Dump Run

I had my first dump 'n run a couple nights ago.

The front desk calls,
"Do you know about a pt. Xxxx, that's a direct admit to CT?"
"Um, No?" I want to say, 'Why would anyone be admitted to CT?", but whatever, the front desk wouldn't know that, anyway.

I warm the scanner up and wait. About 40 mins later 3 EMTs come racing into the dept. with an unconscious elderly woman on their gurney. They're shouting some stuff about low blood pressure, V-fib, O2, something, something - and they rush past me into the CT room.

What I see is a cyanotic old lady actively seizing.

I follow them into the room, "Um, she's having seizures.", I say.
They roll their eyes at me, like duh.
"Yeah, that's why she's here.", one of the EMT's says, while they're moving the pt. on to the CT table.
"Has the ER nurse looked at her?", I ask.
"No. Direct admit to CT.", the EMT says, while they're wrapping up their stuff and heading out the door.

OK - So here I am alone with a cyanotic, seizing old lady. The ER is on another floor. In fact the only other depts. on my floor are housekeeping and HR. They're all gone for the day anyway. There isn't any crash cart or even a blood pressure cuff in our dept. Not like I would know how to use one, right? Actually, for a Rad Tech, I'm very good at taking blood pressure by palpation. Thank you EMT training. Anyway, back to my story. Thankfully, the ER nurse came to my rescue and with her help I tried to scan the pt.'s head. CT and seizures don't really work well together. After the third try we gave up and the ER nurse took the pt. upstairs to be admitted to, get this, a real hospital room, where they gave her some nice Ativan. And I finally got the CT done.

Later on I went up to the pt's room to do a CXR and EKG and the pt's Dr. popped in.
I hate this Dr. Deeply, deeply dislike him. If I were dying, and he was the only Dr. that could save me, I would rather die.
I have the pt's chest uncovered to do the EKG and the Dr. waltzes in, flinging the door open and not shutting it. Granted, she's unconscious, so she doesn't know that her boobies are exposed to the world passing by outside, but gross!
I shut the door.
The Dr. snaps on a glove, "Well, as long as you have her gown open, I'll do a breast exam!" He proceeds to vigorously squish her sagging, floppy breast tissue. "Her family's very worried she might have breast cancer."
She's 88 y/o and unconscious. Hmm, breast cancer may not be her worst problem right now. Then the Dr. grabs my hand, "Here feel this! I think it's a lump. What do you think?"
Eww! I do mammograms, but I DO NOT grope unconscious old ladies!
So I say diplomaticlly, "I feel some tissue, but I don't know what it is."
He snorts, "Well, it feels like a lump to me."

Stop Skinny

Call Sick

Tired, very tired today.

Today was supposed to be my day off, but one of my co-workers called in sick. Wait....the punch line is....she called in sick on Monday.
Yes, she called in sick on Monday and said she would be sick Mon.,Tues., and Wed. She was also sick on Thurs. and Fri. And Sat. and Sun.

Hmmm, how do we know she's not calling in from Mexico?

Well, when I got to work a 2nd person had called in sick. So, that brings the total techs covering 4 modalities with packed schedules - to 2. 2 Techs to do 4 techs jobs. Yeah, somehow that didn't work out too well.

My boss should have let us cancel a few exams, but he said he would 'help us out' . That didn't work out so well either. He tried to do a CXR. Simple. Right? Sigh -I guess not. He ended up doing it over and over and it still didn't turn out (I have no idea what he was doing wrong), so he asked me to fix it.

Sure I'll do my job and someone else's job AND your job!

At one point I had a mini breakdown.

The front desk sent down the 1pm Mamm pt and Dexa pt at 12:15!! OK they're 45 min. early, have them wait at the front desk and let us eat lunch.
At the same time(the phone was ringing wildly) the ER calls and orders a CXR - "Oh, and when your done take them up to the floor, admit them and put them in their room"
I'm sorry, I'm suddenly deaf. I heard chest x-ray and blah, blah,blah.
I had the US tech take the pt back to the ER.
The ER had 1 pt. and 2 nurses.
We had 4 pts and 2 techs.

When I hung up the phone from the ER the floor calls and orders some STAT x-rays, a Dr. calls looking for a previous x-ray on a pt and a pt calls to schedule an x-ray. The 1 o'clock CT walks in.

Then I had a mini breakdown.

Knee Jerk

I had an interesting pt on Sat.
These are his x-rays. Dislocated knee.
They choppered him out to a bigger facility with an ortho surgeon .
Sorry about the dusty images. I guess I need to dust out my scanner.

This pt, a 26 y/o guy, was found sitting beside the highway, in the middle of nowhere, without a car, at Midnight in -10F degree weather. A good samaritan stopped, picked him up and brought him to the ER.

The cops called her a 'good samaritan', but personally I think she, a 40 y/o woman, was crazy. This kid was covered in blood. He had scalp lacerations and there was blood all over his face and hands. Maybe stop and call 911, but he could have been an axe murderer (he looked like one).

The pt claims he was driving, but he doesn't remember where his car is or if he had an accident. And he wasn't drinking! He can't remember anything, but he's positive he wasn't drinking.

Right.

This is the imaginary one sided conversation I have with him:

So you weren't drinking? And that odoriferous odor leaking from your pores would be?
Oh, of course, Eau de Beer Bong.
That is a tempting scent.
I almost bought that for my grandma last year, the in-store sample was enticing, but I decided to stick with plain old lavender perfume.
I know, it's so boring and plain!
Not at all like your aroma.
But oh, well, we can't have grandma getting kicked out of Thursday bridge, because she caused rampant alcoholism to break out at the senior citizen center!

Sat. Here

I'm working another Sat. 24 hour shift. Yuck.

The pts. are just starting to come in- ambulance in ER, clinic pts. trickling in, so I should have a few good stories by tomorrow.

Almost 3 hours down-21 more to go.

Update 11:00AM Sat.: OK in the last 60 min. I x-rayed:

• 2 MVA pts - hip,pelvis,l-spine. Both on back boards(No fx)
• Clinic pt. - 9 y/o wrist (No fx)
• ER pt - 88 y/o fell, goose egg hematoma - CT head neg. (she has dementia-screaming, crying, trying to run away/not the easiest pt to CT)

I want to say thank you to the inventor of the slider board. Three of these 4 pts could not move themselves. Could the ER nurse help me? No. Could anybody help me? No

It's so unfair. I'm like 130 lbs. vs. pts that weigh 300+. It's only possible with the slider. Thank you Mr. Slider (my new best friend).

Update 8:45PM: Highlights from the night- an ER Dr that orders everything she can think of.

An otherwise healthy 55 y/o fell slipped on the ice an fell on her arm. No bruising, pt uses her arm to pick up her giant 10 lb purse, pt didn't try using ice before rushing to the ER. Why? Our ER has a zero to 5 min. wait time. But that's a whole 'nother story.

OK we're going to x-ray her hand, wrist, forearm(hey,got that one with the wrist!), humerous, and shoulder. Can we say overkill? All x-rays negative.

Now duplicate that pt times 10 and that's my day/night so far.

One good thing - today they let me have a pt room to stay overnight in. It doesn't have a working TV, so they can't give it to a pt (!). However, there is a screamer on the floor right now so maybe I will be sleeping in the dept. again.

She's been screaming all day. Pts keep asking me what's wrong with the pt in that room. I have no idea, but her lungs are healthy. She doesn't just scream, she likes to spice things up with a lot of Whooooo who who whoooo ahhhh!

Time Waster

The hopital admin. are instituting another time wasting protocol.

It's called SBAR. Anybody use that at their hosp.? Did it work?

SBAR stands for Situation-Background-Assessment-Recommendations

Basically, as they've discribed it to us, the pt's nurse fills out a 'ticket to ride' every time the pt needs to leave the floor for a procedure. The questions that they fill out are like,

Wheelchair? yes/no (duh, every pt gets a wheelchair ride)

O2 y/n

Circle O2 level: 1 2 3 4 5 6 7 8 9 10 12

circle one: pt stands alone, two person lift, pt immobile

Location of pt pain?:

Level of pain:

Does pain move around?:

Pt confused/disorientated?:

IV: y/n

IV Location?:

IV taped in place? y/n

IV gauge?:

Multiple IV tries?

If so, are repeat IV locations bandaged?

Pt wearing any jewelry?:

Pt provided with slippers and robe?

RN/LPN to sign:

RN to sign if pt changes noted:

OK this is silly!

Sure I want to know if the pt is on O2 or if they're confused. I also would like to know if they are a 2 man lift(so I can bring the strong man we keep in the hallway closet ha,ha), but I can ask the nurse these questions!

Also, I can, instead of reading a piece of paper that was filled out the night before, by the previous shift, talk to the nurse or aide or whoever and tell them, "Oh by the way I'm taking 314 for their x-ray. Do they need O2? Are they combative?" Ect.

That way they won't freak out when they see an empty bed and think the pt. has escaped!

It's not like we are a huge hospital - there are 21 beds in med/surg, 4 in Ob, 4 in ICU, and 15 in the locked mental health ward.

It's just one more piece of paper the nurse has to fill out.

And our hospital is supposed to be paper-less!

Why don't they put this info into the digital chart?

Then before we go to pick the pt up off the floor (sounds bad) we'll know that they need O2 , ect.

Work Here

Hey!

Need a job?

Work with me!

We have openings for : RN-med/surg,

RN- med/surg,

RN-er,

LPN,

EMT,

a pharmacy manager

and ortho surgeon!

We really, really need a pharmacy manager ASAP. They're offering $63 an hour. (Is that a good wage for pharmacy managers? IDK) And you would only have to work every 4th week-end!

If you are an ortho surgeon- consider working here because:

Low crime rate (good place to raise your kids or retire)

Newly remodeled OR (move in date Jan.'09)

Admin. will buy any equipment you want

(or use the $600,000 of equipment the last guy

left behind after working for 5 months - he moved to

CA-not our fault)

Fresh Air

Wide open empty spaces

New Wal-mart

(where old people trip every Sun. and break their hips)

Local skiing (see above)

Many drunk drivers(broken arms/legs ect.)

Metal foundry (back pain/crushed limbs)

9 months of ice and snow(multi fx)

Come work with the best!

JACHO what

In the last few days I've read a lot of posts on other blogs about JACHO.
I know they are a farce and a pain, but let me tell you about working in a non-JACHO facility.

The state, EPA and other government bodies check us out once a year and we always pass with flying colors.
However, they never check things like air return/ventilation.

The air flow in my dept goes like this -
1. Vent outside the hosp., where smokers stand, sucks in air.
2. Air flows down past the cafeteria picking up the scent of fried onions and charcoal burgers
3. Air then passes into Radiology.
4. Air stays in Radiology, becoming muggy and holding the scent of home-less woman's armpit.
5. Same air still in Radiology.
6. Ambulance idles outside ER.
7. Diesel fumes overwhelm cigarette smoke,onions,charcoal and home-less armpit.
8. Radiology dept. workers gag, fall on floor and die.
9. Phone rings 49 times in silent dept.
10. Angry Dr.,looking for x-ray report, finds dead technologists.
11. 2 hours later Dr. remembers rad dept is dead (after calling again for a report) and complains to administration that rad dept is lazy.

Stir Fried

I stayed inside this week-end and cooked. It's -15F outside with a windchill of -35F. At that temp. any exposed skin freezes in about 15 minutes. I hate winter.
I watched The Day After Tomorrow at work last week.
In the movie first there are terrible tornadoes that kill hundreds of people.
Then the oceans rise and finally a deep freeze covers the northern hemisphere.
In the movie, living where I live, I would be frozen dead.
One thing that bothers me about the movie: the temp gets down to -135F and humans freeze instantly, unless they're standing next to a fire.
Question: Would a fire burn at -135F? Wouldn't all the oxygen be sucked away from the fire?


Well, that's what I've been thinking about this week-end. Freezing and dying.
This is a pic of some tofu I marinaded and then baked at 500F. It comes out of the oven salty and crispy on the outside and creamy soft on the inside.

My mom used to make this for me as a special treat.
It's my second favorite snack.
I guess some people think of mac&cheese or chocolate pudding as comfort foods, but this is what I like.
My favorite meal is really weird. Nobody outside my family likes it.
It's fried onions, bean thread noodles, textured veg. protein, mushrooms, and soy sauce.
It's cooked like a casserole. Mmmmmm. Yum yum.

This is a pic of the stir fry I made. I love baby corn! And jasmine rice.

This is a pic of the egg bread I made today. And a radish sandwich.

Eggy bread,butter, and radish. Mmmmmm.

And then I made some molasses cookies.


I slept for hours and hours this week-end. Work on Friday really tired me out. I worked a morning shift after working a shift the night before. Then I was on CT, on a Friday, always exhausting. People always try to get in on Friday for pain they've had all week.
But what if it gets worse over the week-end?
True.

Secretly, I don't really mind. I can do an Abd/Pelvis CT in 15mins.(they're scheduled every hour) and a head CT in 5 mins.
I've made it sort of a game.

Also, one of my co-workers (we'll call her Talky), who is six months younger than me(as opposed to everyone else who are: 35,45,47,57,64 years old) was working and we always have a lot of fun.
We have our own inside jokes and we can complain about other people.
It's fun.
After working for 3 years with people as old and older than my parents, it's nice to have someone closer to my age to work with.


And I can boss her around sometimes.
Because she is younger than me.
But sometimes she talks too much.

Snow Melt

I'm so sick of snow and winter.

Blah.

I just spent >$400 on seeds and plants. Is that excessive? One order from one catalog out of six I plan on ordering from? I need help!

I'll just keep telling myself it's OK. After all, it's my only real hobby. People spend money on hobbies. Deep breaths. It's OK.

Anyway, today we had a ETOH guy in his 40's come in to the ER for jaundice. The ER Dr ordered a chest x-ray. For jaundice? OK whatever.

When I bring the wheelchair into the room and tell the pt I'm taking him for his chest x-ray, he says, "Just an x-ray? I'm supposed to have something else. Like a cat scan (sigh, no cats are involved people! Too bad-it would make my job a lot more fun.) or something like that."

OK I'll go check with the Dr. I talk to the nurse. We roll our eyes. She tells him, 'No the Dr just ordered an x-ray."

I'm wheeling him to my dept. and he's totally obsessed with CTs. Every room we pass, "Is that where you do cat scans?" No. "Is this the cat scan room?" No.

Later on in the ER, I hear him talking to the Dr., "I think I really need a cat scan."

The Dr. (who is famous for ordering every scan in the protocol book) miraculously says, "Well, I want to get your labs figured out first and then we'll worry about that."

They admited him to the ICU for ETOH detox (?) and ordered an abd/pelvis CT for tomorrow.

So he'll get his 'cat scan' after all.

Rice Fire

I love Indian food!
Dum Aloo is my favorite. It's potatoes in a semi-fiery tomato sauce with lots of good spices. Mmmmm and samosas and naan.

I wish I could find a recipe for the red relish that's often served in Indian restaurants for an appetizer. I think it's made out of finely chopped onion and lemon juice, but what makes it red and gives it such a great flavor? Cumin? Annatto?-that would give it a bright red color. Hmmm. I guess I'll keep looking.

So far today at work I have done ONE, yes, count it, one Abd/Pelvis CT on a chemo pt.

My boss asked me today if I would be interested in working from 2pm to 2am x 3 days a week without week-ends and NO CALL!!!!
This seems like a pretty good deal to me. I'll have to see if it works out though. I don't think I would be interested if I still had to work week-ends.

I wish I knew what kind of shifts other x-ray depts. worked.
As I've just passed my Mamm boards (in Dec. score of 98, thanks very much!), it would kind of suck if I didn't get to do mamms at all. They only schedule mamms until 3pm, because there's only a staff of one(me!) in the dept after 3:30pm.
Ho Hum, have to see how it goes.

Moss Rolls

I took this pic on my vacation to CT (for a friend's wedding) this last fall.
I liked Connecticut - they have a lot of trees. It was a little claustrophobic. We stayed in a beach house. So.....not too many trees there.
Bored...bored...yes.
Work is boring. Too many people with abd pain and vomiting.
You all have the flu! Go home and stop throwing up on my hand!

Super Tom's

Wow! What a great superbowl!
I was on the edge of my seat right down to the last minute. Strange last minute that it was - Yay we won! No wait, there's still 1 second. Off the field. Off the field. Ok. Everybody ready? Here's the ball and...Yay we won!
I wanted New England to win, because Tom Brady is such a cutie.
There were 2 great Tom's, Tom Brady and Tom Petty.
That was a great half time show.
I watched the game at my friend's house, they had a party, and I couldn't believe I had to explain to 40 year olds who Tom Petty was.
I wasn't even alive in the 70's.
Who doesn't know and love I Won't Back Down?

Cookin' Cookies

I baked cookies tonight. First, Light-as-Air Sugar cookies and then Old-Fashioned Raisin Sugar cookies.

The Light-as-Air sugar cookies are light, airy,and crunchy. Their crust (do cookies have crusts?) is crispy, but their insides are very soft and tender. They have a subtle almond flavor (from extract) and I used superfine sugar mixed with lemon extract for the topping sugar. So, there's a little tangy bitter-sweet bite when you first taste the cookie.

The Raisin sugar cookie doesn't have any nutmeg or spices in it like other raisin cookies. The recipe calls for vanilla extract, but I always use both almond and vanilla extract. Also, I soaked the raisins in rum. They plumped up beautifully and make for a super soft tender raisin cookie.

And I used my very own eggs from my pet chickens! Fresh eggs, warm cookies, yum!

Henna Head