Tattoos

I took care of a 16-year-old girl the other day. Somehow we got on the subject of tattoos and she asked if I had any.  Quick answer is no.  Naturally her follow up question was why not.

Honestly the main reason I won't get a tattoo are my beliefs.  As Mormons we are taught from a young age that we should "respect our bodies as a gift from God" and "not disfigure ourselves with tattoos or body piercings." Knowing it's unethical to share my beliefs to patients (unless they ask), I gave another reason.

I've had similar conversations with my friends and coworkers.  When my colleagues ask if I'm going to get a tattoo I usually say I'm not interested.  When they insist on having more of an explanation than that I bring up the cost.

The better and more intricate the design (and having a good tattoo artist) can get pricy quickly.  I recently treated a patient in the emergency room with a nice piece of body art covering the side of her body. She admitted it cost her $350.  Several coworkers have admittedly spent over $500 for their designs.  I even found an article that will help you estimate how much your tattoo will cost.  Not to mention a botched tattoo coverup cost (or living with an ex's name/face tattooed on you).

I love to travel and I do it as frequently as I can.  For the amount of money I would drop on a tattoo I can do a lot of things (assuming I have $500 to drop on a tattoo).  From where I live I can go to NYC for a day (with extra money to go to the bathroom in case you aren't near any of the free ones), do a Segway tour of DC (when my kids are older), spend a few days at Ocean City or Virginia Beach, go to the Grand Canyon of PA, rent a cabin for a weekend in the Smoky Mountains, etc.  The longer I think about it the more trip ideas I can come up with.  I could even take a photography class online so I can take (and edit) better pictures for when I do get to these places (most of them are already on my 5 year vacation/day trip plans, some of these may come as a surprise to my wife).

Admittedly I thought about getting a tattoo at one point in my life.  And if I didn't feel strongly about my beliefs I would probably get a Disney themed or a Star Wars themed one.  I would definitely drop the money to have the light sabers with a UV glow to it.  But the combination of my beliefs and my desire to travel is much greater than getting a tattoo.

I don't care if you have tattoos and I will admire the new tattoos that are shown to me because, once again, most are fun to look at.  Many people like showing off their new body art because they are excited about it and who am I to rain on their parade?

Joking with the parents

Some background, I am American-Mexican (I know most of the United States says Mexican-American, just ask Cheech and Chong) but I am American first, of Mexican heritage.

Continuing, sometimes jokes go over my parent's head.  The only thing worse than telling a bad joke is having to explain why the bad joke is funny.

I told a joke that was (in my opinion) hilarious.  As much as I want to take credit for this joke it has to go to Gary Johnson.

Here goes (I'll use a pic):

My parents don't follow politics too closely but they are usually in tune to the major things (like Trump building a wall type stuff).  Unfortunately for me I had to explain this joke to my mom.  She starts laughing uncontrollably. She likes the joke so much (now that she understands) that she passes the phone to my dad and tells me to tell him.

I repeat the joke to my dad.  He also doesn't get it.  He is usually a little more up to speed with politics than my mom.  Unfortunately I had to explain the joke to him as well.  

 Instead of laughing at the joke he asked me "why would the Mexicans pole vault when they normally dig tunnels?"

I got to admit, this caught me off guard.  He has done this before, catching me off guard with his jokes/statements.  He once told me our family couldn't be called wetbacks because we crossed the Rio Grande when it was ankle deep (just to clarify, both me and my parents were born in the US, just a joke).

Smoke Breaks

I consider myself a team player.  I'll jump in and help you if I see you're drowning as long as I am available.  I don't expect you to reciprocate, especially if I'm already familiar with your work ethic (most of my coworkers become extremely frustrated if I ask for help, even if all they have to do is discharge a patient and send them home).

There are some things that are beyond frustrating that have happened lately while trying to help.  The one that pushed me over the edge was a smoke break.

Here's the situation.  I'm working the the "urgent care" section of the ED (Rapid Medical Evaluation in my hospital, sometimes known as Minor Care).  One of my coworkers in the acute side of the ED receives an ambulance (respiratory distress) and has 2 other patients, one of whom they are trying to determine if he has a heart attack.

The Charge Nurse asks me to leave my area and help my coworker.  I get there and she is taking care of the respiratory distress. I'm asked to watch her other two patients. The rule out heart attack needs a second IV started along with a heparin drip (blood thinner) and a nitro drip (vasodilator, makes blood flow easier).  No problem.  I get that going in less than 10 minutes (including all the documentation and explanations to the patient).

Because I am who I am, I take over the care of her other patient as well.  I make sure they are situated, comfortable, and I explain what is going on with their care.  Time passes (about 30 minutes from when I get there) and she steps out of the room she has been frantically working in.  I give her updates on her other patients.  They are settled, just waiting for admission orders (heart attack) and discharge orders (the other patient).  I'm told to stick around for a while until the respiratory distress is more stable. No problem.

More time passes, the doctors involved with the heart attack patient continue to ask me for updates and I continue to help.  I discharge the other patient.  The next time I see her she is grabbing her cigarettes and leaving on a smoke break.  I ask her who is going to watch her patients (remember, this is not my assignment, I'm supposed in the "minor care", just keeping her afloat so she doesn't come back to a nightmare of orders).  She rambles off that someone else is going to watch her people and runs off.

Seriously?  I've been watching her people for 45 minutes at this point and she suddenly have enough time for a smoke break? I still haven't given her report on her other patients so she can officially resume care of them.  I am still answering questions from the doctors for her cardiac patient yet she has enough time for a "breathing treatment"? Unbelievable.

The worst part of this situation is reporting this incident.  It's beyond ridiculous that she did this. Unfortunately the charge nurse is in no position to help because he was a substitute.  Even so, our current boss doesn't know how to confront people (instead of writing people up for playing Pokemon in the ER he sent yet another reminder we aren't supposed to have cell phones, easily narrowed to 2 people on the overnight shift).

So what about confronting the person who went to smoke? Can't bring it up to her because in her mind her people were covered so she did nothing wrong.

Honestly by the time I'm writing this I'm mostly over the situation.  Obviously it still bothers me a bit but for the most part I'm over it.  There's nothing I can do and at this point it's far from everyone else's mind.

Life goes on.

They asked me to stay late that night to help relieve lunches.  I agreed to remain long enough to transport the patients that were admitted but did not want to do any lunches, especially my smoking friend.

Politics and the ER

Politics is a very touchy subject. It can make or break friendships and relationships.  It's not uncommon for people in the workplace to have different political views.

Same goes for the Emergency Department.  While working there we develop a camaraderie that plays into helping the patients, especially traumas, overdoses, heart attacks, etc.  Bringing politics into the workplace can be especially tricky.  I can't take credit for these words but I want to share them.  I can't state this any better.

A plea to all my FB friends in healthcare: As the political season continues to heat up, can we please, please, please at least try and keep politics out of our professional lives? I know what my views are on things, and understand that not everyone feels the same way that I do. That being said, I also appreciate that people's individual political views are as much a part of what makes them unique individuals as their love of their career, their love of family, their hair and eye color, and all their other facets do. I may not agree with you, but that does not make you less of a person in my eyes. For me, what is more important than who you think should be running for a political office is that when the chips are down and someone else's life hangs in the balance, you will have my back and I will have yours. Very few people go into any of the healthcare professions for fame, money, or because they believe that some people are more special than others. The reality is that for most of us, caring for others is a core value that shapes who we are, and why we do what we do every day. No matter what happens in November, this will not change. The other thing that will not change is that we will still have to work together, supporting each other as we work to save lives and help our fellow humans through some of the worst moments of their lives. We are all on this roller coaster ride of life together, and in the end ALL lives matter, which is why we do what we do. Please let's not allow ourselves to forget that in the coming months.

At the end of the day, do you have my back to help save a life, even if we don't agree politically?

The other night

I like to think myself a happy person. I really try to make it a point to stay positive. Unfortunately I have nights like yesterday where I feel like I get shat on.

Working in the ER is a complex beast. You have to be able to juggle a lot of situations at the same time and you have to be able to prioritize what comes first.  If a person isn't breathing they take precedence over someone with a sprained ankle (obviously). Sometimes it gets sketchy. What if you have multiple people who are very ill and an attention seeking drunk? Security isn't available to help you out.

This was very similar to my situation the other day. I get 2 ambulances at the same time. I help one person who doesn't have lung sounds and the oxygen saturation is 40% (that should be above 93%). As I am trying to get her stable and increase her blood oxygen my drunken ambulance starts wandering around the nurses station screaming "I need help, doesn't anyone care if I die?" 

Going back to the complex beast that is the ER, I am in a section where help is nonexistent at this time. I work with multiple other nurses who need so much help that it takes 2 people to do what one nurse should be able to manage on her own. The techs that work with us cannot get to me because they are being utilized by other nurses and the charge nurse is doing something else.

I am able to take care of both patients (and my other 2 less needy but just as sick patients) but by the end of the night I am just shy of yelling at my drunken attention seeking butthole. At one point after I tell him to get back in his room and get in bed he asked me "Just who do you think you're talking to?" I replied "A noncompliant patient who can't follow simple instructions to stay in bed." (security isn't available to help keep him in bed).

My patience was very thin at the end of the night. I am very grateful for the understanding my other patients had with the situation.

This is a situation that happens regularly. Occasionally I will get help from my peers and depending on what is going on I will sometimes get quite a bit of assistance. The problem is I usually get forgotten and dumped on.  I don't complain when I get a lot of sick patients. I do my job. I don't complain (a lot) when I have 4 patients when others have 1 or 2.  Maybe this is why it continues to happen to me.

Will I complain, probably not to anybody in charge. Mostly because I know I can handle the situations they throw at me. If I do get to a point where I'm drowning there are a few people that will come to my assistance.

Besides, when it comes down to it, I like my job. I don't want to be known as a "trouble maker". I do my job (most of the time well in my opinion) and I try to have fun.  I can see myself doing this for quite some time.