Trauma Diva

Serene Saturdays

2011-11-12T13:21:00.001-08:00

Life is sweet at the moment. Great new teaching gig with top uni that pays good money. Love my new workmates. Just an awesome group of women so far. Looking forward to turkey day and military officer son home. Yeah!!! Appreciating the good in my significant other.

I love the cool air of Fall and the hope of joy for the holidays shared with family. Have made some connections with old friends. Life is so weird sometimes. Strange to watch the years pass by and see what unfolds in people's lives. Even more strange to process my own. Long term friend finally came out of closet. Another colleague diagnosed with terminal brain tumor. Life is short. Live for the now.

Time to make some pumpkin bread and watch some football.

Ding dong the witch is dead!

2011-09-29T03:03:00.000-07:00

Which old witch? The witch I was working for. Well . . .she isn't exactly dead, but it is a nice song. It didn't sound so sinister when Dorothy sang it. Long story, but here's the short version:

I started this blog in 2008, just as I was leaving a position with my healthcare system for another internal position. Great job. Loved teaching. Loved the students. Loved my boss or so I thought. Then, boom. . . fast foward after several high profile successfull projects which had great outcomes. Praise from the powers that be. We had some turnover during that time, but our team survived it. However, Jan 2011 we have a management change. It was totally a WTF moment.

We had taught with this person, but to have her as manager? Um....tick box NO! The WTF moment came when as a team we realized that none of had even interviewed her. Superboss just made the decision all on her own. This chica had NO management experience. Nada. Thus transactional. Plus almost no academic experience. Oh dear. Well, you can imagine how this worked out. If you can't. . . think Atilla the Hun in polyester tops with earth shoes. Dutch boy haircut. No makeup. And best of all? Atilla thinks managing means discipline and poor evals. So starts her assasination of staff. Recipricolly, their resignations. Now we have lost two more staff. What a twatwaffle.

Um. . .to support the economy we are told, there will be no new hires. Just buck it up and absorb. And still get written up. Again, tick the box NO!! Productivity and morale went way South where the sun just don't shine. I survived the first round. But like clock work, it happened again. I was kicking myself all the way to HR. I had just turned down two faculty positions to work for this Medusa? Was I nuts.

Box YES. There was nothing to do. I resigned. Start job applications in a desert world of bleakness. Semester has already started. Uggh......so yeah. I can work night shift. Which is what I am doing while writing my blog. At least I can pay the bills.

Finally, after hundreds of hundreds of online applications through SimplyHired; HigherEdjobs; CareerBuilder; etc. . . .I got a few interviews. Then, yesterday. . . a hopeful offer. I am thankful. Honestly. But WeightWatchers? Hard to explain the 40 pound weight gain over the last year. Maybe it was the bottle of wine I drank everynight. That or the donuts and nachos.

Time to cut my losses. Refocus. And move on. Sorry students. You deserved so much better. But ding dong. . . .

Hell Hath No Fury

2011-08-27T12:50:00.000-07:00

Satan's weather monsters are reeking havoc on the East Coast. We in the middle of the country, however, have been in weather hell since about June. 60. . .yes count them; SIXTY I say, plus 100 degree heat. Everything is dead. Shrubs, grass, pasture, trees. Ponds are dry. I have experienced Texas heat before, but never like this.

How my animals are surviving, I just don't know. I have to put water out in the tanks daily. Working farm dogs are inside, panting. I have fans funning. Air con runs day and night with a temp set on 85.

But the worst? The worst trauma of the summer goes to the dumb ass parents who are now arrested, that punished their 8 year old boy by making him stand in a corner in a hot house with no water for five days!!!! RUFKM???? I hope they bodies rot in a hot un-airconditioned cell in solitary confirement in the bowels of Lew Sterrett justice center.

I was so angry when I heard that story. And fat pigs they were. Obese. Trolls. Uggh....poor boy. His soul has risen to a better place. That is the hardest part of this business, the kids. in another case, a deranged, to be estranged father drowned his 3 and 5 year olds whilst Mother in horror watched. Again, WTF???

To some extent, adults victims. . sure it is tragic. But kids? Hello. . . .Elizabeth Smart. Jaycee Dugard. (if you have not seen the Diane Sawyer ABC interview or read her book A Stolen Life you should read it. They just don't deserve it. No sirree doggy.

Our 50th year

2011-08-20T12:30:00.000-07:00

This year mark's the year that Princess Diana would have turned 50. Okay, so it is my trite interest in the history of the British Monarchy or just my fondness for iconic underdogs. . .who knows. But I am a Princess Diana lover of many years.

I started following her when I was a young girl about to get married. I read every snippet in every newspaper I could get my hands on. I dressed like her, wore white tights and flats like her, cut my hair like hers, volunteered like she did. My wedding had the huge satin dress with a long train. Okay, maybe not 25 ft. I even processed down the aisle on the arm of my Daddy to none other that trumpet voluntary.

I watched the media build her up and tear her down. Watched her stuggle to find herself. Ditto with me. Her weight went down. Mine unfortunately went up. I desperately watched as her marriage crumbled. Shocked as she revealed publicly that there had been three in the marriage. Little did I know I would face the same situation a decade later. I watched as she picked up the pieces and made peace with herself and her God. She even met Mother Teresa. And with that, her life was suddenly snuffed out. That was a rough August in 1997. It took me years to get over it.

Then, I watched her sons grow. William into a noble Prince. Harry into a fiery, tempestuous soldier. and viola. . now we have Kate. Diana, who would have turned 50 on July 1st, must really be smiling. What a fresh breath of air into a monarchy that so needed it. Gone are the stuffy days of Prince Charles and the rottweiler (Diana's affectionate name for Camilla). God bless William and the homage he has paid to his mother in what would have been her 50th year. His beloved wore her ring. The wedding at the Abbey was as gorgeous as Diana's in 1981.

She will be eternally young with her death at 37. And I to age at 49 will begin the celebration toward's my 50th year. At first, I was going to just sort of ignore it. Now, I plan to Oprah-size it and celebrate it all year. Seven months away. Time to take stock, mulch a bit, count the blessings, and flush the tribulations for good. Just some reflective musings as I leave my middle adult hood.

Now. . .where to find those Kate Middleton LK Bennett pumps?

Navy Fallen Heroes

2011-08-15T16:25:00.001-07:00

We deal with trauma every day. Is it me? Or does it seem like the 30...YES.....30....Naval Seals and naval and army aviation support team members who lost their lives this past week when their helicopter was shot down. . .were. . .just forgotten?

Go to cnn.com check out the link. . . .Chinook helicopter survivors sorrow. My heart breaks for the men who held the most elite dangerous positions of our military. Our Navy SEALS. But also for the support troops. . .the medic and the aircraft support teams that also lost their lives. Even more importantly. . .for the wives and families. At least four of the surviving wives are pregnant. Babies that will never know their Dads. I looked at each and every face lost. It broke my heart.

And when will it end? Why in the hell aren't we out of there? Wasn't that the promise? This far in. . .as we are supposedly pulling out. Now? We have the deadliest day in Afganistan? I am so over it. So over the politicians who are so far removed and only focused on their upcoming campaigns. How many more lives have to be lost to a lost cause in and of itself.

I know Vietnam was rough. On our men and on our nurses. But we have no purpose in Afganistan, nor Iraq. It is finished. It is over. Obama....back up your words. Get our boys out. Get them home. Put that truth in your campaign speeches.

FON Future of Nursing IOM Report

2011-08-04T09:36:00.001-07:00

We all know about reports. Yet another roles off the pike. But the Future of Nursing report published Spring 2011 by the IOM shakes nursing to the core and is of biblical significance. Never in my career, except maybe for DRGs have I seen such a document have such profound impact so quickly.

Every successful, major healthcare system in the nation has adjusted its strategic plan for nursing and healthcare to incorporate these changes. In a nutshell, they are:

Key Message #1: Nurses Should Practice to the Full Extent of Their
Education and Training (Chapter 3)

Key Message #2: Nurses Should Achieve Higher Levels of Education and
Training Through an Improved Education System That Promotes Seamless
Academic Progression (Chapter 4)

Key Message #3: Nurses Should Be Full Partners, with Physicians and Other Health
Professionals, in Redesigning Health Care in the United States (Chapter 5)

Key Message #4: Effective Workforce Planning and Policy Making Require Better Data
Collection and an Improved Information Infrastructure (Chapter 6)

Everything we do, write, plan is all about this report. It is I believe the pre-cursor to healthcare reform. How get paid for healthcare is already being tied to patient satisfaction scores and outcomes. We all want to deliver excellence in healthcare, with minimal mistakes. But can we really prevent the obese diabetic CHF patient from eating that In and Out cheeseburger and fries? Because he re-present to the ER will prevent us from being paid for that care.

It is a BIG issue. Huge issue. Lots of provocative discussion. At our meetings, we smile politely and forge ahead. Next, I will talk about my newest role . . coordinator of our Clinical Nurse Leader program. A new credential and role in nursing to manage all of the above.

Post script: thanks for coming back to read. It has been almost a year since I blogged. Lot of change during that time. But the good news? The new honey relationship celebrated its one year anniversary!!! Wahoo. . . . and moi is engaged!

Just when you think it would never happen. . . .

2010-06-21T20:25:00.001-07:00

Just when you think you have gone totally cynical. . . . the nicest thing will happen. Ah. . . . sometimes TPTB put you in the right place at the right time to meet the right person. Ya just never know. Hell didn't even freeze over.

When things go well, I sometimes wait for the other shoe to fall. But work is going good. Personal life is cleaned up. Duchenne's kiddo at camp and going to get an experimental treatment which gives ya hope. Knocking on wood as a type.

Life ain't bad. I am centered. Losing weight. Okay, okay. . . the waffling will stop. Just call me Polyanna for gosh sakes. I think Shanda's blog is having an effect on me. Even my trash tv, the Bachelorette I can't be cynical about. It is a boring season despite Ali and the eye candy. But alas, romance is in the air and it has me on cloud nine.

Now I just need to post about a great trauma! Either that or work a shift in the ER!

It was an American - Gaaahhh!!!!!!!

2010-06-06T16:21:00.000-07:00

I am horrified to report that it was an American who killed my colleague in Australia, ED Manager Michelle Beets. Not only that, he was a disgruntled employee whom she had sacked because he was stealing drugs. Gaaaahhh!!!!!!

Downunder, we already have a reputation for being gun-toting, violence driven, non-helmut wearing, drunk drivers. And now this to perpetuate the stereotype. Damn it!!!! I am ticked. Enraged really. Couldn't it have been a random crime like in the US? But no, some idiot YANK goes and kills one of the most amazing nurses EVER!!!!! That is a lot coming from me.

I am saddened and embarrassed for our legacy. It will take 100 good Yank nurses to overcome that deranged one. I am not even going to dignify his infamy with a name. But you can read it for yourselves in the Sydney Morning Herald or from the ABC news.

Hanging my head in shame!

Sex and the City 2 Premier Day!!!!!!

2010-05-27T08:21:00.000-07:00

Wahooo!!!!! It just doesn't get much better than this trauma queens!!!! It is Sex and the City 2 Premiere Day. I am so very excited. Cosmos all around. For a fun blog about Sex and the City, the latest. . .check out Cosmoguy Online. I am sure he will be in New York with his Christian Louboutin pumps!!!!

Now, come on gurls. Put on your glitz to the ritz, order yourself martini. And enjoy!!!!!

POST note: 6-4-2010 Poor Cosmoguy. He was so bummed about the movie and the poor reviews that he quit blogging and gave his sign off. Well, to hell with the critiques. This movie was a romp. Nothign more. Some over the top moments and poor direction by Michale Patrick King who clearly must have snorted some coke or embibed in some mind altering drugs while editing and directing. Eeek - there are some way over the top awful moments. . . but enjoy it for what it is. Shoes, clothes and our fab four getting older - and sometimes that ain't pretty.

WTF Friday is back!!

2010-05-21T08:09:00.000-07:00

Great case for you today. It is a cardiovascular one. Seems on a cath lab table, somewhere in my neck of the woods, lay a trainwreck patient - you know the ones. . .poor perfusion, such a shift in oxy-hemoglobin curve that any little thing pushes them over the edge.

My gasser buddy tells me he was giving this patient conscious sedation and warned said cardiologist that he was seeing some runs of V-tach. He was concerned that she was teetering on the curve, ready to buy herself a tube.

Here is how the transcript of text msgs from my gasser buddy to my cell phone went:

Text 1 This shit sucking job is killing me.

Text 2 We have just lost about 200 ml of blood doing a battery change on a pacemaker. Now

there is a question that the atrial lead is broke and since the AICD is right sided, it changed the vectors. Glad she didn't have any more VT.

Text 3 Holy shit, this cardiologist (female) is rough.

Text 4 Glad I don't do funerals or weddings.

Text 5 Oh my, the defib/shock lead is in half from her yanking. WTF.

Text 6 And there's no way to retrieve it. So, we are putting another one in. What do u

think this is going to do to the VT long term?

Text 7 All these missing wires floating around.

Text 8 In theory, only if she gets infected is the card planning to go after it. Then she'd have

to have her chest cracked.

And that was how the case ended up. Do you know how rough you have to be to break a lead off in somebody? Geesh. Think this ever went to quality? Um. . . box no. Wow. . . just another day at the okay corral kiddies. More medical F#$% ups swept under the rug.

WTF????

Bad relationships

2010-05-18T08:31:00.000-07:00

Why are nurses so bad at relationships? Statistically, nurses have one of the highest rates of divorce. It has been in the literature so many times, so pardon me waxing on about somethings we already know. We care. We care about people. We take care of people. Often, we don't take care of ourselves. We think we can fix people. Change people. If people would only follow our advice. LOL. Damnit, the world would be a better place. We are classic enablers. Way too forgiving.

Take the show Mercy. That girl is messed up in her relationships. Had an affair while married and serving in Iraq. Ignores the guy who she is married to and really loves. Drinks a bit too much. Wears her heart on her sleeve for her lover doc who has moved to town. But when she finally admits it to herself. . . he has moved on. Trainwreck!!!!!

Today was a classic example of why I am stupid in relationships. Going through divorce number two from a narcissist who treated me badly. Long story short, in Jan got an email from his ex-lover and cyber lover for over a year telling me to "keep my lying, cheating, ego-maniac man." But no, I forgave him. He was being sweet to me. Come to find out, the reason was. . . he had broken it off with her and I guess was feeling remorse. But I forgave him - yet again and like a fool took him back. However this time, there was just too much resentment. To much pain. I was a shrew to him. Because I felt he deserved it.

He finally got sick of it and packed his bags, telling me he was never coming back. "Good riddance," I said. The revolving door had closed. Or so I thought. The divorce will be final in a few weeks. Sorry, I digress. Fast forward to last night, he calls me. . . all sick. He sounded awful. He wanted the name of our doctor - like he couldn't remember? And bam - like a fool. . .I fell for it all. Dropped what I was doing. Got him some antibiotics, cold prep, lozenges, echinacea, Vitamin C. . . . to the tune of $80 and breakfast for the poor buggar. Go over to his new place. Help him sort out the meds. Feel sorry for him. Question for a split second wanting him back. And then. . . true to form. . . when I suggested he sit down, as he was looking weak . . he lays into me yelling at me not to tell him what to do. . . yadee yadee. . . yadee.

Can you say fool? I should have it tattooed on my forehead. I could write a book. What not to do in relationships as told by the fool who did them. I was ticked. Not at him, at myself. Bad, bad decision. Do not help narcissists who suck you dry. Lesson learned for the day. He is a bad man. Okay, I am now done.

Happy Nurses Week to my Buddies

2010-05-06T15:55:00.001-07:00

Hard to believe that it again is National Nurses Week. This year marks my 27th!!! Gawd I am old. But to celebrate it up. . . here are a few highlights from my career. The first piccie is graduation.

The second piccie is from what I consider my favorite moment in nursing: trauma nursing while volunteering for the Olympic Games. I was the only U.S. Nurse to be selected to serve in GamesForce 2000 the official volunteer workforce for the Sydney Olympic Games. What an honor to get to volunteer, using the skills of your passion,. Nursing in the Olympics was simply amazing. Although I have had many patient care experiences which have touched my heart, this moment for me summed it all up. Working the night of the Opening ceremonies, being fitted for my official uniforms, getting my gift a Swatch Olympic watch, attending the games as a thank you gift, and seeing the torch lit were just spectacular moments. I will never forget Sydney 2000. I cried my eyes out as the fireworks went off to close the games. We watched from a rooftop of an Aussie Youth Hostel in downtown. Hard to believe it has been ten years.

Hats off nursies to your most precious memories!!!! God bless us nurses.

ED Nurse from Royal North Shore Murdered

2010-04-28T15:26:00.001-07:00

Just when you think you are understanding the world, bizarre tragedy sneaks in and devastates the universe as you know it. My dear colleague, Michelle Beets, manager at Royal North Shore Level I Trauma Hospital in Sydney, Australia was murdered yesterday. Maybe by a crazy out patient or one of her partner's unhappy clients. No matter, she is gone and taken brutally. Suddenly, as she was walking home from the grocery store in an upscale neighborhood of the North Shore in Sydney she was brutally attacked, throat cut and slain.

Things like that just don't happen there. Sydney hardly even even has guns. Only six to eight gunshot wounds per year. In Michelle's case, her throat was slit and the was butchered brutally on the verandah of her home in Willoughby, a suburb of Chatswood. The staff of RNS are devastated beyond belief, for this was a one of a kind nurse. A modern Florence Nightingale, in her no nonsense way, she had no room for laziness or fools. She ran a tight ship of excellent care, and her love for nursing came from her heart. She inspired other colleagues, including docs, nurses and ambos with her direct, decisive decision making. She inspired me to be a better woman and a better nurse.

I will miss her smile. Her wit. Her beacon and lamp to lead ED nurses to the future. God must have wanted you badly my friend.

Love and Loss

2010-04-22T10:53:00.000-07:00

In nursing, due to the nature of our work, you think we would be experts at love and loss. I have read many of the self help books. Studied the content in nursing courses. Taught my students how to reach out and look beyond the surface to understand their patient's locus of control. Bah humbug! How is it then that nurses, especially trauma, ER, and ICU have some of the highest divorce rates in the country! We are relationship disaster areas. Able to counsel others on the ins and out of emotional trauma, but sometimes train wrecks with our own.

Now, I am not stereotyping all nurses. Just eating lots of crow lately. I was my own enabler for a very narcissistic man. I never knew I would end up divorced and certainly not twice. I am hearing Tammy Wynette's song in a loop in my head D-I-V-O-R-C-E. Good golly, why can't I follow my own advice? Oft times I have felt like a shit magnet. In the past that is what my colleagues used to tease me about.

But I have learned from the school of hard knocks some valuable life lessons:
1. Take care of yourself. Make sure your personal bank account emotionally gets deposits, not just withdrawals.
2. Take time for yourself. Eat better. Move about.
3. Hold tight to your values and don't let them be bulldozed.
4. Pay attention to red flags. They always pan out.
5. Don't be a cynic, there are a few good men out there.
6. Cut your losses.
7. Process it, grieve it, and guhrrrlllll. . . .let it GO!

So, now on the upswing. As such I am a humbled person. But proud that I can be like Mary Tyler Moore on the show and truly make it on my own!

Writer out of the closet

2010-04-18T12:11:00.000-07:00

Writing about trauma stories was fun, but get ready for this bombshell: I am now coming out of the closet! I am a writer. Admission time. I adore story telling. So, pardon to my trauma readers, but if you have enjoyed what I have written here, please check out my new blog: J Vaughan Productions.

It is time to stop hiding and start shameless promoting. I have learned these new skills from a friend who is a master at promoting his work via his website Lane Architecture and his blog Larry Lane Architecture

Who knows? Maybe I learned something. Life is short. Test readers thought my latest book was a page turner. I am excited about it. I hope you are too. So please, my loyal readers check out my new site. Opinionated, open, and of course trashy!

I will still occasionally post about TV, trauma and our favorite trash here of course.

Trashy, trauma, drama . . .The Tangled Web

2010-03-03T11:02:00.000-08:00

Would you read this book?

Take a moment to read the following query. If you like the query, please vote on the side of the page. The time has come for all wanna-be-published writers to S#%t or get off the pot. My book is done. Time for test reads. Now to paper my walls with the rejections letters, or at least that is what they say. The writing is easy, it is breaking in that is a bitch.

Please let me know what you think.

Query: The Tangled Web

At what point does internet flirting become cheating? A modern day Scarlet Letter, my recently completed 125,000 word contemporary, sensual romance A Tangled Web explores just that.

Pasta, prose, and petulance reduce Jana Sears’ marriage into crumbling heap of infidelity. Raised a French Creole Catholic girl, she is dazed when an Italian ex-pat sojourn with her husband stalls. Bored, alone, and unable to speak Italian Jana enters the world of social networking to elude la vida Italia. She is soon swept away into a fantasy land of cyber sex; quite unprepared for its consequences. Marriage at a breaking point, she plots an escape with her online lover. Not in cyberland, for real. Masquerading her intended affair as an exotic vacation to oz, Jana embarks on an Australian adventure downunder. Fantasy crashes into reality. She is found out. Amidst roos and didgeridoos Jana quickly realizes she has made a devastating mistake. Affairs by women are not like that of men.

Forgiveness comes at much higher price. A Tangled Web takes a look at damage control for the unfaithful woman’s soul. It is part of a series of steamy novels about strong women of the Deep South.

Diabetes Denial

2010-02-10T07:30:00.000-08:00

I have students who take care of med/surg and tele patients. I have seen such a shocking trend in the last few years. In the past, it was only a few patients that had diabetes. Some insulin dependent, some non-insulin dependent.

In a nutshell for my non-medical readers, when you get diabetes as a child, you usually don't produce insulin and must test your blood sugar and give yourself the insulin as your pancreas doesn't produce any. Most non-insulin dependent diabetics got diabetes as overweight adults. In those people, their pancreas is trying to work, it just doesn't work efficiently.

My students have about 20 patients or more per week. For our large medical center, I would say that about 60 percent of the patients on our floors are diatetic. Most of them are adult on-set or non-insuling dependent. They are overweight and mostly non-complaint. Damage from diabetes comes from large fluctuations in the blood sugar. One day high, one day low. Tight control is the key. When patients are non-compliant and in denial about how tight this control should be - they ultimately require mutiple hospital admissions. After about 10 years, these patients develop cardiovascular disease, high blood pressure, renal failure, required amputations, poor healing wounds, chronic infections. They are a mess.

This costs you, the insured paying for your insurance. . . . . literally BILLIONS!!!!!!! It is what causes your premiums to be outrageous. It is what keeps your cardiologists in their Mercedes. It is what overpulates kidney dialysis centers. The American Diabetes Assocation has screamed about this for years. The news media has storys about the percent of overweight Americans. Gross obesity is like a slow suicide. One way or another, it will catch up with you.

What is wrong with our society that we exercise less and just continue to eat more. Go into Walmart. . . .try to find small men sized clothes. There are three women's departments: young female teen, women's sizes, and jumbo. Where else can you find 4X clothes? We now have to have special blood pressure cuffs, big-boy beds, and erganomic devices to help lift and pull on these tubbos. Have you looked at children's playgrounds lately or been to a school? There are some fat kiddos running around.

I am one to talk. I have personally about 50 pounds to shed. But ya know what? I am movtivated darn it. I don't wanna be the next payment on my internal medicine doc's condo. It is time. Wake up America. . . .take a look at what we do and how we do it. Quit talking about getting healthy and just do it!!! Now THAT would be healthcare reform.

Dichotomous til the end?

2010-01-27T15:55:00.000-08:00

Well, just as it has been since the 1800s, the dichotomy of entry level into practice rears its ugly head again. The opposing forces? Why none other than nursing themselves. From almost the Crimean War. . . once Flo established nursing as a profession, nurses have been split on just how much education does it require to be a nurse, well professional nurse, well registered nurse. . well . . .and therein lies the problem.

The first nurses had only on the job training, the next generation, the nuns providing the dirty work. Then, hospitals got involved in the training. At least they decided between the difference of an LVN vs RN. But once nursing was established in the United States. . .well what can I say? Bi-partisan all the way. The National League of Nursing or NLN (which had the support of hospital based programs and technical colleges) wanted an RN to be an RN to be an RN - no matter what program. The American Nurses Association or ANA (which was collegiate based by founders) wanted the entry level of practice to be baccalaurate prepared. According to the ANA, how could one consider themselves professional without a formal degree.

I learned of these differences circa 1970s in my own diploma program (guess which faction they supported). I later went on to get my BSN. And believe me, I got plenty of marketing for me to join the Texas Nurses Association, a state chapter for ANA. Uggghhhh. . . .

For me, it was a personal decision. I wanted a college degree - period. Later, it paid off in my career for advancement and further study. The argument continues today. Even in my own work area. Recently, my boss posted an article by AACN, the American Association of Colleges of Nursing (an ANA fav) reiterating the thought that due to complications in patient accuity, the RN should be baccalaureate prepared. Within minutes of that article surfacing. . . in our cubicles. . .on of my colleagues posted the NLN rebuttal to that argument!

OMG. . .is it any wonder that 100 years later, just like our bi-partisan US government. . . we can't be unified on anything????? How are we to move forward as a profession if we are still arguing about the same crap? Like Einstein said "you can't solve today's problems with yesterday's thinking."

Time for another glass of wine. . . .

Trauma Diva on the radio

2010-01-18T19:09:00.000-08:00

Okay, I am trying something new. So new in fact that unless I have die hard followers, which is hard to imagine, since I haven't posted in over a month. . .but I am experimenting with new technology tonight.

Yes, tonight you will be able to hear a radio broadcast. TraumaDiva is going live on blogradio! Tonight will be an introduction, but I plan to be a regular on Monday nights at 1000 PM CST. That is 1100 PM for you Eastern folks.

Here is the link: http://tobtr.com/s/870389 or call 347-838-8988

It will be interesting on this test version to see if we have any call ins. More diaglogue soon. Lots going on in TraumaDiva's world that must be discussed!

Tonight's broadcast veres more toward the tv trash popculture genre with a discussion on the show The Bachelor. And I would like to bag on Reality Steve who's predictions tonight sent all that participate in ABC's rose ceremony game to the crapper!!!! I am so ticked. Who wouldn't want the smarmy gifts from the gift bags? Or a trip to St. Lucia where the fantasy dates and final dates are held. I am so glad I am not a gambler and had nothing wagered on this except my gossip repuations. LOL. So much for the reliability of internet sources. EEEGGAHHHADDDDSSSS we are in a new generation of social research. Who to believe?

It just goes to show ya. . .believe none of what you hear and only half of what you see! Please tune in!

Trauma of the Week

2009-12-14T17:02:00.000-08:00

Cyclops. Yes, that is the term that is pretty much universally known in most ERs. It has to do with people that present with unfortunate lesions right smack dab in the center of their foreheads. Mostly infected zits or boils. I know, I know. . . the faint of heart need not read on.

I have heard this term many times. It always comes from some 20-something ER nurse blathering on from triage that yet again, a cyclops has arrived. Why do they reduce fellow mankind to such a humliating term? Are they trying to give rise to their perceptive triage skills? Are they trying to sound cool? A resounding echoing chorus usually follows of "OMG a cyclops" erupts from the chorus of attending nurses.

Okay, most of the time it is an unfortunate urchin who has indeed come to call. Did they forget to wash their hands prior to home expulsion of their whitehead? Did they fail to clean their home surgical instrument? Whatever the reason, here they come. Most times overweight. Many time diabetic, as was the case in this instance.

I was warned by the pretty young thing not to stare. Please, I have twenty-seven years in this business and Miss Thang has to warn ME not to stare? I bit my tongue as a sharp reprimand wanted to put her in her place. This poor girl cyclops deserved dignity too. As for pyt, her reputation major a giant leap to the gutter to me.

Uggh....how to we mentor the young? How quickly they dissolve into crusty old ER nurses bereft of kindness. Alrighty then. Climbing off soap box now.

Trauma of the Week

2009-11-16T14:53:00.000-08:00

Sad but true. In Texas, why do something yourself when you can hire an illegal alien (Mexican) to do it? My trauma of the week was the poor soul who fell off a steep two story roof hanging Christmas lights for the snooty suburbian who doesn't want to risk their own lives doing it themselves. Yes, in Texas we actually have successful business entrepreneurs who have hired these individuals to risk their lives.

Now the question is. . . do you think these "landscape" companies cover these "employees" with workman's comp? Offer them insurance? Benefits? Um. . .a resounding NO!!!! These poor buggars risk life and in this case limb getting up on these steep roofs just to make sure that all is pretty in tinseltown. Check out this garrish example in the cement burb of Plano.

In this case, the patient was a 22 y/o male who ended up with an open tib/fib fracture and near miss cervical spine injury. Luckily or unluckily on how you look at it, he landed feet first. The problem with this injury is loading to the spine on impact. In his case, in landing in just the right angle, he bought himself an orthopedic surgery and Ilizarov fixator instead.

Ah, gotta to keep those orthopedic surgeons and ER nurses busy!

WTF Friday - Ghosttowns

2009-10-23T13:02:00.000-07:00

I never thought I would hear that word used to refer to our hospitals units. Is anyone else seeing this phenomenon? At one of our largest hospitals in our system several units are just empty. At first, we thought it was just that our CEO couldn't wheel and deal with the docs to get them admit. Many had abandoned ship for xyz hospital up the row. But I heard from several other facilities who are seeing the same thing.

Where are the patients? Are we just playing fruit basket turnover with the same docs? Are people just not going to their docs due to the economy? I know our patient demographics have changed for sure. Lots of non-payers now. Doesn't help that the commuter train has a stop right next to the ER.

Also, it was a first. Revenues are down so much, just about every major hospital has had layoffs. Our system even laid off nurses! In education and other departments. But who ever thought they would see that????? Sheessh. With healthcare reform on the horizon. . who knows what we will see next. I keep hearing that whipporwill call of the lone West. Ghosttown indeed.

I would love to hear some other opinions about this.

Long time no see!

2009-10-16T15:15:00.000-07:00

Hard to believe it has been a month since I posted. But in Sept I had the opportunity to embark on a magical trip to South Africa courtesy of Make=a-Wish. My son was granted his wish from them, which was to go on animal safari...the photographic kind...no guns!

What a amazing trip. It was heartwreching in knowing why it was granted. . but none the less, it was truly AMAZING. It takes removing ones self from the drone of daily existance to re-focus onto what is important in life. -watching his face as he saw a lioness up close and personal. -seeing the joy as he caressed an elephant's trunk. -just taking in the glory observing him interacting with the South African guide. -clapping along as he "danced" in his wheelchair to the rhythms of the native drummers of Limpopo.

For that brief fortnight. . .my emotional trauma was arrested; sequestered to some place far, far away. I held tight to my moments with my older daughter and my little son. They are memories that now no one can take away. I will treasure them always.

And then? Touchdown into reality. His medicals in Cincinnati. Dealing with ex and the Ms.Ex, the barracuda. But this time, oh heavens, this time it was different. For every time they made me cringe. . . .at each and every test and doc visit. . . I inwardly smiled to myself. For my son. . . my dear son. . had chosen me to go to Africa with him. Not the ex. Ah. . .sometimes life is indeed sweet.

WTF Friday Classic

2009-09-11T21:03:00.000-07:00

This entry reads like so many other drunk driving incidents. . but this one just got my GOAT! A hispanic male of our community, father of a two year old lost his life this week to someone driving drunk. The drunk, hit him driving even though he had been arrested 19 times for DWI! WTF????

Here is the story:

A family from McKinney is hoping a man's 19th arrest will keep him behind bars following a fatal hit-and-run accident this weekend.
24 year-old Kevin Riddle was released after his arrest for a fatal hit and run accident last Saturday. The family later found out that was his 18th arrest, and after expressing their outrage, Riddle was arrested again late last night at his apartment complex on Virginia Parkway in McKinney.
He was most recently released on 50 thousand dollars bond, so the family of the man he's accused of hitting and killing hope 100 thousand dollars bond this time will keep him in jail.

What the story doesn't say was that he was arrested on drug charges the weekend afer the DWI incident. He shows absolutely no remorse. And what is worse? Keep reading!

Some judge in Collin County Texas allowed Kevin Riddle out . . not once. . .but 19 times. . .knowing he was a repeat offender!!! I am just flabberghasted by this. I was angrily beating my dashboard as I listened to the story. It is a public outrage that our courts just can't take driving while under the influence as seriously as the UK, Australia, the Netherlands and a host of other more responsible countries. UGGGHHHH!!!!!!

What is going to take? Another high profile Kennedy incident? Another Chappaquiddick before some politician, or better yet US. . the public who are at risk to be maimed, paralyzed, disfigured or killed by one of the intoxicated drivers out on our roads before someone takes action. No, it will have to be one of judicial system. Some high profile person before someone cares. This bloke was just some Mexican. GRRR. . .that irks me even further.

Hmmmmph!!!! Okay. . .so now that I have vented. . .I will sign off.

WTF Friday - Truck Nutz

2009-09-05T19:21:00.000-07:00

WTF Friday published late on Saturday. Had a hot date with hubby. Sorry.

This view caused me major trauma when I first confronted it on the highway in front of me. Guys and their nutz. . .geesh!!!! These are supposed to be bull's testicles. As in, "wow . . .I am such a hunka, hunka burnin lurve." NOT!!! BTW they can be ordered in a rainbow of colors. The latest set plugs into your hitch and lights up. Oh brother. . .

Freaking Fabulous Award

2009-09-02T08:17:00.000-07:00

Okay so this is a little self endulgent (really?) but. . . one of my readers awarded the Freakin Fabulous Award to my blog. I am very honored to have been selected by a reader. This reader was LivingDeadNurse.

As a part of this award, I am to list five obsessions of the moment and then five blogs which I rate as Freakin Fabulous! Dame Edna is shuddering with excitement just reading the name of this award. God love her.

So here we go. . .

Current Obsessions:

1. Watching "healthcare reform" attempt to formulate; speculating who the power players are going to be; and wondering just how spectacular the screw up will materialize head on. Cash for clunkers anyone? My resources for this topic are Mother Jones and George Stephanpolous. I feel I will get a pretty rounded view from those people.

2. Getting ready for the ice skating season to begin with Skate America.

3. Finding alternative activities for the bewitching hours (between the time I leave work and 8 PM) to do besides destress in a bottle of Australian Cab Shiraz. Hey. .. at least I am trying to cut down, for which my liver thanks me.

4. Getting ready for the trip of a lifetime, a trip to Africa. Not just to see animals; but see for real - people of the world.

5. Trying to keep my head above water with my 70 mile commute and the beginning of a new semeseter of lovely students.

And then. . . the awards go to. . . my top five FREAKIN FABULOUS

1. Nurse Ratched's Place The one stop shop for politically relevant discussions on today's nursing world. Thanks Mother Jones. I know this is just one in a litany of awards and recognitions for you.

2. The Noble Pig My favorite place to find wonderful and beautifully laid out recipes. Check it out. . you will be salivating.

3. Cake Wrecks I go here because I love cakes. Making them. Eating them. Salivating over the butter cream. So for me. . .this blog takes the cake and makes me roar with laughter at the screwups. Just hilarious.

4. Cosmoguy The one stop shop for updated info on Sex and the City movie happenings. Thank goodness for him. He keeps my SATC obesssion in check by constantly keeping me informed. Thanks Cosmo for keeping me up with my girls!!

5. Front Porches, Sweet Tea and Old Aprons If only my house looked like this. When I want to chill and escape the harsh realities of life, I head over to Shanda's. I know she will have a lovely bunch of flowers and a glass of Southern Sweet Tea ready for me.
She is an angel.

So congratulations to all my top five FREAKIN FABULOUS blogs. Now you guys need to carry the award forth and nominate your top five FREAKIN FABULOUS blogs. And thanks to my readers who keep coming back!

Texting While Driving- Nuff said!

2009-09-01T11:22:00.000-07:00

Wow. . this video says it all!!!! I watched this and the trauma management is so accurate. Also check out the injury sustained from the impact of the trauma and then the t-boning effect of the second impact. You can even hear the girl's neck crack as it would have in that position with that sustained speed. Who cares if it is graphic. . .it is accurate!!!

These types of PSA's are played regulary in the UK and Australia. Why won't the USA and the FCC get real and start educating our peeps like this????

Newbies in the ER? WTF

2009-08-28T10:31:00.000-07:00

Second in the installment of WTF Friday. Do you think newbie nurses should work in the ER? I have a strong opinion on this. My answer is NO!

Now, keep in mind I worked as a tech (nurse extern) in the ICU and then entered the ICU as a graduate nurse. So I don't buy into the philosophy that all new grads should work Med/Surg units for a year before they specialize.

However, literature suggests that the graduate nurse just doesn't have the full range and breadth of general med/surg type knowledge to differentiate when someone is slightly ill or critically presenting. We know triage requires significant experience with ER presentations. Not even the seasoned nurse is allowed to work triage unless they have had at least one to two years ER/trauma experience.

Why would we expect a graduate nurse to be ablt to take on literally a myriad of various illness presentations and be able to function? One article (Stephany, Nursing and Healthcare 12:9)suggests that graduate nurses not be allowed to even work the hospital! In essence, they should preceptor on a unit together with a lead nurse to learn. Now, I admit, that is extreme.

One RN's dissertation (ISBN 978-0-494-23071) demonstrated that often preceptors of new graduates are confronted with newbie nurses that have unsafe practices. New nurses need time and gain that experience. Although many ER patients present as walking wounded, there is always the potential for an urgent or emergent situation to develop.

I do believe we are all life long learners. I just don't think we should eat our young by throwing them to the dogs as new grads. They should be supported, educated, precepted and then be sent into battle. As always, I am interested in what you think? Please post your comments!

Trauma Registry

2009-08-19T06:37:00.000-07:00

This is a survey post. Recently I heard that the encouragement from our RAC is that all hospitals or at least as many as they can encourage should register as trauma centers. . .even if they are so small that they register as Trauma Level 4. We have a little band-aid station hospital in our system. Most ambulance services in the area know this and keep driving. They get minor trauma, like sports injury fast track stuff. Should they register as trauma level 4? All RNs trauma certified? I dunno. . . . In fact I just really don't know how I feel about that. They get so little trauma, the full time FTE for trauma registrar will spend most of her time in staffing. . .not really doing the job - not really out there preventing and teaching. I fear she will be just looking for trauma, registering all these minor cases and making them more severe than they were? Am I being a cynic?

I really would like to hear what you think.

Should all hospitals with EDs be required to register as leveled trauma facilities?

Please post your comments and answer the survey question.

WTF Trauma Friday

2009-08-07T17:00:00.000-07:00

Okay . . so in honor of RUFKM and WTFF on MelRox's site. . Jagged Blatherings. . .I would like to start a sub topic. We have all heard of the trauma's that are just so stupid. . . you do a WTF? I personally am a fan of this new slang term. . . that and my personal Aussie nurse fav. . . Oh, for F#%k's sake! Try it, very guterrall. No need for that TUMS at all.

So. . here we go for installation number uno. In Big D land our latest traffic trauma seems to be wrong way drivers down our tollways. Now I am sure you are thinking WTF? I mean. . how is it possible with the sign postings, oncoming lights, and overheads to end up on the wrong way. I mean. . did you go to the bar in America and think you came out of a pub downunder?

WTF. Seriously. . . we have had five traffic fatalities recently all from people getting on a tollway and facing drivers head on at 80 mph.

Was it surprising that in almost all the cases. . . there was alcohol involved? WTF. Shockers right? Sadly, Yanks just haven't gotten the concept of a) designated driver b) take a taxi c) don't drink if your are driving!!!!

Hearts of the newbies

2009-07-27T13:58:00.000-07:00

Thank goodness there are newbies to replace some of us old crusty buggars. -or at least remind us sometimes of the things that are important in our profession. This semester my students are required to write a critical thinking journal filled with "ah-hah" moments that make them think.

I would like to share, just as it was written, the poignant entry that one of my students wrote this week. It reminded me again of how we should look beyond the tubes and lines and be advocates for those who can't advocate for themselves. Way to go NEWBIES!!!!! It helps to have your hearts bring us back to the profession.

Enjoy!

When to become a DNR (Do Not Resuscitate) status

On 7/xx/09 I was about to walk down to lunch when the nurse I was following that day asked if I could please help her in another room. Me and two other students entered the room to help her with a dressing change. The man lying in bed was on contact precautions for MRSA in a wound, he had a tracheotomy and I noticed right away that he was in decerebate rigidity.
The man was breathing heavily and you could hear the gurgling of sputum in his tracheotomy as he was trying to breathe around it. He had an unproductive cough and twice during the wound change the nurse had to suction his tracheotomy. He had a pressure ulcer on his coccyx that was definitely a stage 4 and like nothing I had ever seen before.
What struck me the most was, as I found out from the nurse, that this man had walked into the ER about 240 days ago. He later suffered a brain injury and other serious complications that resulted in him being unconscious, requiring a tracheotomy, in decerebate rigidity position, and no longer able to care for himself. He was also 41 years old.
She said he would likely never leave the hospital because the family refused to make him a DNR status.
When I heard about how he was able to walk into the ER and then saw his condition now, it made me incredibly sad. I could also not understand why the family would not make him a DNR status. Living like that for the rest of your life in a hospital is no way to live. He is so young too and has a family. I understand that the family probably cannot come to terms with what has happened to him, but I think as a nurse it would be imperative to talk to the family truthfully about what his future may be like and how his quality of life will be. Not to coerce or force them into making him a DNR patient, but at least make sure they fully understand that he is never going to be like he was before and he will have to live like this for the rest of his life, which could be a long time since he is in his 40s.
As someone who aspires to work in a critical care unit, I will keep this in mind because I know I will have patients who are on their way out and have a very slim chance of surviving or may have a severely decreased quality of life if we continue to prolong their life like they have been in this man’s case. It will be something hard to deal with and I cannot imagine yet how it will be to talk to family members about something as sad as this but I truly believe that quality of life is better than quantity. I only hope that if I am ever the patient in this situation, my family will give me rest and peace like I deserve and don’t prolong my life if it meant I was going to live like that.

Political bombshells

2009-07-23T14:15:00.000-07:00

Why in nursing, no matter where you work, is it that you can't just enjoy doing your job without having to walk through a poppy field full of political bombshells?

I hate to admit it; being the woman's activist that I am. . . but I fear it is WOMEN!!!!!

Ugggghhhhh.......somethings NEVER change!

The Ultimate Trainwreck

2009-07-05T09:37:00.000-07:00

You know the story, the situation is just so bizarre, so outlandish, so tragic. . .you just can't look away. For years, I have been intrigued by the iconic status that certain people establish. What makes them not only celebrities, but icons? It goes beyond the talent. It is an ecclecticism that transcends the bounds of understanding. A magnetism.

It is a rare few people on this earth that achieve such an existance. Ghandi. Princess Diana. And yes, Michael Jackson. Those whose sudden departure from the world shatters the public to its knees.

As a consumate people watcher, I try to wrap my head around what makes these people tick; albeit from a mere mortal distance. I certainly would never exist in their realm. As such, I must rely on the academic and savvy intuitiveness of others to stealth information. I couldn't stop myself from following the life and times of Priness Diana. I read every article, every book, and was stunned to the core when her life tragically ended in that crash in the tunnel at Pointe de Alma.

As for Michael Jackson, it was a freakish interest. Peering into his looking glass, one felt garish. His actions outrageous. His life, a spectacle. He was childlike, the classic narcissist. His antics were a tabloid's delight. I posted in an earlier blog about feeing like a voyeur in reading and watching the media glare on his life and death.

For the first time today, an interview captured the full spectacle. The headline was the one I was waiting to see confirmed, Diprivan found at the home of Michael Jackson by Anderson Cooper on CNN. In it, Dr. Drew Pinsky explained very succinctly how being a celebrity with profound addulation fuels this need for adoration and narcissism.

What was stunning to me about the Diprivan was that as a trauma and ICU nurse, I have administered this powerful drug to my patients. -but patients that were entubated, certainly not conscious. Diprivan is an anesthetic. It produces unconsciousness in a plane of anesthesia, not sleep. The most interesting question, why would any reputable physician prescribe or allow a medication such as this to be in someone's home? Dr. Pinsky states that although he finds this so outlandish, "along the lines of aliens landing from Mars," he sees it as a classic example of the power, the need for those caregivers providing service to him to be included in the inner circle. That fact that a lay person asks for this medication by name, in and of itself is an indication of the "breakdown between doctor and patient relationship."

He believes that some celebrities come to view themselves as too special. -so special that they believe they deserve VIP treatment, beyond what the normal patient deserves. What they fail to recognize is that the standard of care IS the standard of care, it is the best for the patient. Often when icons choose to go outside this, demanding things beyond that - the care is actually substandard because the caregiver practices outside the evidence based gold standard.

This interview should be played around the world. It is the perfect explanation for this colossal celebrity free fall - and ultimate implosion.

Training the infantry

2009-07-02T16:43:00.001-07:00

What a cool week it has been. I got a chance to work with our "grow your own" students teaching them CPR. I also got a first aid/trauma lecture in there too. Their eyes were wide as saucers. Every preventable soap box was presented to their willing and eager minds. And as such, I am now a goddess teacher. Well. . . at least in their eyes anyway. I can dream.

Ahh. . .gotta love the fresh new enthusiasm of the young. Great plans, great expectations. I for one plan to motivate them, encourage them, support them. No eating the young from me. I am just getting to old to sling those bedpans. They are a diverse group. Almost half are male too!

Then, coolest of the cool, I got to witness their first day in clinicals. I thought I recognized one of the techs who was orienting my little sheep. She looked up and smiled. We did the "dont' I know you ?" looks. Sure nuff. . . she was one of my ADN students from last semester on her regular job as a tech. She said. . ."ah. . . .Ms. Traumadiva. Great to see you. This is just so cool getting to train the newbies when such a short time ago, I was one of your newbies."

And so goes the circle of our profession. My other RN students were looking on. My newbie was gleaming with pride as she took her first blood pressure. Now that is nursing!! Warm fuzzies for all!!!! Corny? Maybe so. But sometimes one needs to re-ignite the flame.

Icons and Voyeurs

2009-06-28T07:31:00.000-07:00

Farrah and Michael Jackson. I have spent the past few days as a voyeur. I just can't stop looking, or reading about both these two iconic people who have left this world. No one could avoid the media blitz when the King of Pop turned weirdo Michael Jackson died. But tragically, dear Farrah's passing was almost overshadowed.

I have been moved by the the documentary Farrah's story, a very bold and revealing view into the true struggles of the cancer patient. How brave of her to show it. We see her defiantly attempting to fight a disease that took control with a vengeance. She seeks out every possible treatment with hope, only to have each one dashed with news that the tumors come back. The pain and anguish on her face crushes her spirit. But she rises each and every time like a phoenix to try again. It was heartwrenching to me to watch her at her last Christmas of 2008, celebrating her last new year of 2009 watching the crystal ball at Times square and celebrating her last birthday in February. By late April she was bedfast. Hugging her son for the last time.

I just couldn't stop watching. My heart broke for Ryan O'Neal who loved her so. We will miss you Farrah. You gave women a powerful voice in your films, The Burning Bed and Extremities. You were indeed an angel.

As for Michael. A trainwreck waiting to happen. I agree with Lisa Marie . . . .he knew his fate. What astounds me is how did all these people around him, just stand there and let it happen? How could an MD, a cardiologist no less, not a pain management doc. . . inject him with Demerol knowing the poly-pharmacy on board. The last injection was at 11:30. The 911 call was at 12:21. He gave it and walked away. Jacko quit breathing. Autopsy? No need.

My diagnosis on record: respiratory arrest leading to cardiac arrest. No doubt in my mind.

What a dingleberry doc that he was giving CPR on a bed! Glad that cnn continues to report that the 911 dispatcher had to tell "doc" to put the patient on a hard surface, maybe the floor? Duh. . . . Wow . . .Michael never had a chance under that care. He was spiraling out of control. It was his destiny. Now maybe his record sales will pay his debt. I respect his talent. Absolutely. I cannot accept his lifestyle choices.

Icons. . . . gone. Life is short. Seize the day!

rollar coaster times

2009-06-16T17:53:00.000-07:00

Okay. . I am officially ready for my rollar coaster life to STOP!!!! For Gawd's sake! The highs and the lows are like some kind of sick and twisted lithium cold turkey.

Hubby filed for divorce today out of the freaking blue! Marriage number two now toast. I am gutted. Just gutted.

Can't write more now.

Nurse Jackie Farce

2009-06-12T15:18:00.000-07:00

This week marked the premier of the half hour dramedy Nurse Jackie. Several of my colleagues blogged about this early prior to the premier, begging all readers to write in and ban this horrific stereotype of a nurse. I did my part. Did I hear anything back? No.

This show carries a big name star, Edie Falco, of the sopranos. According to Edie, she loves and revels in playing her flawed character; a tough talking woman with issues. But this show does nothing to promote or advance nursing. In the first episode, she advocates for her patient. However in the next scenes, she is popping narcotics and is assaulted with a titty tweak by a physician.

I am sorry, but this is just more of the perpetual stereotype of nurses in general. Kalische and Kalische devoted their entire research lives on evaluating the image of the nurse. It is sad to say that in the year 2009, not much has changed.

There have been some strong nurse characters: Dana Delaney in China Beach, Loretta Swift in MASH, Julianna Marguilies in ER - but there are just not enough. And there is another show on the horizon, Hawthorne RN with a black character. Anyone remember Diane Carroll? Or Dixie from Emergency?

Not only was there stereotyping. It irks the crap outta me when they can't get the medical stuff right on a medical show. For F$%K sake! A trauma with a bleed doesn't die of a subdural. If it happens that rapidly, it is almost always a subarachnoid hemorrhage, SAH. Subdurals take hours to show up. Then, she is calling organ transplant and telling them they have four hours? What? He was already dead. About the only thing salvageable after that time is the schlera. Geesh! And it only continued to spiral down from there. She bangs a pharmacist to get drugs for her back. Makes an IV med error from not paying attention. Goood GAWD!!!!

Please don't watch this show. If you do, then please write Showtime and let them know there are plenty of non-stereotypical nurses ready to lend their stories of real drama.

Update on my random crap (fav things)

2009-06-07T11:24:00.000-07:00

I have spent a most productive Sunday doing absolutely nothing. I cooked breakfast for fam, but honestly, that is it. I have, however, expanded my mind and consciousness by reading my favorite blogs and finding new ones.

I love reading the clever musings of everyday people and wanna-be writers such as myself. But I have to admit, I am in awe. There are far, far more clever individuals than I. I am amazed at the hits some of these blogs get. Jeeez. . . .I must circulate in the wrong circles. -but I am grateful for the 1,790 who have surfed here. Okay. . .so I was 300 of those.

So for today, I thought my buddy, Dame Edna (my idol) and I would update you on some of my favorite things and hot topics:

The Bachelorette: Monday's episode and the next two following it were filmed in Canada. So get ready for some spectacular scenery amidst the cheesy romance of this trashy show. Gotta love it. Latest bach-ette is Jilly, a cute spunky Candian who was the reject of smarmy Jason from last season. Good on her! Who couldn't love the hunks that she has to choose from? Each and every one of them make her dump-er, Jason, look sick! Check out the pics of her top fav four: Kiptyn, Reid, Ed, and Jake. Ooohhh.....laaahhhhh.........llaaaahhhhh. http://www.fansofrealitytv.com/ Link to Bachelorette. Um hum. Gotta love those pecs. This week she finds out that some of the dudes have girlfriends and are only on the show to promote themselves. Go figure! She breaks down over this and her look of disappointment is just raw. They look like dogs called out. Great TV!

The Noble Pig: I love food. I love recipes. I love to cook. And unfortunately, I love to eat. There are some ab fab recipes on this website. The coolest thing about it is that she posts some great how to piccies on how the recipe should look as you are making it. OMG. . . you will be running to the store to buy her ingredients to concoct some of these lovelies. Chocolate Chip Overload Cookies, Gratineed Pineapple. Blackberry-Lemon Muffins. OMG. Check it out: http://www.thenoblepig.com/

The Ultimate Reality TV Trainwreck: Jon and Kate Plus 8! Does it get any better than this? So you had multiple mutilples. So you are on TV about what a great Mom you are and how despite the odds, your family is making it. Making it is right! Making it with other people. OMG. I had never seen this show, but had heard of it. I don't think I could stomach a whole episode. She is like a blond Posh spice. FAKE, FAKE, FAKE. Allured by the bright lights of reality TV, it just got too much for them. So, in true trailer trash fashion, they both started shagging someone else! Fleetstreet and gossip rags delight. See, you just can't write stuff this good. Real people commit way better Jerry-Springer-type acts of idiocy. There are just too many good blogs ragging on these people to post just one. Just google Jon and Kate bad press.

A Girl from the Ghetto: Just about the best blog I have found today. http://thegirlfromtheghetto.wordpress.com/ Over a million hits. Wowsa. I am envious. She writes her opinions on out society's lastest faux pas. Great read. Trashy. True. The best of the best.

Sports: A little slow in the traumadiva sports world. Stanley cup final had two teams that I really don't care about. The French Open - won by a girl that I couldn't pronounce her name. Who? And guy of course, Roger Federer. Was there any doubt? It is not skating season. Plus the 2008 crop of US skaters sucked in every category. Waiting on gymnastics season. BTW Shawn Johnson was just too cute on DWTS. Wimbledon not until July. Jerry world - aka the new Cowboys stadium debacle has just about made any loyal Dallas Cowboys fan want to hurl. The new stadium is an economic quagmire of audacious tackyness. So over the top, Jerry can't seem to get a sponsor. Poor Jerry.

Trauma: Here is an oldy but a goody. West Texas finest. We had a CV surgeon who had the worst GOD complex imaginable. He thought he pissed gold. Brought in major dinero for the hospital. For years, he was boinking his perfusionist (the gal who ran his heart/lung pumps during his cases). We all knew it, but wifey and the rest of the city didn't know it. Well, it seems his son found out. Son storms over to hussy's house. Bangs on the door with a knife threatening to kill her. She panics and thinks it is an intruder. She gets her gun, bought for her by demi-god. She pulls the trigger putting a bullet through the door. It kills demi-god's son. The affair suddenly wasn't so secret anymore. Karma and bad juju are a bitch.

Helmet anyone?

2009-05-31T09:07:00.000-07:00

It wasn't the first time for me to see it, but it sure had an impact on my family. We were on our 2866 mile car trip across America to see my son graduate from the Naval Academy. -more about that later. . . as it was ab fab!!!!

A Harley rider passed me on the freeway at about Texarkana going around 80 mph. He had his leathers on . . and true to form. . had on a dew rag. No helmet to protect his skull. Just a dew rag.
I made the comment, as I always do. . . ."Now there's a head injury just waiting to happen." My family probably rolled their eyes. . . as I see this all the time, get my dander up. . . and make the comments. Skulls when travelling at high rates of speed come to a smashing end when smacking the pavement.

The physics of it are called, deceleration. In deceleration injuries. . . when a hard object comes into contact with a non-moving surface. . .i.e. the pavement. . . the decelerating object (in this case the skull) strikes the non-moving object at twice the speed it was travelling. So, in this case if you were travelling 80 mph, like our Harley man. . .your skull would smack the pavement when you were ejected from your bike at 160 mph. An injury not really compatible with life. For inside your skull is your brain. . . which smacks the hard skull on impact and thus. . . .massive head trauma.

A few miles down the road on Interstate 30, nearing Hope, Arkansas, we hit a traffic jam. It seems there had been a wreck. As we approached, I was stunned. It was our Harley rider. He was lying on his side. . . . .body totally intact. Head. . .well you can imagine. He was dead.

Please wear your helmets - and throw a fit to those who don't!

Trauma irritants

2009-05-12T19:19:00.000-07:00

So you are driving. . . .

Do the following things just irritate the bejeezus out of you?

I. Rubberneckers.

Approaching an accident scene on a freeway in the opposite lanes. All traffic is at a standstill . . . even the lanes you are in which are opposite in direction from the accident. Why????

RUBBERNECKERS!!!!!!!!!!!!!!!!!!!!!!!! HATE THEM!!!!!!!!!

Even in the worst accident. . . i.e. unrestrained passenger, ejected from a rollover. What is there to see? No spouting arterial blood. No severed head. Nada. . . .nothing. MOVE ALONG people. Nothing to see here. Let the EMTs do their jobs. And for GAWD's sake. . . .let the tow trucks in to get that crap outta there.

II. People who park in the crosswalks.

Hello people! Crosswalks are for pedestrians crossing. Especially wheelchair people. Get your car off the freaking crosswalk. When a wheelchair access vehicle parks to let out. . . we can't get through because your car and your precious children . . . . all of whom can WALK are being let out for school with your big fat SUV parked in a damned crosswalk.

Read your state highway department safety and driving guide! That is a ticketable offense. Where are the po po when I need them???? MOVE ALONG PEOPLE!!!!!

III. Bikers who hog the road and don't follow traffic laws.

Okay they are being green and all that. Taking up space in your lane. Indignant that they too have a place on the road made for cars. But for Christ sakes. . . .if you are going to act like a car. . then follow the traffic rules for cars. STOP at red lights. Signal with your arms if you are turning. YOU ARE NOT SPECIAL . . .you bikers you.

Alrighty then. Clear that trauma diva needs an appointment to her gyno to get some hormone therapy to reduce stress. But I am just saying. . . . .

Ex Dickwads

2009-05-11T16:31:00.000-07:00

Okay...so yesterday I was all just sappy and pathetic at Mother's Day. Sorry, it just has that effect on me.

But, as Scarlett O'Hara so famously put it, "Tomorrow is another day."

Boy, I'll say. Today, after yesterday having sent my ex a sappy, oh-I-am-still-in-love with you (Yes, insert self-flagellation device here) . . . . email. . . . . he is acting like the royal JERK he is!!! And classic example of the reason I divorced him not just once, twice!

Gawd. . . what a dickwad DELUXE!!!!!!!!!!!!!!!!!!!!!!!

Where is that montra? "Fool me once, shame on you. . . Fool me twice. . . shame on ME!!!!

GGGGAAAAHHHHHHH!!!!!!!!

A Mother's Love

2009-05-10T07:15:00.000-07:00

A mother's love is like no other.

It is the foundation of the soul.

It began with Mary, the Virgin mother of our Lord.

It is eternal.

It is selfless.

It is unflinching.

When the toughest gangster presents to trauma, for whom do they cry?

Mother.

When the most brave of our soldiers pulls into port, what is the tattoo most requested?

Mother.

When the gift of life is given to another it comes from non other than. . .

A Mother.

Today, celebrate the Mother's that you know. Those that have their children close. Those that gave life by giving their child to another. If you were born, you too have a Mother.

In your heart today, for better or for worse, remember your Mother.

Missing

2009-05-03T16:57:00.000-07:00

Irene Blakey Missing since Jan 28, 2009 from Riverdale, IL
Alanni Arriola Missing since Feb 13, 2009 Las Vegas, NV
Brittannee Drexel Missing since May 2, 2009 Myrtle Beach, FL

Yet another young girl is missing. I don't know what it is about these cases, but they really bother me. As a crusty old trauma nurse, I just have a hard time accepting it. Maybe it is because I have a daughter, and if she doesn't call me at least once a week, I am sure she is missing too.

Above are the latest. They all fit the same profile. Young, pretty young thangs who dress like they are 25, lie and tell their parents they are with friends, go out and honky tonk and then. . . . never come home.

At 17, I too, thought I had full command and understanding of the world. And as we all know - God we were wrong. Try till, oh. . . 35? 45? Sometimes I am still learning. But these girls. These precious girls. They will never get that chance.

We see them come into the ER. Its never good. A classic I remember was the the young, pretty blonde who was dumped out on our tarmac from a limo. Dumped and left. She had vomit in her long hair and all over her white leather short skirt and bolero jacket. -probably an $800 Versace thing. She was unconscious. Smelled of alcohol. Tested positive for GHB. She wasn't breathing. Bought herself an ET tube. We looked into her purse for some ID. She was 16. We had to call her parents who told us "No, she was staying at a friend's house." They had spoken to her. They were sure we were wrong. -but we weren't.

Remember the slogan that came out that said, "It is 10:00 PM. Do you know where your children are?" Maybe there is some truth to that. Maybe I have watched too much Law and Order: SVU. But I wish it would stop. I wish the cops could find the bastards that are raping these girls and killing and then it WOULD JUST STOP!!!!!!!

Caring for your own

2009-04-27T14:56:00.000-07:00

God bless the nurses, EMTs and physician's who must care for their own. Just this week, I heard of an Australian colleague down under who had to be resuscitated as a Jane Doe trauma by her colleagues. She was a hit and run victim. Only after they had been working on her, did they discover who she was from ID.

She was treated with aggressive trauma resuscitation and advanced life support by one of the finest trauma teams in Sydney, at Royal North Shore. Rhonda was a fellow nurse in the ER. She was brought in unconscious and with such massive head trauma, she was unrecognizable. Magnificently, they went through their paces. Trauma surgeons, Resusc intensivists, trauma coordinator, trauma nurses, respiratory, their wonderful techs. At one point, she coded and was revived.

The angels of mercy in that emergency department cared for her with dignity and grace. Brilliance and excellence. Care, compassion. Technique. I have seen them in action many times. I was priviledged to work along side them. They are nothing but superb.

Then the horror, her ID. All were aghast. It was one of their own. -and it was bad. She survived to the ICU, but follow-up brain scans indicated brain death. She didn't make it. RIP Rhonda Moon.

That is the nightmare. We care for patients everyday, but it rips your heart out when they are your own.

In another case, we resusc'd a baby, unsuccessfully for an ER pediatrician who was the mother. In another ED, I worked, a gun shot wound was brought in, CPR'd and didn't make it. The ER unit clerk never even looked up. It was only the photo revealed in his wallet as they checked his ID that illuminated it was her husband. She sat a mere 20 feet away, never knowing they were working on him.

Life is fleeting. Life is short. Live for today. Live with a vengeance. Love whole-heartedly. Care for those who care for others.

March of Dimes

2009-04-24T13:57:00.000-07:00

I have been hearing about March of Dimes at work this past month. But through several blogs, came upon the story of the little girl featured in all the posters. How tragic that only this month, a mere few days ago, Madeline Spohr died.

The internet is a funny thing. A powerful vehicle. A voice of people who have never met, but find common ground. The story of Mike and Heather and their little Maddie is tragic. The love of a child that you know you might lose. Hospitals, nurses, oxygen, treatments, hope and despair. Not unlike what many parents of chronically ill children face.

Was it her adorable face, that lit up like an angel that captured so many? I am not sure. But the powerful message is. Life is precious. Short. Unpredictable. Live for today. Be happy and love with a vengeance. All lessons that my little Harrison with Duchenne's know.

So today, take time. Make it a purple day. Make it a Maddie day. Give generously. back. As of now, Maddie's March of Dimes page is still up, so please go visit and donate if you can.
Maddie’s Monster, designed by Mike and Heather in Maddie’s memory, are now available for purchase from Curly Q Cuties. Purple in honor of Madeline, with eyes as big and blue as hers, these plush dolls are sure to warm your heart. Proceeds from the sales of Maddie’s Monster will go to the March of Dimes.

This blog today is purple, in honor of Maddie. Purple was her favorite color.

Mourning ER

2009-04-23T13:38:00.000-07:00

Okay, call me hokey. . .but I am just missing the hell outta the show ER. I know there is Grey's Anatomy and all, but I loved the original Crichton masterpiece. Did ya see the finale? I balled all the way through it. . . all those stories and memories. Hard to believe it was on for 15 years! Geesh I am old.

At least nurses had more of a role in ER. Grey's rarely shows a nurse and when they do she works OR and sleeps with McDreamy. WTF?

Nursing was a strong piece of the ER TV show. Network television has yet to produce a solid show about nurses. For whatever reason, they cannot help themselves and just stereotype the heck out us. They should call me! I could script a goody. An ER spinnoff that focuses on the real stories of nurses. Just look at all the nursing blogs out there - especially the ER related ones. Do we have material or what? My Master's thesis was a full length screenplay about a male nurse. Crikey!

Ah, maybe in another life!

Re-Open for Business

2009-04-19T12:25:00.000-07:00

Due to the traumatic events that were going on in my life, i.e. death of my career . . .I inadvertently became the blogger we all detest - the blogger who doesn't blog. That is just how long it has taken to sort this whole job thingy out. I am so bloody thankful I am a nurse! -and thus could even get another job. In today's economy, in any other profession, I would have lost my shirt! and house! and who know's what else.

Numerous interviews in my only two suits. Smiling so much my cheeks hurt. Acting fabulously interested in the drably uninteresting. Finally, I am DONE. I was offered a position as, you guessed it, an educator. It is within my own health care system, but thank God, a different venue. So now I happily schlep the 65 miles to be free of Cerberus. It is a bitch to get there, but once there. . . bliss!

Now, to get back to the stories for blogging. Tonight is my big diva event - being celebrated for that nurse award. I splurged on a pedicure. Made sure my dress fit and got a new pair of shoes. Hubby is preparing his gear. Should be a festive evening.

Please keep reading. Thanks for sticking it out!

Many moons and job interviews later

2009-03-14T07:42:00.000-07:00

To any faithful, devoted, but small number of readers who still surf here, I am alive! - just buried under computerized online applications, cover letters, resumes and hopeful interviews. All to get away from my darling Cerberus.

Micromanagement 101 has continued, although after her third write up of me, I finally detached emotionally from the job and decided to look elsewhere. Took me long enough. I know. Pathetic.

But I am an eternal optimist and naive hopeful. Tragically forgiving. Sure things will turn around. Hahahahaha.. . . . . . I know you are laughing. But it is true.

So I have now interviewed for Clinical educator, nurse manager, and various other positions. My institution within has been poisoned to my qualifications thanks to Cerberus, so I was forced to scour the remains of healthcare systems in my town and research missions, values, docs and all that BS. My place offered me night shift in the ICU medical stepdown unit. -complete with MRSA, c-dif poopers, and long term vents. Are they daft?

Anywho, I will keep you posted. In a more rapid fashion this time.

Great Nursing 100

2009-02-07T13:19:00.000-08:00

Hey, my dear nurse buddies! I came home last night from a very stressful day with my boss to find a HUGE surprise in my mailbox. I knew that a dear colleague had nominated me for the Great 100 Nurses. I was so honored that she even thought to nominate me. She was RN previous manager of Labor and Delivery, now in risk management at large suburban hospital. What a sweetheart.

Well, last night, after stopping off to get some well needed chocolate and a bottle of red, I got to the farm's mailbox. There was a fat envelope in there, but it was too dark for me to see. Once I got inside, as I sat at dinner I thumbed through the mail. OMG. . . . it said GREAT NURSES 100 DFW.

I couldn't believe it, after 25 plus years. . . . numerous jobs and positions you all know. . . there it was. I shrieked and then just broke down in tears. I am so touched and honored. So much has happened through my family and career. So many highs and so many lows. I am just so humbled to have been chosen. It is a blind choosing, they don't know your name. Hahahahahaha....I know you are laughing, but that probably was a good thing!

I am even more honored, because there are three main nursing mentors in my life:

Dolores Alford, RN, PhD, FAAN she was the nursing leader and guru I met as she gave a talk about geriatric nurse practioners and nursing leadership. She was one of the first independent nursing consultants I had ever met. I asked her about a theme of her talk. She said, "Jeanette, the pioneers are the ones with arrows in their backs." She was right. As an outspoken innovator, I am not always a manager's delight. And I have the war wounds to certainly prove that. She later spoke and was featured on one of my videos in the All About Aging Series. Little did I realize how famous she was to become and be recognized. TNA now gives the Dolores M. Alford Lifetime Achievement Award. -but from my humble level I learned from her with that statement to grow with each experience. Pull out the arrows, toughen up, don't give up and try to keep paying it forward.

PK Scheerle, RN, CCRN is a nursing pioneer and founder of the very first Great Nursing 100. It happened in the 1980s down in New Orleans. Beth Mancini got the idea from her and brought it to Texas. I met PK again at a National Nursing Conference on geriatrics. She attended a lecture I was doing. We became instant colleagues. She treated me to a high powered lunch with champagne and chambord. She was the President of her own multimillion dollar nursing agency that she had started herself. -because, she believed that agency nurses should be quality, educated, CCRNs, dressed professional and acted professionally. American Nursing Services was a huge success. I was in awe of her entrepreneurial and professional businessskills as a woman. Simply, par excellence. I love ya PK. I am finally one of your Great 100.

Nancy Vish, RN, PhD now some of you who know me are going to be surprised that I put Nancy on here. But you know what? She rocks my nursing world. Nancy is a CCU nurse by trade, who became manager of CCU at Baylor and then CNO of Baylor Heart and Vascular. Nancy is a true pioneer of nursing excellence. She isn't afraid to test the untested. Do what hasn't been done. She amazed me with her investment in her people. She has a gift for bringing out the very best in her employees at every level. She empowers them with knowledge. She is now President of Baylor Heart and Vascular, and through her leadership, BHVH became one of the most fiscally successful Heart and Vascular hospitals in the nation. Others have been modeled on it. I thank Nancy for coahing me and teaching me better communication skills (I am still working on it), nursing leadership, and never to lose the most important gift of all, the importance of the bedside nurse. That touch. That extra effort. That is the magic. Thanks Nancy, you mean the world to me.

So, thank you to these three Goddesses. Without you, I would not be the nurse I am today. An educator, a proud bedside clinician with a huge heart. Okay. . .and sometimes still, a huge mouth! But I have learned from you. I am paying it forward. I hope that some of you can join me at the Great 100 Nurses Celebration on April 19th, 2009 (drinks at 6:30). It would be a pleasure to see you there.

It's a Conspiracy!

2009-01-31T10:47:00.000-08:00

Well, it has happened again. Retribution from my boss somehow getting my blog address. It seems she is on a mission to get me fired. This week, I got written up on corrective action documents. We had horrible weather. But even as an ancillary department in the our institution - we are under education, she requires that we come in. If fact, her policy specifically suggests that you have kitty litter in your car such that you can drive on the ice.

Day one write up. . I am exempt employee, meaning as long as I work my 40, M-F I can schedule my own hours. Many times I work more than that, teaching in the evenings for my docs and on weekends for some classes. But I knew and signed the policy, so I made my plans to come in. All school districts were closed due to ice. My son, in the 400 pound wheelchair was off too. He can't toilet himself, so someone has to be there.

I knew better than to call in. So, I waited for my hilly driveway to thaw about 1000 AM and we were on our way. I had to contact the highpowered ex to meet me to pick him up. That was a challenge too, but by 1130 I had my angle safely at his Dad's and was on my way to work. I got there about 12:08 PM. She was at my office door, asking, "did you have some issues getting to work today?" I said, "No. . . I am hear. Just doing a late day since Harrison had off from school. I had to get him to his Dad's." "Well, you missed a meeting?"she continued.

"No, don't think so. With who?" I asked. "These ladies in the hall here," she pointed. "Oh, that. . that isn't a meeting, just needed to tell these two instructors there was no pulse check after the first shock of the defibrillator or AED. There- meeting done." and they went on their way.

OMG.......she wrote me up!!!! WTF!!!!! For violating the weather policy. Coming in late to work, and missing a scheduled meeting! WTF???? I was bloody pissed.

Then, it gets worse. Day Two. We left the farm at 0630. By 0730 I had gone 15 miles due to frozen fog on the bridges and the dumbasses who can't drive on it. Both routes were blocked with wrecks. I had a class at 0900. By 0830 I was on the phone to my admin asst asking her to bring the equipment to the classroom and explain. I knew I was going to be late. Long story short, after taking the train in, my boss is in the classroom. Making apologies. Despite the fact that I had a sub teacher there. So what happened? You guessed it. . . . she writes me up again.

Now, keep in mind I taught 282 classes in the last two years with glowing evals . . . and was never late. Not even once! Such that I late literally 0.3394% of the time. WTF???? How does being late one time! . . . warrant getting corrective action.

That is two. It only takes three to be fired. She is on the bloody warpath! Anyone know a lawyer? I went to HR to give them a heads up and potentially request an immediate transfer. They wanted to see her kitty litter policy, which also has a reference to having a "yankee" drive for you that isn't afraid of the ice. Yeah. . . okay. Is that politically correct?

They said they will work on the transfer. As now, what she wants to do is meet with me to "plan out my schedule and hours" -fraid not!!!!

Buggar. . .it is back to the bedside I go. Damn it! Why are female bosses so threatened? Why are they such witches???

So. . . thus is why my blog is now locked down. Can't take the risk right now. I am a single provider for my son. My sweet partner makes all of $8 per hour. God love him.

Thank you for your prayers and patience. Monday is going to be hell. I pray that the transfer comes in quickly.

When will my life be boring.....sedate...tranquil?

Weekend Delights

2009-01-24T07:59:00.000-08:00

If you want to see something funny, you just have to watch the Barbie Doll Bachelor takes. At the bottom of Chris Harrison's blog about The Bachelor. . there are video outtakes from the season that end up on the cutting room floor.

After a catty scene with the girls Lauren and Megan. . .there is a hilarious video sequence satire with bardie doll bachelors and bachelorettes. They are complete with construction paper clothes in some crazy scene take offs from the show. I am still laughing.

http://link.brightcove.com/services/link/bcpid8541492001/bclid8482960001/bctid8554913001

See. . .for me, sometimes the heartbreaking realities of life have to be relieved with some riotous trash. So this weekend, I am cleaning my house, keeping warm, enjoying the US Figure Skating Championships, Miss America, and emotionally preparing myself to see the screening of Darius Goes West. (Yes, I have my huge box of Kleenex ready) . . .and then looking foward to relieving the profound sadness of Duchenne's by watching another 2 hours of wonderful TV trash on Monday night with this season of . . . you guessed it. . .The Bachelor.

Like Scarlett O'Hara. . . I will think about the crisis of life and the world . . . tomorrow.

Real meanings in life - Darius Goes West

2009-01-17T10:37:00.000-08:00

What does your life mean to you? What does the ability to walk mean to you? What if someone told you that you have a disease? A progressive disease that will eat away at your muscles, make you unable to run and play? Cause your heart muscle and respiratory muscles to fail? And that you may not see your 25th birthday?

Would you begin to live for today? Would you fight the fight of this disease without a cure? This disease is Duchenne's Muscular Dystrophy. This is my son's disease. This is Darius' disease. There is no cure.

Next Sunday, January 25th, I will attend with my son, a screening of the movie starring Darius. Darius Goes West. Everyone told Darius that like his brother he would die young. He might not graduate from highschool. Darius said. . . watch me!

During his freshmen summer, Darius traveled in his wheelchair West. He wanted to get it done up by Pimp my ride. His journey was videotaped. During the next summer, a film crew made it into a movie. During the next summer, his junior year, Darius realized that he people were watching. . . people were beginning to listen. Darius dared to dream. He dared to dream that during his Senior year and beyond, he would sell one million of his videos. . . so that there would be a cure. So that there would be hope.

This movie is about his journey. This post is about helping Darius and my son achieve that goal. Please, go to this website:

http://www.dariusgoeswest.org/

Buy this wonderful movie for $17. All the profits go to Duchenne's Muscular Dystrophy. Watch the trailers. All of them. Watch this film. Post it on your blog or facebook. Show this boy. . .who did graduate from high school that you are listening too.

Time for Trash

2009-01-12T09:42:00.000-08:00

The Golden Globes were on last night. The Hollywood foreign press group is a spirited hodge-podge of pseudo journalists who put on a tacky event as a pre-cursor to the Academy Awards. Basically to quality as a Hollywood foreign press, you just have to fill out the application and put down what internet or fly-by-night publication you write for. Oh and in the nationality section, put something besides the US. I love this awards show, you just never know what people are going to say or wear. TV combined with movies. It's great!

So, in honor of the Awards season kicking off and in the spirit of the new year, I decided it was time to post about some trash. My trash. TraumaDiva's Trashy Top Ten.

There are several things that are a bit trashy that I enjoy. I am sure it is due to the fact that I have to be so nice and professional on my job all day - that by the end of the day my niceness has just run out. My daughter lovingly puts it this way, "Mom, I listened to you for an hour at work and how nice you had to be to all those people on the phone or in your office. Man, no wonder you are such a witch by the time you get home. Gotta love ya."

She is right. Come 5 PM, it is time for some Mother's little helper and a good dose of mind numbing trashiness to soothe the soul. I think that's why trauma nurses love trauma. It's like old Forrest Gump said, "Life is like a box a chocolates, you never know what you're gonne get." You just never know what biotel 911 is going to call in next. Gotta luv it!

So, here is my 2009 list of favorite trashy past times and enjoyments.

TraumaDiva's Top Ten

10. Watching ice skating competitions on TV, especially the kiss and cry section.

9. Watching old ice skating competition videos if ice skating isn't on.

8. Watching old Princess Diana videos.

7. Watching anything on PBS or BBC about the Royal Family.

6. Fixing a plate of easy nachos. . .corn chips, Velveeta, and Pace picante in the microwave and watching Sex and the City videos.

5. Watching awards shows - favs are Grammy's for the tacky clothes; Golden Globes for the tacky speeches; and the Academy Awards. . .hey I do have some class.

4. Watching each and every season of the Bachelor/Bachelorette with my glass of champers.

3. Sleuthing screen caps, reading, posting and predicting the winner of each season of Bach/Bach-ette on FORT. (see link in TraumaDiva digs)

2. Reading and writing trashy novels. My favs: Scrupels, The Nannie Diaries, and just about anything by Sandra Brown.

1. Reading and writing blogs.

Yes, these are the fav pastimes of yours truly. And you know what? I love every minute of them. Notice the couch potato theme? No wonder my favorite holiday besides Christmas is Mardi Gras. Les bon temps rollez.

When not taking care of my children, I have absolutely no problem in filling my down time. Albeit there is room for personal growth here. Maybe I could sub one or two items on the list for a 30 minute work out on the bike or a long stroll - but if I am being honest, the list above are the things that I really love to do.

Ah, guess a lifetime membership to Weight Watchers will always be Oprah's and my destiny.

Medicine Disaster

2009-01-07T15:32:00.000-08:00

The beginning of 2009 has done everything to confirm that medicine and healthcare as we know it - is in the shit-house!

I returned from a week of holiday to find that our Cardiovascular services had gone down the toilet. TPTB (several) had turned in resignations, mostly upper leve director/manager cardiovascular positions.

That was on top of several other resignations prior to the holidays. Honestly, if it weren't for our top notch labor and delivery high risk business. . . our hospital would be in trouble.

Bedside staff (and I am one of those on some days) and management just never seem to see eye to eye. It doesn't matter who the hospital adminstrator is. . .they just don't seem to be able to convey the most basic information to staff. Nor do they listen to what staff are telling them.

This time, I think it is staff not listening and only hearing what they want to. I haven't gotten to the bottom to understand if they are being told just how bad it is. And to top it off, Joint Commission is coming. . . . . gahhhhh.

I feel this latest round was due primarily to lack of patients. We have lost major business interventional cardiology and other to Med-in-the-box clinics!!! Which makes our Premier productivity numbers suck! Nurses are really powerless to do anything about this, but management had better figure out how to get the docs back on board!

That's all were doing. Trading spaces. Same docs make a better $$ deal at XYZ facility. So, they go there. For a while, until that facility pisses them off. . then they hop to another. Wheeling and dealing. That is the name of the game. Why aren't we seeing this on the nightly news?

There are 50 and 1 pop-up mini clinics and doc partnered surgi-centers all over town. And know what? The average patient doesn't think about this. . . but those facilities are NOT certified or regulated by ANYONE! No honey, no Joint Commission there. No guidelines. Just practice as they please.

It is all about the BUCK. We know. . . .re-imbursements suck for in-hospital business. All our docs know this. They are smart folks. So, they have cleverly (temporarily albeit) figured out a way to get their bucks and still do their stuff.

I had three plastic surgery RNs from a docs office take my ACLS class the other day. Why? The doc was making them. As he was doing surgery in his office with a CRNA. Not mole removals. . . full breast augmentations, tummy tucks, and face-lifts. Good God ALMIGHTY!

What do you think is going to happen when all this un-regulated surgery going in free standing clinics goes bad? Just imagine. . . . entubated patient on his table . . . embolus. . .code. . . okay. . . boobies are cut open . . . .and they code. So. . . .now what????? EMS gonna transport that open wound? Uh. . .okay mate.

They ain't got no crash carts there. No code teams. They are stuck calling 911! You think those non-RN medical assistants they have hired to save a buck instead of RNs will be able to rescusitate that patient? God help us all. I am waiting for it. I guarantee you will see it.

Orthopods are doing ortho cases with barely any anesthesia and blocks. So the patient in day surgery with his rotator cuff repair feels fine. Recovers in a mini pacu. Pain level? Oh. . .maybe a 2. His arm and shoulder are dead. But wait. . . after he is discharged on his Lortab. . .he goes home. At 2 AM his block wears off and he feels like his arm was amputated not surgitated. OMG . . pain level >100!

Is this what medicine has come to today? Do you think most patients know this?

Change of Shift

2009-01-01T12:04:00.000-08:00

Trauma Diva's article was featured in Nurse Ratched's Change of Shift!

http://www.nurseratchedsplace.com/2008/12/change-of-shift-with-curious-george

Many thanks to Nurse Ratched for featuring an article written by TraumaDiva in this month's blog carnival Change of Shift. I am very honored. I loved the theme of the thread Curious George. As always, Nurse Ratched is very creative.

One of my goals for 2009, explore further publishing. I have pulled from the archives of my computer several recessed stories, scripts, and my unpublished novel. This weekend, as I awaited my total revenue for three boxes of used books at Half Priced Books (a whopping $ 9.50 woo hoo) for the hundreds of dollars of literature and publishing agencies I have funded, I browsed some of the genres of the paperback world to see where said novel would fit. Romance, erotica, chick lit.

I have contemplated putting part of it online and self publishing it, serializing as it were. I have heard many horror stories of the publishing world today. Tough to find an agent. Tougher to make substantial earnings even with a best seller.

To date, I possess unpublished:

Angel of Mercy - a full length screenplay written for my Master's

synopsis: a male nurses story from West Texas hot oil trucker driver to RN, breaking all the stereotypes - hot hunk who values of family are tested to the limit

The Tangled Web - a full length novel synopsis: as a marriage of 15 years is on the brink, a bored expat nurse-wannabe-writer, living in Italy explores the ins and outs of internet relationships. She falls for a steamy, hot, romantic Australian online, meets up with him downunder, and attempts to survive the devastating consequences of an affair

To Err is Human - treatment

synopsis: a vivacious young mother tackles a Catholic divorce, an affair with her flight instructor, a love child, and a rebellious teen, amidst the pop-art vs. domestic suburb dichotomy of culture in the 60s

Oceans Between - outline synopsis: sequel to The Tangled Web set during the Sydney Olympics of the millenium

Do people read books anymore? One would think if you travel the aisles of bookstores. Ah, from wanna-be to author. Jane Austen, Danielle Steele, Sandra Brown, JK Rowling. One can dream for 2009.

Happy New Year - Happy Holidays

2008-12-31T12:39:00.000-08:00

Due justice. This is the former Utah state trooper, Brian Smith believed to have been the shooter in the Dallas Christmas nightmare shootings which I referenced in the previous post.

Sorry so late in getting this up, but my internet was down for a week. HORRORS!!!! How can one be expected to survive! Anyway. . . back up and running now.

http://www.foxnews.com/story/0,2933,472296,00.html <----- here is a link to the story.

It seems former Trooper Smith was addicted to pain killers and resigned his post last May. We shall never really know the motives for the killings, as Trooper Smith shot himself, ended up unresponsive and was taken off life support.

My prayers and thoughts go out to the families for those who lost their loved one.

Happy holidays, I hope yours was GRAND. Be careful out there tonight. And please don't be like the idiots in Dallas who "shoot out" the new year to bring in the new! Say what????

Yeah, you can stand on the dock of XYZ trauma center and hear the gun fire begin to go off at 11 PM because the dumb bunnies are out there watching Dick Clark's New Years rocking eve and thinking the ball fell already. Nutters!

Be careful. Use a taxi or designated driver. More trauma to come!

Detox update: Christmas alcohol units: 4 (hey, the parentals alcoholrequired)

Calories: too many to count

Been doing okay, except for that day. Last night to drink! Allowing self glasses champagne. Then, cold turkey for 2009! I save my wine bottle corks in glass vases. So, maybe for each day I don't drink, I will take a cork out. By the end of 2009 - I should be even!

Christmas Trucker Tragic Trauma

2008-12-23T09:12:00.000-08:00

No doubt you have heard the national news about the trucks who were shot at last night. Two were killed in three separate tragic drive by shootings, likely all related by same shooter in Dallas last night.

As I drove home from work last night around 7 PM, I passed both of the 18 wheelers on LBJ freeway. Cops cars surrounded the site. As I passed by in the opposite lane, I saw one of the slain truckers, the young man from Kentucky slumped over his wheel. So sad.

As he was dying, word has it that he managed to slow his 18 wheeler rig to a completed stop to prevent a huge multi-car pile up in rush hour traffic. A hero in death. He was hauling someone's goods via United Van lines. Now, he will never make it home for Christmas.

Damn you gang shooter! I hope you burn in hell for taking two lives last night. And for attempting a third. I hope people watch this video, track down your car, and bring you to swift justice for this senseless tragedy. Two families will be mourning Christmas forever now. Thank God you missed the third victim.

Watch now!!! http://www.youtube.com/watch?v=EtKHR3EsXT4

Please watch the above video from youtube.com If you know this car or license plate, please contact 911 immediately. My thoughts and prayers today are for your family. May your soul RIP. Let us all here remember that life is short. Carpe diem.

Detox update which seems silly to post today in light of tragedy: Day 2 Successful

Alcohol units - 0; Crufierous veggies - five; On program - yes!

Day One Glory! Plus Great Resusc Story

2008-12-22T09:22:00.000-08:00

Alcohol units - 0

Calories - scant

Fast with Magical Juice - SUCCESSFUL!!!

Weight loss in one day - 5 pounds! God I love diuresis!!!

Yeah for me! I got through day one. I never complain about my health or aches or pains, but holy moly I had a massive headache last night and this AM from no caffiene all day. GAWD it hurt. And made me, well. . . less than pleasant to hubby.

(Cartoon courtesy of: www.cartoonstock.com)

Okay, so Day one complete and thank to diuresis I pee'd off 5 pounds of fluid! Joy and success. I know this is just water loss but seeing the scale go down is a mental helper. It gives me motivation to keep going. I am midday into Day 2 - liver lovin' veggies and slimming star foods.

Here is what I had for breakfast:

Massive cup of coffee - joy!

2 scrambled eggs with cumin and chilipowder for spice - Yum!

Lunch:

1 cup natural yogurt low fat with 3/3 cup raspberries

Baby raw carrots

Plum

Planned dinner:

Slow cooked chicken breast (in crock pot as I type)

Broccoli and cauliflower (steamed and then dabbled with some of the chickenjuice)

- I admit I am using the power of positive thinking to choke down the cauliflower.

Cooked carrots

Baked apple with 1 tbs ground flax and cinnamon on top (gotta get that flax in as forgot to put it in yogurt)

I am going to be honest. Technically you should not have coffee. But I don't smoke. And I have given up alcohol. I limit myself to one diet coke a day. And get in all my water. So, sorry. . . . on this point I am NOT flexible. I drink my coffee strong and black. So. . .my liver will have to forgive me this one vice. Goal: being totally honest here in my liver de-tox experiment. I will report the results at the top of my blog daily for a bit. Acountability. Accountability.

Now for the GREAT resusc story. It really is about the ABCs.

I got a call to help staff the ICU. My current role is as a hospital base nurse educator. We were getting in a post V-Tach/V-Fib arrest (lethal rhythms, i.e you are dead if we don't fix those - for those not medical) Careflighted from a small hospital in Durant, OK. He had been defibbed 4 times prior to arrival. Entubated. Shocked another two times on the cath lab table. He was stented x 3 to his LAD.

Yahoo! Just my kinda patient. I couldn't pull on my scrubs fast enough. Off I went. I got there just as he rolled in. Femoral sheaths still in place. Five drips: Dopamine; Integrilin; Amiodarone; Propofol; and mainline fluids. LOVIN IT!!!! He was having reperfusion arrythmias with short runs of V-tach. Still on the vent. His sheath was oozing and he required some direct pressure to his groin as his ACT was still too high.

I got the story: he was 72, woke up "not feeling good." Smoked 2 ppd. Called daughter to take him to hospital. She was delayed. So . . .(don't they all do this UGGH) drove himself. He arrived to triage with the complaint, "I just don't feel right." Triage was not busy, so took him back for vitals. As she is getting them, his eyes roll back. He is out! PEA (Pulseless Electrical Activity). She calls a code.

He is bagged and CPR begun. Then he V-tachs the first time. Shock. Airway was maintained beautifully with bagging. They continue to code. Shock him again. When they get his rhythm back he has HUGE ST elevation in his V lead.

Small town ER doc calls for air evac transport. He is started on TPA. In the chopper, he arrests again. V-tach requiring two more shocks. He is tubed at this point. Great bagging continues. We are the only cath lab spot open. He is taken to XYZ hospital. On the cath lab table, they shock him another two times in-between stents.

So, now I have him. The BIG QUESTION with post arrests is: neuro status. We can often fix the heart. But if the responders didn't give super-duper quality basic life support. -with great airway! Forget it. You now have a veg head.

About 20 minutes into my caring for him, I repeated a neuro check. My co-worker was just shaking his head. Sad case. Six shocks. All wagered he'd be a gomer! As I asked him, "Mr. Wilson. . . can you hear me?" Suddenly, he nodded. I thought I was seeing things. So I sternally rubbed him and asked again. OMG. . he shook his head! CRIKEY!

I shouted, "Hey. . great news. . .he is bloody well in there! Christ almighty, wadda ya know!" His wife was elated. She gave me the biggest hug. I had her hold his hand and kiss him. When doc rounded, I told him "Dude. . have I gotta a surprise for you!" He said, "Yeah, I know I fixed his heart. But I bet he isn't in there." I lead him by the hand. "Go ask him to shake your hand." He did. "OMG! He's there." I said, "You did good work in there. " Tears welled in his eyes. "Yeah, somedays I like my job." And I said, "We oughta be buying the guys up in Durant a big steak dinner!" He said, "No doubt." Then, he wanted to know if I would sign off his ACLS renewal as he used all the algorhythms today! Haha. . .for SURE I will.

Just goes to show you. It really is ALL about the ABCs. Airway, airway, airway.

Massive Liver Detox

2008-12-21T09:14:00.000-08:00

Alcohol units 6 Cal > 3000 Choco units 4 Exercise 0

That was yesterday. However, my massive live detox began in earnest today. It was time. Way past time. Why a week before Christmas you ask? Massochistic? Stupid? Insane? Probably, but the inner voice moved me today. I must listen.

I woke up and set out only to research how to do it, but I came across a lovely plan that included my favorites. No colonic hot salt water flushes. No cayenne lemonades. No 21 day fasts. So, I was SOLD! It starts with a one day fast. Surely I can do one day!

You fast drinking this lovely concoction of fresh cranberry juice, lemon juice and grapefruit juice. It says orange, but I had grapefruits on hand. Dash of cinnamon, ginger and nutmeg. The morning cup also included ground flax seeds. Which I had from my previous unsuccessful Fat Flush plan of 2003. Yes they were still good and weavel free!

I made the juice and heated it as directed. Added ground my flax seeds to the morning cup and I was off! It is frigidly cold, so the warm cranberry juice tasted marvelous. I drank the required one with the flax, a bit chewy at the end. So I swashed down a second cup of juice to enjoy flax free. Yum!

Seriously, I don't adhere to gross, weird-strange fasts, colonic irrigations or yucky tasting diet foods. So if they don't taste good, I simply won't do it. But something had to change. I am Oprah on steroids. I can quote verbatim just about every diet, weight watcher foot point and calorie. I know the plans like the back of my hand. But I have been wallowing post divorce now for. . . oh, three years.

Once, I kept a weight loss journal and documented on a graph my weight gains and losses over time. Shocking to see it on paper, but I had gained and lost over 70 pounds at least three times. You might think that being a nurse, I should know better. But many nurses are artisans at self abusive and destructive behaviors. As caretakers we often care not for ourselves.

My one to two glass of wine whilst cooking dinner (which started circa 1996 with my crumbling marriage) had quickly advanced to half a bottle on a good day, and full bottle on a bad day. I swear, even under the massive poundage, I could feel that organ growing. It was time.

I just hope it isn't too late. Cirrhosis is a nasty thing. So, I am keeping the faith. Desperately committing to the detox. And we shall see. Day 2 involves live loving veggies such as berries, artichokes, broccoli, beetroots and cauliflower (which I dont' like...but will try); natural yogurt; eggs; and of course flax seeds! You consume those items during the next two days.

Then, it is a healthy consumption of whole grains, fruits, veggies and lean proteins. I was successful on this prior to my post in Sydney. I think I can do it. I know I can do it. I feel like the little engine who could.

See this site for more info: Best Liver Detox Diet Ever!
http://www.sparkpeople.com/mypage_public_journal_individual.asp?blog_id=990025

I am going to read more on Day 2 for quantities and recipes. I have also ordered my Fat Flush herbs and Liver Lovin' herbs from Unikey. Those are helpful too. I have failed way too many times, but this time, I am determined!! Cooowwwwwbbbbuuunnngggaaaaa!!!!!!

The key to any program is simple: eat less, exercise more. Fix the head f&*k that made you overeat. And above all - STICK TO IT!!!!!! I will keep you all posted on my progress. I am determined to NOT be one of our orange pumpkin patients.

Domestic Violence and Corruption

2008-12-19T13:06:00.000-08:00

I was recently appalled to hear of several heinous crimes and murders that took place in a small community south of our big metroplex. What is even more outrageous is that these crimes NEVER made the news. NEVER. Not one word of them, yet they occured in the last half of this year.

Photo courtesy of: www.solitairemiles.com

Case # 1 Domestic violence, murder. Wife shaggin boyfriend. Husband jealous. Demands her back. She goes back and is beat up. Then boyfriend furious that wife returned to hubby. Ties her up naked for two days. Cuts her. She finally espapes and crawls to neighbor, near death. Neighbor calls 911. Boyfriend sobers up and catches her escaping whilst she has collapsed on neighbors doorstep. Drags her by the hair back to home. Threatens neighbor with gun. Neighbor afraid to shoot as he will hit wife. As police arrive, boyfriend threatnes he will slit her throat. Police bust in. BF slits her throat. She strangles in her own blood.

Case #2 Domestic violence, double suicide. Wife returns from shaggin bf. Bf after shaggin has beat her up. Hubby pissed that wife out. Beats her up a second time, all in front of tiny tot. 911 alerted by neighbor. Police arrive. Arrest hubby. Wife distraught and mental. Brain not the best after long drug use. Stabs self in self flagellation 9 times in front of tiny tot. 911 called again. Police arrive to find wife slumped in pool of blood. Tiny tot sitting in and crying, "why won't Mommy wake up." Tot taken to hospital for check, physically fine. No one to care for tot, so Daddy dearest let out of jail. Daddy returns to home. Sees chaos and blood and hears of wife's successful suicide. Offs self with overdose of Clonipin and tranquilizers whilst tot at home. Now tot parentless.

Case #3 DWI, corruption. City councilman busted for driving whilst intoxicated. Asks cop, "don't you know who I am?" Cop replies, "Of course I do, I pulled your plates - and its a small town." City councilman retorts, "well if you bust me, I guess you don't value your job." Cop replies, "You are breaking the law. It doesn't matter who you are." Sargeant consulted. Agrees to bust. Chief requests, "just make this go away." Cop refuses. Cop suspended.

None of these cases ever made the press. None ever made the nightly news. Why is that? Well, as luck would have it. . . or as corrupt city governments would have it, Glenn Heights is being marketed as a great place to live. A peaceful community where one should build a home. In great proximity to our fine Big Bad Dallas. - and it doesn't hurt that the Chief of Police is also the city manager, thus up the backside of the city council. Uh....huh. Case # 3 although not domestic violence is testament to the wacky code of justice in this PD and small town.

How do I know these crimes took place? A cop buddy of mine has worked in another small town land and knows as fact of these busts. These Core Values. . .are part of the mission statement for said small town.

Glenn Heights Police DepartmentMission and Core of Values
Mission Statement
"It is the mission of the Glenn Heights Police Department to provide services with integrity and dedication, to preserve life, to enforce the law, and to work in partnership with the community to enhance the quality of life in the city of Glenn Heights"Core Values
WE RESPECT LIFE...

We hold the preservation of life is our sacred duty. Our values of human life set our priorities.
WE REVERE THE TRUTH...

We accept nothing less than truth, honesty, and integrity in our profession.
WE ENFORCE THE LAW...

We recognize that our basic responsibility is to enforce the law. Our role is to resolve problems through the law, not to judge or punish.
WE SEEK COMMUNITY PARTNERSHIP...

We view the people of our community as partners who deserve our concern, care and attention. We are committed to reducing the fear of crime in our community, and we endeavor to do this by creating partnerships in our neighborhoods.
WE HONOR OUR POLICE POWERS...

We understand that our powers are derived from the people we serve. We do not tolerate the abuse of our police authority.
WE CONDUCT OURSELVES WITH DIGNITY...

We recognize that our personal conduct, both on and off duty, is inseparable from the professional reputation of both the officer and the department.
This code is used by:
Glenn Heights Police Department

I guess the city manager....er Chief of Police....has a little trouble living by his own code due to (yet again) TPTB. I ask you, if corruption and hideous crimes against women can happen at this level . . . and we don't hear about it to protect the "reputation" of a community. . . then how in the world is ANY education we provide to those we serve going to ever help and assist victims to come forward?

How are we ever going to stop the admissions to our emergency departments of women and men plagued by this epidemic? We must STOP domestic violence now!

If you or someone you know is experiencing domestic violence, call 911. Here is more information on this important topic: http://www.genesisshelter.org/dv_stats.php

Saving the Day

2008-12-18T08:55:00.000-08:00

Many apologies to loyal readers who have checked and re-checked only to find that my pages were no longer updated. The reason? Censorship.

Long story short, TPTB read said blog and deemed unprofessional. I thought long and hard about what to do. Open a new blog. Erase, cut and paste previous posts. Succumb to the pressure.

And decided, NO. My blog is my therapeutic exercise and outlet for my dabble in writing. I publish professional stuff for my nursing career. These are my "say what?" pages. These are my musings on nursing and medicine and life in general.

So to Catherine of Petite Anglaise and Helen Fielding of Bridget Jones. . . .and especially our own Mother Jones of the blogging world. . . .thank you! Thank you for the encouragement, motivation, and cattle prods to keep going. I love your work you three by the way!!!! MAJOR KUDOS. Please, if you enjoy this site. . .you will love the others:

Petite Anglaise

http://www.petiteanglaise.com/

Secretary blogger who sued her firm for firing her over writing her blog and WON! -and turned it into a best selling book deal!

Bridget Jones

www.friendsoffirth.com/bjd/columns.html

This is an archive site in homage to the original Bridget Jones columns that appeared in the Brit tabloid The Independent that inspired the movies and then were briefly resurrected in 2006.

Nurse Rached

http://www.nurseratchedsplace.com/

This is the home of Mother Jones the best in my opinion of all nursing blogs. Homage!

I will continue to write!

Many Moons!

2008-10-26T17:42:00.000-07:00

It has been a busy fall for traumadiva. But I have some cool info to share with you. Have you ever wanted to have a conversation with someone, but feared the response?

We work trauma, this happens every day! In our personal lives, it happens even more often. Divorce rates aren't exactly great among firemen, policemen, and trauma nurses.

Well, here is an article worth reading!

http://www.mdaquest-digital.com/mdaquest/20081112/?u1=texterity

It is about having those crucial conversations with our family. Now, this article was written for those caring for special needs neuromuscular children, but the principles ring true for all.

Enjoy! And soon, yes...some real TRAUMA case studies! Afterall, this is a trauma site!

Cheers!

Honor, Courage, Committment

2008-09-24T15:25:00.001-07:00

The above ideals are the caveats of the US Navy and its premiere training ground for future officers, the US Naval Academy. I just got back from a trip to see my son, a Firstie, at Parents weekend. A "firstie" means a midshipman, first class, graduating this year. It was an awe-inspiring weekend.

These young men and women are not only committed to their collegiate education, but to the honor of becoming Naval officers and leaders amidst the fleet. They are bright, dedicated, super-fit, shining stars of youth. I was inspired to walk among them. I was encouraged at knowing that they were so dedicated; endeavoring to protect our fundamental rights of freedom and democracy. Wow......all I can say is WOW!!!!

If you look at those ideals; honor, courage, committment - isn't that what we all hope for? In nursing, I think many of our peers embody those same values. Those who have stayed in the trenches and at the bedside for years caring for our sick and injured, despite the ups and downs in the world of healthcare.

Sometimes, of late, I have seen a different trend; those that enter the profession not as a vocation, but as a job. When the going gets tough, they bail for a buck or two more at another facility. Why put up with the politics or garbage at one facility when for a bit more, you can have it at another? I hope this trend is transient. It is putting a huge strain on the longevity of our nursing workforce. These fly-by-nighters that are not committed, nor honorable, and lack the courage to go the distance.

Also, there seems to be a disconnect between TPTB and the frontline trench nurses providing the care. We have all this great experience and leadership out there. But bedside nurses often complain that their voices go unheard. What will it take to connect the dots?

There is a great nursing program out there called Frontline Nursing Leadership Academy. Its purpose is not to train managers, but to have experienced nurses mentor potential peer leaders. Nurses who can be leaders at the bedside and strengthen teams. What a brilliant concept. In developing the skills of communication, the power of influence, collaboration, and effective team management they are enhancing the talents of the few who have stayed the course. Bravo!!!!

Programs like this help to restore and re-light the candles within potential leaders. - to help restore our faith in the honor, courage, and committment of us older crones who stuck it out in the profession. Maybe there is hope.

Much too Much!

2008-09-10T11:26:00.000-07:00

I am sad today.

I gave summer my all. Delved into work projects. Planned a mini vacation to New Orleans. We had to drive, as gouged prices stuffed other plans. Swam with my youngest son for his therapy. Ignored my obnoxious ex and his spouse. Savored every moment with my oldest, a Naval Academy boy in his last summer home before Uncle Sam owns him. Before you knew it, Summer was over.

The Labor Day telethon marks the beginning of Fall to me. It is also a stark reminder of my son's Duchenne's Muscular Dystrophy. I shore up my spirits, paste on a smile, and head for Lone Star Park where our local telethon is televised. The devoted spirited announcer spurs our DFW public year after year into donating thousands for research. It is a worthy cause - these Jerry's kids. MY Jerry's kid.

Indeed, hats off to my community firemen - DFD, Garland, Plano, Mesquite - and their "fill the boot" campaign that raises $50,000 $60,000 - just huge amounts for Muscular Dystrophy. In fact, not only do they raise money - but this year they showed the video of them lifting all those boys by hand into buses for camp, helping them swim at camp, all the man power that goes into it. God bless their souls.

And now, I face the dreaded annual visits to Cincinnati Childrens and Dr. Wong. For although the medical expertise there for Duchenne's is brilliant bar none! - it is never good news. Each year, my son slips a little bit more down the slippery slope of muscle degeneration. I am a nurse. I know the story. It breaks my heart, rips up my guts, and just devastates my normally uplifted state of being. I know what is to come. There is no cure.

I try to hold onto hope. The promise of research. But for now, the reality is a steady slow progression to heart failure and an early death. Knowing that, it is hard. Very hard to stay upbeat.

I love fall. And I hate fall. The brilliant colors, the crisp air, football, and the holidays. All things Americana in my heart. But always tempered with the reality of my son's disease. The disease that during the rest of the year - I manage to keep at bay. But it always comes back.

Yep...today. I need that hug.

Band Reunion was no Trauma! Brilliant Drama!!!!

2008-08-01T17:45:00.001-07:00

I haven't posted in a few days because recently I attended a most AMAZING event! The day finally arrived for my 30 year band reunion. It was utterly amazing. Great times, great fun. What a day reliving old memories with friends.

It all came together. Packed capacity of 130 in our venue. Amazing margaritas and food. Loads of hugs, smiles, and great times. One very creative band buddy crafted a beautiful slide show/movie with music reliving those times. There wasn't a dry eye in the house.

Bizarre as it was seeing people you had not seen in 30 years, when you looked into their eyes, the magic carried you away. Wonderful people and wonderful times. One dear buddy said, "it was so worth it. . . just transporting yourself away from reality for one magical night to relive all the memories, soak in the warm fuzzies - one chance to bring it all back for an instant."

If any of my buddies read my blog, thank you from the bottom of my heart for making this pipedream of two crazy BFFs come true. Who knew that from that phonecall between us that such a wonderful event would come about. How sweet to relive the goodness, happiness and joy of youth. I guess you can go home again.

Cops and Nurses - the Pact

2008-07-19T13:41:00.000-07:00

Okay, as a trauma nurse, surgeon, ER doc or EMT. . .when was the last time you got a ticket? Well for the past 22 years my answer was NEVER. I've gotten plenty of warnings and statements like, "well as a trauma nurse, you know to slow down" and stuff like that.

But come on, it is da brudder hood! Cops and nurses. Cops and docs. Cops and EMTs. We "get it" ya know? We look after them and they look after us. We bend the rules for the copper post outside any cops room when one is hit. We never say a thing. It is the pact of the hood. All cops know that.

All cops except, a certain Sargeant of the Fort Worth police department. It seems this officer had a bad day. And for the first time in 25 years!!!!!! I'll be darned, he gave me a ticket. I wasn't even driving my own car in my own town. I had been at my Mom's and she loaned me her sedan. It was 100 degrees outside and hers had a working air conditioner. Nurses don't make enough dough to keep their cars ship-shape. Mine is a hot box.

Anyway, I came over a hill, looking for the exit I was supposed to take. Her newish sedan purrs like a kitten and zooms down a hill like a rocket. It just wasn't like driving Bertha...my early model beat up red Durango sans air. That thing is a tank.

I had just hit the brakes and whammo. After me he came. Pulled me over. Didnt' give a darn about hearing "the story." It was...."I don't care Mam, you were doing 50 in a 30." I pleaded and gave him the "but we take such good care of you guys. . .you know?" That usually always works. But NO! Not for this officer. I was blowin in the wind. It was a done deal. I was written up.

What was bizarre was, I was on my way to a shin dig where I was actually meeting another Fort Worth cop. He just couldn't get over that Hopper wrote me up. He said, "dang girl, you musta really caught him on a bad day. Either that you just totally pissed him off."

Whatever. So now, it is $110 fine. Six hour defensive driving course. All because he didn't get "the pact." Geeessshhh!!!! I sure hope he never turns up in my ER!

If you coded, what are your survival odds?

2008-07-08T12:57:00.001-07:00

If you really snuffed it - and your heart stopped. Do you know what chance you have to really survive?

Well, survival rates in America kinda go like this:

Code outside the hospital? Survival less than 6%

Code inside the hospital? Survival about 12%

Now, considering all the CPR and PALS and NRP and ACLS we teach - that is just pretty darned dismal. In fact, the AHA just can't really figure it out. It seems that outside the hospital, since the dawn of AIDS, increased hepatitis, and TB lay folks are just kinda calling 911 and hoping for the best. Gone are the days of by-stander CPR. It is a rare herculian bird that will go down on a stranger!

In fact, it is so bad that American Heart recently came out with a position statement on "hands only" CPR. That was their spin on it. Basically, so that folks wouldn't get the hibbie-gibbies at having to BREATHE into someone (cuz let's face it, who really carries around their own personal pocket-valve mask) they piloted a study in Phoenix where people just did chest compressions and NO AIRWAY until EMS got there. You know what? People did something. They would do the chest beating like they had seen on TV.

So, the survival rates went up! Therefore, the news flash about "hands only" CPR. Now, for us resusc folks - obviously it is still the ABCs. Airway, breathing, circulation. Check out this news story:

http://images.google.com/imgres?imgurl=http://msnbcmedia2.msn.com/j/msnbc/Components/ArtAndPhoto-Fronts/HEALTH/080331/g-080331-hlt-hands-only-CPR-12p.hmedium.jpg&imgrefurl=http://www.msnbc.msn.com/id/23884566/&h=273&w=379&sz=17&hl=en&start=140&tbnid=ADYyPpuW7dJFTM:&tbnh=89&tbnw=123&prev=/images%3Fq%3Dcpr%26start%3D120%26gbv%3D2%26ndsp%3D20%26hl%3Den%26sa%3DN

Our in-house survival rates aren't much better, so most hospitals are having their mortality and morbidity committees look into that. In many cases, it is a "failure" to rescue situation. In other words, this patient was out on a unit somewhere and tanking and staff failed to notice the warning signs, prior to the big fish-mouthed "O" breathing or flatline!

Much education is going into retraining staff to look for the warning signs: dropping sats, low MAPs, unexplained brady's or tachy rhythms. Also, focus in basic life support classes is honing in on making sure folks can really provide adequate airway with bag-valve-masks and rapid defib with AEDs prior to the resusc (ACLS) team getting to the bedside.

I am personally glad to see floor nurses be brave enough to start taking ACLS and calling RRTs (rapid response teams) to the bedside when they see something that "just ain't right." Maybe this intervention will help improve the numbers!!!

Crucial Conversations

2008-06-30T10:14:00.001-07:00

"I am sorry, Mr. Samuel, your wife has had a stroke."

"Carol is a such trauma-drama queen. Dang it, she rushes in so fast, I never get a chance to work it."

"Mitch, you've lost so much weight. Are you sure you are okay?"

"Lo siendo. Su bambino e murte." (I am sorry, your baby is dead.)

Have you ever been in a situation where the conversation just suddenly became so uncomfortable, so tense that you could "cut it with a knife?" Whatever the drama or trauma things just got too weird. What did you do?

Did you get upset and say something you regretted? Um...that would be me. Did you clam up and say nothing at all? Did all parties involve mysteriously disperse? Suddenly scrambling into patient rooms and away from "the talk?"

We have all been there. When talk turns tough, people generally run! Confrontation breeds discontent. But it doesn't have to be this way. Recently, I went to the coolest seminar called Crucial Conversations. Yeah, yeah, I thought it was going to be a bunch of hooey! But it wasn't.

This group of business gurus put together some powerful stuff that can be used in any arena. A crucial conversation is any talk between two people where the stakes are high, opinions vary hugely, and emotions run strong. -Basically, any ER or trauma unit.

Nurses, doctors, EMTs and policemen have to do this everyday. So do families. So do friends and loved ones. These tools give you the know how to handle any tough situation with grace. You learn how to sus a situation out, think, and learn to say the right thing to keep the dialogue free flowing. Wow, what a novel concept! Who knew!

Check out this book and this website for more details: http://www.vitalsmart.com/

You and your workmates . . . or your loved ones will be glad ya did!

Trauma, Rescue and Lies

2008-06-24T10:46:00.000-07:00

One of the most moving experiences I had working trauma came on Christmas Eve in 2000. I was working with a young surgeon. He was going in to tell the parents of a 16 year old MVC that the boy was brain dead. The dilemma wasn't whether the boy would live or die, but when did they want to take him off life support. Christmas Eve? Christmas Day? What a choice.

This surgeon had tears in his eyes. He said to me, I wish it could be like this poem. I wish I could just lie and say he was going to be okay. Then out of his pocket, he pulled a crumpled up, very worn and page torn version of the poem "I Want To Tell You Lies" When I read it, all I could do was throw my arms around him and hug him. We have all been there.

Many of you have read this. It is posted on many a fireman's and policeman's web page. But I wanted to share it with you today.

I WANT TO TELL YOU LIES

I want to tell that little boy

his Mom will be just fine

I want to tell that dad

we got his daughter out in time

I want to tell that wife

her husband will be home tonight

I don't want to tell it like it is,

I want to tell them lies

You didn't put their seat belts on,

you feel you killed your kids

I want to say you didn't ...

but in a way, you did

You pound your fists into my chest,

you're hurting so inside

I want to say you'll be OK,

I want to tell you lies

You left chemicals within his reach

and now it's in his eyes

I want to say your son will see,

not tell you he'll be blind

You ask me if he'll be OK,

with pleading in your eyes

I want to say that yes he will,

I want to tell you lies

I can see you're crying

as your life goes up in smoke

If you'd maintained that smoke alarm,

your children may have woke

Don't grab my arm and ask me

if your family is alive

Don't make me tell you they're all dead,

I want to tell you lies

I want to say she'll be OK,

you didn't take her life

I hear you say you love her

and you'd never hurt your wife

You thought you didn't drink too much,

you thought that you could drive

I don't want to say how wrong you were,

I want to tell you lies

You only left her for a moment,

it happens all the time

How could she have fell from there?

You thought she couldn't climb

I want to say her neck's not broke,

that she will be just fine

I don't want to say she's paralyzed,

I want to tell you lies

I want to tell this teen

his buddies didn't die in vain

Because he thought that it'd be cool

to try to beat that train

I don't want to tell him

this will haunt him all his life

I want to say that he'll forget,

I want to tell him lies

You left the cabinet open

and your daughter found the gun

Now you want me to undo

the damage that's been done

You tell me she's your only child,

you say she's only five

I don't want to say she wont see six,

I want to tell you lies

He fell into the pool

when you just went to grab the phone

It was only for a second

that you left him there alone

If you let the damn phone ring

perhaps your boy would be alive

But I don't want to tell you that,

I want to tell you lies

The fact that you were speeding

caused that car to overturn

And we couldn't get them out of there

before the whole thing burned

Did they suffer? Yes, they suffered,

as they slowly burned alive

But I don't want to say those words,

I want to tell you lies

But I have to tell it like it is,

until my shift is through

And then the real lies begin,

when I come home to you,

You ask me how my day was,

and I say it was just fine

I hope you understand,

sometimes, I have to tell you lies

This is dedicated to all the Police Officers, Firefighters, EMTs, Paramedics, MDs, Nurses, and Emergency Flight Crews and all civil servants who deal with the tragedies oflife and death. The saddest of all, being those that involve children, andcould have been prevented.

Wear your seat belts...

Keep poisons, flammables, fireworks, etc. out of reach of children...

Keep your smoke alarm in operating order.

If you don't have one, get one...

Never, ever drive if you've been drinking ...

Never leave your toddler unattended...

Teens, be responsible drivers,

Obey all traffic lights, posted limits, warnings and signals at RR crossings ...

Keep your guns locked out of reach, buy a trigger guard....

Protect our children, they are our future...

Am I preaching? Am I nagging?

I guess I am just telling it like it is.... Or I could just tell you lies.

Final Moments

2008-06-12T14:06:00.000-07:00

What is it about a funeral that just stops you short and makes you think. Wow. . . I wonder what my final moments will be like? As trauma folk, we see death and dying every day. We cope with tragedy, loss, catastrophic illness, devastating diagnoses.

Sometimes, now matter how hard or crusty we would like to think we are, something or someone touches us and despite how much we try to choke it back - a tear forms and we are farklempt!

This past Friday, I was to attend a funeral. I don't like going. Either they are cheezy. The person was a jerk and now being praised as saintly. There is some relative I would rather avoid. I have to work. Usually I can find an excuse on why not to go.

But this time, I felt the need. I went mainly to support the wife. She has often prayed for my little one and so I felt the favor need be returned. My parentals were going to be there too. Her husband had been diagnosed with throat cancer only a year before. It was an agressive buggar. I knew from the first emails she sent out about it, he was toast. But Claudia maintained hope up until the final moments when the physician told her - there was just nothing more they could do. That was May 1st. Cliff died on May 19.

The family kept a journal on the Caring Bridge website. Again, being a medical person, it is hard for me to read those things. But, I surfed there. Wow, TraumaDiva was moved. If you really want to read a story about "keeping your fork" (see original fork story below) check out this link: http://www.caringbridge.org/visit/cliffloffler

If only we could be so lucky to die this way. Loved by so many. It was said, Cliff died having no bucket list. He lived life to the fullest everyday; gregariously sharing his warmth and humanity with whomever he came into contact. He retired early. Traveled. Hugged his kids. Adored his wife. He wasn't a holy roller. In fact, he was baptised only at the very end. But cha know what? The dude knew how to live his life.

The next day, I saw a kiddie movie with my little son that has Duchenne's Muscular Dystrophy. It was Kung Fu Panda. (yawn). But in this movie, the wise tortoise had a brilliant saying:

"The past is history. Tomorrow - a mystery. But today. . .is a gift. Live it!"

Message? Carpe diem! Seize the day! You never know when it may be your last. Hug your kids. Let your partner know you love them. Pick the flowers. Stand silent for five minutes. Remember that you are not in control. Love all with a vengeance. Be your own Kung Fu Panda!

Your Lack of Preparation is NOT my Emergency

2008-06-04T14:53:00.000-07:00

Yet again, I have spent the day muttering this phrase to myself as I dealt with customers across the spectrum in various degrees of stress due to their lack of preparation. Here was some of the rhetoric I experienced today.

"It looks the dates are altered on the CPR card. She was suspended cuz it was out of date. Do you think she faked it?"

"But I have to get into that class, or I can't work tomorrow."

"No, we are not approving sternal insertion of the EZ IO by R1s (baby residents)."

"Yes, charge her the cancellation fee, this is the fourth time she was a no-show to the class."

"I am sorry you didn't get a book, but no, I cannot download the 130 page PALS abridged pretest for your class tomorrow."

"Does the last day of the month in the year your license expired really mean the last day? Or can I take it the next week?"

"You overbooked? Well, it is 8:55, Dr. T is in your class. And the class was scheduled to start at 8:00. No worries then."

I can cognitively tell myself that. Over and over and over. Their lack of preparation is NOT my emergency. Smile and give a half way polite, customer service oriented answer. But all the while I am muttering "for heaven's sake" under my breath.

Honestly, by the end of the day, it is that kind of garbage that makes me head for the margarita mix every time. What happened to accountability? Are we that stressed out that we constantly expect others to clean up our messes for us? Well, alrighty then!!

Keep Your Fork!

2008-06-01T16:39:00.000-07:00

Trauma Diva does indeed have a heart! A sometimes jaded, twisted, suspect, over-worked, underpaid, trauma junkie, sardonic one. . .but indeed a heart.

One of my fab gay friends shared this truly cool story with me. It is called Keep Your Fork!

Enjoy! A Woman and a Fork

There was a young woman who had been diagnosed with a terminal illness and had been given three months to live. So as she was getting her things "in order," she contacted her Pastor and had him come to her house to discuss certain aspects of her final wishes. She told him which songs she wanted sung at the service, what scriptures she would like read, and what outfit she wanted to be buried in.

Everything was in order and the Pastor was preparing to leave when the young woman suddenly remembered something very important to her."There's one more thing," she said excitedly."What's that?" came the Pastor's reply."This is very important," the young woman continued. "I want to be buried with a fork in my right hand."

The Pastor stood looking at the young woman, not knowing quite what to say.That surprises you, doesn't it?" the young woman asked."Well, to be honest, I'm puzzled by the request," said the Pastor.The young woman explained. "My grandmother once told me this story, and from that time on I have always tried to pass along its message to those I love and those who are in need of encouragement. In all my years of attending socials and dinners, I always remember that when the dishes of the main course were being cleared, someone would inevitably lean over and say, 'Keep your fork.'

It was my favorite part because I knew that something better was coming...like velvety chocolate cake or deep-dish apple pie. Something wonderful, and with substance!'So, I just want people to see me there in that casket with a fork in my hand and I want them to wonder "What's with the fork?" Then I want you to tell them: "Keep your fork. The best is yet to come."

The Pastor's eyes welled up with tears of joy as he hugged the young woman good-bye. He knew this would be one of the last times he would see her before her death. But he also knew that the young woman had a better grasp of heaven than he did. She had a better grasp of what heaven would be like than many people twice her age, with twice as much experience and knowledge. She KNEW that something better was coming.

At the funeral people were walking by the young woman's casket and they saw the cloak she was wearing and the fork placed in her right hand. Over and over, the Pastor heard the question, "What's with the fork?" And over and over he smiled. During his message, the Pastor told the people of the conversation he had with the young woman shortly before she died. He also told them about the fork and about what it symbolized to her. He told the people how he could not stop thinking about the fork and told them that they probably would not be able to stop thinking about it either. He was right.

So the next time you reach down for your fork let it remind you, ever so gently, that the best is yet to come. Friends are a very rare jewel, indeed. They make you smile and encourage you to succeed. They lend an ear, they share a word of praise, and they always want to open their hearts to us.

Show your friends how much you care. Remember to always be there for them, even when you need them more. For you never know when it may be their time to "Keep their fork."Cherish the time you have, and the memories you share ... being friends with someone is not an opportunity but a sweet responsibility.

I LOVE MY BUDDY AMBOS!!!!

2008-05-27T16:27:00.000-07:00

The Australian slang word for ambulance EMTs and paramedics is Ambo. God, how I love my ambos. What a rockin' group of folk. It takes guts, courage, and a set of kahonas to go out and face our lovely world each day. I just think Ambos in general ROCK!!!

Both guys and girls. Ground and flight. Fixed and rotor. What great stories! If you want a great happy hour, go with an ambo. Crikey! It is just bloody amazing (no pun intended...LOL) what they see in a day.

And yet, here they come. Covered in the muck, slime, and grime of the latest MVC with a cheery smile on their face. They are brilliant too! Want a great ACLS instructor? Nothing can beat an ambo. Especially to teach docs!! I wouldn't trade my Shane Ambo for the world. He is just amazing!! Flies fixed wing for Air Evac.

And military ambos? It just doesn't get much better than that. There is nothing like see one, do one, teach one. They are awesome!!!! Thanks guys and gals for being the super-duper-trauma scoopers of the day! They are our unsung heros day in and day out.

Next time you want to do your nice deed for the day. . . bake an ambo a cake and take it round to the fire station. Or better yet, take em out for pint! Gotta love em.

True Trash: Why Do Women Do This? and Why Do Men Publish It?

2008-05-17T08:12:00.001-07:00

Okay, I am going to sound like the biggest frump in this post. I love eye candy, just like any one else. Examples: Colin Firth, Grey's Anatomy Doc McDreamy, Mikhail Baryshnikov, Denzel Washington, Mr. Big. But when eye candy becomes smut, especially degrading women. . .I have to draw the line.

If you read this blog, then you know it is a perfect paradox. Professional educational trauma information and the true trauma of trashy people and trashy shows. . .i.e some of the bowels of society that visit our ERs and reality romances. A warped contradiction to understand by some I am sure, but people watching is a great sport. It never ceases to amaze me how low people will go. Thus, people make great entertainment.

I have been watching the show, The Bachelor for quite some time. First, a smarmy bachelor, Alex that picked big jugs instead of sweet Trista. But then Trista got ultimate revenge, her own show and picking the love of her life, Ryan. They now have a cute baby boy. So, after that, I thought, well maybe it could happen, finding love on TV. At least it was fun to watch!

So, fast forward several seasons. I began to get jaded as one by one, as each bachelor "fell in love" only to announce immediately after the show that "it just didn't work out." Yet ABC provided a "hook" each time that reeled me in. First a professional football player super hunk, Jesse Palmer. Then, a millionnaire, Andrew Firestone. An ER doc, Travis Stork. But the biggest one was eye candy and superstud, Andy the Navy doctor. OMG, total turn on except for those way too shiny white veneer teeth, but built? Ya baby! Then, there was a Texas bachelor, Brad Womack, who owned two bars. I was hooked. He seemed so genuine. Then in the WORST ending ever, refused to pick either of final two - breaking all of the viewers and indeed the girls' hearts. For me, at that moment, the show The Bachelor jumped the shark.

But then, TPTB at ABC hooked me once more. I am a confessed anglophile. I married an ozzie and swoon each time he speaks. Fleiss cast a British bachelor. I had to eat so much crow after chastizing the last season and now being caught watching it again! But despite the promos, something about the show just wasn't right. It was leaked on the blogs early on by Ted C, a trash journalist that scoops the behind the scenes production stuff of many shows that a "flaxen-haired soap opera starlet" had indeed won this season. Ted leaked this just days before the show premiered. It had also been leaked before the 25 women's names were announced that Shayne Lamas, daughter of Lorenzo Lamas (granddaughter of Fernando Lamas and Arlene Dahl, hollywood greats) a soap starlet from General Hospital had been cast on The Bachelor!

Well, duh, it didn't take much to put those puzzle pieces together. Indeed the whole season was considered by most to be the Shayne show with a foregone conclusion: the Brit Bach, Matt Grant was smitten with the whole class C hollywood scene from day one! It was no surprise that he picked, of course, Shayne. For behind the scenes stuff on The Bachelor, read the blogs Adventures in Tina Land, I'm Hungry, and Bevin Powers myspace for real info on how all the contestants are treated/mistreated and liquored up on these shows. (see links left) All is never what it seems.

What was so disappointing, was the day after the show aired. These photos were released. Obviously shot way before the season concluded. What was so bad was not so much the naughty piccies, but the magazine they appeared in, the total smut Girls Gone Wild, in which Joe Frances stereotypes, degrades, and trashes the disgusting behavior of young, underage, mostly drunk girls. Even Ellen Degeneres, who loves The Batchelor and religeously watches the show, was at a loss.

That is it. I am this time truly done. Not only has this show jumped the shark, but the characters sank to the smut gutter just a bit too fast for me. Thus, no after the final rose show. No major appearances. They might as well get married at the Las Vegas Chapel of Love and invite Hugh Hefner and his bunnies. Even ABC recognized how guttersnipe low this behavior went. "Good on ya" Chelsea and Amanda who thankfully were NOT picked by this Hollywood-Star-Smitten-Bach who wants his 15 minutes of fame. I can't even bear to watch Deanna, the new Bachelorette (i.e the gal dumped by Texas bach) parade around her 25 guys. No matter how much eye candy that is provided. I guess it is back to British comedies and looking forward to the Sex and the City Movie premiere May 30th for me.

HAPPY NURSES WEEK FOR GOD's SAKES!!

2008-05-15T17:07:00.000-07:00

To all my fellow nurses, A HUGE HUG!!!! Thanks for being the fellowship that has kept me employed regularly for the past 25......yes you read that right TWENTY FIVE SILVER years.

To the patients, support staff, adminstrative assistants and docs. . . it has been a wonderful run so far. So hats off to us, NURSIES of the WORLD. Pat yourself of the back. Treat yourself to a massage and a pedicure. YOU DESERVE IT.

As my diva Edna would say. . .YOU GO GIRL!

And yes, I did get my phalic-shaped water bottle from my hospital; my free $1 snack ticket and my other cup to get free drinks this week. I do, indeed feel special! Hey. . .it is better than a key chain.

Gotta love it!!!!!!! Ab-sa-bloody-lutely!!!! Fabulous!!!!

Trauma Trash that Only a Mother Could Love

2008-05-09T09:05:00.001-07:00

We have all been there at the 11th hour of a hellish shift. A couple of CPR's; working 6 peeps down; somedood from da hood that shot some other dood. And then it hits us, the wicked, twisted funny bone that only true trauma rats can relate to. Those names. Those crazy, messed up, what was their Mama thinking names of the bowels of society that visit our EDs every day.

All it takes is mentioning one. . . and people are on a roll. In fact, most trauma rats hold these people so dear, that sometimes they even imitate them. One of my favorite all time trauma nurses, who died tragically and way too young, was Debbie Love! Sweet Debbie. On one of the best Halloweens I ever had to work. . . Debbie was our Charge Nurse for the Red team. Meaning she admitted all the ambulances. I clocked in for my night shift. . . and there she was. . . in all her glory. Debbie, it seemed, had dressed up for Halloween. She had come as a Grovite! Pink spandex; bleached and poofed out hair; over the top makeup; and when she turned. . .and smiled. . .that was what took the cake! Her Grovite hillbilly teeth. It was hard to keep a straight face as she triaged stetchers; started lines; and resusc'd trauma as the ultimate. . . trauma trash diva! But there she was.

Now for those of you who don't know Dallas, the neighborhood of Pleasant Grove is anything but. Most of our ambos and trauma rats know that the "Grove" as we lovingly call it. . .spawns some of the most bizarre trauma clientele known to man. In fact, EMTs that have to route the grove are true heros. The residents of the "grove" our beloved Grovites are a species all unto themselves.

Human beings that only a Mama could love. So in celebration of Mother's Day this weekend, I invite any and all readers to PLEASE share and post your favorite trauma names and trash cases. Again, HIPAA complaint of course.

Here are some of my favorites:

Formica Dinette (here with LAP, "will the sono tell what my baby is?")

Mattress (pronounced mu-trice)

Royal Tee (a low rent stripper complete with duck tape pasties)

Anjtwon (pronounced Ant-ja-wan who cops free rides from ambo services by feining ill after one of his crack crashdowns, then absconds home from our ER)

Freda Freeloader (we called her who on her 250th visit to our ED we celebrated with cake and champers)

Can't wait to read yours!!!

Emotional Trash Trauma

2008-05-05T07:37:00.000-07:00

I waxed professional in the last few posts. So now it was time for some trash! This past weekend could only be described as emotionally traumatizing. An old high school buddy of mine, my BFF, as it were, and I decided it would be cool to look up all our old band mates. We marched in a Sweepstakes high school band in Texas 30 years ago. THIRTY YEARS??? Now that is traumatic just to think about.

We started by identifying some of the more colorful people we could think of and googling them. It was amazing what you can find on the internet. A reformed poofter. A pageant director. Some architects. Several politicos. A cop. A fire department chief. A minister. Handful of teachers. Medical folk. And several desperate housewives. After a few hours and an excel database later, we were well on our way to rekindling old friends and indeed old flames.

What fun! Our ten year high school reunion was LOUSY. Everybody was so full of themselves and into proving what they had done. And all we wanted to see was our band peeps!! I guess now, that most of us are in our late forties. . .folks are more chilled out! Reconnecting felt good. Many had experienced some kind of emotional drama, trauma, or life experience that caused them to chillax! Be cool and just be themselves.

The trash trauma came when we realized what we had done! It was all well and good to ring up these people and email. But then, it was time to plan a meeting to get together and do up this shin-dig. EMOTIONAL TRAUMA! OMG. . . that would mean we would have to actually see these people in person. But wait! There hadn't been enough time on my 20th rejoin of Weight Watchers. I was screaming, I am not ready! The bod just isn't worthy! I made out with several of those dudes.

BFF had more confidence. She became my stoic true blue friend that would stick beside me until there was enough vino on board to reduce the emotional trauma of having to appear in person.

What relief. We went. We hugged folks, love handles and all. I think BFF and I had the most. But folks were pleased and happy to have remade contact. We relived old memories and good times. Hearts were warmed. Bridges were built and barriers broken down. Sweet.

I guess it was worth the bucket of tums I chewed on the way there. I was okay. Desperate housewife? Maybe not. But good old friend, you betcha!

Code OB: ACLS for OB peeps

2008-04-27T10:22:00.000-07:00

There is a cool course out there for folks wanting ACLS but with an OB focus. You receive and ACLS card, but most of the 10 core cases are OB related.

This course is in compliance with the recommendation by AWHON and Joint Commission for L and D peeps to have frequent mock codes and drills based on possible OB emergencies.

The median age of mothers has dramatically gone up. This fact, coupled with the co-morbidities that occur with older mothers has made them more at risk during labor and anesthesia. Another factor is something called a NICU graduate. NICU graduates are mothers who were NICU babies themselves. Some have co-morbidities such as heart and lung conditions that they are not even aware they have.

Moms truly code only about 1 in 30,000 births. However, they have a series of near miss complications a lot more often than that. There are several nuances to coding a mom that us general ER folk just don't know.

Google to find links for this great course!

The EZ IO - your answer to access!

2008-04-22T09:34:00.000-07:00

So what exactly is the EZ-IO? It is an intraosseous device by VidaCare which resembles a mini-electric drill like what you might find in your garage. This product system is the one of the most remarkable and best solutions developed for the rapid, secure and safe delivery of intraosseous drugs and fluids when existing methods of vascular access are challenging or impossible. The battery-powered device is used to place a stable port, via the intraosseous route in the tibia, achieving vascular access within seconds, with minimal trauma to the patient.

Okay, so you are thinking intraosseous, fast? No way. Well, WAY!!! It literally takes only about 20 seconds to find the placement, place the gun, squeeze the trigger, pull the stylet, place your tubing and “waahhhh-laaaahhhh” access!! It was developed to meet the stringent needs of first responders and emergency department personnel for dependability, precision and user-friendliness.

Both in the emergency setting and during emergent critically needed care, the system offers the potential to establish new standards of clinical excellence in the safe, rapid institution of life-saving medical therapies. They are now onboard all Dallas Fire Department ambulances and are being used with great success. The EZ IO can stay in place for about 24 hours until another line placement can be completed.

EMTs, docs and nurses. . if your organization doesn't have one - go to this website and call the rep today! http://www.vidacare.com/ Too bad I don't have stock in this!

Our hospital now owns one – located in the emergency department. Cost: about $800. In its transportable small box, it can easily be borrowed for use in any emergency when access is a life saving issue.

Blog Blues and Why don't some nurse managers WALK the TALK?

2008-04-21T08:06:00.000-07:00

Blog Blues
Okay. . so I was so very excited to be have finally created and written a blog. But I found out I could only get so far with my basic blog skills. i.e. adding pictures as mentioned in the blog. Or pic of me. . .or well. . . just about everything was complicated. So, I thought. . .okay. . .option #1 CAN this blog and start over. Or option #2. . . do a little self study in how to improve my blog and try to stay the course. Decisions. . .decisions. I am a great starter of stuff. . .just have a bit of trouble getting to the finish line unless it is only a 50 yard dash. No marathons for me. Maybe I was a gypsy in another life?

Great trauma story of the day: Why don't some nurse managers WALK the TALK?
I worked in a fabulous large city ER. Fabulous from the standpoint that our trauma and ER docs ROCKED!!! We got it all: major MVCs; about four gun shot wounds per day; acute strokes; acute MIs; farm implements gone wrong. . .and plenty of clinic care. We had the same director for 25 years. {{Pause, whilst we revere her -darn retirement.}} The powers that be (TPTB) did a 2 year search for a replacement. Got some young chick who thought she knew it all. Within three months of her onboarding. . . 10 quality staff had resigned. One of new chick's first comments to our staff was - "Well, first things first, when I interviewed here, I thought you all looked like a bunch of slobs. We are going to now require that everyone where the same colored scrubs. Here is the voting sheet, you have three months to get it together."

Within six months. . .another 30 staff bit the dust. By the end of the year. . . 45!!! What in haddes? When I resigned (as I saw my career under her tanking rapidly) she sent me a two word email, "resignation accepted" from her blackberry. Okay, so I felt a bit validated when I heard that 30 had left. . .but when the main two guru Clinical Coordinators resigned! Holy moly! . .they had over 40 years of trauma experience between them! There just wasn't nuttin' they couldn't do. . .ya know??? I thought, surely administration will sit up and take notice. Silly me.

Now, let's do the math here. It takes more than about $10,000 to recruit, train, and orient a basic experienced RN. Add a trauma specialty and up that about another $2000. By year end, this Director had lost 93!!!!!!! people. Um. . . I sure aint' no mathemetician. . .but this chick cost this hospital close to ONE MILLION DOLLARS during her first YEAR of employment.

My buddy recently phoned me and said, "Drop what you are doing and call me." I couldn't imagine what was shaking this trauma queen's chain. Her first words, "Ding dong, the witch is dead." Well. . . .finally! Seems TPTB finally gave her "the nudge" to move along doggie! Of course the spin is. . . . Shewhowillremainnameless. . ."resigned" to go care for family . . . oh yeah. . . .RIGHTO!!!!! Barf. . .do they think we really believe this dribble?

Now, a SMART TPTB, er, interim director would go back to through the files and go. . ."okay. . .let's salvage something out of this. I mean, we lost some QUALITY peeps here." Boom.....93 letters would go out that say:

<Dear Fabulous RN/Tech/Highly desired individual:

Due to recent management changes (i.e. the demise/disembowelment of recent, pathetic, poorly-chosen, maggot-bag director), we here at XXZYTrauma Center would like to carry out our mission and values by humbly groveling and admitting that carrying out exit interviews might have been a good idea.

Therefore, we would like to extend our arms and beg for forgiveness at not listening to you, our precious staff. Please, please, oh please (with a sugar cube) judge NOT our idiocy in hiring that person. . . but hear our plea/beg/desperate cry for HELP!!!!

Return, oh devoted ex-staff member of XXZTYTrauma Center. Return to not only your fabulous unit, but with a one dollar increase in pay. All of your benefits restored. . . .and our profound apology. Start today! And help us restore our dignity and fine quality service.

Best regards, Chief CNO>

Okay. . . so maybe not worded exactly like that. But think about it, I bet about 1/3 of those folks might actually consider coming back. I mean, you are talking Level I trauma at its best!!! And as we all know, true TRAUMA JUNKIES never die!!!

Enough rant. But get my drift? Why, oh why do nurse managers not practice what they read in their almighty bloody journals? Is it so hard to WALK THE TALK???

Silver Anniversary

2008-04-16T13:23:00.000-07:00

Wow. . .so this coming May, 2008, during nurse's week. . . it will be my 25th year in Nursing! Twenty five years of ER, Trauma, ACLS, CCRN. . .blood, guts, IVs, CPR, whiny docs, wonderful docs, drama, Nurse Ratchet managers, Joint Commission. . .oh right. . and of course patients!

Has it really been since 1983 that I was pinned and donned (so proudly) my first nursing cap? Sat my boards with paper and pencil (all two days of them)? Got up and gave a doctor my chair? Proudly started my first IV? Rescucitated my first dead patient? Held my first newborn? Ahhhhh. . . .yes it has.

See fabulous pic of me in my graduation nurse outfit. Dang it, I was thin. That was nursing then, in 1983 and here is it now 2008. With the lowriding, slim leg with slit styles, no wonder I can't find any scrubs that fit. Where are the grandma style streee--tttcchh fabrics?

And dang it, I didn't make it to my silver wedding anniversary (let's see I will have to be 69 for my second shot at it). . . but ya know? I made it to my silver anniversary in nursing. Florence would be proud! I did it. I stuck it out. Nineteen name tags, errr. . .jobs. . .later I finally made it!

So flip off, you naysayers who said it couldn't be done. To heck with you nurse managers who didn't see my potential. I love my job! I love being a nurse. And who knows. . .with a little bit of luck, I might just make it to retirement! Barbados. . .here I come!