Now all I want to watch

(while waiting for Deadwood of course) is this. Am obsessed.

Why is BBC mystery so much better than US mysteries? Not just the accents, though that does add about 600,000 points.

Now I want this too or I'll just die.

So. CHARGE NURSE. Convinced snarling spitting (ew) pt to 'cut the shit' and follow me to Open Seclusion or lose all privledges for good. Nood. N

--

Mobile Email from a Cingular Wireless Customer http://www.cingular.com

Apparently I just can't shut up...

so here's a little bit more. We all know that heroin kills. The town I grew up in was wealthy- most kids had everything they could ever want, most of the mothers didn't work- (no need when Daddy pulls in that much cash- the kind of high school where most of the cars were brand new BMWs or Mercedes or Lexusi which is my version of the plural of Lexus, similar to octopi for more than one octopus.) My mom worked (still does) and people would say "Oh your mom works? That's so cute!!! " Yeah. Totally adorable.

Anyway, since the kids in my area got whatever they wanted, a lot of them decided in the late 90s that what they wanted was heroin. I had some sort of automatic detector that let me know that trying heroin would be a really bad idea. Cause it seems like everyone who tries it end up addicted or dead. I didn't really want to try either of those, and I'm glad I stuck with that choice. Not that I didn't do stupid things, but that wasn't one of them. (Mom, Dad- really. Never quite that stupid. But about 6 or 7 people that I knew didn't have that same auto detector thing and totally wrecked their lives. 5 of them I know nothing about their evenutal fates, other than one told me while I briefly attended collge in Worcester, Mass that it had "the purest heroin in the country, man!" . One quit, was doing really well, relapsed, and committed suicide by driving into a tree. The other one I saw going into the methadone clinic at my hospital a couple of years ago. Whether he's still on methadone, back on dope, or dead, I don't know. I just hope I don't ever see and recognize one of them. OD as form of death is obviously not a great way to go out. Being photographed while it's happening and then having photos published?? Well I just hope the dead guy's family sues for invasion of privacy or something. Although sitting in Boston's Public Garden and shooting up may be the legal equivalent of signing away privacy rights. This is another reason I didn't really like Boston- other than the fact that the guy I dated who lived there had a huge colony of roaches and Chinatown didn't have egg rolls. (I know it's cause they're American, but still. Couldn't one Chinese restaraunt out of 200 have an egg roll??)

The only thing magnificent about Boston is the penguinarium. The New England Aquarium is great- and in this link, you can see the people I totally loathe because they have MY DREAM JOB.*

As for anti Boston sentiments, it's mainly cause I grew up visting NYC. Other cities just seem lame in comparison. Plus, the entire transit system, above and underground, is completely cracked. And there were all kinds of cute fresh off the boat Irish guys I couldn't flirt with because of aforementioned lame boyfriend.


I'm going to try my hardest to shut the hell up for the next few days so I don't scare off the remaining few readers of the blog. Although I am going to look for wedding dresses with one of my dearest friends in Clifton, NJ- which means tacky dresses may abound. I may have to post photos.

*Knowing my dream job will be one of the requirements for visiting Aughra and Foxglove's Goat Farm of Wonder.

Goat Farm Update

Goat farm update!

Teensy camera phone picture. Mine says Star & Bullock hardware. Aughra make my heart beat faster- there have so many times she has kept me from completely losing my mind that there's actually a small metal tag on my frontal lobe that says "PROPERY OF AUGHRA" .

The goat farm will happen- and Bug will join us- if there's a goat free area he can retreat to when the bleating gets too loud. Will try to send another picture that better shows off shirt (and incredible rack, also) from our romantic dinner date at the diner.


Aughra, doll, I love you. Sending you text right now and in the car- so that Bug can get all irritated and say "would you stop playing with that phone? You love it more than me!" - just like I say to him about the computer game- World of Warcrack.

To be like me and Aughra- watch this show and be prepared to be quizzed on it by us. Also- must use and approve of words "cocksucker" and "cunt" . It's the old west- it's gritty....

Double Doors- keeping the inpatients "in" and Christ I Write A Lot- (cause I write like I talk- Rambling- see this title? rambling, man. Rambling.)

Um.. I thought when I did the mobile blogging thing, it would go to "edit" before popping up on here. But it didn't. Heh. What follows is just more complaining and whinging about work. You can ignore it if you like. Look at the boots I want . And these other boots that I pre-ordered. The pre-ordered ones won't ship till mid October. The first pair (in black not purple, you silly people) also states that they won't ship till 10/10. But I need them now. Went to Nordstrom on dinner break. Tried on these in black. They looked stupid. Wanted to try on these, but realized futility.

End of shallow shopping tales. If you're still trying to kill time before your lunch break or some dull meeting or something, read on for more of Foxy Whinging About the Job She Actually Loves.


Got into fight with manic patient tonight- she got reaaaaaaly bitchy cause the doc increased her Risperdal from 2mg twice a day to 3mg twice a day. Cause she needs it- she's not getting better and she's acutely psychotic on top of manic as all get out. Commonly people who are manic don't feel like it's a problem- they're euphoric and feel wonderful, over the moon and all that. But the women- alas the women, they apply make-up badly. Like Tammy Faye Baker badly. That it inself almost works as a diagnostic test. I had a patient once who had black eyeliner rubbed into her cheeks as rouge. She asked me if I was pregnant- I said nope, just fat. "Why does your stomach stick out like that then?" she demanded. "Just lucky, I suppose." I answered. But what I wanted to say was "why the fuck do you have black eyeliner all over your cheeks?"

But we don't get to ask those questions, because it would be "inappropriate."

Instead we simply just say "Look, Ms. Doe, I understand your frustration. But I'm not able to change the medications. Only the doctor can do that, You can discuss this with her tomorrow- if you really feel that you cannot accept this medication, then you can refuse for tonight." Calm, right? She just kept going, screeching and pointing, until one of the other nurses came over and physically removed her from the med station. An hour later she was yelling how her heart was pounding in her chest and she couldn't relax and it was because "that redhaired bitch poisoned me". When we tried to get her to take some Ativan to calm down and allow her heart beat to slow down (which it would do if she stopped screaming and pointing and slamming her hands on the desk) she called me a bunch of other names and said that she was going to call 911 and tell them I was trying to poison her- that I was changing the medications the doctor ordered. Sighing, I once again tried to explain how it works- the psychiatrist writes an order, we take the order off, double check it, and fax it to the pharmacy. The pharmacy eventually sends us the medications. Then we give them to the patient at the assigned time. I explained this, slowly and calmly about 3 times before I gave up and pushed the med cart back into the med room and imagined the conversation I really wanted to have with her. It sounded something like this....

What we do, Bitchface, is administer the medications ordered by the doctor. If it was up to us what meds you got, well, then people like you would be in your room all day, drooling and half unconscious because the highest amount of tranquilizer we could give without killing people would be de riguer. Only for the mean ones. Like you.

Bitchface(s) need to do more than just be nasty to me- they have to also be terrorizing other patients, particularly those who are easy targets. (Disabled, elderlyish- our patients only up to 65, acutely paranoid, suffering from severe Extrapyramidal Symptoms which are terrible terrible side effects that are unfortunately way too common that can result from many antipsychotic medications. These people are minding their own business, trying to do their best to get well or as well as they can get- and people like Bitchface torment and tease them, almost always resulting in the teasing victim in tears or shaking in terror and needing to take PRNs to calm down. And me wishing I could just kick the responsible party in the head and ask them what the fuck is wrong with them. But we don't get to do that. Instead, I dream about Ativan in a Can. Like Lysol, instead of making the air smell clean, instead it fills the air with benzodiazepene. Mmmm. Makes everyone happy...

When this picture was taken, Isaac's tongue wasn't out. Yet here it is. Because he's magical.

the mobile blog is born

terrible shot of fantastic candle from uncommongoods.com

Prepare for small, somewhat indecipherable entries and possibly photos.

Do not comment on this.

Comment on my HNT!

Lucky In Love

lucky in love 

edited to add- while perusing other HNTs, my cable channel set to "Retro-Active" started playing one of my all time favorite songs- Eloise by the Damned. Making HNT even better....3:12 AM or "way too late to still be doing this" crawling off to bed


Partial shot of tattoo. Made with camera phone and painful cyst on wrist. For Half Nekkid Thursday. Posted with assistance, as always, from the lovely and brilliant Aughra.

Full tattoo has two swallows, 5 stars, an upside down horseshoe (to keep the good luck from falling out), two dice- one with a 3 and one with a six, because the Number 9 has mystical values, and more importantly, it's my sweetie Bug's lucky number. The tattoo also says "Lucky in Love". I got it a little over 2 years ago- it took 3 1/2 hours and cost $200. I love it. Someday, my bug will have full sleeves, or at least quarter sleeves. They don't have to be Asian styled- I like the old Sailor style, similar to mine, and Bug is a big fan of Edward Gorey particulary this lovely couple. Help me convince him! (and send me money!)

Unfortunately I won't be able to comment on as many HNTs today as I wish I could because I've got to get up early to get parasitic twin investigated, and then go into work early. I promise to come visit as many as possible on Friday though...

Until then- Happy HNT!

ps = for all those who stopped by hoping for a bigger shot of full back and top hem of cute panties...couldn't get the picture right. And I'm shy. May eventually post pic of adorable panties, but they'll almost definitely be sitting on a pretty velvet pillow or something for display....

Oh, and my parents read this. Hi Mom & Dad!

Once again, tech impaired Foxy begs for help.

I notice people somehow find out what google searches lead to their blog. How do you do that? How do you know how many people came by and looked (compared to how many posted so I know just how bitter to be?) How do you stop shopping online when it seems that you may be developing a compulsion. (side note to mom- not me. It's about Mary. I'm worried..)


Also- please please please read below post about shattering of dream (sort of) and HNT pic will be of tattoo with possible hip exposure and if I can find cute enough panties they might not get cropped out. Like Aughra, I'm resorting to bribery. No comments on post below = HNT of Susan, the parasitic twin/ganglion cyst AND the ankle scar. But no lovely Foxy back and hips......

The Dream is Shattered. Well, partly.

Why you ask? Because I got into work to find out we had a paraplegic patient with a colostomy and a foley- the foley was draining dark dark red urine (i.e. BAD) and also has bed sores and numerous other physical problems. The question that remained- what the fuck is she doing on our floor? When our psych patients get ill- like physically ill, we send them to medicine. It is NOT supposed to go the other way around. We had to change the bag (because the day shift basically tossed her in a room and closed the door) and there was SHIT all over her and all over the bed, and we had to get a urinalysis done. The results came back + for everything. Occult blood, glucose, wbcs, protein, nitrate, you name it. Anything that is NOT supposed to be in urine was in hers. The red blood cells were actually "Too Numerous To Count" which is a CRITICAL value and definitely equals- should be on a fucking medical floor. So we bitched and moaned to the Queen Nurse. Her response? Send us another patient from Long Term Care who has a hemoglobin of 7.8. . Normal values are: Hemoglobin
Male: 13.8 to 17.2 gm/dl
Female: 12.1 to 15.1 gm/dl

See the very not normal that she is. So apparently if she needs more blood, we'll have to give it to her on the psychiatric unit? WTF??

Borderline Nightmare Girl was on CO. I win the imaginary $100. None of the nurses got any dinner break or any breaks at all because we were too busy dealing with these two patients. I also gave out a world record of 7 Ativan 2mg pills, 8 Klonopin 1mg pills (one guy got 2 of them- that's a shitload of benzo) and countless .5 Ativans and .5 Klonopins. Also half a dozen Haldols and Cogentins. We had one patient who had been previously just bitchy slamming her head into the wall over and over. That's where Ativan 2mg the first came in.

I wish I had vacation tomorrow. If those medical patients are still there, there's going to be some seriously angry paperwork headed administration's way.

But in good news- the 29 year old cry baby went to another floor. Odds are he'll sign out AMA and then present in ER threatening to kill himself, which will place him right back on our unit. All the other floors get to say no- we don't , and you bet your sweet ass that if they had tried to place colostomy S/P CVA foley w/urine suggestive of KIDNEY FUCKING FAILURE on any other unit, it woudn't have happened.

But we don't get to say no.....

Oh and

quick poll: For upcoming HNT- should it be shot of tattoo on back or lovely photo with:
a. brand new ganglion cyst or as it's alternately known, my Parasitic Twin, Susan
or
b. the scar from the long winding ANKLE/FOOT saga?

Anyone? let me know so I can camera phone picture and then e-mail to Aughra so she can log in for me and set it up cause I just don't understand this picture thing. And also there's no webpages to post pics to that you can use for link if you have a non PC. My computer is a Mac, and thus wonderful in many ways except that it won't let me do things that are only for Microsuck.


Also- please please leave comments on long post below. I put a lot of time into writing it and probably lost precious days off my lifetime living it.

So feed Fox's ego. Sad, sad, sad Foxy.

Edited to add- Vote's still open- and chances are Susan will still be here next Tuesday, so it looks like the tat is winning...

Psychiatric Weekend Wrap Up

Worked Saturday and Sunday. Earlier in the week I noticed my right wrist was kind of hurting and when I looked at it, I realized that I had grown a new body part overnight! . Now, being a nurse, and being a smart person overall, I realized this was not normal.. So I investigated it at work Monday, Tuesday and Wednesday, asking my fellow nurses for their opinions. "Ganglion cyst." was the universal answer. The one psychiatric resident I asked said "I'm not sure, but I'd go with ganglion cyst." So it's unanimous, right? I have this hideous old blue wrist brace that cuts off the circulation and looks really really ugly. So I slap that on Saturday afternoon and go to work early so I can visit my mom in the ER and get the doctor's opinion. He's not around, so I end up at work early for no good reason. That is until I realize I get to be the med nurse, which equals about 95% less writing than I'd have to do otherwise. Just jot in my initials in a bunch of boxes, and write out the patient's name, the doctor's name, and my name over and over on the narc sheet which does get a lot of use. Still, I only have to write 2-4 charts, instead of 8-9. Much easier on the hand.

When I finally went back and saw the ER doc, he told me it was tendonitis from some kind of injury. Now, I know I'm not always that swift on the uptake, but if I had fallen or slammed my hand into something so hard that this grape sized thing popped up on my wrist, wouldn't I remember doing it? It's not like I'm a drinker with blackouts or anything, and I sure as shit am not an exercise freak. So the verdict- Find another doctor. Did some research online and realized choices are- do nothing and hope it goes away (which I'm doing), implicitly wrist (ditto) and aspiration. That means someone (hopefully a doctor) sticks a 23 gauge needle (that's very little) into my wrist over and over filled with lidocaine to numb the wrist. It will work- however lidocaine shots BURN a lot. Then with a much larger needle (probably 18 gauge) they suck out all the icky joint fluid in the cyst, thus deflating what I've been referring to as my parasitic twin, Susan to normal wrist size. And then hopefully filling me full of painkillers so I can go back to work.

My patients this weekend- a summary of exciting happenings:
Previously aforementioned pt that makes me wish for high powered rifle? Doing much better, acting like an immature 18 year old instead of hopeless 5 year old. At this rate, in ten years, he'll act like the immature 29 year old he actually is. However, he's found himself a girlfriend of sorts on the unit and is thus all blissful and happy. We (staff) are all HORRIFIED but if it keeps him from freaking out and throwing tantrums, we're ok with it. We got another nightmare borderline patient-

let me just interrupt myself here for a moment. I'm sure there are many , many people with Borderline Personality Disorder who lead productive lives and don't totally suck as people.

I"ve just never met any of them because the ones that come to the hospital are different. They like the attention of being a patient, they like the attention they get when they say they're going to commit suicide, especially when they've been "Administratively Discharged" (kicked out of hospital by admin and staff for general suckitude and mass disruption and total waste of funds, and then walk right out front door, smoke one cigarette, and then march back into ER where they spend next 18 hours until the ER docs also discharge them. Why ? Because this individual, now known as Borderline Nightmare Girl, similar to the Riverbottom Nightmare Band from Emmett Otter , then walked outside to pay phone and called 911 saying she was suicidal. Police come and walk BNG the 10 feet from phone to ER. And thus, BNG is admitted.


The other units and other doctors all universally REFUSED to admit her. "Not on my floor, no fucking way" they all said. But my floor? We don't get the veto option. That's how we ended up with Crying Boy and BNG. Cause we're the dump site.
How many patients got ignored while we dealt with these 2 all weekend? (Actually, Crying Boy was pretty good until about 10:45 pm last night when he freaked, sobbed, and slammed door to his room. Luckily I'd given him Ativan 2mg and Ambien 10mg plus his usual night meds which include 200 mg of Trazodone, which will knock out a Kodiak bear, so he just sort of fell asleep.)

18. Between Wed and Sat, there were 9 new patients. We had more MICA patients than usual. MICA means mentally ill and chemically addicted. They can be a handful. We had one who prostituted herself (though in a very sexist remark, I can't figure out how she got any money as she's seriously unattractive), one who used between $300-$400 worth of cocaine a day _ (I have a hard time digging up cash for cigarettes!!) and one who smoked 30-40 bags of crack a day, and my favorite, the guy who traded his car for cocaine. He insists he's only in the hospital because his parents are mad at him for no reason. Certainly not that little car thing, right? Who could get mad about that? Lack of insight is pretty common in mental illness, but probably not that much more than in the rest of society. There's things about me that I don't deal with or admit, so my insight's impaired too. But that' s ok. Cause I dress better than anyone in psych, and possibly the entire hospital.

But Foxy decided to take the high road. Feeling good in my non sanctioned black jeans (jeans are not allowed) and cool ass Slytherin T shirt (t shirts are not allowed) I decided to try and talk some sense into BNG cause she's only 19 and therefore not doomed. I explained the concept of being nice to people- even when you don't want to- and that coming off as demanding princess who shrieks and screams and calls people names before slamming doors is not the way to get people to want to help you out. I wrote out a step by step guide to how she should approach her AM treatment team meeting. Instead of "I want to be volontery" {sic} I wrote "What steps do I need to take to become voluntary?" and instead of "I'm not taking that fucing depacoat" {sic} I wrote " I am concerned about the Depakote because of the monthly blood tests. Is it a dangerous medication? What if I can't afford the blood tests? Could I try a different mood stabilizer?"

Finally I told her to think long and hard about what "borderline behaviors" the other floor's Dr said they couldn't deal with anymore and what kinds of things she might be able to realize could really alienate and annoy other people. She said she didn't know. I gave her the reminder of when she called me and the other 2 nurses "stupid fucking bitches" because we, as nurses, are unable to write Doctor's orders and even if we could, we weren't going to write for 2mg of Klonopin. She then started screeching and kicking the door, telling us she hoped we'd all die and that she was going to kill herself. When we quietly and calmly tried to explain the situation to her, she just kept screaming about how everyone is out to get her and that we are just like everyone else and that she can't deal and as such she will kill herself.

This, BNG, I said, is a Perfect Example of Shit You Need to Stop Doing. You don't want to spend your life in and out of here, right? Then buck the fuck up and figure out what it is you need to work on. Your friends kicked you out of their apartments? The doctor kicked you off the other unit? Obviously there is something going on with you that you're not willing to own up to.

There are people who are so sick that they have no choice- You're not one of them. Things in life can suck. Being 19 can suck. But you know what? People deal. They deal with things they hate, people that cause them to break out in hives, and jobs that suck out their souls. And they do it without kicking doors, cutting themselves with paper clips and saying it's a suicide attempt, and fucking their best friend's boyfriends. (True info from chart) . She promised me she wouldn't freak out in the meeting even if it didn't go the way she wanted. I told her if I came back tomorrow (Tuesday) and found out that she had in fact freaked and done a pile of stereotypical nightmare borderlne behaviors, I'd be really ticked and wouldn't be devoting another 40 minutes of my time helping her think of the medications she thought had helped and offering her suggestions if she isn't going to take them. (incidentally- she wasn't my patient. I only have to have true 1:1s with my patients. This was done purely out of the goodness of my heart and an apparent streak of masochism I didn't realize I had)


$100 says she freaked, threatened suicide, and is on CO right now.....

Sometimes being a nurse is a magical, uplifting thing.

Other times, it makes me regret not owning a high powered rifle. Tonight, for instance, was a "boy I wish I had something to shoot with" night.


29 year old male. Graduate of Sociopath Training Academy (the children's unit) and the world's biggest crybaby ever. Seriously. Imagine the worst 3 and 4 year olds you've ever seen in the supermarket or Toys R Us down on the floor yelping and screaming and kicking their legs. This guy actually does that shit. Like all day. And his new thing is stuttering. When he gets really upset about something (like not being able to use the phone all day long because there's 19 other people who want to use it) or not getting his extra high dose of ADHD medicine (he doesn't have ADHD, he's just addicted to stimulants) he starts wailing and screaming like a dying cow.

He's a fucking nightmare. He has literally ZERO redeeming qualities. He's just an immature little fuck with a drug problem who would rather scream and yell and act like a baby to get his way than to get off his ass and try to do something with his life. He takes no responsibility for any of his actions, for instance this evening when he (6'1 230 lbs) pushed down a (granted seriously annoying but actually ILL) woman (5 6' 150 lbs) landing her on the floor (which created a whole separate nightmare involving her pretending to be paralyzed while threatening to sue all of us over and over and over) he said it was her fault. Cause she called him a crybaby. Now, never mind that he is a total crybaby. I don't care if she called him a testicle sucking eggheaded pile of goat shit. You don't hit people. You just don't. IF that was the ok thing to do, he'd have been a bloody pulp long long ago.

Then he cried because it wasn't time for his PRN. (this is 2 hours later) Having spent the larger part of his life in and out of the hospital (because his parents indulge his every fucking whim and never set any limits and then when he got out of control they put him in the hospital and have I mentioned how some people should be banned from breeding?- and this is why he's walking around with a bunch of organs that other people could better utilize) he knows the rules. And yet continues to believe and actually INSIST that they don't apply to him.

This reminds me of when my parents first met Bug's parents. My mom was talking about being in the ER and seeing the same patients over and over- the drunks, the borderlines (BTW- there are borderlines who aren't total sucks. They're just not as common and never come to my hospital), the addicts who cry that they're suicidal and then when they sober up deny it, and mentioned- very casually- that "some of these people should just die."

My in-laws looked as though my mother had just said that she sacrificed newborn babies to Satan. I had to try and defend her- "Because they VICTIMIZE people! They take advantage of their families and their friends, robbing them, hurting them, and generally causing misery."

I don't think my in-laws quite got it. But if they had spent 90 minutes on my unit today, it would have been crystal clear.

It was also still way better than any night I can remember in med/surg even though our paperwork was quadrupled and the lady who got knocked down bit at me and scratched and kicked me.

I realize this may make me sound cold hearted and cruel. But because of these two- the other 18 patients got NOWHERE near the attention they both need and deserve. Because we had to babysit these two instead. So, again...high powered rifle.

Any other nurses or medical professionals out there?

Good. Write something and send it to this blog for the Grand Rounds.

Sigh.

I cannot figure out how to put my wishlist back on here. I also want to change the links that blogger has chosen to links I want- like Aughra's blog and other things that are kewl. Somebody help me. I'm totally missing the part of the brain that understands all this shit. I typed in the the code that I used last time in like 8 places in my template and it doesn't seem to do anything except not work and make my amygdala and wernicke's areas hurt.

ghljralkej. Hmph...

A Direct Order From Foxy.

Go here.

Join the advocacy brigade. You'll be helping out these guys.

The Power of Isaac compels you.

Also- we have on the unit a 23 year old female with schizophrenia. She has a lot of repetitive motor behaviors, purposeless behaviors, like walking around with her hands out in front of her, pointing and wringing her hands. She's very paranoid and very difficult to communicate with. She doesn't like to answer questions and gets agitated really easily. However- I complimented her on her cute flip flops and she immediately turned into normal 23 year old girl talking about shoes- for a good 2 minutes we discussed differences in heel height, flip flops with the toe thing (she can wear 'em, I can't) versus slip on sandals, and whether sneakers should ever have high heels. (no). Then, like a switch was thrown, the light kind of went out of her eyes and she started wringing her hands and walked off. It was sad. Brief moment of lucidity brought on by mutual love of footwear.


Since most people don't really know what schizophrenia really is- for example- the Tshirt that says "I'm not schizophrenic and neither am I" doesn't represent schizophrenia!!! If it represented anything other than ignorance and the promotion of a dehumanizing stigma, I'd say it represented Dissociative Disorder, which is a controversial diagnosis that I won't bore you all to death (if it's not too late) with details about. Remember Sybil?

Anyway, this page does a great job describing the things that I see on a daily basis.

And to assure you all that I'm still the same essentially shallow, greedy little bitch you all love, please go to this site and look at the ring on the far right. I wear a size 6. Thanks. Oh, and I still totally loathe Tom Cruise and want to kick Lindsay Lohan in the face.

The Smart Thing to Do

Is just go to Blog Ho's site and read everything there. Cause it's always funny, and always smart.

But if you actually came here to read about the AMAZING DOUBLE SHIFT that I worked, then this is for you. Was working Friday, Saturday and Sunday nights, according to the All Mighty Scheduling book, where you check ahead and plot days you'll call out depending on if you're to be surrounded by assholes (fellow employees, not patients, cause you never know which ones will be there and there's always at least one total asshat) or if it'll be a good night because you are working with smart, funny, and most importantly- competent people. (Hi Anita!) The aforementioned nurse is awesome, she's funny as hell and really efficient and has a good rapport with the patients (much easier said than done- believe me) and she's training me to be a good soldier. Everyone comments on what I wear, since I refuse to wear scrubs or elastic waist pants. I make an effort to look cute , by wearing actual clothing , and boots..

So Sunday at some point...maybe 7ish, the Queen Nurse of the Weekend came and asked me if I'd be interested in staying and working the overnight shift. I told her, 'yeah I totally would but I have to work tomorrow evening and I can't function without sleep'

'but then you can have tomorrow off!' That gives me no work Monday, Tuesday and Wednesday....So I said ok and didn't even regret it until about 2 hours later when Bug came to meet me to bring me food, pants to throw on (cause it gets cold at 3 am) vivarin, and another book to read. I think the reason I accepted the offer was that
a. I was clearly possessed
b. I was in a good mood cause I was doing meds, which mean I can basically lock myself in the med room and only come out at 4 pm and 7 pm (then go to break at 7:30 and not eat cause I'm still just not that hungry) and then come back and give all the 9 PM and 10 PM meds at once.

From then on out, and also during the rest of the time, it's usually patients coming up and asking for their PRNs . It's pretty laid back, even though the pharmacy fucked up hugely by not giving us 6 patients' entire trays with ALL THEIR MEDS and also missing 7 miscellaneous meds from 7 other patients. Yippee! Angry Phone Call to Pharmacy Time to coincide with snooty fax of MISSING MEDS that ended up being three pages long.

But I stayed- went up to my old unit where I had previously worked as a MentaL Health SpeCialist (babysitting patients, writing BIRP notes- behavior, intervention, reaction, plan- & completing the Evac sheet or as we called it the "headcount" which listed all 24 patients and had little boxes next to their names from 7 am to 3:30 pm at 15 minutes intervals. ) Unless they're on a CO which means Constant Observation, or 1:1, usually after coming out of LSR- locked seclusion and restraints, or if they've done something really clever, like threatening to kill themselves if they're not released.

Now, just think about this. You're locked on a psychiatric ward because you've been legally committed, for being a danger to yourself or others, incapable of taking care of yourself, or a danger to property. So- unsurprisingly, you want out. That's fair, I'd want out too. But telling us that you will kill yourself if we don't let you leave is NOT going to get you to leave- it's going to extend your stay and get you on a 1:1 which irritates everyone. Now, I realize my patients are ill. However, I strongly believe that being crazy does NOT mean you're also stupid!! . Granted, there are exceptions to this rule. There are at least a dozen people I can think of off hand who meet both requirements.

So - anyway- back on old unit, working with nurse I used to see for the first 15 minutes of my shift when I worked days on that unit, and learning how to do night shift work. First off is the Narc Count, which is where the oncoming RN (me) counts the actual pills and the offgoing (yes that is how it's written) RN checks that the numbers match, which mercifully, they usually do and when they don't it's usually cause someone put a mark in a wrong box, and easily fixed if you do what I do (and what I was taught by other nurses to do) which is Save all the Blister Packages from the pills with the patients name written on the back. That way at the end of the shift, if there's a problem, you can dump out your Dixie cup full of empty pill cases and match up with what was recorded. Simple. Usually.

Important lesson learned? It's even easier when they're all asleep! The patients, though the 3 women I worked with did take turns sleeping in the break room.

Go through MAR, which is where all the patients are listed in alphabetical order with any allergies in bright red ink, and make sure all med orders are current , i.e. not expired today (cause it's after midnight now so it's now Monday, as confusing as that was for me) or expiring tomorrow. If they are- you jot down pt's name, the med, how it's ordered, and when it expires in one of those cute little composition notebooks we all used in 1st and 2nd grade. Then I go through charts looking for orders taken that day (August 8) and make sure they've been taken off - that means double checked by two RNs or one RN and one LPN , transcribed correctly into MAR, and faxed to pharmacy, and also that it's signed by ordering doctor (you'd be AMAZED at how often they forget to do that) and the nurse who took the order off, then lift up the big fun stamper that says Order Reviewed and Confirmed with a little line for my initials, the date, and the time I checked the order. And then....STAMPY STAMPY STAMPY. These first two things kept me occupied for about an hour and a half, making it now 12:45 or so. Then I went to the med room and made sure all the 8 am meds were there, which of course they weren't because if I haven't mentioned by now, our pharmacy is run by lobotomized Chinchillas who, while very soft and very cute, make crap pharmacists.

Took first break at 2 am- had to walk alllllllll the way to the front entrance (I'm on the ground floor as far away from the main entrance as you can get except for my regular shift when I'm one floor down). Hospital is totally deserted- lights are on, and my cowboy boots are clicking along (a phenomenon I used to call "teacher shoes" cause you could always hear the teacher approaching cause of the clickety click of the shoes.) It's surreal- I know there's people around, but I don't see any of them. Am just about to walk out front door so I can grab a smoke when a security guard calls out hello, nearly scaring me half to death. Why? Because he is sitting at the main desk in complete darkness. If I didn't know that they paid security crap, I'd get my husband to come do what is obviously not a back breaking job.

Get outside, light cigarette and sit on curb. It's totally dark out and there are bats circling the streetlights, bingeing on bugs. Incidentally, that drawing of the bat is the one I used to make a Sculpey Bat for Aughra's little boy. I smoked another cigarette and went back inside, where in the next 5 hours, I gave out a total of 3 narcotics. One percocet, for a young guy who's a graduate of the hospitals "Sociopath Training Camp" and who is a known addict and yet when he complained of a toothache, the medical doctor gave him percocet. Dummmmb. There's another patient on the floor who had ankle surgery similar to mine but more advanced and more mangled, and he gets Ultram. He's not happy. I advised him that begging or complaining about not getting narcotic painkillers was just going to get him stuck in there longer, to ask the doc if he could have Ultracet instead of just the Ultram. It's Ultram with Tylenol no matter what the "cet" at the end makes you think. Cause the secret? It's the PERCO part that is the narc. Cet means tylenol usually. Told him suck it up while you're here, do your physical therapy exercises that I know you know (made him demonstrate) and then said "when you get out, go ask Dr. ___________ for more Vicodin. In here- don't bother.

Also had great fun reading the Kardex- as its' not official legal document, just something to help the shifts communicate with each other, people write what they really think, not just what's legal and appropriate. Best entry ? About a 32 year old Borderline patient who is a continual nightmare and frequent flyer. "Jane Doe is Vying for Best Borderline on The Unit"

Maybe you had to be there. Post is kinda long, yeah, but I threw in educational links (oh and the anthropolgie one- check out the Vauxhall boots that I pre-ordered and will be arriving in October, and notice that I want basically everything on the site. Bug is going to buy me the Edwardian coat for our anniversary, that is he's gonna buy it if he remembers even vaguely the sex he wants to have EVER.....

I worked a double shift last night

From 3-11 and then 11-7 am. Still out of it. Will tell you all the exciting details of what the hospital is like at 4 am.


Also the glorious sartorial decisions I've made in the past week, as I'm sure you're all breathless with anticipation for details of that...


Aughra is away- life is depressing and hopeless without my hourly text messages. Help.

Foxy's Book Club

Like Oprah's except without the free cars and wheelbarrows full of fat. There's this one, about a man who performed over 3500 lobotomies (who coincidentally married his wife on the same date albeit many years earlier that Bug and I got married), and this one, about a hospital in New Jersey,
that no less than 4 co-workers have already expressed giddy anticipation over borrowing.


Work goes well- who thought they'd ever hear that from me? I am quite pleased to be back in psychiatry- my kind of people. I like the nurses I work with, I like our attendants- they actually walk around and interact with the patients all the time instead of only when we need them to hold someone down. Last night me only had to hold down one patient who'd been 72 houred - and give her injections. Most everybody gets their meds PO- per os- the fancy medical term meaning by mouth instead of IM- intramuscular i.e. big fat shot in the butt, but some meds come in injectable long lasting forms and some meds come in injectable acting right fucking now form. Those are what we use when someone is acutely acting out (we prefer to just give pills and not put people in restraints, really) like attacking the other patients or us or banging their heads against the wall repeatedly, cutting themselves, etc.

The lady who got the shots last night got them cause she's refusing her meds, she won't get better without them, she's a danger to herself (or others)- she hits and kicks and spits- yippee - and she's involuntarily committed. Hopefully they'll be kicking in soon and I'll get to meet the actual person, not just the symptoms of the illness that she has.

We had two other patients who had the same set-up, only both of them took their pills instead. Yay! Having to do 3 72 hour injections means a lot of holding people down and giving shot, not fun and makes you feel kind of evil. Overall a good night- we got admissions late which always sucks cause it's like applying for mortgage sized paperwork pile, but I didn't once find myself wishing I was anywhere else on earth than at work, like I used to all the time at the medical surgical job.

Oh, and we're down 15 lbs now, not 11. However I got strep, got prescribed Cipro, and it seems to be helping so hopefully the stomach ailment that ate Foxy is almost done. I'm just hoping I don't gain back the 15 and then extra. I can actually show people my lovely back tattoo without having to pull the sides of my back up to show them.


And I"m working with Tserisa of the Pro Slug Page to adopt a virtual slug. You all should adopt one too! (follow the links from this page cause the old link didn't work!)