Phx Adventures of a civilian nurse in the Justice System...*graphic medical descriptions enclosed*

Hey guys...I don't get to talk to you much these days being as busy as I am so I thought I'd let you know what's been going on with my new job that you all helped me get by sending your good vibes when I was testing for it.

I've been working at the jail now for two weeks and I really love my job. Saturday nights are particularly interesting and in two weeks I've seen more stuff than I ever expected and have dealt with more emergencies than I thought I would this early in the game. In two weeks I've treated a girl with a heart defect who started having crushing chest pain - luckily I had digoxin, oxygen and lorazepam on hand and she avoided a heart attack; a man having a grand-mal seizure from ETOH withdrawl who gave himself a good crack on his head which bled everywhere; a man with an infected arm from a human bite on his hand - I've never seen a liter of pus actually squirt out of human being before; another guy who had a bacterial infection of one of his blood vessels in his arm - we could actually measure the red streak as it climbed his arm toward his heart; and last night a man had a massive heart attack - so massive that his head and left arm actually turned purple, he was alive when the medics finally got there and we'd given him digoxin, aspirin and oxygen, but who knows what happened after; and my personal favorite a crazy guy whom we had to give three simultaneous intra-muscular injections to because he wouldn't take his oral meds and was an extreme danger to himself.

That's just the tip of the iceberg too...I am loving this job and I'm learning so much everyday. I also enjoy visiting inmates and treating them for everyday problems as well and doing the med passes. I get a kick out of the imates and officers alike and I never feel endangered because I have so much back up.

So how is everyone else's life going?

 

AH!! A liter of puss?? **turns green** And watching the red streak climb up his arm?? Methinks there's a movie you might like to see - Requiem For A Dream. Aside from being an amazingly good (albeit depressing) movie, you basically watch one of the main characters get a massive gangreen infection in his arm from shooting heroin. Sounds like Nurse entertainment. Well, okay, your experience reminded me of the movie.

My life feels so... mundane now.

 

Yeah, I was just thinking the same thing about my life kreleia. But hey, Wenchy needs me, I'm probably testing some of the samples she collects

 

("liter of puss" Thanks for the help on my diet wenchy. I don't think I'll be eating that pudding at lunch.

 

glad to hear stuff is going so well for you wenchy!

 

Thanks guys, and uh sorry for any grossing out I've done. I was quite stunned by the quanity of pus myself and the coolest thing of all is that it came out of a cut less than a centimeter long. The guy punched another guy and when his hand struck, the guy bit him. Human bites often get infected but I've never seen one so bad. We took off his bandaid and he started squirting. It was so cool...except the clean up of course. We then had to make sure we could get as much as possible out of his arm so we had to squeeze it out and the guy screamed like a woman getting murdered on a rollercoaster. Needless to say, he got narcotic pain killers and hefty doses of augmentin which he is still on. His hand is looking better everyday, but its still twice the normal size.

The streak on the arm guy is also returning to normal after mega doses of antibiotics. His started out as a pimple.

Cool stuff, I'm telling you!

 

That started out as a pimple????


It's a wonder some teenagers don't die from acne.





I'm glad you're having fun there. It doesn't sound like much fun to me. [face_puke]

 

Yep, started out as a pimple on his finger that then began to itch. He tried not to scratch it, but he did in his sleep and voila! red streak headed toward his heart. We measured it and it was moving at an inch an hour! Craziness!

 

kreleia and Mick: You guys are so far from mundane it's not even funny!

You know Mick, you just may work on some of our samples, especially if our lab can't id them. That would be cool.

 

We get a lot of stuff from the prisons, and I'll be testing a lot of them.
Bacterial infections, gotta love 'em. As an FYI to those who don't know, in prime conditions some bacteria are capable of redoubling their numbers in as little time as every 8 minutes. Naturally, those condidtions are rarely present, but it shows you how it was possible for them to watch the infection progress like that.

 

That's so awesome wenchy. Put a warning in the topic about possible graphic details then go to freaking town I love hearing about it too.

 

It's pretty hard to gross me out [Orderly in a County Hospital as a teenager... Worked as an EMT.... I've seen and cleaned up worse (Ask me about the shoes at lunch story sometime )]


Glad to hear that your job is providing you with entertainment as well as satisfaction

 

oh, boy.The stuff We have seen in the medical feild.On one of my ER rotation we drained 16 liters out of a guys belly who was in end stage liver failure.He looked like the girl on willy wanka but was yellow and smelled like dead guy.

edit: have you hade the chance to bring a junkie out of his heroin induced coma yet? wanna talk about an angry person.

 

Hee hee...I love people like you guys who don't get grossed out.

Birrer: I've seen that much fluid come of someone in end stage liver failure like the guy you're talking about and some other with congestive heart failure or pleurisy from cancer, but never a liter of pus from an arm before. Though I haven't woken someone up from a heroin induced coma, we get to deal with them when they're in jail after they get released from the hospital and are barfing their guts out for a week. They get Tigan to help them stop puking, but that's about it. Our detox protocols mostly cover ETOH and opiate DT's, the most common ones.

My adventure from last night: Trying to explain to a girl who is a drug seeker that she would not be getting narcotics for her supposed gall bladder attack. We'd gotten her records and there was never a diagnosis not to mention the fact that I'd watched her before going to the door and I've never seen a happier, spunkier, more mobile woman in the throes of a gall bladder attack before. She's a great actor at the door, moaning, bent over, saying she wasn't eating or drinking, etc. But when I had watched her through the security cameras, she was climbing up and down her bunk, laughing with the other girls, walking around and drinking a coke. Gall bladder attack my rear end!

 

i am so loving these stories of yours, wenchy. it's amazing what happens when things go awry in the human body.

and kreleia, what are you talking about "requiem for a dream" being depressing? i thought it was pretty freakin' funny.

 

funny? ooooookay... to each their own, I suppose.

 

I don't think i'm going to get over the 'liter of pus' thing for awhile. Dude that's SO COOL.

 

My two personal favorite inmates from last night:

I go down to intake, the area where people are booked, and one of the officers says, "Nurse Rachel, there's a guy here claiming he's hypoglycemic and a lady who says she's got ashtma, high blood pressure and back problems." So, I go to check them out.

The hypoglycemic guy says, "I haven't eaten all day and I'm hypoglycemic and these guys won't give me food." So I say to this gentleman: "Let's check your blood sugar and if it's low we'll get you a glucose tablet or a snack." He says, "I don't want a snack, I want dinner." I say, "Sir this is jail. They serve dinner at 5 pm (it was 9 pm) and unless you have a medical reason to eat after dinner, you don't eat until 6 am. That's how it works in jail." He looks at me all astonished and we proceed with the finger stick to see how "hypoglycemic" he is. Well, his blood sugar is 93, a perfectly normal blood sugar. So I tell him, "Wow, for being hypoglycemic and not eating all day, you've got an amazingly healthy blood sugar." He looks at me and I smile and say, "Have a great night, breakfast will be served at 6 am, pleanty of time for you to eat before court in the morning." As they're taking him back to his cell he yells, "What if I go into a hypoglyemic coma?" I yell back, "The officers will call the night nurse who will come stick you again, test your blood sugar and if it's low, she'll give you a glucose tablet and possibly a snack. Have a wonderful night!"

See, there's one thing you have to understand about jail. It's not the Hilton, it works on a shoestring budget, and most of the people who are in intake, or booking, never stay. Many of them leave the next morning after court. Now we will take care of any of their medical emergencies or urgent care while in our custody, but it is just that...emergency or urgent care only until we know that they will be in our custody for any real length of time. It is amazing to me how upset people become when you won't give them their narcotic pain killers just because they say they take them, but have no prescription bottle, no family to verify a prescription and no regular doctor or pharmacy. How stupid do they think I am?

Anyway, on to charming inmate number two...

After hypoglycemia-boy I go to check on asthma-girl. She weighs all of about ninety pounds, and is coughing when I get there. I talk to her politely and try to learn more about the situation. When I question her about her asthma, she can't tell me the name of her inhaler, who prescribed it, and doesn't have anyone to bring it in for her. I say, "Usually people with asthma know the name of the medication that they take." She says, "Well, I only take it when I really need to and today is one of those days." Mind you, by now she's forgotten to cough dramatically and is talking to me normally and without wheezing and without effort...a sign that someone is breathing well. Anyway I say, "Well, I think you're fine for right now, if you do have an asthma attack, call an officer and they will call us." Suddenly she starts coughing dramatically again and slumps to the floor and whispers, "I'm having one now." Of course I think ok, fine, she wants drama I'll give her drama. So I have an officer pull her out of the cell, I listen to her lungs (no wheezing, no adventitious sounds of any kind), take her blood pressure which was low (remember she says she has high blood pressure), and take her pulse. Putting on a very serious face which makes her eyes widen I say, "Hmmm, interesting. Well, my dear I'm afraid that your lungs are clear, that your blood pressure is low, and that your pulse is the finest I've seen all day." In fact if anything, her blood pressure was on the fringe of too low. So I tell the officer to give her two cartons of milk because she had told me she hadn't eaten all day and her blood pressure was like 94/50, and order her to lie down and drink as much water as possible during the night. (When someone has border-line hypotension like her, you encourage fluids...usually th

 

The coolest thing was the look on hypoglycemia-boy's face when he saw asthma-girl's two cartons of milk. Talk about a jealous man.

*Nelson voice* Hah-hah!

I'm glad you're enjoying your job (pus and all ).

 

Thanks Ion!

My favorite inmate from last night:

Every inmate when they are brought into booking has to fill out a health screening form which asks them two general questions: 1. Do you have any health issues that need to be addressed before court? and 2. Do you plan to hurt yourself or anyone else while in jail? (The second question may sound silly to those of us with good mental health but you'd be surprised how many people say yes to that question and get put in a nice concerete cell with a hole in the floor to pee in and get put in a nice padded suit.)

Anyway, this guy answers yes to question number one: Do you have any health issues that need to be addressed before court? If they circle yes they need to explain in the box below the question...this guy writes (I kidd you not):

Lack of blood flow to the front of my brain, I need to see a nurse right away.

Now we're talking the frontal lobe here...let's just think about this for a moment...let's just think about the logic here...

After picking myself off the floor and wiping away the tears of hilarity I try to put on the straightest face I can and go talk to the man. I won't insult your intelligence with the details of the conversation, but let's just say I had a very interesting time explaining to this man that if he had no blood flow to the front of his brain that not only would he not be able to talk to me or remember who he was...he, in all likelihood would not be living and certainly he would not be in jail.

That was the funniest damned thing I've read for a LONG time...I laughed about that all night long.

 

<voice=dr.smith>
Oh... the pain...
The pain!!
</voice=dr.smith>

 

My favorite kite from last night:

When an inmate has a health request they have to fill out a kite (flyer) that notifies us of their health needs. We got a real gem last night...and I quote:

"DEATH IN LEFT EAR"

Now that's just gross! BLAH!

That's going to be a hard one to remove. I don't think hydrogen peroxide is gonna do it.

I love my job.

If you like that one, you'll also find this jail classic entertaining:

"I feel sick after eating pooping blood."

WHOA! That needs attention and quick...someone needs a dietary consultation! [face_shocked]

 

Reading this at owrk whilst eating burrittos covered in sauce. . .good times my friends, good times!