Gratuity Included

So here is the deal. Why is it that almost every profession in this world expects to be tipped (okay not every but there is a lot). This is on my mind for two reasons. #1 I just got back from a trip to DC and here is a list of who wanted a tip...

* Curb side check in
* Super Shuttle Driver
* Doorman at the hotel
* Tour bus driver
* Waitress/waiter
* cab driver

#2 Tonight, I was being the kind nurse that I always am :) and I wheeled a patient out to his car as he had a sprained ankle and no one with him to be of assistance. So I get him to the car and he asks if I would accept a "small tip" as he tries to hand me two 20 dollar bills. I graciously decline, telling him I was glad to help him and would not take his money. (As health care providers we are not allowed to take money from the patients.) I've actually been offered money quite a few times and as tempting as it is to take, I know deep down, I would not accept it even if it was allowed. I did have one patient ask for my address (I know what you are thinking but it was an old man in his 80's and I took care of his sweet wife for 2 days while she waited in the ER for inpatient bed) and he sent me a beautiful hand carved roadrunner. I have it sitting on my entertainment center.
Anyways, I really don't want tips...I've just decided that when it comes to the nurses...the gratuity is included!

What brings you to the ER tonight?

Okay, so there are great things about being an ER nurse and I really do enjoy helping those that are in need of medical care...but then there are the 80% of those that I care for that don't need to be in the ER...here are just a few examples!

*I need my toe nails trimmed
*I need the wax cleaned out of my ears
*I have had abdominal pain for the last 3 months
*I have had abdominal pain for the last 5 years
*This mole that I have is changing colors
*I think I may have testicular cancer (this is a female pt)
*"I'm bleeding to death, it's pumping blood"...I unwrapped the dressing she had applied and she had nicked herself shaving her legs...it had already stopped bleeding
*"I have a headache, my husband has placed metal plates in my head...the FBI is tracking this and they are on their way here with pictures."
*I'm pregnant and I feel nauseated
*I need you to check and see if I am pregnant
*My body is burning
*I have had some small bumps on my arms for one month (this pt came in at 3am)
*I have a bad tooth and I don't have money to pay the dentist to fix it
*I have vaginal bleeding (me: when was your last menstrual period, her: I'm on it now)
*I was already seen yesterday but I didn't fill my prescriptions and now I feel worse
*me: sir please have a seat I'll be with you in a moment
him: well I just can't sit down
me: what do you do at home
him: I think I'll go to another hospital cause I just can't sit
(he was there for leg pain...I can only imagine that he stands 24/7)
*I think I'm getting shorter
*I'm having trouble breathing (when we call her name, we find her outside smoking)
*I have this big abscess and my friend that just got out of prison lanced it for me (he was bleeding all over the place)
*My baby has been fussy today (me: well, they do that sometimes)

There are just so many I can't even begin to write them all down. If you can think it...someone has been to the ER for it!

Pink Cowboy Hat

Okay, so a few weekends ago the ambulance brought in the little old lady. I'll never forget her or the pink cowboy hat that she was wearing. It didn't take long for us to figure out that she was a little short upstairs. I can't actually remember her main complaint, maybe abdominal pain of some sort. After only about 30 minutes of waiting for the doctor she called me over to tell me that she had waited too long. She rambled some other crazy things and I explained that she just had to wait. Another ten minutes and she called me over to tell me that she was leaving and that we had better "disinfect" this room due to the contents that were in a paper cup on the counter. She goes out to the lobby and a few minutes later the ambulance company calls us to tell us that a patient in the lobby called 911. Our charge nurse went out and kindly told her that she could not call 911 from OUR lobby to have the ambulance come and get her. About 30 minutes later I walked outside to get warm and this is what I saw....an ambulance by our front door with the lights on and the same lady sitting inside on the stretcher. This is what had happened. She walked outside and borrowed a cell phone...she then dialed 911, told them she was having chest pain and was outside of our ER entrance. Well, now the ambulance has to come and because she is having chest pain, they have to come with lights and sirens. I guess the lady whom she borrowed the cell phone from (and a bunch of others in the lobby) were very concerned about Ms. Cowboy Hat and was pretty upset at us for not taking care of her. So....

#1 Many people think that we are heartless, careless people!

#2 They will never understand that we really tried to care for her but she's just plain crazy!

#3 Ms Cowboy Hat got another ambulance ride, to another ER (I guess she had ER hopped all day with nice ambulance rides in between) just as she wanted.

#4 There was nothing we could do about it!

#5 Any guess to how much tax payers money she wasted on just this one day??

As the ambulance drove away I waved to her. She sat up on the stretcher, smiled and waved back. A few minutes later and truck pulls up and the man is looking for this lady. I explained to him what had happened...he sighed and headed for the next hospital. I told him to hurry. I doubted that she would be there long :)

Feeling queasy

So I had only been working as a tech in the ER for a few months when this happened. At first even watching the doc suture would make me a little queasy....so I knew this incident would be tough. We got the call from the medics that they were bringing in a girl who for her 14th bday was teaching her cousin how to jump on the train that goes through our small town (the train goes pretty slow). Well, she fell and the train cut off her leg. They brought the girl in and then one of the EMT's brought in her leg and he handed it to me. I was sick, I really felt like throwing up but didn't. We took her leg over to the sink and started to clean it up. It was a ragged tear and the leg had dirt, sticks, etc. in it. We got it cleaned the best we could and we sent the girl and her leg to a trauma center. The cut was near the hip and with it being jagged they were unable to attach her leg. I saw her a few more times in the ER over the next few years and she was doing well. She was also not a candidate for a prosthesis so she will use crutches for the rest of her life. I was proud of myself that night for being able to do my job. Every night at work I would get better and the nausea feeling would lighten. Now, nothing upsets my stomach!