Monday, October 28, 2019

Planetary Intelligence Is A Constant; Population Is Increasing

h/t Kenny




















Behold, the dangers of listening to the horseshit they put in the Washington Compost, and mistaking it for factual information:
Falls remain the leading cause of fatal and nonfatal injuries for older Americans. Hospitals face financial penalties when they occur. Nurses and aides get blamed or reprimanded if a patient under their supervision hits the ground.
But hospitals have become so overzealous in fall prevention that they are producing an “epidemic of immobility,” experts say.
This is easily solved.

Waive all your rights to sue in case of a fall, accept full responsibility for all injury and damages in writing, including to any other parties, and consent to binding arbitration with capped damages, and we can talk.

Refuse, and you're full of shit, and your ass can stay in the wheelchair, or in the bed with the siderails up. Once you're back in your house, you can play by any rules you damned well please, as it should be, okay? But in my house, it's my rules. Fair is fair.

If you make it past that hurdle (literally) we can talk about mandatory drug and alcohol testing (because people lie, pretty much 75% of the time, about that), and about how many people got to the hospital because they fell at home in the first place, and were too stubborn and stupid to use things like a light switch, their eyeglasses, walkers, canes, crutches, etc., and are now lined up for a shiny new titanium hip to replace their new three-piece femur, because they had to get to the bathroom right this minute, in the dark.

Last night's genius wanted to be released, despite being drunk at 3-4X the legal limit, and not able to recollect how he ended up on his face in the street, right up until the CT revealed he had a major brain bleed. Pull the other one, Einstein, it has bells on it.

I had one lady, brought in because she was too weak to get up for seven hours after a fall at home, tell me she was leaving. I told her to go ahead. And waited. And waited. She could barely raise her voice, let alone her body.

Look, I get that it's frustrating when your 60-, 70-, or 80-year old body doesn't act like it does in your still-18-year-old head. But it isn't my job to mollycoddle your weak grasp on reality. It is my job to make sure I don't have to explain - or lose my license and livelihood - for why you're on the floor of your room on your ass, especially when you're frail, feeble, confused, broken, or on narcotic medications. If you could do Gene Kelly's "Singin' In The Rain" with full choreography, you wouldn't be in the hospital, now would you, smartypants?

This is on my bucket list. But not as a patient in the hospital.

"Patients are idiots" should be carved in stone above the hospital front door, because they won't let me wear a button that says DLTDHYITAOYWO. (I'll help out: "Don't Let The Door Hit You..." work the rest out yourself.)

And hockey pants with pads, and crash helmets should be mandatory attire after age 70.
You tell me which is sillier; dressing that way, or those neat-o zipper scars on your hips, and 6-9 months of OT/PT learning to walk again in your 70s and 80s. If you don't fail, stay in the hospital endlessly, get pneumonia and twenty other opportunistic infections, and then just die.
Because in case you didn't notice, you don't bounce as well as you did when you were five or ten years old.

When someone tells me that 98% of tort lawyers are literally dying of starvation due to lack of business, then we can talk about "overzealous" fall prevention from the medical professions.

Until then, it's crybabies wanting to have it both ways. If you don't like being group punished (and sorry about that, but make no mistake, you are) for the 25% of people (minimum) who're just conniving weasels and outright morons, punch them in the throat in the waiting room, and then go burn their ambulance-chasing lawyers' offices and homes.

But thanks for the entertainment.

You'll win this argument when pigs fly outta your butt.

I truly enjoy taking care of people, and I want each and every one of them to go home and enjoy life as near to whole as human wisdom and the medical arts can make possible. Even when they're not smart enough to figure out that I'm going to act in their best interest, even (especially) if it pisses them off or spoils their plans right this minute. Me and my coworkers easing off for ten seconds can turn into 5 years of court appearances, and six-figure damages. Or someone dying.

Alongside that consideration, someone's momentary butthurt is not a medical complaint, it's a character flaw for them to work out on their own.


Don't like hospital rules? Don't get sick, injured, or old. (As if, but that's the truth of it.)
No one's going to come to your house to enforce them on you. Problem solved.

Monday, September 23, 2019

Notes From The Trauma Bay



Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.
Motorcycles are not your friend.

Unless you want to be deader than disco before you're 25 years old.

In which case, please make sure your driver's license says "organ donor".
Thousands of people needing transplants await your demise.

Every few years, when I start to think about getting a bike, someone comes in really jacked up from a motorcycle accident, and beats the idea out of me in about one head-to-toe assessment.

Or, sometimes, a head-to-thigh assessment, because that's all the paramedics could find to bring in.

Motorcycle?
Don't.

Tuesday, September 10, 2019

No, Really

















I have now officially spent more time in annual re-certs than the amount of time I originally spent in nursing school.

Sunday, July 7, 2019

Is It Just Me, Or...?




I really do love my job, and saving lives never gets old, except when you don't, but I was just wondering...

does anyone else ever get so tired from a shift that when they get home, they could fall asleep in the Porcelain-Clad Thinking Room?

Not that it ever happens to me or anything.

And does that mean "pooped" is etymologically a dual-meaning word?

Sunday, April 21, 2019

Assinus politicus - Assclown Of the Year



It has come as a rudely unpleasant shock to WA state senator and walking braindead jackhole Maureen  Moron Walsh [R - Retardia] that nurses do not, in fact, "play cards for a considerable amount of the day". Only someone who's never performed worthwhile labor in their adult life, and/or has a resting IQ in the low teens, somewhere just north of fungus, could managed to get both feet thusly inserted in their own gaping mouths, with their empty head simultaneously shoved so far up their own hindquarters so as to choke off the passage of light or oxygen. But it always cheers my heart when some elected functional moron's political turkey timer pops up to let us know they're done.

Someone on the Twaddleverse helpfully added her WA office number:
(360) 786-7630.
How cute. Have fun. Maybe you could invite Moron to a nice card game at your hospital shift.

I will personally pledge to contribute to every opponent she faces in her next primary, and every other party's candidate from opposing parties in the general election, the next time this sorry sack of sh*t is up for a vote. She needs to be kicked RTF out of the state house for being that egregiously stupid in public, and based on her speech, we're guessing this is one of her brighter and more coherent stupid utterances. The rest certainly have to sound like she's having a stroke, every time she squawks and squeals. If she has the good grace to quit now, quickly, I'll contribute a like amount to Alzheimer's research and money to care for actual retarded people.

Were I in WA state, I would be gathering signatures for her immediate recall, as being too stupid to suck air and a waste of skin has to be a disqualifying factor in holding office, even in a community like Walla Walla.

But in true form, the memes and Twittterlanche on her head have been properly brutal.
“Nurses … probably play cards for a considerable amount of the day” is in the running for most inane, indefensible, disgraceful thing said by a legislator this year (even though the competition is really fierce). — Ajai Dandekar (@ajai_dandekar) April 20, 2019
When world-class retards tell you you're retarded, YOU'RE REALLY RETARDED. - A.
















(And yes, I made that, but Kathy absolutely tweeted it.)

I'm also pretty sure Joy Behar ( "Why is she wearing a doctor's stethoscope?") could send along a few tips on coping with being the biggest jackass in America today to state senator Walsh.

More here.

I'll be dog-goned if I'm not piling on to this monumental level of stupidity.
















And a personal benediction to Sen. Moron Walsh:

Don't worry, Sh*t-For-Brains. No nurse would ever treat you like you just treated a few millions of us.
Or...would they?
Sleep tight. Take your vitamins.
And may God have mercy on you when (not if) you end up in a hospital needing care.
No one else will.
You might want to think about getting some gold-plated Costa Rican medical policy.
For the rest of your life.
And for pity's sake, do the world a favor: Change parties.
You're already overqualified to be a Democrat socialist, so by all means, run down and sign up today. You'll increase the IQ of both Republicans and Democrats in WA state the minute you do that.

But walk tall, sweetheart.
Earning Assclown of The Year honors in April has to be some sort of record, even for a politician who's overmatched by celery bunches at the grocery store in a contest of wits.

You might have thought someone who'd had a heart attack and gotten two cardiac stents a couple of years back would have been a wee bit more circumspect, but remember, this is a politician we're talking about, not someone with a functional brain, let alone one connected to their mouth.




















Jesus rose from the dead today. But, you, Bright Light, should invest in a shroud and a cemetery plot.
Hey...is that a fork sticking out of your back?
Yeah, you're done.

Tuesday, January 1, 2019

Year End/New Year's Ebola Update




















As multiple commenters elsewhere have observed, we've brought an M.D. exposed to Ebola in DRC, but asymptomatic and not contagious, back to Nebraska for observation.

Ok, fine, so far.

This is how it's supposed to work for everyone exposed, even TV spokeshole doctors and whiny Mimi Crybabypants "nurses" who think they should have the right to run hither and yon and hopefully not start infecting people when they pop a fever. Or not. Because they're special, and the sun shines out of their anuses, apparently. Contrary to quarantine policy and black-letter health laws going back 700 years.

Sending the guy to quarantine at Nebraska Medical Center is fine too, as it's home of one of the four BL-IV treatment centers with the 11 actual BL-IV beds extant in North America, should that become necessary, and their patient becomes symptomatic.

The gaping flaw in what they're doing is that they plan to observe Doctor Oopsie for two weeks - fourteen days.

But Ebola Virus Disease incubates for between 1 and 25+ days, NOT JUST 14 DAYS(!), and while 99% of cases appear in 25 days or less, 1% of cases don't show up until after 25 days.
(Another very small but non-zero percentage of persons exposed are asymptomatic, but may still carry the disease and be infectious without symptoms. Nobody is talking about that last part, either, because if you pretend it doesn't exist, you don't have to deal with it. Until you do.)

Geniuses in action, right there.













It will be cold comfort to anyone subsequently infected if they stop checking Dr. Oopsie on Day 15, and he doesn't become symptomatic, and thus infectious, until Day 18, or 23. Especially if he celebrates the end of his quarantine at the mall or movie theater, coughing out virus onto random passersby.

If you're going to half-ass a quarantine (and clearly, they ARE doing exactly that in this case), better to not do one at all, and just tell people to kiss their asses goodbye, because - EXACTLY LIKE IN 2014 - TPTB are playing roulette with the entire populace, because for them, that's more convenient.

Sleep tight.
And cross your fingers.

 
Oh, and that Congo outbreak itself?
 
As we warned, it's accelerating out of control, growing from 503 cases on 11/30 to 692 cases as of 12/21, a week ago. IOW, more new cases in the last 21 days than the total number of cases for the first ten weeks from August to mid-October.
The experimental vaccine is still, AFAIK, 100% effective, but the outbreak has blown through every containment ring like a brushfire in a gasoline-soaked forest.
 
Buckle up. 2019 is looking seriously fugly.
 
And that doctor is just the first case we're watching.
He won't be the last.

UPDATE:
And for those unwilling to follow this closely, bringing him here is not the problem.
Bringing back 12 or more symptomatic patients is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days ("You could look it up." - Casey Stengel), and that standard should apply yet again, in this case. Six weeks' surveillance, not two.
Anything less is rolling the dice, and we're all the chips in that wager.