Observation and rant about the observed.

So, on my way home from work I stopped at a gas station to get a snack for my ride home. There was 3 or 4 ppl ahead of me. The lady that I was directly behind had her daughter with her, whom was not just over weight or obese for her age, but morbidly obese at the ripe ol' age of 8 or 9. The girl had a bag of chips in her hand and picked up one of the red-hot sausages and said, "Mama, can I get this, too?" The lady replied with a yes. Then the girl asked what all she was allowed to have. And I shit you not that the mother said, "Girl you got ten dollars, just spend it." So now the girl could have had a lesson in money management and savings but mom taught her instead to blow the wad. 

So, the girl is going around the convenient store just picking up shit from the shelves (a yoohoo, chips, two redhots,) and makes her way to the 3-day-old cold sandwich/lunchable section and the mother turns around to me and tells me to go ahead of her and in the same breath tells her daughter not to get any of the stuff from there because they're really expensive. So great, the most healthy choice the child was gonna make (albeit, not too healthy b/c we are at a Cirle K) and mom discourages it b/c it's to expensive to get and tells her to get a whole bunch of cheap stuff vs a few cheap items and one more expensive more quality item. 

FANTASTIC! Way to go lady! You had a chance to educate your child in finances and health (kind of--a ham and cheese sandwich is better than two Snickers) and help her to not be as broke as you are but instead you helped ensure she'll continue to be broke like you, and be on welfare all her life, and you've helped her to get diabetes, high blood pressure, high cholesterol in her future so she can come in to the hospital once a month and be disabled by the time she's 40 y/o and be a complete drain on our society. I give you mad props...not. SMH. 

Pet Peeves

So, I recently moved from a rural ER to a pretty fucking huge level 2 trauma center ER.  Yeah, I like it.  It's a lot to take in, but I like it.  But in moving to this new facility, I found some things are just universal; or at least they are in my southern redneck of the woods.  And this is where I'm gonna let it out. My biggest pet peeves... for the moment.  The first two run neck and neck for top pet peeves, one just takes the cake.

My number one pet peeve is when people tell me that something has been going on for a minute.  No fucktard, I need a real fucking time frame.  Nowhere in my electronic charting system can I chart "1 minute" as a time frame.  I'm not asking you how long this has been going on out of the need to pass the time or because I'm making small talk.  Do I really look that "nice" to you?  I really fucking need to know how long you've been having that CP, AMS, abd pain, cellulitis, abscess, cough or green shit coming out of your twat. Just fucking tell me.  An hour, a day, a week, a month?  What is so damn hard about that?

And the runner up for my biggest pet peeve is improper communication of the 0 to 10 pain scale from the patient to me, the RN.  For instance, when I ask a patient what their pain scale is from 0 to 10; with 0 being no pain and 10 being the worst pain ever possible in human existence.  "100 out of 10" is NOT an appropriate response because 10 is the highest number possible.  You can't put your stereo on 20 out of 10 volume because the dial only fucking goes to TEN!!  Or let's say I go to reassess the pain after giving 4mg of Dilaudid and I ask the patient if the medicine helped any and the patient states that it did (a lot) and then rates their pain as 9/10 when that was their pain rating prior to administration of the fucking med.  So now I'm confused, did it help or not.  Oh, you're probably not high enough to think it's "helping" your pain.  Which leads me to me next pet peeve.

When did our society come to believe that in order for pain relief to be affective one must have a head rush?  And I'm not just talking about the frequent flyer sicklers.  Even patients that have a legitimate reason to c/o pain, don't even want to try some Motrin or Tylenol or Toradol.  If it doesn't give them a fucking high, they think that it doesn't work and won't try it.  I seriously wish that we had a drug that could induce mild vertigo and no other mind altering effects and put it in the toradol or the IV tylenol.  I bet people would want it then because they'd be thinking they were high and getting pain relieving measures.

Another thing that irritates me is when we've just put an ETT in a pt, dropped an OG and a foley and started the propofol drip and in walks the family and screaming at me because her feet are fucking cold and she has no socks on.  Well, you know, them cold feet are kinda the last thing on my list when I have three other patients and this NOW critical ICU patient on a vent and I'm trying to chart everything that just went down in the last 45 minutes for no reason at all other than the MD wanted to intubate your loved one that was brady and responding to atropine swimmingly (no SOB or resp distress).  I kinda have to keep increasing the MJ juice out of our defined parameters because your loved one opens her eyes to look across the room when I call her name and she's supposed to be sedated, but instead she's bucking on me and trying to pull out all these tubes so now I'm restraining her ass.  Yeah, get your head outta your ass and go sit the fuck down.  Her cold feet will keep as long as we can keep her heart beating.  Not that I don't realize that your traumatized from this event too, but I don't have time for it.

Yeah, so those are the top 4 pet peeves I can think of right now.  What's yours?