Sunday, December 30, 2012

speaking of...

Oh hi. So I've had several half-done blog posts hanging around for, like, the last two months. I don't want anyone to get the wrong idea that I've grown tired of writing about myself, so now, in the midst of working 15 days (errr, nights) in a row with one day off, after working a particularly busy 7pm to 7am (errr, 8am) shift, while eating an obscene amount of Trader Joe's Thai Lime & Chili Cashews and drinking red wine, at 8:36am I have decided it is time to clean out the blog cobwebs.

Please pardon my grammar/formatting/whatever else you may find subpar and/or offensive. 

Speaking of Trader Joe's Thai Lime & Chili Cashews...

I think I have just entered into the Contemplation stage of what we in the biz call the "Stages of Change." No longer am I in denial that eating these delectable, multi-dimensional nuts with increasing frequency is causing me GI distress and my scrub pants to fit more tightly. But at the same time, thinking about "giving up [this] enjoyed behavior causes [me] to feel a [HUGE] sense of loss." I feel I may need to replace my beloved, comforting post-work snack with something a little lighter and less abrasive, but I am not quite ready yet. Whatever the replacement is, it will of course need to go well with boxed red wine. 

Speaking of change, I am hoping that by posting my blog cobwebs I will free myself to start posting other stuff on a more regular basis (probably still in Precontemplation on this front)...

The other night (and by "other night" I mean like two months ago) I hung out with a whole buncha nurses without even planning to (one thing I love about living in a smallish city is that there are only so many areas people congregate). At one bar it was people who work on my unit including my bosses (I clearly work in the right place), and at the other people I went to school with who work elsewhere in the hospital. Our conversation topics were as follows:

*Calling the attending physician at home on a weekend in the middle of the night because you suspect your patient's urinary catheter is clogged, and the doctors on the floor aren't taking you, new nurse, seriously, and it turns out your patient's urinary catheter had like a three-inch clog in the tubing gaaaaaaaaah.

*Whether Resident MD So-and-So is or is not a player.

*How frustrating it is when doctors keep throwing out aggressive, debilitating treatment options at 87-year-old patients with inoperable cancer.

*What to do when you see a former patient out in the wild, i.e., at the Urban Outfitters downtown. Answer? Wait for them to initiate, or, in my case, turn away from them hoping they didn't see you and will therefore not initiate even though said patient was one of your all-time favorites and you'd just love to say hello to her and chat about overpriced faux-vintage clothing and the recognition probably would have made her freaking day, that sweet, shy little soul. GAAAAAAAH.

*How kale was soooo 2011 and swiss chard is the official bitter green of 2012.

I've said this a million (or at least like five) times, but Mimi Smartypants is one of my favorite bloggers in the short history of blogs. While some bloggers have had me utterly captivated, reading two years worth of posts for eight hours nonstop (not exaggerating--I used to work in finance), they generally haven't stuck. I have been reading Mimi's old-school semi-weeklyish posts for almost ten years now and she always makes me snort/restores my faith in humanity. Her description of trying a particular blended kale beverage is worth a read: 
There was no love and no light. There was a bit of energy, if you count how I stayed grimly present-in-the-moment in between sips, sure that if I lost focus I would either vomit or throw the whole thing out the window.

During my downtime at work I like to read all the doctors' notes. They help me put my patients' current presentations into context (don't even get me started on the percentage who have been physically and/or sexually abused as children Jesus Effing Christ), and they introduce me to new medical terminology and phenomena I didn't have time to learn in two years of task-focused nursing school. For example, the rhythmic hypnopompic. According to Wikipedia, this is "the state of consciousness leading out of sleep" in which our "emotional and credulous dreaming cognition [is] trying to make sense of real world stolidity." Which I think basically equates to the time when I was around eight years old and I dreamed I acquired this awesome new Trapper Keeper with dolphins on it, and I woke up and for a second was all excited about my new Trapper Keeper and quickly had to come to terms with how I remained pitifully, un-hiply Trapper Keeper-less. (I freely admit to having just had to look up the words "credulous" and "stolidity" in order to come up with this example.)

colonic seepage - I think this one pretty much speaks for itself, but in case you need clarification: IF YOU TAKE TOO MUCH IBUPROFEN YOU WILL GET TINY HOLES IN YOUR INTESTINES AND YOUR POOP WILL LEAK OUT INTO YOUR ABDOMINAL CAVITY. Thank you, New York Times

snuff box - We've had a patient recently whose coping skills are unfortunately limited to punching walls and other forms of self/object-harm, and she had an injured snuff box. According to my old friend Wikipedia: "The anatomical snuff box is a triangular deepening on the radial, dorsal aspect of the hand--at the level of the carpal bones, specifically, the scaphoid and trapezium bones forming the floor." In other words, it's that little groove on the side of your wrist between your thumb bone and your thumb tendon. Back in the day, people used to inhale powdered tobacco from this groove. Neat! 

Here are some links, in case you are really looking to kill some time.

This is an article (with pictures!) about a guy who took photos of abandoned patient suitcases at an abandoned psych hospital, The Willard Asylum for the Chronic Insane in the Fingerlakes region of New York.

This is a roundup of ancient and modern Chinese architecture that really makes me miss the weird-ugly-stunning-depressing-beautiful-dirty over-the-top-ness (I really can't think of any more eloquent way to put it) of China.

My kind of art:
Big Appetites is a series of fine art photographs by artist Christopher Boffoli. The series presents tiny, meticulously detailed figures posed in real food environments, referencing both a cultural fascination with tiny things as well as an American enthusiasm for excess, especially in the realm of food.

And last but not least, some serious, moving sadness from someone famous for his 99% hilariously unserious Tweets.

Wednesday, December 12, 2012

fuckin' magnets

So I was all set to work on the post I've been "working" on for like the past two weeks, but something so awesome, so, uh, miraculous happened at work last night that I must share before anything else.

So I get to work last night and am reading though The Report Sheet and, under one new patient's updates is: "12/11: Insane Clown Posse is really a band."

Questioning of coworkers and reading of the patient's intake note revealed that doctors and nurses on the day of his admission thought he was delusional that he was a follower of some made-up "gang of clowns." In reality, the patient is a Juggalo, complete with ICP t-shirt and tattoos, and my coworkers had clearly not been spending much time on the internet in early 2010 when the Miracles video went viral.

The sad part is that the patient is, in fact, quite delusional and bizarre in other ways--his psychopathology just has nothing to do with his following of a band on a label called, wait for it, Psychopathic Records.

In other quirky patient news, we've recently had a sweet old chronic schizophrenic who is preoccupied with the drug Anacin, which he takes to "get wasted." The sad part of this story is that Anacin is a combination of aspirin and caffeine, so whenever he indulges, to the tune of 300 tabs per his report, he OD's on not only caffeine, but aspirin, which as you can probably imagine is toxic in large doses. I tried to do a little harm reduction teaching with him--"Next time you feel the urge, can you just, you know, go drink some coffee?" He stared blankly at me. I hope his discharge plan included a clause about having someone to keep him away from Rite Aid.