Man bites dog - dog bites back

A busy day again ,  and whilst briefly checking the triage list , I saw the statement about the self administered lethal injection.

Out-standing...the patients aren't even waiting for me to kill them now....
I immediately called the patient through to the Resus Room.

"Good evening...what's going on then?"

Well...what it is...obviously...I'm a veterinary nurse...

"Yersss.....?"

And I was putting a dog to sleep this afternoon...

"Yersss.....?"

And as I stuck the needle in his neck he moved...

"Yersss.....?"

And I injected the lethal drug into my thumb...

"Right...how much did you inject?"

I don't know...

"Whats the name of the drug?"

I don't know...

"Whats the active ingredient in the drug?"

I don't know...

"Did you bring the syringe in  with you?"

No...

"Did you bring the box that the drug came in, in  with you?"

No...

"Did you bring the package insert about the drug , in with you?"

No...

"Okay....can you please phone the vet and find out the name of the drug?"

No...we're closed now ...
...this happened at 2:30 this afternoon and my boss  said I could only go to A&E when we closed 'cos we were too busy...
...so we're closed now, aren't we...
...that's why I've come in....
...only the emergency vet is open now...
...its after nine you know...?...she replied smugly.

"Okay....can you please phone  the emergency  vet and try and  find out the name of the drug?"

Do I have too...?

"Well...its difficult to treat you if I don't know what to treat..."


She did.
She found out the name of the drug.

Since she really only had sustained  a needle stick injury...
...and the toxic dose was 4mgs / kg...
...and the syringe only contained 5mgs....
...and she weighed about 120 kgs...
...I decided she was probably safe.

And when the staff at the Poison Information Centre stopped laughing I sent her home.

Is it Venus or her cyster ?

Late at night and I was trying to clear the back log of patients from the list as my colleagues seemed set on spending most of their time talking about the Christmas party...when they weren't taking turns to go outside to smoke.

"What's this one ?",  I asked Mrs Challiot, the triage nurse  as I picked the next admission form out of the in-tray. 

"is it a quickie, or something that needs an x-ray?"

Uhmmm...she peered at the form...oh no...you can't see her...

"Why not?"

Well I think she  needs to see a female nurse...

"Uh huh...why?"

Well...shes walking funny...and I think  she has a Botticelli thingy...

"What exactly is a 'Botticelli thingy' ?"

You know...that abscess that women get ...

...and then she pointed at the ground and whispered...

...down there...

"What...her feet?"

(And the Oscar for Best Devils Advocate goes to...)

No...

...again in a whisper...

...her 'lady parts'...

Now look , in one guise or another I've probably seen more than my fair share of "lady parts"...

...and to be fair, I've never seen 'lady parts' that I didn't like...

...personally that is...

...those I have had to see professionally  tend to just make me remain a vegetarian...

...but even in a drunken lustful state , I am unlikely ever to describe them as like anything painted by Botticelli.

A bag of chopped liver maybe.

A toasted ham-and-cheese sandwich maybe.

A tuna fish-mayo wrap maybe.

A chill tamale maybe.

But not an oil painting.

*sigh*

"Do you mean a Bartholin's cyst?"

Oh...yes...that's what I mean.

"Pass"

Q & A

The patent was a 78 year old woman who was feeling generally unwell...

"Right...so when did the headache start?"

Just after I moved into my new flat...

"Okay...when was that ?"

Just after I left my three-bedroomed house...

"Okay...when was THAT ?"

Well after the left total hip replacement...

She couldn't manage the stairs, said her companion a dapper looking gentleman holding her bag and coat.

Yes...I couldn't manage the stairs...

"Okaaaaaay then....when was THAT ?"

Well...about 2 months after my husband died...

He was a lovely man...

...he was my best friend for years...

...its an honour to be dating his wife now...said her companion...her 80 yr old boyfriend

Oh....he was the love of my life...

And then she started to cry.

Oy.

"Please...have a tissue....I'm sorry about the death of your husband...but when did he die ?"

Oh about seven years ago now...

Oy vey.

"So you've had a headache for seven years then ?"

No...only since I started the anti depressants last week...

...but the problem started seven years ago when my husband died.

By the way...I've seen you before...

"Uh huh..."

But your hair was darker...did you used to colour it...?

"Jah...I used to colour my hair but I decided to stop a few months ago..."

Oh...well the grey makes you look older...

Ahhh...what a sweet old lady...

Don't you just want to poison her...

A pain in the assssprin

Saturday afternoon...and 3 days after her car crash...and after a morning spent shopping...my patient thought she would "pop in to see someone" about the pain in her back.

"Have you taken any analgesia...?"

What does that mean?

"Have you taken any pain tablets...?"

Yerss...

"What have you taken then...?"

The tablets in the white box...

"What white box...?"

The one you get from the supermarket...

"Which  ones that you get from the supermarket...?"

The ones that cost 49 pence a box...!

She looked at me like I was stupid.

I returned the compliment.

Footloose and fancy free

"Mrs Amazon?"

A tall ,well dressed, well built and middle aged woman (who looked like she had played rugby for England...and possibly as a male), and started to lever herself out of the chair she had been sitting in...

...first she grabbed hold of the arms of the chair and pushed herself upwards,a few inches off of the seat...

...then she ordered her husband to stand in front of her...and grabbed hold of the lapels of his expensive looking tweed jacket...and pulled herself completely upright using his bony body as a ladder.

From 4m away , at the doorway leading from the consulting area to the waiting room,I could see her right ankle was swollen and bruised and deformed...and that she was reluctant to weight bear through the foot.

She started to hobble slowly towards me,grimacing in pain,clutching hold of her desperate looking husband.

I thought I should be kind...to her husband...

...he looked like he had just been through a famine...she looked like she had caused it.

Also...I had just asked Julian to put my 'M&S Beef and red wine casserole' into the microwave....I only had 4 minutes to see the lady.

"Would you like a wheel chair Ma'am...?"

No...she snapped...I don't need a wheelchair...I managed to get myself here all the way from London you know...

(Some 110 miles away...)

"Did you *walk* from London...?"

Oh...ummh...no...we drove...

Mrs Amazon looked at her Lunch (ticket).

He looked back at her.

The other patients started to snigger.

"Please get into the wheelchair then..."

The ankle was broken.

Divorce is a four-letter word

We take a social history as part of the therapeutic relationship to "promote" 'concordance'…to make sure that you are 'safe' when you leave my care…that you have some support if you need it…that we can keep you at work, in your job, earning a living…

…and also to try and gauge how thick you are so we can pitch the conversation and discharge information accordingly…

The patient was a 67 year old man who had fallen off of a kitchen chair whilst painting the ceiling.

“So…what work do you do then Sir?”

I’m retired mate…

“Okay…what sort of work did you do before you retired then?”

Oh…I was a painter-and-decorator…

“Okay…are you married…do you live with anyone…?”

No I’m divorced…

“Oaky…do you live alone then?” ...(thinking of his dodgy knee and the help he might need.)

No mate…I have a room in my ex-wifes house…I’m very comfortable there…

“Okay…so is that the same house that you lived in when you were married then?”

Yes…she got the house in the divorce didn’t she…

“Oaky…so you’re divorced but sharing a house with your ex wife…?”

Yes…

“You paid the bulk of the mortgage and yet you’re renting the back bedroom…?”

Yes…

“And you were on a chair painting the kitchen ceiling…?”

Yes…

“So how is this any different from being married to her then…?”

Well…we don’t have any sex…

“Well…not to be rude..but how much were you having anyway,when you were married…?”

Not much really….which is why I had the affair…

“So…she got the gold mine…and you got the shaft…”

The call of the wild

The patient was a middle aged woman,from one of the many housing estates that completely surround our Unit.

Indeed I often feel like I am working in Precinct 13

"Good morning...what can I do for you today then?"

She held out her right index finger.

Apart from it being heavily nicotine stained,I couldn't really see much wrong with it.

"Uh...whats wrong with your finger...?"

Its bitten,innit ?

I couldn't see an actual wound or obvious bite of any sort.

"Uh...what happened?"

We wuz trying to catch a mice...and it bit me...

"Uh...you were trying to catch a mouse then?"

No...a mice....there were only one of them...

*sigh*

So much for not breaking my diet at work today, then.

Crackers

"So...is you daughter allergic to any medicines?"

Ummhh...no

"Okay...."

Ummh...but we think she might be allergic to blue cheese...so we don't give her penicillin...

*Sigh*

Neal's Yard Diary is one of the very best places to buy cheese if you are in London,specifically in Covent Garden or Borough Market.

Ophelia Cheese Wedding cake

And finecheese.co.uk is one of the best online cheese shops...their hampers are stunning and the cheese makes you weep with joy and sigh with pleasure.

And...yes...this is a nursing blog but I'm allowed to diversify...

Crazy comments

And the top three weird comments to me today were:-

Mother to her teenage daughter:-

You’ve been a pain in the arse since the moment you were conceived.

So exactly *how* did that conception work then?

Mother of son with broken arm, to me:-

…well I'm glad it’s broken and that I haven’t wasted three hours sitting here for nothing.

Well you could have helped me complete the Social Services referral.

Distraught young woman who has seen every health care provider in town,to me,at 0805 :-

I've been unwell for 11 months...and you are my last resort.

No....Sun City is the last resort.

Biology 101

One of the cleaners wanted some information about her health....

So...you know I've been having all this tummy pain....?

"Yes..."

So...I saw my doctor...and it turns out that I have a cyst on my left ovary...

"Okay..."

And he wants to take out my ovary....

"Okay..."

So....I was just wondering...if I only have one ovary left...does that mean that I will only have a period every two months...?

"No..."

*sigh*

The picture of Dorian Grey...not!

Saturday afternoon was pleasant...to the extent that at one stage there were no patients to be seen and we were all sitting around the nursing station,having a cup of tea.

So is it true,-asked SimplySomerset,the new Health Care Support Worker-,that you cannot give blood to a Jehovah's Witness?

"Yes....its true..."

Oh! That's strange...

"Well...its what they believe...of course,in life threatening emergencies with children, hospitals usually get a court order to give the blood..."

Oh...do you know anybody who is a Jehovah's Witness?

"Ja...in fact my hairdresser is a 'Witness' ...do you know that they also do not celebrate birthdays...?"

No....really...??

She looked bemused.

Do you mean that they don't get older then...?

"Well...of course they get older..."

The S&M Queen snorted her tea.

UglyJulie had to walk away.

But then...how do they know how old they are...?

"Well...the same way we all do...subtract your birth year from the current year..."

"Perhaps you could go and clean something now?"

So now my colleagues are a rich source of craziness!!

Stand well clear...

A very busy Sunday...with a 3 hour wait to be seen for most patients for most of the day.

The lady...just before lunch...was hugely obese...and was 63.She looked 20 years older and walked in using 2 sticks and a son-in-law.

She had cellulitis to her left calf.

The clinical history conversation went like this...

"Okay...so just to recap then...you are diabetic...hypertensive...have COPD and a thyroid problem...anything else?"

Well....ummh...theres my colostomy...

"Oh...okay...why do you have a colostomy then?"

I don't know...the surgeon said my guts just exploded and my insides were all covered in sh*t!

"Good news ma'am....I think you're going to have a disease named after you."

Open wide...

"Good afternoon...what can I do for you today?"

I have a sore throat...

"Uh huh...how long has it been sore?"

About 4 years...

"I beg your pardon...4 years?"

Well...what it is...I had tonsillitis 4 years ago...and its come back...

"No...no,it hasn't come back...if you have got tonsillitis today then its a new and different infection..."

Are you sure...?

"Ma'am....your kebab from last night may come back if you drink enough...bell bottoms may come back...herpes will definitely come back...and inexplicably,even the Labour Party keeps making a comeback...

...but honestly...your strep throat from 4 years ago...has...not....come...back!"

And so I examined her...and indeed she had a full blown,foul breathed,bilateral follicular tonsillitis...and I gave her the Penicillin V 500mgs QID that we use here.

I heard her tell her husband as they left the Unit...

You see...he were wrong...I told him I had tonsillitis from 4 years ago....!!

It sometimes feel like Earth is the insane asylum for the Universe...and my Unit is the waiting room!

Be careful what you wish for...

She was a small shabbily dressed woman who I had seen sitting on the kerb outside the Unit when I got to work at 0730 yesterday,smoking a home-made roll-up cigarette.

She looked terminally tired...as if the 'slings and arrows of outrageous fortune' had all landed upon her in the last few years,her shoulders slumped,her face marked with the vicissitudes of poverty and loneliness.

"So...do you have any medical problems then ?"

I have asthma...

"Do you take any medicines for the asthma ?"

Well...I take ventolin...the blue pump

...and...

...umhh...cyanide?

Sex in this City

So there I was in my consulting room,with a 14 year old girl -who is the patient-,and her mother.
They are both chewing gum and are both displaying more flesh than I would hope for just before lunch.

The girl has a really bad strep throat,fulfills all the criteria for antibiotics, and so I am about to give her a course of Penicillin.

She is however,-and although she is only 14-,already on the oral contraceptive Pill.

Now there is a lot of debate about the possibility of adverse interactions between antibiotics and the Pill,where basically,its thought that the antibiotics could stop the Pill from being effective and working properly.
Some say there is no effect;some say there is an interaction.

In our Unit,in our Health Authority Area,and given the problems attendant to an unsought pregnancy,we tend to err on the side of caution...

"Right...here are the antibiotics I would like you to take for the next seven days...now...just to advise you...you may not be covered by your Pill for the rest of this cycle...and all of the next cycle...Okay?"

What do you mean...I won't be covered?

Yeah...what do you mean?? says the alleged mother

"Well...its thought that the Penicillin can stop the Pill from working properly...so if you are going to have sexual relations with someone else,then you need to use an alternate means of birth control...Okay?"

What do you mean...'alternate'?

"Well...a condom..."

Well I don't like using condoms...and my partner doesn't like them either...!

(Her 'partner'...?)

Yeah...she doesn't like using condoms!!

So what am I supposed to do then...huh??

"Well...perhaps you could just pretend you are actually 14 years old and NOT have sex for six weeks...how does that sound...?"

But its the holidays!!

Yeah...its the holidays!!

"Gosh...aren't you a little 'black-hole of need'..."

"Okay...here's a phone number for you...its the Chaplain...phone him and see if he cares...have a nice day now...somewhere else."

I'll have whatever he's eating...

The next patient was complaining that he had "explosive diarrhoea"...no vomiting...didn't feel unwell...and had no other problems.

Well...no other problems that couldn't be solved with a refreshing shower...and a change of underwear and socks. I thought these people had indoor plumbing...was he squatting over a hole in the floor?

Well...what it is...obviously...I've had this diarrhoea all day...really burning my arse !

"Right...and do you have any idea what might have caused it ? Do you have IBS or diverticulitis...any thing like that?"

No...what it was...I had some friends around to watch the match...and we had some beers and some nacho chips....

"Yerrrrrrss?"

Well...the only dip I had was a jar of Guatemala that I found at the back of the fridge...and it had a bit of fungus on the top...but...you know...I thought that the chili in the Guatemala would kill the fungus...

"Right. You had a jar of Guatemala in the fridge...do you mean Guacamole ?"

No mate Guatemala...you know...the green dip...made from abomonocados

"Right...Okay...thats as opposed to 'Guacamole' the charming and mountainous central American country ?"

Yerr!

Don't let your mind wander Sir... it's too small to be let out on its own.

I'm sorry...can you say that again?

The top five rhetorical questions asked by staff to patients in our Unit so far this year are:-

1. So... have you taken any medicines for the pain ?

2. So...have you given your child any medicine for the temperature ?

3. So...did you try and cool the burn down ?

4. So...do all your children have different father's then ?

5. So...are your child's vaccinations and inoculations up to date ?


With this question edging very closely into sixth place :-

6. So...do you really think that I don't know you're lying ?

Young man , very small problem

I think my penis has got gangrene!

"Yes...well...thats certainly a painful looking sore there..ummhh...okay...well it doesn't look like a chancre..."

Yer wot ? Did you just call me a wanker !?!

(I should explain for non-British readers that 'wanker' is a pejorative term)
(I should explain for British readers that 'pejorative' means "a disparaging or belittling word or expression")

"I didn't call you anything Sir...I said that the sore doesn't look like a chancre...a sore that you get when you have syphilis..."

I've never dated anyone called Syphilis!!!

"Well that's because its a sexually transmitted disease..."

Oh...

"Have you ever had a sexually-transmitted-disease ?"

No...my girlfriend takes the Pill doesn't she...

"Yes...well...that only stops her getting pregnant...it doesn't stop you,-or her-,from picking up an STD"

"Tell me...are you in a monogamous relationship ?"

Yer wot ...you telling me you fink I'm a homo ?!?

(Buddy , you're barely Homo Erectus)
(Despite what a stud you think you are!!!)

"NO...calm down...'monogamous' means that you are only in a relationship with one person...only sleeping with one person"

Oh...okay...well yerh...I suppose I am then...

So...do you think my c*ck is going to fall off then ?

(I wish!)