ER life, from a nurse working as a lifeguard in the shallow end of the gene pool.
Wednesday, January 21, 2015
Over there someplace --->>>
there should be a new addition to the blogroll:
Hogwarts' School of Grid-Down Medicine.
AKA providing medical help for you and yours, when you're all there is, or is likely going to be, for any number of reasons.
Doc Grouch, Ivymike, and myself had it suggested upon us courtesy of Concerned American over at WRSA.
We promptly all fell all over ourselves thinking what a great idea it was. Doc Grouch and Mike did just about all the work of launching it.
My input was some tinkering, and then I got a vacation, and then my return to reality, as previously noted, has been a bit...bumpy lately.
Thus any credit due to me for it so far is right about nil, so I'm not being immodest to tell you the site looks great, and there's stuff there you should read, learn, and pay attention to, if you think big shiny white hospitals and endless streams of Government Bux to pay for visits there will not last forever, in all places and times, for the rest of your life.
In other words, if you have any grasp on medical and sociological realities, let alone an awareness of the frequency of life's normal allotment of natural disasters.
Doc and Ivymike have done great things there thus far.
As my situation stabilizes, and I get back to regular posting, I'll have more of a share carrying my end of the log, along with Doc Grouch, IvyMike, and anyone else we can cobble together to keep it a going concern, and improve it.
Start at the beginning, read the posts, do the homework.
Our goal is not online medical school. (There are probably laws against that anyways.)
It is that everyone with the time and inclination be provided with the guidance, resources, and gentling prodding (of a solid boot in the ass, metaphorically) to be as prepared as they may choose to be to deal with medical emergencies anywhere, with what's in your pockets, or even better, with the prudently-stocked contents of your home version of Somewhere General Hospital. And anyplace on that spectrum between those two. Guided by what we have invested and reaped from a combined goodly number of decades each and all trudging through the corridors practicing our medical arts.
Go.
Pay attention.
Learn stuff.
Practice it.
Save Lives.
Potentially even those that mean the most to you personally, at a time when you may be their best, or only, chance.
(And though Life's been kicking my butt a tad lately, I'm kicking back, and I'll shortly be back with more Shepherd stories - from a host of new assignments, and a number that have been kicking around for awhile, as well as seeing what Ebola is doing these days besides killing people as efficiently as ever. So whatever you've been coming here for will return in short order, once things settle down a bit for me. thanks for your patience.)
Thursday, January 15, 2015
And the other shoe drops...
My vacay was lovely. As will become apparent, I should have stayed there.
(If you have the chance for two weeks on Maui, I highly recommend it. Anytime.)
Upon my return, I found out the reason they were so cheerful about letting me have time off for the holidays, was that in their ceaseless efforts to not go broke implementing ObamaCare, my facility will be "re-organizing", and wished me their best in securing another position. Just. Like. That.
The fact that I'm experienced, at the top pay tier, and recently passed the half-century milestone were all purely coincidental, they assured me. And I have a bridge for sale too, right next to some beachfront property in Kansas.
Step Two was dusting off the resume, and getting a gig with any number of nursing registry agencies hereabouts that are swamped with the need for ED nurses locally, because for some reason, there are a ton of facilities with openings for non-permanent personnel on all shifts. Everywhere.
Doubtless this is just another purely random coincidence, I'm sure.
The sweetener is that they pay on average 10-20% more than my former employer, for doing the same job, and (after a few months not there), even including my former hospital home. So they laid me off to get me a raise, and set my own days and hours forever, including no more holidays at my discretion, and all it cost them was any shred of loyalty or concern for their best interests I might have had after the last ten-plus years in their trenches.
Such a deal.
The other bummer was instantly being ripped from amongst the greatest bunch of people, doctors, nurses, and staff, I've ever worked with. $#!^ happens.
The fly in the ointment was that I needed to do all the pre-employment hoops I haven't jumped through since Clinton was president, and dig up paperwork from the late Pleistocene, as well as document my decades of competencies in everything, from scratch. (Satisfying my inner hyper-anal control freak, I have so far aced everything they've thrown at me. And thank the Flying Spaghetti Monster I can do this stuff online, at home, in my pajamas, whenever I feel the urge. Yay, 21st century technology.)
During which, it turns out that between eating like a teenager, no small amount of it grazing on craft service, and the very same two decades of dealing with nightshift ED work and the lovely people deposited on my gurneys, my blood pressure seems to have decided to translate into flight data from a space launch liftoff, after being textbook normal up to at least six months ago.
Oh goody. After a quarter-century in healthcare, I always wondered what it'd be like to be the patient. (Not.)
I have consequently been just a wee bit pre-occupied with securing gainful employment, and not having my head explode, while finding a regular physician for the first time since I was a teenager, managing new meds, and embarking on a new quest to burn off at least a decade of crap daily diet and not enough cross training. With my former health insurance a distant memory.
So the 20 extra pounds around my gut are my fault, and the ED is the ED, but a hearty "Fuck You" to president
Regular blogging will resume when the recent roller coaster comes in for a landing.
The fivefold teaching moments are thus:
The government is not here to help you. Ever.
Neither is your employer. Loyalty is for dogs. Their end of the contract comes when the paycheck clears. Anything else is icing on the cake, but don't count on it.
Keep your resume current and updated.
More veggies, less pizza.
More PT, sergeant, more PT. Because I miss the Daily Seven like BUDS candidates miss getting wet and sandy in January.
And if you thought I was a non-cheery cranky caustic SOB before all this needless personal drama,
GET OFF MY LAWN.
Back regularly as soon as I can. The medical chances of me shutting up on the internet are about 8 billion to 1, against.
Monday, December 22, 2014
Paradise, Bitchez
For the first time in two decades, I got the holidays off for personal vacation. (Seniority, or the gods of random fortune, thank you).
Consequently, by the time this goes up, I'm sitting on a beach much like this one.
Just because.
Happy Holidays, &c.
Back after New Year's.
Tuesday, December 16, 2014
@$$Clown Of The Ides: Chuck U Very Much, Senator...
The real motivation for all that Ebola preparedness comes out:
(PORKVILLE) -Senator Chuck Schumer on Monday called on U.S. secretary of health and human services Sylvia Mathews Burwell to recognize the enormous amount New York hospitals have spent preparing for and treating the Ebola virus, and use some of the money she was given by Congress to reimburse hospitals for their expenses.Try and look surprised at the prospect of a Democrat senator trying to shove both arms armpit deep into the taxpayers' pockets and keep everything he can get his hands on.
Burwell has 30 days to come up with a spending plan for the $733 million her agency received from the latest continuing resolution, a $1.1 trillion spending package that allotted a total of $5.4 billion to combat Ebola.
Most of that money is headed to West Africa, where the epidemic continues to claim thousands of lives, but some can be used domestically.
Schumer said he would like New York hospitals to receive roughly $50 million
“I am urging secretary Burwell to make sure all of New York's institutions are completely reimbursed for their funding,” Schumer said at a press conference today outside Bellevue Hospital. “That was the purpose of the fund when we push for it and created it.”
Mayor Bill de Blasio has already reimbursed Bellevue, a part of the city's Health and Hospitals Corporation, $20 million for the expenses it incurred when treating Dr. Craig Spencer, the physician who contracted Ebola while working with Doctors Without Borders in West Africa.
But other hospitals have spent tens of millions of dollars preparing for the virus, Schumer said.
Montefiore has spent approximately $7.5 million building a biocontainment unit and training staff, Mount Sinai has spent between $7 and $8 million, and New York Presbyterian has spent roughly $3.3 million, according to Schumer's office.
Ken Raske, president of the Greater New York Hospital Association, estimated the ten Ebola-designated hospitals in New York have collectively spent between $50 million and $75 million on capital construction, the purchase of protective gear and training.
Webster's Dictionary could save space by consolidating the entry for Chuck and the entry for chutzpah. Or at least using the same picture.
Like Getting Ebola Wasn't Bad Enough
Kenema, Sierra Leone (Al Jazeera )- Massah Kamara sat patiently with her brother Momoh, her haunted eyes focused somewhere in the middle distance beyond the walls of the post-Ebola clinic.
Three months earlier, doctors gave her the good news - after weeks of fighting the disease, she had finally beaten Ebola. She would live.
Back in her home neighbourhood of Nyandeyama, a quiet suburb of sandy streets and mango trees, she found out 22 members of her family were dead, including her parents. She had no money, so was unable to go back to her tailoring business, and many of her possessions had been burned by terrified neighbours.
Then, just when she thought things couldn't get worse, she began to lose her eyesight.
"My eyes are dark," she said sadly. "Even when the sun is shining, my eyes are dark." Kamara said she was happy to have survived Ebola, but fear and misery were etched onto her face.
Kamara is one of 40 percent of Ebola survivors to have gone on to develop eye problems, according to a recent study carried out by the World Health Organisation and Kenema's District Health Management Team. It has been more than a month since the district saw it's last case of Ebola, and attention is turning to the plight of survivors.
The results of the survey, a copy of which was seen by Al Jazeera, outline a raft of physical, social and psychological problems the survivors are experiencing.
Seventy-nine percent, for example, now suffer from joint pain; 42 percent have problems sleeping, while more than one-third of those surveyed experienced peeling of the skin. Many others reported problems with their reproductive system.
Post-survival effects
"There is so little written about post-Ebola problems," said Maggie Nanyonga, a WHO consultant working with Ebola survivors in Kenema district. "We don't know if it's the drugs that are causing it, or the disease, or just stress."
In a small room at the government hospital in Kenema, now known simply as "Psychosocial", volunteers busily transcribed forms with survivors' complaints. "Serious backbone pain. Difficulty breathing. Properties burned but not replaced," reads one.
"Ear and joint pains. Poor health with red eyes," reads another.
"Tired legs and weakness. Cannot see clearly," reads a third.Health education officer Michael Vandi said the eye problems are of particular concern. "We just weren't expecting this. A lot of them are experiencing it, often combined with headaches," he said.The head of the hospital's eye department, Ernest Challey, said he believes he has found the cause - a condition called Uveitis that occurs when the innermost coating of the eye becomes inflamed.And it gets worse, according to the rest of the story: the locals treat survivors like pariahs, having burned their few belongings, and shun them afterwards, so they're left with no place to live and no job, as all the health problems pile on.
It is triggered by problems with the immune system, a viral infection, and sometimes trauma, he explained. It leaves patients with dim and blurred vision, and pain when they're in bright light. If left untreated, said Challey, it can lead to blindness.
But the physical symptoms are just a part of the immense challenge many Ebola survivors face. "Sometimes I cry when they tell me their stories," said one nurse after writing down Kamara's details in the post-Ebola clinic, the first of its kind.
There's never been a post-Ebola clinic, because historically, the Ebola Survivors Clubs have usually been able to meet in a phone booth.
But with a few thousand survivors this time out of at least 20,000 victims, medical science is getting a new chapter in Ebola treatment: follow-up prognosis for survivors. And it isn't pretty.
Not least of which because what little assistance is going there is aimed at trying to curb the actual outbreak, not deal with the aftermath.
We never had to do much of that before...
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