Wednesday, February 26, 2014

Head colds

I hate head colds.  You know what I'm talking about.  Your nose runs like a faucet with a slow leak.  Your head feels like someone is blowing a balloon up inside your face.  None of your thoughts seem to be clear and you have that nagging, tingling itch in the back of your sinuses that is driving you insane.

That is not an excuse to go to the ER.  Unless of course, you work in the ER.  Then it is not an excuse NOT to go to the ER.  Staffing for a shift is usually pretty tight anyway.  If one person calls in it usually means everyone else has to take an extra patient or two and when patient to nurse numbers go up, outcomes are pretty well correlated to go down.  We all know this.  So just try calling in to work with anything that doesn't involve needing to go to the ER, some other ER because you wouldn't willingly show up at your own (I fear they might create new and inventive ways to use catheters).  Sinusitis?  Bronchitis?  Ha.  We train to not get sick from contacting sick people.  The reverse is true as well.  Besides, as a traveler, I don't get PTO.  Don't work, don't eat. 

Usually you just slog around the nursing station like the zombie you are until you need to go into a patient room and then marshal all your energy so you can appear like a normal human while you work with the patient.  Wash your hands, wash your hands, wash your hands.  Then, as soon as you leave the room, you re-zombie and trudge about your business. 

Then they bring me a code stroke.

This is a patient that has developed symptoms of a stroke recently.  Like, within the last hour.  You see, if you have signs of a stroke, it is a race.  There is a medicine we can give you if you are having a certain type of stroke, but we can only give it to you if we can start it within around 4 hours of the onset of symptoms.  Later than that and the risk outweighs the reward.  The drug tPA essentially dissolves all blood clots and prevents new ones from forming for a period of time.  This can be detrimental to you, so the decision to use it is not taken lightly.

By the time the patient is in the room, they have been in the ED for 40 minutes or so, getting triaged and then taken to CT to rule out a bleeding stroke.  They want the medicine administered within 60 minutes of arrival.  The guy at triage has tried three times to get a line on the patient and failed, they are a hard stick.

So, there are 20 minutes to get two IV's started, administer a stroke scale, get the medication from pharmacy  and about a hundred other things.  Do you think anyone cares about that head cold?  Nope.

I got two lines in two sticks, we beat our target times and got the medicine in...with help from the stellar crew here.  Then I had to stay in the room with the patient for the next hour to make sure nothing more drastic than bleeding from those three missed IV's earlier happened.

So, I'm happy to have a couple of days off.  Head colds suck.

Sunday, February 23, 2014


We lived in Houston for ten years. We have a house here.  This is where we started's the place we left.

That should give you an idea of how we feel about the place.  We left for a reason. And every day, we are reminded in a hundred little ways of why we don't live here anymore. 

Miles outside of the city we started to dread everything.  The traffic built up.  The trees and ponds were replaced by strip malls and storage yards.  Flowers were replaced by plastic bags.  Even the prettier places, and there are a few, are all landscaped and designed.  They are the golf courses and wealthier neighborhoods.  I don't really like those personally, I prefer a wilder beauty. 

So I decided to do a little cathartic photo essay of why I don't like Houston.  I keep forgetting my camera when I go out though.  Seems like my motivation is to capture beautiful scenery and not the ugly stuff.  I think it would make an interesting project and still want to do it.  Since I keep forgetting my camera, I used my cell phone.  Not the best, but it will have to do for now.

Houston hates trees.  Houston kills trees all the time.

See, more dead trees with a tank of flammable liquids to finish them off.  Probably so they can put in another strip mall or dollar store.

Because we take such great pride in the beautiful strip malls and dollar stores we already have. 

Why is there a path in the middle median and not the side?  This is the panhandler path.  Back and forth.
Still, we come back.


Papa helping Michael with math homework.
Because this stuff can be priceless.