Tuesday, December 16, 2008

Stepping Up

I have always been interested in forensics. Of course, my job consists of gathering evidence every day, evidence of injury or illness, but evidence for criminal investigation is different.

I went to my first meeting yesterday for SANE (Sexual Assault Nurse Examiner) and came out so excited. Now that is how one should feel when going to a meeting on your day off. I was hooked.

Then they started talking about pediatric exams and showed some horible pictures and I wondered if I could do this. This meeting came a day after I took care of a 4 month old who was found to have fractured legs, a skull fracture and was sexually assaulted. I was pretty shook up. I can't avoid seeing this part of ugly life so I might as well be a part of putting some sick ass in jail over it.

Some one must do it and there aren't very many out there doing it. So..... training starts in April.

I'm stepping up.

Monday, December 1, 2008

Harmony in the ER.

When you work with the same people for a long time, you tend to become like family. That includes all the good things and the bad things in family relationships. We love each other, dislike each other sometimes, disagree, clash our personalities, and don't make very good music together when over worked and over stressed.

But sometimes, if you watch and listen for it, there is harmony to be heard.

A 95 year old woman came to my room with abdominal distention and pain. Her bladder was distended and I easily took care of that problem by inserting a foley catheter. The distention was gone but the pain still persisted. On further examination, we found her in need of bowel relief as well.

Another nurse came to me to say she also had a patient in need of an enema and could we keep them in the same room to maybe contain the smell to the end of the hall. I thought that was a good idea.

Dual "do do" duty.

The daughter of my patient was elderly herself and very hard of hearing. She chose to sit in a chair at the end of the bed and offered her assistance if needed. And it was! Mom was not a willing participant in this necessary procedure.

I was well "into" the problem when the lady in the next bed began her ordeal. And, for awhile, there was "harmony" in our department.

"Ow! Stop that! You're killing me!"
"Ow! Stop that! OH, OH, OH!"

And the daughter looked on as her mother began to climb up my right shoulder with her poop smeared left leg while reaching down with her left hand for a grasp at the thing that was causing her so much distress: Me and her poop!

I glanced over at the daughter and asked her come to my rescue, wondering to myself why I had to ask. I had the daughter remove the leg from my shoulder and continued my work.

Now the daughter asked me if there wasn't some other way to do this. I said no while wanting to add "Don't you think I'd be doing it?"

The other nurse was having an easier time of it. Her patient was empty and well into the last stage of this procedure....The Grateful Stage! (Ever been constipated? Really constipated? The kind where it feels so good to get it out you want to cry?)

I wasn't so lucky. Not only was I a failure at disimpacting my patient, but when I decided to call it quits the daughter began fussing at me for "making" her help me.

"Are you short of help around here?"
Aw, yes...The old "short of help" syndrome.
"No mam. You offered to help and I let you"
"Well, I have bad hips and I can't stand for that long."

Well, crap. I thought. But the harmony was nice.