Blog 2; Pens and Needles

     One of the things I love about working in the ER is the fact that you never really have a “routine” day. Most days, just when I think I am getting a bit bored of abdominal pains, flu-like symptoms, and constipation, something truly crazy comes in. This week was no different. Probably the most memorable patient we saw in the ER this week was a middle-aged female patient that came through triage claiming that she was in respiratory distress from swallowing an ink pen. She was sent back immediately to one of the trauma rooms where her airway was assessed and she was stabilized. No big deal, right? She was scheduled for a psych eval and a trip to the OR to remove the pen. Everything seemed to be going according to plan… By law, every patient must either sign a Consent to Treatment form or verbally give consent for treatment, so eventually, a guy from the registration team made his way into the trauma room with a consent form, and, yes, an ink pen. Knowing the patient’s history, he asked the nurse if it would be ok to have the patient sign the form. At this point, the patient was wearing a mask attached to oxygen so I guess the nurse must have thought that this would prevent her from swallowing anything before she could be stopped. At any rate, with the nurse standing literally right beside the patient, the registration guy handed this lady the paper and the pen… The lady picked up the pen, pulled down her mask, and asked “Ok, so where do you want me to…. “ And, just like that, the pen was gone down her throat! Now, I didn’t actually get to see this happen, but both the nurse and the registration guy told me that it happened so fast that there was no way to stop it! There was no gag reflex or momentary pause… They said she literally threw it down her throat! Long story short, the lady went to the OR with 2 pens in her gullet instead of one and one very special nurse received a “Golden Pen” award from the staff of the ER! 

     A few other honorable mentions from this week include:

Chainsaw to thigh; muscle, no bone

• ·         The sizeable person who called EMS claiming that it felt like something was eating away at “down there.” It turned out to be an ingrown hair… Yes, people, this is where your tax $ are going!
• ·         The drunk pedestrian vs motor vehicle... a drunk lady wandered out into traffic and was hit by a car traveling fast enough to throw her completely over the car… she had some pretty significant injuries but was still drunk as a skunk when she came in.
• ·         The chain saw incident… Not really so significant except that I am guessing with all the hurricane work going on, we are going to be seeing a lot more of these types of injuries. Safety first, guys! I actually got sent a picture of this one, which I will try to post,… (taken by permission)
• ·         The prison hanging… young prison inmate caught dangling from a bed sheet. Senseless and sad since she was in for a short time for a non-violent offense! I’m guessing some pretty rough stuff was happening to her on the inside or she owed someone money! I guess we’ll  never know!

     So, that was my work week, along with a morning of mowing grass for my bro-in-law and some quality time with my niece and the twinsies on Thursday… I tried to cook supper for everyone Thursday night, but it didn’t turn out quite like I wanted it too… I tried to grill chicken but the grill ran out of gas and the chicken sat there raw for a bit before I got the other tank hooked up. Then the grill ran hot and I ended up with fiesta-lime charcoal briquettes instead of chicken. Honestly, people, the key to enjoying grilling is simply having a decent grill!!! At any rate, I don’t think anyone lost any teeth trying to eat it and we did have some good fruit salad and corn, so I can’t complain!  

     Many thanks to all of you for the kind comments and encouragement! It is definitely appreciated and I hope I can just be a willing and useful part of the Kingdom right where I am! Your comments have helped me to see my life from your point of view and has given me a little different perspective. Thanks for that! I hope all of you have a good week! Stay safe! Wear your seat belts and take your vitamins!

And, now, story time…

    I didn’t even try to tally the votes for which story to tell on this blog episode, but the most popular choice seemed to be “all of them…”, so I’ll just start from the top!

                               The Roach in the Ear and Other Roach Stories
       As an LPN, I am most often assigned to the part of the ER call the Rapid Treatment Area or RTA. Basically, it is an urgent care at the front of the ER that is staffed by an LPN, sometimes an RN or a 2^nd LPN, and a nurse practitioner (CRNP) or physician’s assistant (PA). This is where the lower acuity patients go, so if you come into the ER needing stitches for a small laceration, x-rays and a splint for a broken bone, treatment for an STD (I better not see you in here for that!!!) or a migraine, chances are I will be your nurse. One evening last spring, I had a patient whose chief complaint was a “bug in the ear.” I went into the room ahead of the PA just to see if the patient actually had a real bug in her ear. (I do this because you would not believe how many people think they have bugs in them or on them when, in reality, they do not. Don’t do drugs, people!) The patient was a lady with  neurofibromatosis, which is a condition where a person has hundreds of rounded tumor-like bumps all over their body. In my patient’s case, she was pretty “bumpy.”  I could see that all the areas between the bumps weren’t exactly clean, but she was nice and polite and as sweet as could be, so I instantly liked her. I looked in her ear with the otoscope and, sure enough, I could see the back quarter-inch or so of some type of bug. It looked pretty stuck to me, but the poor lady said she could feel it moving occasionally.  To this day, I have a great amount of admiration for this lady. I don’t think I could have stayed sane knowing that I had a bug deep in my ear and could feel it wiggling around. However, this lady was as cool as a cucumber! The PA went in, had a look, confirmed the bug sighting, and proceeded to flood the ear with lidocaine. …lidocaine was used to kill the bug or at least paralyze it from moving around and trying to burrow deeper into the ear when we started trying to get it out… After about 15 minutes, I found some more experienced nursing help and we went in the room armed with lots of warm ear flush. We flushed that ear for at least 5 minutes and got nothing… well, some ear wax and maybe one insect leg. Every time we looked in her ear, it was still there… hadn’t budged an inch! No one really wanted to go in with curettes or alligator forceps and pull the bug out piece by piece, so it was time to bring in the big guns… suction! I kept irrigating while Nurse A kept steady suction in the ear, and after about 5 minutes and a couple more bug legs, I heard the suction give a "blurping" sound. Nurse A pulled the tube out of the ear, and there was the cockroach in all his disgusting glory, staring back at us from the end of the tubing, antennae bent but intact! I wish I had measured it, but I’m guessing it was at least an inch to an inch and a half long. I don’t know how it had gotten that far into her ear, but I am guessing by the condition of her skin that she was no stranger to bugs. Needless to say, no one wanted to keep the roach as a souvenir, so into the trash it went.

     The other good roach stories that I can relate were told to me by hysterical nurses after the fact… This summer, Nurse C was helping in one of the trauma rooms when she was asked to pull the patient’s shoes off. Big mistake! In one shoe, a colony of roaches had taken shelter and scattered across the room when the shoe hit the floor! I don’t know exactly how many there were, but to hear Nurse C tell it, there were a lot! She even reported seeing an albino roach, which, supposedly are a product of roach inbreeding. I guess this basically means that the poor homeless gentleman had not taken his shoes off for some time!

     One day, I heard some commotion coming from the middle pod and saw Nurse D running pell- mell out of room 10, yelling for help! Of course, everyone immediately thinks Code Blue and starts running for the crash cart, crash meds, ect… But no, the patient was fine… Nurse D had been putting an IV in the patient’s arm when a large cockroach came crawling out of his jacket and toward Nurse D. Cue the running sequence… When the dust settled, Nurse K, who has been at this ER nursing thing awhile, went into the room, put one foot on top of the cockroach, (yes, it was still up on the bed!) and finished drawing blood. I don’t exactly know what she said to the patient who was still blissfully unaware that he was playing host to one of the nastiest bugs ever created, but I can guess it went something like this… “Sorry bout my foot way up here on your leg! I don’t normally do this to my patients but you’ve just got this little bug up there and I don’t want it to crawl on me before I get this IV in your arm!” 

*Disclaimer: Any names, ages, or genders may have been changed for this blog. If anyone feels that any part of this post violates HIPAA, please comment below... I'm trying to be as vague as possible about ID but want to give as many details as possible!