Archive for the ‘Pre-GEPN’ Category

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ER 101

24 August 2008

The move is complete. Orientation starts tomorrow. And although I am technically staying on per diem, I really have ended my tenure (ha!) in the ED. So before I have tons of nursing-school hijinks to write about, I wanted to share just a little of the wisdom I gleaned from 2 years of semi-controlled chaos in your friendly neighborhood Level I Trauma Center:

  1. Don’t run from the police. That rarely turns out well. Doubly true while on a motorcycle.
  2. Remember, cartoons are for entertainment purposes only — Gunpowder is not a toy.
  3. Don’t get your octogenarian mother completely, totally, shit-faced drunk and then wonder why she’s having gait instability and slurred speech.
  4. The Vagina: Not an approved storage device. For anything. Like, say, drugs. Or glass drug paraphernalia. Cuz that shit *does* show up on X-ray.
  5. If you’re an IV drug user, don’t inject other things that might have once contained drugs. Like month- old wads of cotton.
  6. If you’re an insulin-dependent diabetic, don’t embark on a solo multi-state road trip without any.
  7. If you’re allergic to peanuts,  don’t get drunk and have a Butterfinger.
  8. If you’re male, intoxicated, and your wife/girlfriend/sister/mother/any female bystander says “I don’t think that’s a very good idea”, cease and desist, immediately. Particularly if your plans involve firearms, sharps, fire, or a moving vehicle.
  9. Parents, don’t drag your child in to the ER for a low-grade fever that they’ve had for all of three hours. It’s called Children’s Tylenol. And a phone call to your pediatrician.
  10. Oh, and moms, the ER is not free daycare, and RNs aren’t babysitters. If you do bring your child in, expect to be with them the entire time. And if you really have to have that cigarette, don’t expect the nurses to be cordial when you take your toddler outside with you for your nic fit. Especially when she’s here for an asthma attack.
  11. And finally, it’s never a good idea to threaten ER staff. For some reason the huge guys in suits ALWAYS take our side.

Alright, all joking aside. If I learned anything I’d really want to share, it’s this:

Your PCP’s practice always has someone on call. Trust that qualified professional to decide whether you need to come to the ER at 3AM for your hemorrhoids or sore throat or the back pain you’ve had for eight months — because maybe, just maybe, it can wait until Monday and a routine office visit.

Because the ED is for (gasp!) Emergencies. The MDs and RNs there are trained to manage crises. It is not their job to solve all your medical problems, diagnose and treat all your possible ailments, and update all your medications in three hours. It is their job to determine if the symptoms you are having are life-threatening or require immediate medical intervention, and once they’ve decided that is not the case, you will get the ‘follow up with your PCP’ dispo and shown the door. You may not have any answers. You may still feel like shit. You may feel like you wasted a whole day and a large copay for them just to tell you what you don’t have. But that’s how they manage to save lives and still keep one or two beds open for the MVAs and the heart attacks and strokes. Just something to remember next time you come for a visit.

Oh, and one other thing.  Use car seats.  Wear helmets and seat belts.  And for the Love of Bob, people, don’t drink and drive.

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Mood swings

4 March 2008

Hi Patrick,
Thank you for the offer, but yes, I am declining UW’s offer for admission to the MEPN program. I will be attending Yale University this fall. Thank you for all your patience and help throughout this process. It has been an honor to be considered for UW’s prestigious program.

Sigh. After a day of terror and tears trying to figure out exactly how I am going to come up with an additional 30,000 dollars (on top of 28K in federal loans) to cover my first year at Yale, and simultaneously still manage to pay off a significant amount of credit card debt, AND manage to pay the $2,000 I owe on this year’s taxes and the $600 to Yale to hold my place — I had a voicemail last night from Patrick at UW which I knew could only mean one thing.

I have somewhat mixed feelings, but it’s clear now that if I can barely afford to move to and live in New Haven, Seattle would be a bit of a stretch. All the YSN GEPNs are freaking out about having to take out nearly 60,000 in loans, just for the first year. Emesis indeed. I was a total basket case yesterday.

But I got a personal loan this morning so I at least know that I will have no more revolving credit card worries and that the monthly payment on that loan should be manageable while I’m in school as long as I budget well and get a cheap apartment. Which I am committed to doing.

So there! Take that, evil nursing school and associated debts! I shall make you my bitch!

And I just made some tasty banana muffins. Today is going much better, thank you. 

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Saving Monica

20 February 2008

Stories like this one make me proud to work at this hospital and in this ED. I’m already aware of how much I will miss this place and the environment that is acute care. One of the crazy things about working in a high-profile trauma center is that very often I’ve seen these patients that are in the news — the drunk drivers, the tragic MVAs, the sexual assaults, the stabbings, the pedestrians struck. It’s always interesting, being on this side of what gets reported in the Globe.

I’ve wondered off and on (along with the debate of MD vs. NP, a story for another blog) about whether or not I should’ve chosen Acute Care and if I’ll be bored going into geriatrics/primary/long-term care after two years of fascinating cases in the ED. But the more I think about it, I realize that I’m  just plain excited by everything that has to do with taking care of people. And I think I’ll always be eager to be a part of it.

ps. For another amazing nec fasc story, check out this book by another Boston doc.