I woke up at 2pm after working all night long, this is actually early considering the time I go to bed. Sometimes I think of myself as a vampire, sleeping during the day and taking people's blood at night. wahahahaha. It seems I am always doing IVs or poking people with needles at work. It doesnt phase me anymore.
My child self would be scared to death of me now. lol
My close friend Brachkoki called me. Brachkoki and I have a long history, we met in korean language school in the summer of 2000. He was 23 or 24 at the time and I was 19, I always looked up to him as older and more experienced in life. He called me for advise, I was grateful for the call because it woke me up one and two it was good to talk to him. A life long friend.
Sometimes I think if nobody called me in the morning (my morning is 2 or 3 pm) I would never wake up.
"Well buddy, I hope that all goes well. Call me again soon." I said and hung up on the phone. Just as I was hanging up I noticed a voicemail.
"Sarah, this is Stacy, we are really short staffed today. Was wondering if you could come into work. Call back if you are able to." I wondered if she liked my call tone.
MY CALL TONE: Michelle off American Pie saying "And this one time at band camp, we all lost our music and we were supposed to play this song, but we didn't know it, so we just made it up and we kept playing and the conductor didn't know what we were doing and it was funny."
It makes me laugh every time, especially since some people have said that I talk like her.
The voice mail seemed simple, but to me it was a plea for help. In my mind this is how it went.
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"The waiting room is full sir, of sick and dying people!" The unit clerk tells the charge nurse in a panic. "There are so many that they don't all fit in the waiting room, many of them are waiting outside in the cold, and by some freak of nature chance it is hailing hail stones the size of golf balls, people are getting hit in the face and limbs, furthermore breaking bones or worst of all concussions and head injuries."
"I know, I know. We are full in here too of the sick and dying, there are simply not enough nurses to care for all of these people!"
"Ahhhhhhh!!" Someone yells from one of the rooms, "help me I am sick and dying!"
"We need to call some more nurses into work or everyone in here will die." the charge nurse says with a worried face.
"I will call our emergency contact list of employees," the unit clerk says and rushes off to the phone.
"Sir," one of the nurses taps the charge nurse on the shoulder, "we had to send nurse Patty home because her son's deveriticulitis exploded within him ten minutes ago while he was at school, she has to pick him up and bring him here for emergency care."
"Her 11 year old has deverticulitis?" the charge nurse said surprised. "Can this day get any worse?"
After a horrible half an hour or so of relentlessly trying to get nurses into work an extra shift the unit clerk gets exhausted. She wonders if she will ever get anyone to work. "No, I can't," kept echoing in her mind.
The phone rings.
"Hello, this is Sarah, may I please speak to the charge nurse?" Stacy's face lights up relieved that this fair young lady would perhaps work.
"THis is charge," the charge nurse picks up the call hoping that it is a nurse volunteering to work.
"Yes, I can come in today, I shall be there as soon as possible."
The charge nurse hangs up the phone and is relieved, hope becomes within reach.
"Hey everyone! Sarah is coming in to help us." He announces to the nursing station.
Everyone cheers.
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It probably didn't happen that way, but I did feel like Super Girl swooping in to save the day. During the shift I had the Director of Nursing, Nurse Manager, Nurse Educator and the Charge Nurse thank me for taking the extra shift.
I felt appreciated. It was a good feeling.
Tuesday, October 27, 2009
Monday, October 19, 2009
Texas isn't So Bad
"I want to move here!" my sister in law Monyka told me as I drove her to the airport. It touched me that she was so excited about Texas. I wished inside that her, my brother and my sister, her husband and my niece would move here too.
Texas the land of opportunity.
I said goodbye to her and she left on her plane.
We don't hug in my family so there was no exchange of hugging like any normal family.
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ONe time at my brother's house sometime last year my sister was visiting.
"Goodbye" she said and waved. I stood up out of my chair..."What do you want me to hug you?" she asked jokingly knowing I would probably decline.
"Ummmm sure..." I said awkwardly, she seemed surprised at the awkward response, although I had just stood up to walk her to the door.
We gave each other an awkward hug and my brother stared at us in shock.
"Wow that was awkward." My sister said outloud after hugging me.
"We aren't a hugging family," my brother said and laughed.
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So Monyka and I didn't hug goodbye, as I expected. I know we have a strange non touching family.
On my drive home I thought about how much Monyka loved Texas, and I started to wonder why. I guess I didn't realize how lucky I really am to live here as I looked back at all the fun we had in San Antonio on the Riverwalk and in Austin at the Highland Mall where we went to the haunted house, not to mention all the shopping outlets we stopped by.
I guess Texas isn't so bad.
Texas the land of opportunity.
I said goodbye to her and she left on her plane.
We don't hug in my family so there was no exchange of hugging like any normal family.
------------------------------------------------------------------------------------
ONe time at my brother's house sometime last year my sister was visiting.
"Goodbye" she said and waved. I stood up out of my chair..."What do you want me to hug you?" she asked jokingly knowing I would probably decline.
"Ummmm sure..." I said awkwardly, she seemed surprised at the awkward response, although I had just stood up to walk her to the door.
We gave each other an awkward hug and my brother stared at us in shock.
"Wow that was awkward." My sister said outloud after hugging me.
"We aren't a hugging family," my brother said and laughed.
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So Monyka and I didn't hug goodbye, as I expected. I know we have a strange non touching family.
On my drive home I thought about how much Monyka loved Texas, and I started to wonder why. I guess I didn't realize how lucky I really am to live here as I looked back at all the fun we had in San Antonio on the Riverwalk and in Austin at the Highland Mall where we went to the haunted house, not to mention all the shopping outlets we stopped by.
I guess Texas isn't so bad.
Tuesday, October 13, 2009
My first DKA
I had my first Diabetes Keto-acidosis (DKA) patient. For those of you who are not familiar with this condition, it occurs mainly with those people who have type one diabetes. It is an acute metabolic condition that is characterized by hyperglycemia (we are talking like 400 blood glucose and up), hyperketonemia, and metabolic acidosis. It causes nausea, vomiting, abdominal pain and can progress to cerebral edema, coma and worst case scenario death. The patient will also present with symptoms such as low blood pressure, due to dehydration and a crazy high heart rate from acidosis, to compensate for this acidosis they breathe rapidly. So I am sure you can see what a critical patient this is, in the absence or tardiness of care the patient WILL either end up in a coma or die. I can't say this enough, it is very serious. One thing about the patient is severe dehydrated, like almost 6 liters behind. With such insane dehydration a patient's kidney's with lowered perfusion can also be permanently damaged. The hyperglycemia causes an osmotic diuresis that leads to increased urinary excretion of water and electrolytes, particularly potassium. Sometimes DKA patients are unaware that they even had type one diabetes. What a shock right?
So I get this patient.... I will not go into details because of HIPPA (patient privacy rights). I already had three rooms of patients needing my care...
Right when I felt like I was on top of my game.... This patient comes in with one of the most critical conditions we are presented with in the ER, and he was assigned to my room!
When I first walked in the room and saw this patient breathing rapidly, with a crazy high heart beat and low blood pressure...What a stressful situation.
"AHHHHHHHH!!!!!" I screamed on the inside.
I had to collect myself, stay calm, this patient's life was in MY HANDS! This is not the time to lose it.
"First thing is first, let's put him on oxygen," I thought to myself and immediately put him on two liters a minute. I looked at the monitor, that worked, his Oxygen Saturation was at a normal level.
I didn't touch my nursing notes, I would rather have incomplete notes then a dead patient. ....... "Dead patient," I kept thinking in my head, "nobody is going to die here, not in my room."
"I need help in here!" I loudly announced to the nursing station where the doctor and nurses were intermittently gathered. Two nurses came in my room and one doctor.
"We need some lines on him and labs drawn," I said taking charge as primary nurse.
"We better start the DKA protocol," the M.D. said to me, "I know this is your first time but you can do it, let's start an insulin drip at 5 units an hour and get him 2 liters of fluids stat."
"Sarah, Room 13 needs you." I heard overhead.
"DAMN patients!" I knew exactly who it was and what they wanted. I imagined their whining faces....... "How much longer is it going to be till we can go home?"
"You are NOT the only patient in this ER!! You CAN wait! Now, don't bother me right now for the love of everything that is good and holy!" I answered them in my head while walking to the medication room to gather the necessary insulin for my DKA patient.
"Dead patient....." I couldn't stop thinking...
I will be damned if I am going to stop doing what I am doing to answer stupid questions, I ignored the overhead and proceeded to concentrate my insulin drip. I was at the mercy of the other float nurses to cover every single trivial question and complaint my other less serious rooms had. Surely they knew I would be tied up for the next half an hour or so.
Alot can happen in half an hour.... Mr. E in room 12 can fall off his bed.... I would have to fill out an incident report... Answering all the questions on the computer..Was he in non slip socks, were the side rails up, the call light within reach and how much morphine did he have before the fall? Basically asking. "was it your fault as his nurse?"
"I just gave room 12 five mg of Morphine, I wonder...Are the side rails up?" I thought to myself... I imagined him fallen in a pitiful position on the floor, he looks to me... "if only you would have put the side rails up I wouldn't have fallen."
"AGHHHH!" I screamed on the inside again.
"NO, you have to focus on this now!!" I brought myself back to my critical patient and wheeled the IV infusion pump into the room with my bag of insulin drip.
I started it and the patient's fluids.
NEXT...... "I need lab results." I say to the unit clerk, "like now."
We needed to know how much potassium he lost in order to start replacing it, low potassium can kill.
Within a few minutes I had a print out of lab data.
Thank god!! Potassium looked good. I ordered more potassium in Normal Saline from the pharmacy per the DKA protocol, which I have never done before!
While I waited for the potassium I made sure a room was ready in the ICU for my patient. They had one room left, for codes. It was mine! I called the ICU nurse and gave report.
After about an hour of running around, I finally got my patient transferred to the ICU. It was a good feeling to have the craziness over, and to know that you made a difference, the patient is alive...
I got back to the floor with an empty bed, once occupied by a VERY critical patient. I couldn't believe I handled that situation without freaking out.
I did it...
I am an ER nurse...
I helped save a life....
And thankfully, the float nurse covered my three other rooms. Everyone was okay, nobody fell out of bed or coded on me.
So I get this patient.... I will not go into details because of HIPPA (patient privacy rights). I already had three rooms of patients needing my care...
Right when I felt like I was on top of my game.... This patient comes in with one of the most critical conditions we are presented with in the ER, and he was assigned to my room!
When I first walked in the room and saw this patient breathing rapidly, with a crazy high heart beat and low blood pressure...What a stressful situation.
"AHHHHHHHH!!!!!" I screamed on the inside.
I had to collect myself, stay calm, this patient's life was in MY HANDS! This is not the time to lose it.
"First thing is first, let's put him on oxygen," I thought to myself and immediately put him on two liters a minute. I looked at the monitor, that worked, his Oxygen Saturation was at a normal level.
I didn't touch my nursing notes, I would rather have incomplete notes then a dead patient. ....... "Dead patient," I kept thinking in my head, "nobody is going to die here, not in my room."
"I need help in here!" I loudly announced to the nursing station where the doctor and nurses were intermittently gathered. Two nurses came in my room and one doctor.
"We need some lines on him and labs drawn," I said taking charge as primary nurse.
"We better start the DKA protocol," the M.D. said to me, "I know this is your first time but you can do it, let's start an insulin drip at 5 units an hour and get him 2 liters of fluids stat."
"Sarah, Room 13 needs you." I heard overhead.
"DAMN patients!" I knew exactly who it was and what they wanted. I imagined their whining faces....... "How much longer is it going to be till we can go home?"
"You are NOT the only patient in this ER!! You CAN wait! Now, don't bother me right now for the love of everything that is good and holy!" I answered them in my head while walking to the medication room to gather the necessary insulin for my DKA patient.
"Dead patient....." I couldn't stop thinking...
I will be damned if I am going to stop doing what I am doing to answer stupid questions, I ignored the overhead and proceeded to concentrate my insulin drip. I was at the mercy of the other float nurses to cover every single trivial question and complaint my other less serious rooms had. Surely they knew I would be tied up for the next half an hour or so.
Alot can happen in half an hour.... Mr. E in room 12 can fall off his bed.... I would have to fill out an incident report... Answering all the questions on the computer..Was he in non slip socks, were the side rails up, the call light within reach and how much morphine did he have before the fall? Basically asking. "was it your fault as his nurse?"
"I just gave room 12 five mg of Morphine, I wonder...Are the side rails up?" I thought to myself... I imagined him fallen in a pitiful position on the floor, he looks to me... "if only you would have put the side rails up I wouldn't have fallen."
"AGHHHH!" I screamed on the inside again.
"NO, you have to focus on this now!!" I brought myself back to my critical patient and wheeled the IV infusion pump into the room with my bag of insulin drip.
I started it and the patient's fluids.
NEXT...... "I need lab results." I say to the unit clerk, "like now."
We needed to know how much potassium he lost in order to start replacing it, low potassium can kill.
Within a few minutes I had a print out of lab data.
Thank god!! Potassium looked good. I ordered more potassium in Normal Saline from the pharmacy per the DKA protocol, which I have never done before!
While I waited for the potassium I made sure a room was ready in the ICU for my patient. They had one room left, for codes. It was mine! I called the ICU nurse and gave report.
After about an hour of running around, I finally got my patient transferred to the ICU. It was a good feeling to have the craziness over, and to know that you made a difference, the patient is alive...
I got back to the floor with an empty bed, once occupied by a VERY critical patient. I couldn't believe I handled that situation without freaking out.
I did it...
I am an ER nurse...
I helped save a life....
And thankfully, the float nurse covered my three other rooms. Everyone was okay, nobody fell out of bed or coded on me.
Monday, October 12, 2009
Shrimp
I woke up at 4 pm after working a full sixteen hour shift, I know it seems bad but considering all of the overtime, bonuses, night and weekend differentials it was well worth the strain and stress of a sixteen hour shift on the busiest night in the Emergency Room. Which by the way I only sat down for maybe ten minutes during the whole thing. "Hell Night"
ALONE.....
It didn't feel so bad this time, usually I feel that loneliness is my worst enemy. It was a relief to be rid of people begging for pain medication, asking how long till the doctor is going to see them among several other needs and wants that keep me on my feet in the ER.
ALONE...... at last, it felt like a breath of fresh air.
I decided to live it up, I bought some shrimp.
Strangely enough, I didn't start liking shrimp until last summer in Las Vegas when Dulce cooked them for me on the grill at her house. It was incredible. Now I can't have enough shrimp.
If only my step sister Rachael didn't cause me to loathe shrimp when I was fifteen years old.
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"Leo Ho, I dare you to eat 10 plates of shrimp," my step sister Rachael, 21 years old at the time (which then seemed so old to me) said across the table with a candid smile.
"Do you?" I asked, unaware that the joke was on me. "What will you give me if I do?"
"I'll pay for the meal and you will have bragging rights for the rest of your life," she said looking over the menu and laughed.
"You were going to pay for it anyway," I said catching on that there was nothing in it for me.
It wasn't unlike Rachael, the sadistic step sister, to dare me to do things and me having no benefit of having done it. I suppose bragging right, but who brags about:
"I can drink a 60 ounce drink and not use the bathroom for four hours."
or
"I can eat 11 plates of shrimp at Sizzler."
I try my hardest to include these in my everyday conversation now.... I did the dares for a reason right?
"And what will you be having?" the waitress asked me.
"The all you can eat shrimp," I said with motivation and a mission in mind.
"I love you," Rachael laughed at me.
The challenge was on....."I hate you." I told Rachael as we drove home.
I ate 11 plates of shrimp, and I felt sick! Right after I went on a bike ride with my best friend at the time, Holly. I tried to pretend nothing was wrong, surprisingly I managed not to puke leaving a trail as I road off into the sunset with my friend.
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I marinated my shrimp with lemon and olive oil, cut up some tomatoes and marinated them too. Then added some fresh parsley. I don't know why I added parsley because still to this day I am not sure how to apply it to cooking. I understand the theory of parsley but I don't get it in practice. Does anyone know the point of parsley? It just sounds nice to say
"I added fresh parsley," makes you sound like you know what you are doing.
"But of course you did!!" someone would reply somehow trying to act like that was somehow a good thing and in reality they have no idea what parsley is for.
THANK GOD for parsley!! What would I do without it.....????
Get off the parsley, you are probably thinking.
I snacked on shrimp, lit some apple pie smelling candles and watched Knocked Up. It was bliss...
ALONE.....
It didn't feel so bad this time, usually I feel that loneliness is my worst enemy. It was a relief to be rid of people begging for pain medication, asking how long till the doctor is going to see them among several other needs and wants that keep me on my feet in the ER.
ALONE...... at last, it felt like a breath of fresh air.
I decided to live it up, I bought some shrimp.
Strangely enough, I didn't start liking shrimp until last summer in Las Vegas when Dulce cooked them for me on the grill at her house. It was incredible. Now I can't have enough shrimp.
If only my step sister Rachael didn't cause me to loathe shrimp when I was fifteen years old.
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"Leo Ho, I dare you to eat 10 plates of shrimp," my step sister Rachael, 21 years old at the time (which then seemed so old to me) said across the table with a candid smile.
"Do you?" I asked, unaware that the joke was on me. "What will you give me if I do?"
"I'll pay for the meal and you will have bragging rights for the rest of your life," she said looking over the menu and laughed.
"You were going to pay for it anyway," I said catching on that there was nothing in it for me.
It wasn't unlike Rachael, the sadistic step sister, to dare me to do things and me having no benefit of having done it. I suppose bragging right, but who brags about:
"I can drink a 60 ounce drink and not use the bathroom for four hours."
or
"I can eat 11 plates of shrimp at Sizzler."
I try my hardest to include these in my everyday conversation now.... I did the dares for a reason right?
"And what will you be having?" the waitress asked me.
"The all you can eat shrimp," I said with motivation and a mission in mind.
"I love you," Rachael laughed at me.
The challenge was on....."I hate you." I told Rachael as we drove home.
I ate 11 plates of shrimp, and I felt sick! Right after I went on a bike ride with my best friend at the time, Holly. I tried to pretend nothing was wrong, surprisingly I managed not to puke leaving a trail as I road off into the sunset with my friend.
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I marinated my shrimp with lemon and olive oil, cut up some tomatoes and marinated them too. Then added some fresh parsley. I don't know why I added parsley because still to this day I am not sure how to apply it to cooking. I understand the theory of parsley but I don't get it in practice. Does anyone know the point of parsley? It just sounds nice to say
"I added fresh parsley," makes you sound like you know what you are doing.
"But of course you did!!" someone would reply somehow trying to act like that was somehow a good thing and in reality they have no idea what parsley is for.
THANK GOD for parsley!! What would I do without it.....????
Get off the parsley, you are probably thinking.
I snacked on shrimp, lit some apple pie smelling candles and watched Knocked Up. It was bliss...
Wednesday, September 23, 2009
About Healthcare
Here is a little something I wrote last night. Its up for debate.
Accreditation and regulation work hand in hand in health care agencies to insure quality of care. First of all, to understand their roles and meaning we must know the definitions. According to the Merriam Webster Online Dictionary, ‘regulation’ comes from the root word ‘to regulate’, meaning ‘govern or direct according to rule and to bring under the control of law or a constituted authority’. Interestingly enough if you look at the etymology of the word ‘accredit’ you will see it comes from the Latin word accreditus which is the past participle of accredere, ‘to give credit to’, break down the word more and it can be divided into ad and credere meaning ‘to believe’. In fact, the word ‘creed’ comes from the Latin word ‘credere’. So ‘to accredit’ an agency is to not only give credit to the agency but to believe the way it functions is at a certain standard.
When I think of health care and regulatory and accreditation agencies the first two that come to my head are the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and The Department of State Health Services (DSHS). I believe that the most impact on quality of care lies with the State run regulatory agency. The reason is that this agency can focus in on the hospitals in their state; therefore they have a more specific scope of jurisdiction. The regulation agency (DSHS) makes sure that regulations are enforced and quality of care is being given. They can closely monitor their state and thereby know what their areas of improvement are and work on improving those areas. The JCAHO, on the other hand, is a federal commission, and is physically unable to monitor all 3,537,441 square miles of this great country of ours. It is impossible to ensure that regulations and standards of care are being met on a daily basis with the number of visits they pay to a healthcare facility. The accreditation they merit to a healthcare facility is based on a belief that they are upholding standards of care. However the JCAHO does know with clarity that the institution is upholding standards of care with one or two visits a year. It is up to the State to pick up the slack and keep up quality of care.
Tuesday, September 22, 2009
Texas Friends
I remember a time where I had friends to call up and hang out with all the time. There was never a dull day. Wherever I have lived, which has been various places, I have always made friends. Everyday was an adventure. I was never bored.....
Until now.... I am so freaking bored.
All of my close friends are a 1-3 hour drive away from me. So if I wanna have fun with friends I have to plan it out over a weekend.
I have my friends in Houston. My friend Mexican Princess and her girlfriend Blondie and Blondie's best friend since childhood Adam Sandler, (he looks exactly like Adam Sandler, its awesome).
How did I meet these people?
When I used to live here in Texas, back when I was in the Army. I had a friend, Julia Stiles
(she looks like Julia Stiles to me) who was dating Mexican Princess in San Antonio. Julia Stiles left to New York to go to Law School, which she graduated (I am so proud of her) and broke up with Mexican Princess who then met Blondie after she moved to Houston a year later.
My friends in San Antonio are also fun. Eve and her girlfriend Smoking Hot. I met Eve also through Julia Stiles, they had been on a few dates but it never progressed to anything serious. Julia Stiles suggested that Eve and I become friends because Eve is so freaking hilarious!! I can't be with Eve without laughing so hard my stomach hurts. Now she has Smoking Hot, they have been together for one year and just moved in together. Hooray for them!!
So the web of friends here in Texas all lead back to Julia being our common denominator. Yes, Julia Stiles has dated a lot!! But she just has a lot of charm and irresistibly. And yes I am guilty also. I met Julia Stiles in language school in Monterey, California. We met at Lighthouse Bar and Grill (the only gay bar in the city). I can imagine what you are thinking.... It wasn't like that....
"You see that girl over there," the Bar Tender said to me and pointed to Julia Stiles sitting outside with her friends.
"Yeah," I said and took a drink of coke, "What about her."
The Bar Tender and I had been 'special friends' for several months. I was her go to girl when she needed...... company, to put it nicely. She was the most gorgeous girl I had ever seen, gay or straight, at this point in my underage life. She had me whipped, the entire 'thing' between us was all on her terms. I was her girl toy and I loved it and hated it at the same time.
"I invited her out on a date a few months ago and she showed up at my apartment wearing sweats," the Bar Tender said and laughed.
"Oh really," I said looking at the beautiful Julia Stiles. How someone could not want her was beyond me sweats or not, the Bar Tender must be crazy.
"I dare you to go and talk to her," the Bar Tender said mischievously and started mixing a drink for a customer.
So I went to go and talk to Julia Stiles. I wasn't sure what purpose this would serve, but there was one thing for sure, the Bar Tender was a devious playeress. A gorgeous playeress nonetheless but still a game player. I decided that I was going to play a game of my own.
"Hey, my name is Jasmine Vanilla," I said to the beautiful blonde Julia Stiles.
"I know who you are Jasmine," she said matter-of-factly.
"Really!??" I said shocked.
"Everyone at this bar knows who you are," she said and took a puff of her cigarette, "and you go to class with my best friend."
"Right," I was unaware of these new facts, "the reason I came to talk to you is because I want to ask you out."
"Oh, yeah sure....but aren't you dating the Bar Tender?" she said and started to write down her phone number.
"I wouldn't call it dating," I said and gave her my phone number and walked back to report to the Bar Tender who was more than curious about what had happened. I told her that I just introduced myself and had small talk, little did she know that the tables were about to turn on her.
So Julia Stiles and I went out on a date for the sole purpose of upsetting a venomous woman we had both had the pleasure of 'dating'. The thing about poisonous plants is that they appear the most beautiful among all the plants, so you are deceived until you finally bite into it and start feeling its unforgiving actuality of its existence, to prey upon the innocent.
Our first date went marvelously. We had so much to talk about, so much in common, and enough differences to make things interesting. I had a great night so I decided to park at the beach and kiss her. It lasted about 20 seconds but within that time I realized there was absolutely no chemistry what so ever. As I drove her back to her barracks on base I could tell the feeling was mutual. Despite all this we became great friends, and I am thankful for that.
Its been 7 years since Julia Stiles and I met, and I have her to thank for introducing me to my friends in Houston and San Antonio.
Lastly, my friend Shorty in Killeen, Texas. A short Peruvian girl with whom I had the pleasure of meeting in one of my community college classes I was taking when I was stationed in Killeen. We sat next to each other and instantly cliqued. She may be small but she packs a lot of punch, so don't mess with her, she will kill you.
So there you have it, besides my friend India and Croatia here in Waco, I have several friends in Texas, they are just to far to hang out with regularly.
Which leads to my dilemma. The boredom..... and loneliness on the weekdays that I have off.
Until now.... I am so freaking bored.
All of my close friends are a 1-3 hour drive away from me. So if I wanna have fun with friends I have to plan it out over a weekend.
I have my friends in Houston. My friend Mexican Princess and her girlfriend Blondie and Blondie's best friend since childhood Adam Sandler, (he looks exactly like Adam Sandler, its awesome).
How did I meet these people?
When I used to live here in Texas, back when I was in the Army. I had a friend, Julia Stiles
(she looks like Julia Stiles to me) who was dating Mexican Princess in San Antonio. Julia Stiles left to New York to go to Law School, which she graduated (I am so proud of her) and broke up with Mexican Princess who then met Blondie after she moved to Houston a year later.
My friends in San Antonio are also fun. Eve and her girlfriend Smoking Hot. I met Eve also through Julia Stiles, they had been on a few dates but it never progressed to anything serious. Julia Stiles suggested that Eve and I become friends because Eve is so freaking hilarious!! I can't be with Eve without laughing so hard my stomach hurts. Now she has Smoking Hot, they have been together for one year and just moved in together. Hooray for them!!
So the web of friends here in Texas all lead back to Julia being our common denominator. Yes, Julia Stiles has dated a lot!! But she just has a lot of charm and irresistibly. And yes I am guilty also. I met Julia Stiles in language school in Monterey, California. We met at Lighthouse Bar and Grill (the only gay bar in the city). I can imagine what you are thinking.... It wasn't like that....
"You see that girl over there," the Bar Tender said to me and pointed to Julia Stiles sitting outside with her friends.
"Yeah," I said and took a drink of coke, "What about her."
The Bar Tender and I had been 'special friends' for several months. I was her go to girl when she needed...... company, to put it nicely. She was the most gorgeous girl I had ever seen, gay or straight, at this point in my underage life. She had me whipped, the entire 'thing' between us was all on her terms. I was her girl toy and I loved it and hated it at the same time.
"I invited her out on a date a few months ago and she showed up at my apartment wearing sweats," the Bar Tender said and laughed.
"Oh really," I said looking at the beautiful Julia Stiles. How someone could not want her was beyond me sweats or not, the Bar Tender must be crazy.
"I dare you to go and talk to her," the Bar Tender said mischievously and started mixing a drink for a customer.
So I went to go and talk to Julia Stiles. I wasn't sure what purpose this would serve, but there was one thing for sure, the Bar Tender was a devious playeress. A gorgeous playeress nonetheless but still a game player. I decided that I was going to play a game of my own.
"Hey, my name is Jasmine Vanilla," I said to the beautiful blonde Julia Stiles.
"I know who you are Jasmine," she said matter-of-factly.
"Really!??" I said shocked.
"Everyone at this bar knows who you are," she said and took a puff of her cigarette, "and you go to class with my best friend."
"Right," I was unaware of these new facts, "the reason I came to talk to you is because I want to ask you out."
"Oh, yeah sure....but aren't you dating the Bar Tender?" she said and started to write down her phone number.
"I wouldn't call it dating," I said and gave her my phone number and walked back to report to the Bar Tender who was more than curious about what had happened. I told her that I just introduced myself and had small talk, little did she know that the tables were about to turn on her.
So Julia Stiles and I went out on a date for the sole purpose of upsetting a venomous woman we had both had the pleasure of 'dating'. The thing about poisonous plants is that they appear the most beautiful among all the plants, so you are deceived until you finally bite into it and start feeling its unforgiving actuality of its existence, to prey upon the innocent.
Our first date went marvelously. We had so much to talk about, so much in common, and enough differences to make things interesting. I had a great night so I decided to park at the beach and kiss her. It lasted about 20 seconds but within that time I realized there was absolutely no chemistry what so ever. As I drove her back to her barracks on base I could tell the feeling was mutual. Despite all this we became great friends, and I am thankful for that.
Its been 7 years since Julia Stiles and I met, and I have her to thank for introducing me to my friends in Houston and San Antonio.
Lastly, my friend Shorty in Killeen, Texas. A short Peruvian girl with whom I had the pleasure of meeting in one of my community college classes I was taking when I was stationed in Killeen. We sat next to each other and instantly cliqued. She may be small but she packs a lot of punch, so don't mess with her, she will kill you.
So there you have it, besides my friend India and Croatia here in Waco, I have several friends in Texas, they are just to far to hang out with regularly.
Which leads to my dilemma. The boredom..... and loneliness on the weekdays that I have off.
Monday, September 21, 2009
Emergency Room
I have been working in the ER with a preceptor for the past 5 weeks. I have learned a great deal about Emergency Medicine, valuable lessons about acute care and a lot about people.
The ER that I work at is comprised of three zones, red, blue and green (which is rarely open) and Minor Emergency Care (which I shall never deal with being a RN.) There are a total of 40 rooms all together. On one given shift there are 3-5 Medical Doctors, an Emergency Nurse Practitioner, and at times Physician Assistants. Additionally, there are 10 RNs who have 4 rooms each. Working with the RNs are nurse techs (who are nursing students) they are an enthusiastic member of the team and do everything legally possible without a license. The other team members of the ER team are unit clerks who manage orders and take phone calls, housekeepers, and CT, Xray, and Respiratory Therapists.
An RNs job is to do an initial assessment, draw labs, start IVs, give medications, and monitor the patient. Most importantly they serve as advocates to the patients. We are the eyes and the ears, the first line of care. If we believe the patient is about to cease from breathing or their blood pressure is dangerously low, we go to the MD and let them know. We review medication orders and if we believe that the drug will cause more harm then good for the patient we relay our concerns with the MD, we double check their math on dosages and compatibility. We also anticipate treatment and labs needed, and most of the time we already have blood drawn, urine collected, cultures obtained and EKGs done before the doctor even orders them. We just know. This makes your stay at the ER a shorter amount of time, good nurses who know their jobs.
I mainly deal with the RNs, needless to say most of them are girls. One of which being my friend and classmate India. She would also agree with me that infiltrating the RN emergency nursing room has been tough, these girls have formed cliques and resent new people. They are mostly Associate Degree Nurses, and they wear their degree with pride. For this reason I keep my Bachelor Degree a secret, I don't want them to resent me more or cease to assist me with my questions that only experience can answer. There is one or two BSN nurses, they somehow managed to put white out on their badge and write in dark pen next to their name, 'BSN.' I believe that all the BSN nurses are charge nurses too. I refuse to flaunt my degree having very little experience on the floor. The male nurses, which I have only met 5 of them, yes one of them is gay, very gay. The other 4 are former EMT guys who had the brain to see that they could get paid more as a nurse and went back to school. They are probably the most competent nurses on the floor and the nicest, they are nowhere near as judgmental as the female nurses.
The patients we receive are various. I have noticed that there are several categories of patients. There are the really old people. They seem to really enjoy being in the ER, they see it as a social visit. I imagine they are very lonely people. For the most part the really old people love the attention us young nurses give them. It is almost like they get depressed when you have to discharge them. Then there are the several patients we get that have chest pain, only about 25% of all chest pain patients actually end up being a heart attack, but we take the necessary precautions regardless with nitroglycerin, morphine and aspirin, the rest of the cases is pneumonia, bronchitis, pulmonary embolism or a pulled muscle. These patients, about 75 % of them, are easily irritated, they get annoyed at the length in which we keep them in the ER. Let it be known that if you go into the hospital for chest pain you can expect to be their no less than 4 hours, and that is if you are lucky, most likely you will be there for 6-8 hours. The other group of patients we get is abdominal pain for females, I have noticed a lot of these patients. Females with their female reproductive system, whether it be an inflammation caused by an STD, a pregnancy, ectopic or normal, or a urinary tract infection. These are usually younger women, many of them you know are permiscous just by looking at their slutty faces. haha ok that is harsh but it is so true. Another group of people that come in are the ones that have colds, flus, pneumonia or bronchitis. Many of them children brought in by their paranoid parents. Most of these people could easily be treated at their family doctor's office but overreact. Then of course we have the people who have freak accidents, bug or snake bites, allergic reactions, broken bones and dislocations and suicidal patients (we get a lot of those.)
My first week in the ER one male nurse 'Bob' (not the gay one) told me that the ER is comprised of scum bags and real emergencies. He then told me 90% of the people who come in the ER do not need to be there, only 10% are real actual emergencies. I didn't realize how right he was until I started working on the floor. Most people who come in to see us could easily see their primary care provider, BUT in the ER if they don't pay us the hospital can't do anything about it nor does it reflect on their credit score. The ER is filled with the poor class of our society who can't afford a doctor or insurance in the first place. It is truly sad.
I love the ER. I thoroughly enjoy working. My nurse educator at the ER told me that Emergency Nursing runs in your blood and once you have a taste you are hooked, you will never do any other kind of nursing. I think that she is right, I can't see myself doing anything else in nursing. I found my place in this career field. Only 3 or 4 more weeks with a preceptor and I am on my own on the floor. I can't wait.
The ER that I work at is comprised of three zones, red, blue and green (which is rarely open) and Minor Emergency Care (which I shall never deal with being a RN.) There are a total of 40 rooms all together. On one given shift there are 3-5 Medical Doctors, an Emergency Nurse Practitioner, and at times Physician Assistants. Additionally, there are 10 RNs who have 4 rooms each. Working with the RNs are nurse techs (who are nursing students) they are an enthusiastic member of the team and do everything legally possible without a license. The other team members of the ER team are unit clerks who manage orders and take phone calls, housekeepers, and CT, Xray, and Respiratory Therapists.
An RNs job is to do an initial assessment, draw labs, start IVs, give medications, and monitor the patient. Most importantly they serve as advocates to the patients. We are the eyes and the ears, the first line of care. If we believe the patient is about to cease from breathing or their blood pressure is dangerously low, we go to the MD and let them know. We review medication orders and if we believe that the drug will cause more harm then good for the patient we relay our concerns with the MD, we double check their math on dosages and compatibility. We also anticipate treatment and labs needed, and most of the time we already have blood drawn, urine collected, cultures obtained and EKGs done before the doctor even orders them. We just know. This makes your stay at the ER a shorter amount of time, good nurses who know their jobs.
I mainly deal with the RNs, needless to say most of them are girls. One of which being my friend and classmate India. She would also agree with me that infiltrating the RN emergency nursing room has been tough, these girls have formed cliques and resent new people. They are mostly Associate Degree Nurses, and they wear their degree with pride. For this reason I keep my Bachelor Degree a secret, I don't want them to resent me more or cease to assist me with my questions that only experience can answer. There is one or two BSN nurses, they somehow managed to put white out on their badge and write in dark pen next to their name, 'BSN.' I believe that all the BSN nurses are charge nurses too. I refuse to flaunt my degree having very little experience on the floor. The male nurses, which I have only met 5 of them, yes one of them is gay, very gay. The other 4 are former EMT guys who had the brain to see that they could get paid more as a nurse and went back to school. They are probably the most competent nurses on the floor and the nicest, they are nowhere near as judgmental as the female nurses.
The patients we receive are various. I have noticed that there are several categories of patients. There are the really old people. They seem to really enjoy being in the ER, they see it as a social visit. I imagine they are very lonely people. For the most part the really old people love the attention us young nurses give them. It is almost like they get depressed when you have to discharge them. Then there are the several patients we get that have chest pain, only about 25% of all chest pain patients actually end up being a heart attack, but we take the necessary precautions regardless with nitroglycerin, morphine and aspirin, the rest of the cases is pneumonia, bronchitis, pulmonary embolism or a pulled muscle. These patients, about 75 % of them, are easily irritated, they get annoyed at the length in which we keep them in the ER. Let it be known that if you go into the hospital for chest pain you can expect to be their no less than 4 hours, and that is if you are lucky, most likely you will be there for 6-8 hours. The other group of patients we get is abdominal pain for females, I have noticed a lot of these patients. Females with their female reproductive system, whether it be an inflammation caused by an STD, a pregnancy, ectopic or normal, or a urinary tract infection. These are usually younger women, many of them you know are permiscous just by looking at their slutty faces. haha ok that is harsh but it is so true. Another group of people that come in are the ones that have colds, flus, pneumonia or bronchitis. Many of them children brought in by their paranoid parents. Most of these people could easily be treated at their family doctor's office but overreact. Then of course we have the people who have freak accidents, bug or snake bites, allergic reactions, broken bones and dislocations and suicidal patients (we get a lot of those.)
My first week in the ER one male nurse 'Bob' (not the gay one) told me that the ER is comprised of scum bags and real emergencies. He then told me 90% of the people who come in the ER do not need to be there, only 10% are real actual emergencies. I didn't realize how right he was until I started working on the floor. Most people who come in to see us could easily see their primary care provider, BUT in the ER if they don't pay us the hospital can't do anything about it nor does it reflect on their credit score. The ER is filled with the poor class of our society who can't afford a doctor or insurance in the first place. It is truly sad.
I love the ER. I thoroughly enjoy working. My nurse educator at the ER told me that Emergency Nursing runs in your blood and once you have a taste you are hooked, you will never do any other kind of nursing. I think that she is right, I can't see myself doing anything else in nursing. I found my place in this career field. Only 3 or 4 more weeks with a preceptor and I am on my own on the floor. I can't wait.
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