fredericks

For those who play Guitar Hero III - Through the Fire and Flames is like...like...okay, like some programmer took a baby kitten, plied it with crack-laced syrupy milk, placed it on a keyboard, and let it go crazy. That song is INSANE, and not even in a "man, this is hard yet it rawks" way, but in a "Jesus, this song sucks so much nut and-oh GOD, my hand is cramping up! Quick, bring me a banana!" way. Overall I am liking the set list for this one. There are some surprising duds, though: Paint It Black is very fun to sing along with, very boring to play. The game needs more Dethklok. I find Dethklok's songs to be the musical equivalent of cowbell. I'm not the only person watching Metalocalypse, right? Come on!, it's 11 minutes of brutally concentrated awesome every week!

I want to see about heading to Dragon*Con next year (the website states "only 293 days left!"; how cute). It would be my first year going. Have many people reserved rooms in the main hotels yet? Y'all think I can wait a bit before I do the same? How many of y'all will I be able to powwow with down there? I know there's at least three people from my FL heading out.

Saw "Lars and the Real Girl" (I keep calling it "Lars in Real Life" by mistake) with

atraxia the other day. I let the film marinate and, fine, call me a cynical bastard, but I'm left feeling it was entirely too saccharine-sweet. There was the kernel of a *great* film on the study of the human need for connection, and the writers/director knew it. The air of "Oscar! Oscar!" permeates the movie, resulting in overlong shots and schmaltzy dialogue that appeared to have been placed for emotionally evocative reasons but end up feeling quite manipulative. All that being said, and in spite of myself, I sort of liked it (I'm a sap, goddamn it). And the use of USB cables and CPR? For the WIN. I just wanted to take Ryan Gosling's character home and give him a hug. Or a quick pat. Whichever.

Is it possible to have a negative NaNo word count? If so, the absolute value of my pace would result in a word count that's staggering. Otherwise, not so much.

I had an older patient who'd come in with GI bleed a couple of days back. Before she came to the floor she'd received three units of blood. During my shift her counts and BP'd remained okay, but she had three episodes of passing bloody stool. And when I say "bloody stool" I mean massive amounts of dark red blood with an infintesimal amount of stool. She was in with GI bleed and everything else was stable (H&H remained okay, BP was well within normal, patient had zero complaints otherwise) so I didn't stress things too much. She ended up getting two units from the day nurse, and the day nurse reported the physician was "upset" because he hadn't been informed of the bleeding episodes.

This is why the doctors get on my nerves: read the damn notes I *painstakingly* put in the patient's progress notes and you'll see EVERYTHING that was done for the patient by the nursing staff - to wit, the Medicine NP was called and informed as per policy, the patient was evaluated as per policy, lab work was sent as per standing order and (in addition) NP stat order, the patient was monitored closely. Don't come in all huffy when you didn't initially order to be informed if the patient has a bleeding episode, particularly if the patient is admitted for GI Bleed. I expect patients admitted for COPD Exacerbation to be short of breath, I expect patients admitted for vertigo to be dizzy and lightheaded, and I expect patients admitted for GI Bleed to bleed from their gastrointestinal tract. Jesus. Anything abnormal will be followed up on, and anything *exceptionally* abnormal will warrant the NP calling your ass in the middle of the night. Otherwise, please, STFU.

Right. Abnormal. So the patient left in the middle of the afternoon for a angio of the aortic area to see if the bleeding was, in fact, not in the GI area. The report I got from IR was that the angio was negative. The patient came back to the floor and I got her situated. A couple of hours later she said she had to use the restroom. No way was I taking her to the bathroom, and she was fairly adamant about not staying in the bed and/or using a bedpan, so I put her on a bedside commode. Yeah, that wasn't one of my more brilliant ideas. She promptly fainted on me, and my nose was filled with the distinct smell of GI bleed blood (once you smell it once you'll never not know what it is). She sort of regained consciousness, but I didn't waste any time and called Rapid Response for the patient.

The whole thing was hilariously scary: I couldn't take her back to the bed so I had to hold her upright on the commode and ask her roommate to go to the desk and ask for help. It took maybe a full minute before people actually got off their asses to see what was going on (the lady was Korean and perhaps a little timid? I'd have thought the whole "nurse supporting a flagging patient" thing would have made her more forceful, but comprehension on my coworkers might have been an issue. Or they're all lazy and annoying, who knows), and a couple of the other nurses didn't *want* me to call Rapid Response because the patient was conscious when they came into the room. To which I say, again, STFU. Are you fucking kidding me? The woman passes so much blood while sitting up her pressure drops and she passes out, yet you want me to wait for the NP?? Fuck that shit; I LIKE my license, thankyoukindly. Rapid response came, triaged the patient, the MICU doc ordered another unit of blood and wanted to move the patient up to the unit, the patient initially refused (she told them I was doing a wonderful job of caring for her and she was confortable where she was, to which I silently replied "aww! how nice!... now get the hell up to the MICU before you become my first code, lady"), but was convinced by the staff and her physician to go on up. When I looked up at the clock I was surprised to realize ALL of that stuff (and there was tons of calling the physician, then calling the physician again, then checking in on the patient, then giving report to the MICU nurse) took place within 45 minutes. I checked up on her when I went up to put my final notes in her chart. She wasn't intubated, wasn't getting any additional blood, was just sleeping comfortably in the bed. She was cute but, man, no Codies for me.

Before all that happened I was supposed to get the flu shot. The CNS on the floor was going to give it to me. Then she pulled out the IM needle and I chickened out like Kentucky. I think my time in healthcare has actually made me *more* scared of shots. I know how much IMs hurt and there's no way I want to voluntarily subject myself to one. She tried to stick it in once and I moved back so fast it wasn't funny. And, man, the actual flinching/withdrawal *felt* involuntary. I felt terrible, but not terrible enough to let her stick me.

Entries of this length are what happen when I try to avoid posting short snippets here and there. The plan for tonight? Co-op Guitar Hero III, NaNo (I'm not joking), and sleep. Not necessarily in that order.