelling them to make sure we didn’t, say, push lorazepam in the insulin drip line. He shrugged. He looked — worn out.

“Screw it,” he said. “They can do it on Days. I’d like to get out of here sometime before sunset.” I glanced over to the Resus desk, saw our replacements for Days, and my heart quailed, just a little.

I need to explain there are two types of Emergency nurses. The first kind view Emergency nursing as a continuous and continuing process: what isn’t completed during one shift can be picked up by the next, because in the Emergency Department, sometimes it isn’t humanly possible to finish everything before shift change. The second type of ED nurse may publicly endorse the first, but believe deeply and firmly that all patients must be presented to the oncoming shift all fluffed and buffed and tidied, with a ribbon on top. If they aren’t, well, let the snark begin.

Unfortunately,  our replacements were Beth and Judy. Beth is a superb nurse, but she’s irritable and has little patience for foolishness. Certainly she is far more knowledgeable and cleverer than me; but also, she’s clearly in the second camp. Her partner, Judy, is also a good nurse, but tends to get a little flustered, especially when asked to do too many things at once.

Beth doesn’t like Judy, much.

Beth thinks Judy is an incompetent boob.

So Beth was already pissed off when I started report, Brad sitting beside me, head in hands.

“EF,” I said, ” 24 year old female brought in by EMS obtunded, smelling strongly of ketones, history of insulin dependent diabetes and seizure disorder. . .” and so on, detailing every diagnostic, treatment and intervention, the seizures, the status epilepticus, the intubution —

“You got a foley?” Beth interrupted. Brad’s head had sunk to the desk. I was quite sure he was sleeping.

Uh, no. We were going to but. . .

“I can’t believe you didn’t put in a foley. . .” Beth shook her head. Clearly she was disappointed, whether in us, personally, or in the nursing profession or the declining standards of the world at large, I don’t know. She made her discontent plain by her expression and a baleful sigh summarizing her indignation.

And so on. I continued with report, punctuated every 30 seconds by the repeating complaint  — “I can’t believe you didn’t put in the foley.”

And then a deep, annoyed rumble from Brad, head down, assumed to be in the attitude of sleep:

“ABC before pee pee pee, so can you please shut up about the fucking catheter, Beth?”

Brad told me later Beth’s face was a picture. But I was too busy jamming my fist in my mouth to keep from laughing hysterically to notice.

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In Which I Get a Clue

The other day EMS offloaded in Resus 3 a 77 year-old guy from home, alert and oriented, but pale, hypotensive, BP 83/43, diaphoretic and complaining of weakness and dizziness.

What can cause hypotension?

Hmmm. . .

Do not try this at home

How about six Nitro-Dur 0.4 mg/h transdermal patches scattered across the torso and back?

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