Tuesday, December 25, 2007

bertha/booger shootin



if only i could get a picture of bertha. imagine the man above, only a woman, with a giant smile full of gums and bad breath, squinted eyes, a greased up mop of hair on her head, an outfit straight out of clash day from high school spirit week, and 5x drunker. here, we have bertha 'd'. what a lady.


though homeless, friendless, moneyless, and toothless, this woman is street smart man. quite literally.

when your pride is no longer an issue in life, imagine what you can get by with. get away with.

when the whiskey isnt quite enough to warm her bones, bertha will pay the ER a visit. with 288 visits in 11 years, bertha reminds me of one of those cats in the tag body spray for sick cats clip from family guy.

a few of the docs just have too big of heart, and let her in. after all, they cant turn her down. rather than turning her away, and instead of making tonight visit number 289, the doc just let her sleep off her drunkeness in a bed. this was after she passed out in the hallway in front of the men's bathroom.

all in all, tonight is just another night. im hoping bertha wakes up before my shift is over, so i might be able to sneak a pic of her on my phone. either that, or at least be able to her that sweet, sweet voice and engage in conversation.


on another note:

i went to church on christmas eve. the midnight mass. held at 11pm. catholics.

i usually go once a year on christmas. i'm not a very religious person, but i'm very aware of religion, if you can catch my drift. going on christmas usually helps warming up the spirit. shaking the hands of strangers and watching women over 50 and under 10 try to sing louder and 'prettier' than each other just sort of puts you in the mood.

anyway, the most glorious thing happened to me in the middle of the our father reading. which, along with every other prayer said inside the church, has become more and more of a monotonous rendition of some cult gathering. where's the umph, my fellow christians? anyway, there's a young couple with a little girl and a baby sitting in front of me, and naturally like every other girl under 10, the girl cant leave home without some piece of hanna montana to cling on to. so im standing up, people watching through the pews when all of a sudden a booger flies out of my nose and lands on hanna montana's face! if that's not a sign from god, i dont know what is. the meaning i've yet to come up with, but overall it was a pleasant church visit.

Sunday, December 23, 2007

one good book


paul neilan is one of my favorite authors. if you get the chance, i highly recommend 'apathy and other small victories'. if reading anything over 4.5 pages not only makes you nauseous but also a little teary eyed in the fact that you havent completed an entire book since charlotte's web in grade school [where all you had to do was follow along, but somehow your new onset fascination of farting left you immobilized on the path to grasp interest in literature - you know who you are], then at least check out his blog.
here are a couple of my favorite quotes from paul:

"These Are Some Of The Things I Did At Work Last Week:
Invented a new game called Stand in Front of the Urinal. It's exactly what it sounds like. I guess it's more a test of endurance than a game. Bonus points if the same guy sees you standing there after he's already been in and out of the bathroom more than once, and for saying "What's up dude?" whenever someone's at the urinal beside you, and for whistling the entire theme song from MASH. Hero points for doing any of this with your pants pulled all the way down."


"I think our generation has been called to apathy just as our grandparents were called to defeat fascism and the baby boomers were called to get divorced and fuck around for most of their adult lives before bankrupting the entire goddamn country when they retire. But we have the chance to do something really special here. Imagine a world where people didn't care enough to go to war over anything. Where some guy gets up in the morning and says, "I know God wants me to kill the infidels and keep gay people from marrying each other, but I just don't give a shit. I'm going back to bed." It would be paradise on earth. This is our mission. I think we can make it happen, but I really don't care either way. And that's called hope."

Saturday, December 22, 2007

psyche evaluation

this is the chief complaint for more people than you would think. a patient hardly ever admits they need a pysche evaluation, but when they answer the 'what are you coming in for today?' question with statements such as 'im hearing voices', an assessment of their mental status is usually in order.

unfortunately for the docs but fortunately for the bums, when there is no obvious medical concern for a homeless man, these three words equal a golden ticket to a brand new bed to rest their mangled head on. it is my personal belief that these bums had a meeting many years ago, and discussed the ways to get into the ER. apparently saying you're insane was the rivaled winner. coming in second is 'possible frostbite', followed very closely by 'im suicidal.' also a free pass for a mental assessment.

usually when i get a nut sitting in front of me, i like to sound real concerned.

always, though, im trying to hide some sort of 'great, another psychopath' expression.

one particular night comes to mind. the usual 'i'm hearing voices' thing came unexpectedly, i mean the guy was well dressed, spoke normal, and was in his mid twenties. i get him to the back, he pulls me aside and says 'hey, can i ask you something? off the record?'

'sure,' i said.

'what would you say if i told you it was beyonce that keeps talking to me?'

jesus.

'i dont know, i guess i'd say you're pretty lucky. could be worse.' i learned then that telling an ER patient, especially one in for a pysche evaluation, that it could be worse is usually the wrong thing to do.

'she's telling me i should kill myself,' he says. 'after i kill everyone i know.'

christ.

Wednesday, December 19, 2007

being homeless for dummies

sometimes i'd like to be homeless, just to show these bums a thing or two about survival.

and then i think to myself, andy, you're an idiot.

im the one who has so much to learn from these modern life refugees. i mean let's face it - if for whatever reason i was absolutely homeless, with no suitable place to stay (maybe i'm in a lifelong quarrel with a sibling, or my uncle just plain doesnt like my character) im as good as dead. in the summer, i could probably survive. the heat could be overcome by wading in a nearby lake, pond, or even laying in a puddle. why not? i dont care what you think, im a bum.

in the winter though, im as good as dead. granted, i've learned how to check myself into the ER with no insurance and no actual emergency other than im cold and have terrible survival skills. but any reputable ER doc can point out a homeless man just looking for a bed to sleep in (maybe a few pain pills, or maybe just to eye the nurses) and will quickly evaluate the patient and get them out of there in 20 minutes flat. after all, your uninsured ass isnt bringing them any money. before you know it, you're kicked out of the ER doors, welcomed by a big slap in the face of the cold, cold winter nights.

the one thing i cant figure out, is why they ask for cigarrettes all the damn time. look around you! there's smokes everywhere, on every sidewalk, in every gutter. put one or two together and you got yourself an entire cigarrette. never will i hand you a full smoke out of my pack. you bastards.

Monday, December 17, 2007

reading material

id like to write in this thing solamente de trabajo.

but i dont see that happening.

here's some reading material for my future midnights that i just bought :]

Friday, December 14, 2007

my first blog :]


ok, i've decided to keep a blog of my thoughts on the events in ER. im hoping this can help me out on a future project that i'd like to accomplish. if not, no biggie. here's to some memories.


first, an overview of what an E.R. registrar [god damnit i hate that word, especially when it is said out loud] does.


[this could get lengthy and boring, but if i say something later in my entries that you or i do not understand, we can refer to this initial blog entry.]


-sit at a desk in front of a waiting room, protected only by a thin, glass window. with shades. open. now the reason i even mention the fact that im slightly protected, is you have to imagine how people can be in a waiting room. violent, loud, smelly, and of course, sick, are the first adjectives that come to mind.


-when a patient signs in, i call their name from the waiting room. they sit down at my desk, and i ask what they're coming in for today. i usually like to get straight to the point. somehow 'how are ya?' just doesnt suit the situation.


-i get all the information which includes but is not limited to: name, address, phone number, social security number, insurance, and so on and so forth.


-after typing up their 'chart', i assign them a bed in the ER and walk them back to it. i attach their chart to their clipboard, and write the last name up on the wall with a giant red 'x' next to the name. whichever nurse decides to take the patient erases the 'x' and writes their name.


-verify the insurance via the internet or telephone, and bam. on to the next patient.


-during this entire time, i must process bed arrangements for patients on the inpatient level. meaning, if someone is to be admitted to the hospital whether they are coming from the ER or not, i book the beds. this includes calling the floor they are going to, asking if they can take the patient, then tubing a chart to the designated floor. each floor of the hospital has different patient care types.


exceptions:

~~~

there's always exceptions. for example, if you come in with your head attached to your body by nothing more than a sliver of skin, then naturally there isnt going to be any waiting. i take you right back to the ER and get your information when it's a good time. most commonly, the patients i take right back have an open wound, complain of chest pain, are having a heart attack or seizure.


another exception is that sometimes i dont ask patients their names. sometimes, i know them on a first name basis. their track record for ER visits are very lengthy, and everyone gets to know them very well. most commonly, these patients are homeless.


sometimes, patients get brought in the back of the ER by ambulance. most commonly, this happens when you are already very busy. these patients are priority over the waiting room. i collect as much data as i can from the ems guys, and type up a chart. sometimes, there is no information whatsoever other than the chief complaint. no name, age, address, anything. these patients are typed up as john and jane doe's.


now the insurance exception. of course, nobody is turned down to be seen by a doctor regardless of if they have insurance or not. verifying whether or not they do can be very boring, difficult, and time consuming. most commonly, i 'forget' to do this part.


booking patients to rooms can be a huge hassle. most commonly, i get stuck doing this because most commonly, i work with a bunch of lazy ass hoes.