Wednesday, May 11, 2011

Not the kind of bedrest I typically recommend

Yesterday morning I spent some time going over preoperative paperwork and instructions with a patient who was scheduled for an urgent surgery today.  The reality is that he would have had surgery yesterday, but thanks to Bayer's commercials and people having a need to self-medicate, he was taking an 81 mg Aspirin daily.  The surgery wasn't a life or death situation so holding off for a while to allow the anti-coagulation to wear off not only was in his best interest but also allowed his surgeon (read: my boss) to retain pigment in a few hairs.

After he signed all the releases I reminded him that the doctor wanted him to be on reduced activities and sleeping in a very specific - albeit a very uncomfortable - position. 

Krista:  "Do you have any other questions?"

Ron Jeremy Jr:  "Yes, is there any reason I should avoid having sex tonight?"

Krista:  "Sexual intercourse is typically very strenuous.  Your blood pressure will go up and with the specific positioning the doctor wants you to be in until your surgery time it wouldn't make intercourse very easy.  I'd strongly recommend against it."

RJ:  "Strongly recommend against it?  So that means it isn't forbidden?"

Krista:  "It isn't a good idea, but no it isn't strictly forbidden.  You ought to spend the night low key, fairly relaxed."

RJ:  "I never said I was going to be banging my head on the headboard, I just want to get laid."

Thursday, April 14, 2011

Not that kind of doctor...

Why do I love my patients?  Because they provide me with stories like this:

Recently I was in my office trying to put the patient education packets together on my ever decreasing (read: next to none) budget when the receptionist rushed in and shut the door.  Her face was bright red.  "You need to come out and speak to Mrs. AnimalLover.  Now."

When things get heated, when patients get irate and when any of the staff feel like they are going to flip on a patient, I get the S.O.S. call.  I don't know why, but handling the crazies seems to be my specialty.  "I'm running pretty far behind, is there anyway you can deal with her?"

"No, you MUST speak with her."

I walk into the waiting room where a long standing patient is at the front desk.  With her dog.  This isn't an assistance dog who is there to help her in any way, just your run of the mill small breed mutt.  I turned on the million-watt smile.  "Hi, Mrs. AnimalLover!  What can I help you with?"

"I brought Fluffy in for his exam, but this woman insists he can't be seen today."  She glared at our receptionist.  "I know he has an appointment today and he needs his shots updated.  I know I have the right day."

"I'm sure you do have the right day for his exam, Mrs. AnimalLover, but this is just the wrong office.  This isn't the doctor you bring your dog to, this is the office where you come for visits."

"It is?"  She suddenly looked around realizing that there were no animals nor animal paraphernalia in our office and, thankfully, we had an empty waiting room.  "Well, they should have let me know they moved their office!"

We've been in our office for several years and the veterinarian she is talking about has, according to the receptionist who has lived here her entire life, been in the same building for 20 years or more.  Umm, yeah.

Tuesday, April 5, 2011

The best laid plans...

By 6:20pm I had a delicious smelling chicken marsala simmering on the stove, garlic smashed redskin potatoes on the warming burner alongside almond green beans and a chocolate cream pie in the refrigerator.  A full ten minutes before Dan was supposed to arrive.

And then the phone rang.

"At what temperature is it reasonable to start freaking out over my daughter's fever?"  No greetings, no niceties, just thinly veiled panic.  Even though his question and tone made it crystal clear the date was off, I had to smile a little.  Dan in overprotective daddy mode was pretty damn cute.

"Why don't you start by telling me what's going on."  My potential girlfriend hat was set aside pretty quickly in favor of my nurse's hat. 

He listed her symptoms and they seemed pretty consistent with the same flu bug that had been going around.  Not a life-threatening emergency, but sick enough to concern someone who had only been a daddy for less than a year.  "You have two main priorities here: keep her hydrated and give her some Tylenol or Motrin to get the fever down."

"She hasn't kept any liquids down today.  All she did this morning is cry and now she's just laying in my arms with her head on my shoulder."  He wasn't covering the panic as well.  "I can't even get her to keep down the medicine.  Should I call her doctor?"

"Is her soft spot sunken in?  Is she still making tears when she cries?"

"I don't know."  There was a soft beep in the background.  "Krista, her temperature is 104.2"

Dating a single parent is tricky.  You don't want to insinuate yourself into the life of a child who has already had a parent leave until you know you're going to be around for a while.  But I know his situation.  His gem of an ex-wife bailed almost 9 months ago - a mere 2 months after their daughter was born - for another man across the country.  He doesn't have a support system and he sounded incredibly lost.  My inner Florence Nightengale took over.  "I'll be there in 15 minutes."

By 8:00pm we were pacing the ER, taking turns comforting his daughter.  She was showing signs of dehydration and wasn't keeping medication down long enough for it to have any effect on her fever.  Thankfully after a single dose of the Tylenol suppository, IV fluids and 6 hours in a cubicle her fever was under 100 and she was snoring in her carseat as we drove back to Dan's house.  No underlying UTI or ear infection, just the same nasty virus plaguing everyone.

He pulled in the garage and tried to remove his daughter from her carseat without waking her.  "I'm going to put her to bed... Can you hang out for a minute before you go?"


The next day I could remember sitting down on his couch and thinking it was almost sinfully comfortable.  I couldn't, however, remember being covered with a blanket.  I didn't recall Dan sitting next to me, putting his arm around my waist or my head on his chest, but that's how I woke up.

I couldn't have planned a better night.

Saturday, March 26, 2011

Textually Speaking

Don't stop, make it pop
DJ, blow my speakers up...

A little after 11:00pm last night my cell phone lights up and the sound of Heather Morris's take on the Ke$ha song makes me jump in the quiet of my office.

hey beautiful

I stared at the text for a few minutes before entering a reply.  If it had been from anyone other than Dan, I would have totally labeled it a booty call based solely on the time stamp.  The fact Dan was texting me from Europe made me a little more confident that he may be interested in more than just sex.  Well, that and the little issue of Dan seeming to be immune to my charm.

What's up? Absorbing all kinds of good food, culture and beautiful scenery while I sit alone in the frozen tundra?  I purposefully kept my reply light.

i heard that it has been in the 50's and 60's there

Lies.  You need to find more reliable sources.  I spent the whole day trying to dig out from under 6 feet of snow.  Humor is a good cover when you aren't sure what in the hell you are doing or where things are going.

funny the channel 4 website spelled snow as s-u-n

I've been foiled by the interwebz once again.  Damn those tubes!  I added a cute little smiley face to this message because I was smiling.  And this is why I like him; the rapport and easy conversation.

i miss you

I waffled on my response.  I haven't played this game for quite some time.  Is it time to guard my hand or show a couple of cards?  Be coy or be transparent?  Screw it.  I'm too old for the games.  I miss you too.

my plane comes in saturday night what are you doing?

Birthday party for son's best friend.  Besides you will need to recover from jet lag, not smart to go out.  Okay, so a bit of an exaggeration, the party is in the afternoon.  I could do an evening date, but it's still a little early to be that accommodating.

hell with jet lag i want to see you.  sunday?

He's never been this open and, while I appreciate guys who play things close to the vest, I like this turn of events.  I'll see his wager and raise him one.  Want to come over then?  I'll cook.

now that is an offer i cant refuse

I'll see you at six :-)

make it 5

Thursday, March 3, 2011

Oh well if your calendar says so...

A patient walks in to the office yesterday more than 2 hours early for their appointment.  In an effort to keep the peace in our waiting room, the receptionist called her to the front window to let her know she was there early in case they wanted to get the hell out of the office a bite to eat until their actual appointment time.

"I just wanted to let you know that your appointment isn't until 2:30.  If you want you can go out to eat or maybe do some shopping until then.  You're welcome to wait if you'd prefer, but there are other people scheduled ahead of you and I can't promise you'll be seen before that time."  She said all of this very politely and with her usual gentle demeanor.

"No, my appointment is at noon."  She didn't even pause before responding and had a little tone to her voice daring the receptionist to argue.

"I'm sorry, but that isn't possible.  We don't schedule anyone between 11:30 and 1:20 to allow enough time for the doctor to have lunch.  According to the schedule in the computer your appointment is for 2:30."

At this point the patient became more agitated.  "Listen here girl, I don't care what that thing says my appointment is, I wrote it on my calendar as noon and that is when I expect to be seen."

Irritated and slightly psycho patients are nothing new in the office and the receptionist has a fuse longer than anyone I know, so she let the patient sit back down and threw her chart into the mix to try to move her along as quickly as possible.

The office has a mostly open floor plan.  Even though there is a window and counter at the front desk, there is no way to block it off from the waiting room so everything said in the waiting room is easily overheard at the front desk.  Especially when the comments are being made by hearing impaired 87 year olds who think whispering is about the same volume as a chopper coming in to land.

Shortly after the receptionist sat back down, she overheard the patient complaining to the waiting room about "that girl" changing her appointment and lying about what was recorded in the schedule.  I believe the word "incompetent" was thrown around as well.

With grace and dignity our long-suffering receptionist quietly got up, grabbed the patient's chart from the circulation pile, stowed it away under her desk and went to lunch.

Friday, February 18, 2011

A helpful tutorial

There are times when being a total ass can pay off.

Being sugary sweet and nice can get you pretty far most of the time (or get you out of speeding tickets for doing 61 in a 35), but it doesn't always cut it.  Sometimes you need to be firm, stand your ground and argue your point to get the desired result.

There is one place this will never be the case and that is in my office.  With that in mind, here is a friendly guide for anyone who interacts with a doctor and his staff:

How NOT To Suck As A Patient

  • If you have been coming to this office since the dawn of time, for the love of all that is good on this earth please do not complain about the wait.  This ain't your first time at the rodeo, cowboy, buck up.
  • If this is your first appointment and the referring physician's office warned you that your visit would be 2 - 3 hours, don't complain about the wait.  You were warned, you were given other options and you still chose us because, well let's face it, we rock.  Our physician is brilliant and our staff kicks ass.  Period.
  • We work a finite number of hours.  We have a much broader schedule than most physicians, but we still can only schedule patients within hours X and Y.  If you asked to be scheduled at Z we reserve the right to bop you over the head with an inflatable bat.
  • Don't bitch.  
  • Google is a wonderful research tool.  Hell, I'm an RN with a decade of hands on experience and I just Dr. Google for a lot, but even in all his infinite wisdom he does not trump the physician who has nearly 2 decades of education under his belt or his RN who has the aforementioned assets.  Yes, I realize the information listed on all the websites you researched spoke of the drug we want to treat you with as a treatment for another disease, but trust me when we tell you that it is nothing short of miraculous for the disease you have.  Yes, it is an off-label treatment, but everything has to start somewhere.  Viagra started as a cardiac medication and look at it now.
  • Don't bitch at me and then turn on the charm for the doctor.  It is annoying and will earn you no prime appointment slots in the future.  I have untold amounts of power in that particular arena.
  • If you are married and notice that the faithful and caring RN who has been wonderful to you for several years is no longer wearing a wedding ring, it probably isn't a good idea to ask her if she wants to have an affair with you.  The answer is no.
  • If you are single and have hit on said nurse at every blessed appointment you have and it has not resulted in a date, bow out gracefully.  A sixth attempt will yield the same result.  I promise.  I know me.
  • Finally, don't bitch.  Just don't.

Friday, February 11, 2011

Those stupid fat, flying babies

It's that time of year.  The world is covered in shades of pink and red.  There are hearts and teddy bears lining all the store shelves.  There is enough chocolate circulating to send the entire population of Baltimore into a diabetic coma.  It's the time of year for loud declarations of love and whispered sweet nothings.

Anyone else as nauseous as I am?

To be honest, I've never been one to swoon over Valentine's Day.  I'm not saying that out of the cynicism of a divorcee, but out of a true dislike for a corporately engineered holiday that plays on the emotions of those in like lust love to guilt them into spending even more money to prove how much they love their significant other.  I firmly believe that if you truly adore someone you should show that person every day through words, actions and gifts. But I digress.

In spite of my general apathy for the holiday, there are a few people in my life that feel the need to take this opportunity to solidify their place in my life.  It appears I have been pulled into playing the part for this holiday.

Luke is still present on the periphery of things.  I must admit that when Dan entered the scene, I pushed Luke towards the end of the line because my feelings just weren't as strong.  Apparently my lack of undivided attention to him hasn't been a total deterrent as I was surprised with an early Valentine's gift today at work.  It was clever and unique.  And very endearing.  Luke officially charmed me with that one.

And Dan... he has become rather ambiguous.  In one way or another - be it text, talk or email - he touches base every day.  If we are sitting at a table together, he will lay his hand on mine and rub his thumb across the back of my knuckles.  He gives every indication that he likes me, but aside from a few kisses he has not made any attempt to take things farther.  He seems content to be a casual date and nothing more.  The problem is that I like him.  I don't know how long I can dig this casual thing.