Orthette

Define "Race Card", then...

2008-12-31T08:44:00.004-06:00

From the Chicago Tribune's Rick Pearson:

A day after making racially charged remarks warning critics of Roland Burris's appointment to the U.S. Senate to "not hang or lynch the appointee as you try to castigate" disgraced Gov. Rod Blagojevich, U.S. Rep. Bobby Rush said today that senators "don't want to see themselves in the same position" as George Wallace, Bull Connor and others who promoted segregation in the Civil Rights era".

Burris, appearing this morning on WGN-TV, defended Rush's comments and denied the South Side congressman -- whom Burris invited to yesterday's U.S. Senate announcement--was playing racial politics.

Rush, Burris said, was just relating "facts and not playing the race card and not being emotional about it."

Well, they're refusing to seat the guy, as he was appointed by Blago, who's about as white as wonder bread. And they said they wouldn't seat any Blago appointed well before he named Burris.
So, if it goes to a general election, will the entire population of Illinois be "racist" if we don't elect Burris?
Considering Obama has issued a statement saying he does not support Burris' appointment, apparently he's racist too. Maybe Bobby Rush can start calling him "Bull Connor Obama".

Link to the Trib:
http://www.chicagobreakingnews.com/2008/12/bobby-rush-to-critics-take-a-chill-pill.html

SNL vs. Blago's hair

2008-12-14T14:57:00.000-06:00

"volumes" vs. "utilization"

2008-12-14T01:54:00.002-06:00

Every Thursday is inservice day. This means that most Thursday mornings, I get to nosh and sit in a comfy chair while the educator points out the features of a new and exciting device (that we have to buy 100 of, even though a newer and excitinger device will be out in a month). Occasionally someone, maybe the safety officer, gets up and mumbles something to the effect of "public health and JCAHO will be here soon so quit wearing all your jewelry, you look like Mr T. fer chrissakes".
This last Thursday, the manager got up and informed us that the administration is upset because "our numbers are down". Much confusion immediately manifested. "Whatthefuh, we're all pulling 8 hours a week of OT, we're all staying late 3 times a week, what are they complaining about?"
Our brilliant administrators:
1. Are phasing out our minor (mainly eye) surgeries, and phasing the surgeries in at other hospitals in the chain.
2. Are having surgeons schedule more and more whipples, which are 5-6 hour cases. They hired a surgeon for chief of surgery that promised to make our hospital the whipple capital of the state.
3. Have brought on Slow and Slower, the ENT/Neuro combo trying to do transnasal brain surgery without training in the technique (wherever else it's done) first.
4. Want our hospital to be a spine hospital. Ortho spine: moderately fast.
Neuro spine: never fast.
As the whipples come in, the easier surgeries (like gallbladder removals) are increasingly sent out to other hospitals in our chain instead. But the administration is concerned that we "aren't doing as many cases" as we did last year. News flash: If you take out all of our short cases, and replace them with mind-numbingly long ones, we can't do as many. Duhr!
The manager has tried to explain utilization (high!) vs case volume(low!), but it's falling on deaf ears. It seems so simple to the nurses, it's hard to believe the MBA's can't get it.

PengWIN, seen on failblog:

2008-12-09T20:16:00.001-06:00

Pricey wheels

2008-12-05T21:31:00.002-06:00

I loves me some 2-wheeled machines. I've taken to scooters lately, on account of the ease of using an automatic transmission in nasty Chi-town stop-n-go-n-stop-some-more traffic. I recently saw that Honda was bringing out an automatic transmission motorcycle that they had also introduced overseas. A bigger scooter, honestly. I thought it was arse-ugly, but the idea of a city bike that I could take on road trips out-of-state had it's appeal... Until I saw the price tag. $14,599. For a freakin mega-scooter.
Um, thanks, Honda, but at that price, I can buy an automatic-transmission _car_.
For fun, google the "DN-01" and boggle at the unfortunate combo of sportbike and chopper styling. Ugh.

Rickrolled FTW!

2008-11-28T22:23:00.003-06:00

The Macys Thanksgiving Parade gets rickrolled. Heh.
I don't know if this signals the end of the rickroll phenomenon, but I imagine it's close.

If.

2008-11-25T22:30:00.007-06:00

If:
A. You are a rep from an ortho company, and if

B. you are here because of your company's failed implant, and if

C. you have brought in 20 trays to go with the three I use, and if

D. you are whining while the patient's blood pressure is 58/40, and if

E. you are whining while the patient has no radial pulse, and if

F. you are complaining that the circulator is ignoring you while she tries to get the patient's positioning equipment away from the abdomen where it's pressing hard enough to stimulate the vagal nerve, and if

G. you are still complaining after the abdominal positioner is removed and the BP is now in the 200's and the patient still has no radial pulse, and if

H. all your complaining is because you don't think the extra back table in the hallway is big enough for the scrub nurse to put six trays on, and if

I. you're calling the circulator offensive names and inferring that she's harming her patient as she ignores your whining,

you should be subjected to bilateral orchiectomy via bolt cutter. But I'm gonna be satisfied with barring you from the corporation's properties. That includes all those ortho-specific hospitals, asshat...

Another religion rant

2008-11-25T21:06:00.004-06:00

Catholic Cardinal Frank Stafford is aghast at the election of Barack Obama. Possibly someone should tell him the guy's name is Barry O'Bama and see if he calms the f**k down.
From Slate:
"Cardinal Frank Stafford almost sounded like one of those people who thinks Obama is the Antichrist, referring to the president-elect as 'apocalyptic.' Stafford told his audience, 'For the next few years, Gethsemane will not be marginal,' comparing Christ's agony in the garden to the suffering of Catholics under Obama. 'On Nov. 4, 2008,' he added, 'America suffered a cultural earthquake.'
Stafford is apparently concerned about the fact that Catholic healthcare providers may be forced to refer people seeking sterilization and/or abortion of a non-viable fetus to other people providing those services, under the Freedom of Choice Act. They would not be required to provide those services, just to advise people seeking them as to where to go. (I think refusing to provide vasectomies and tubal ligation is counter-productive if you're trying to stop abortions, but then I'm not papally infalible like some guys are.)
Not mentioned by any Catholic Bishops lately: the 10 million abortions in India in the last 20 years by families desperate for a son instead of a daughter. Too bad the church couldn't have spent some of those millions they spent on Prop 8 on saving young babies and abused women instead.

http://www.guardian.co.uk/world/2008/nov/23/india-gender

Someone else's oombacat.

2008-11-19T21:16:00.001-06:00

It's posted everywhere already... But dang, it's funny.

Cue the World's Smallest Violins

2008-11-09T07:39:00.002-06:00

The Mormon Church is feeling very, very picked on by gay couples protesting outside it's temples. An excerpt from the LDS website:

"It is disturbing that The Church of Jesus Christ of Latter-day Saints is being singled out for speaking up as part of its democratic right in a free election."

Hey, the Mormon church singled out anti-gay legislation for 20 million in donations. Gay protesters are just returning the favor. And to be honest, they're protesting outside Catholic churches out there also.

"...it is wrong to target the Church and its sacred places of worship for being part of the democratic process."

It's wrong to target a group? Really? Are you sure?

Cardinal Roger Mahoney of LA also complained about having protesters outside the Catholic Church.
The anti-gay campaign spent somewhere in the neighborhood of $30 million on various media attacks on gay people featuring slippery slope arguments and blatantly untrue statements. Maybe they should read Ezekiel... Ya know, where it mentions that Sodom gave no aid to the poor and needy, and rather became haughty. (In case they're wondering how God views spending $30 mil on pushing an anti-gay legislation, versus spending $30 mil to help feed the poor.)

Gonna do a Transphenoidal?

2008-11-07T22:11:00.005-06:00

We have a neuro-surgeon who is painfully, painfully slow. We have an ENT surgeon who is painfully, painfully slow. They've decided to form a slow surgeon alliance and work together. Arrrrrgggh.
(painfully slow = >8 hours per case)
Anyhoo, nurses are not to sit down during these cases. Most of the time the surgeons stand for cases, sometimes on the ENT and neuro services, the surgeons sit while they're working. Fine by me if the surgeon's sitting, you don't want someone who's picking at a patient's brain getting tired and sore. The argument against the nurse sitting is that the lower part of the scrub gown could ride up and contaminate the chest and arm area (which is considered "sterile"). There's not really any research to support that, but scrub nurses will stand the whole time if it's potentially in the best interest of the patient.
I am going somewhere with this post. When you are the scrub nurse for a long procedure, like a transphenoidal (a brain surgery performed through the nose and sphenoid sinus), you're standing on a concrete floor. If you're working a ten hour shift, and you have a long sinus/brain surgery performed by Slow and Slower, sucks to be you, cuz your knees will _hurt_ at the end of the shift. So when I saw this on CNN, I started wondering... It looks like it could be somewhat uncomfortable with that "saddle", but maybe something like this under the gown could make life a lot more comfy for the OR someday.

http://www.cnn.com/2008/TECH/11/07/robotic.walker.ap/index.html

What is it and can I have one?

2008-11-07T20:33:00.006-06:00

So I'm all over the place with posting. I saw this on a couple of sites, and fell in love. I don't have a clue if it's even street legal... Just, um, EPIC WANT.
This pic is from Visor Down, an interesting UK cycle site.

http://www.visordown.com/motorcyclenews/view/milan_2009_aprilia_mana_x/5879.html

The picture was taken at a European bike show called EICMA (?). Apparently at the European bike shows, manufacturers bring out their concept bikes (and scooters too). Sounds a lot better than the "Cycle World" bike shows where you wind up paying thirty-five bucks for parking and admission, only to find out you're just seeing the bikes that were sitting at your local dealer two days ago.

heee.

2008-11-05T21:06:00.000-06:00

I don't necessarily agree, but it's funny as hell.

Obama Win Causes Obsessive Supporters To Realize How Empty Their Lives Are

Orthette's new word of the day

2008-11-05T12:05:00.003-06:00

Homelesque:
Not actually homeless, as evidenced by the cell phone you're texting on and the messenger bag you're carrying. But you choose to go for the "look" (and the "smell"!) with the layers of nasty, layered, unlaundered clothing and lack of hygiene. That's your choice, but if you get as close to me on the el as ya did to the poor woman next to me, expect an "accidental" knee to the privates as the train goes around a sharp turn.

And another thing...

2008-11-05T10:44:00.003-06:00

The rally was inspiring.
If you were watching on TV, you probably didn't see everything that happened between McCain's Speech and Obama's speech.
After McCain's speech...
A. A bishop came out and said a prayer.
B. A political leader led the crowd in the Pledge of Allegiance.
C. A singer came out and sang the national anthem.
D. Lots of music got played on the PA, including a lot of country. (?)

As for letter C: If you are a singer that's a native born, fiftyish American, and you're going to sing the "Star-Spangled Banner" in front of 200,000 people and on some national TV channels, learn the words. Learn ALL of the flippin' words. And don't try to show off your damn voice on the parts you do know after you screw up the first part because it makes you sound like a bigger nitwit.

Mixed Bag

2008-11-05T09:35:00.013-06:00

So...

Anti-gay initiatives passed in Arizona, California, and Florida. Florida's initiative was especially vile as the law also banned recognition of civil unions. In Arkansas, voters banned adoption by gay couples, or any unmarried couple. Better to have kids in state custody than with loving gay parents, apparently.

And yet, the night was not a loss.

"It's the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Hispanic, Asian, Native American, gay, straight, disabled and not disabled. Americans who sent a message to the world that we have never been just a collection of individuals or a collection of red states and blue states."

Having had a president for the last eight years who won his position by rallying his right-wing "family values" extremists against gay, American, tax-paying citizens, hearing this in a victory speech was amazing. The two guys next to me were holding hands, and as he said this on the stage, we all went into a bit of shock.

I don't know if there will be a national civil union bill. I don't believe that Obama will pursue a Gay Marriage bill. I think all politicians are afraid of the toxic effect that a Gay Marriage bill would have on their careers.

I do wonder about what the Republicans will do next. As another blogger has noted, McCain worked very hard to energize the Timothy McVeigh crowd. Many Republicans were either attracted or repulsed by Sarah Palin. I don't know if the Republicans who found her to be extremist will join the Democrats, or if there will be a schism in the Republican party. (They could apparently have a Republican party for the moderates and a Joseph McCarthy party for the extremists.) I did really wonder while we watched the concession speech, listening the the shouted sentiments of the McCain supporters. Apparently the McCain supporters leaving the rally were telling the reporters that Obama is a "Muslim and a Black Panther".

Must have been on teh internets.

(And senator Ted Stevens, Senator "The internet is a series of tubes" Stevens, was re-elected. Yeesh. Enough from the Republicans about corrupt Democrats, then.

http://www.youtube.com/watch?v=EtOoQFa5ug8

Heeheehee

2008-10-22T18:56:00.002-05:00

A link to an article by british car critic Jeremy Clarkson...
I saw this first on 2strokebuzz, where an excerpt was posted:

"However, many people are making the switch because they imagine that having a small motorcycle will be cheap. It isn’t. Sure, the 125cc Vespa I tried can be bought for £3,499, but then you will need a helmet (£300), a jacket (£500), some Freddie Mercury trousers (£100), shoes (£130), a pair of Kevlar gloves (£90), a coffin (£1,000), a headstone (£750), a cremation (£380) and flowers in the church (£200)."

http://www.timesonline.co.uk/tol/driving/jeremy_clarkson/article4963194.ece

Infiltration

2008-10-21T07:12:00.005-05:00

I vaguely remember hearing something about Drug X* in nursing school. (After 6 years in the OR, most of nursing school seems like a pretty distant memory.) So when I had a physician get paged in the OR about a Drug X* infiltration, I thought, "Oh, that might be a bad thing. Hmm". We all kind of looked at each other and asked how bad the reaction would be. The anesthetist jumped on her computer and googled it... Apparently, it's so toxic that infiltration has led to digital amputations. The surgeon got his resident to go see the patient and get the case on the OR's schedule as an emergency, and he did the surgery as his next case.
Things about Drug X* infiltration:
A. Blisters. Big ,ugly, golf-ball sized blisters.
B. There's no drug/chemical antidote for it.
C. If you have a patient with a Drug X* infiltration at your hospital, you can apparently ship them to my hospital to get surgery/treatment, using the excuse "He had neurosurgery there once, several years ago."

I shudder every time I hear that drug ordered now.
*Drug X is an anti-emetic. That's all I'm gonna say.

Allergic, as in cannot be exposed to...

2008-10-16T23:58:00.003-05:00

Orthette waits as Dr. Whinemaster wanders in from the scrub sink.
Orthette gowns Dr. Whinemaster and reaches for the gloves.
Dr. Whinemaster: "What are those? Those aren't my gloves!"
Orthette: "Your patient is latex allergic. You need latex free gloves."
Dr. Whinemaster: "I want my gloves!"
Orthette: "These are nitrile gloves. Your normal gloves are powdered latex, which could cause a nasty reaction in the wound."
Dr. Whinemaster: "Well, can't I put my powdered gloves on and put the nitrile gloves over those?"
Orthette: (glares)
Orthette: "I can't stop you from doing it yourself."
Dr Whinemaster: "What is that supposed to mean!?"
Circulator: "You know, you'll contaminate Orthette and the field if you put those on."
Dr Whinemaster: (thinks really hard and glares at us)
Dr Whinemaster: "Fine, I'll wear the latex free gloves."
Two minutes later:
Dr. Whinemaster: "These gloves are nice. They have more give than the normal gloves."
Orthette: (wishes for a vacation day)

haaa.

2008-10-16T23:56:00.001-05:00

http://www.toddstrogerisanidiot.com/

Yes, he is. This is a link to an audio file- turn on those speakers to hear the Cook County Board Prez tell you what kinda guy he is.

NBC WTF?

2008-10-16T22:47:00.003-05:00

I like the last couple of years of Saturday night live. And given, I'm not a big fan of the G.O.P...

But the last episode of SNL seemed like it was 95% attacks on McCain. (Although it was funny to see the "Obama is a muslin that associates with terriers" lady.)

(from http://punditkitchen.com )

EDIT: CNN says Palin will appear on this weekend's SNL. This will be interesting.

a comparison...

2008-10-11T17:15:00.004-05:00

I'm seeing on more and more sites that a number of Mormon churches are contributing the lions share of contributions to the anti-gay marriage amendments in California. While it may be up to the states to decide how to make laws for themselves, the Mormons are determined to stick their noses in. Why people in Utah need (or want, actually) to regulate marriage in California is beyond me. Apparently the Mormons want everyone to know that marriage is not between a man and a man, or a woman and a woman. Based on Mormon beliefs, marriage is between a man and a couple of underage women. (A cheap shot, but keep in mind that Mormons only officially gave up polygamy because they wanted statehood, not because they thought it was wrong).
The opposition I see to gay marriage is reportedly based on religious grounds. This bears comparison to other issues from this country, issues argued before the US Supreme Court in 1967.
I've cribbed relentlessly from Wikipedia... They have more eloquent sources than I do.

"In the 18th, 19th, and early 20th century, many American states passed anti-miscegenation laws, which were often defended by invoking racist interpretations of the Bible, particularly of the story of Phinehas and the "Curse of Ham".
"Between 1913 and 1948, 30 out of the then 48 states enforced anti-miscegenation laws.
"In 1871, Representative Andrew King (Democrat of Missouri) was the first politician in Congress to propose a constitutional amendment to make interracial marriage illegal nation-wide. King proposed this amendment because he feared that the Fourteenth Amendment, ratified in 1868 to give equal civil rights to the emancipated ex-slaves (the Freedmen) as part of the process of Reconstruction, would render laws against interracial marriage unconstitutional.
"In December 1912 and January 1913, Representative Seaborn Roddenbery (Democrat of Georgia) again introduced a proposal in the United States House of Representatives to insert a prohibition of miscegenation into the US Constitution and thus create a nation-wide ban on interracial marriage. According to the wording of the proposed amendment, "Intermarriage between negros or persons of color and Caucasians... within the United States... is forever prohibited." Roddenbery's proposal was more severe because it defined the racial boundary between whites and "persons of color" by applying the one-drop rule. In his proposed amendment, anyone with "any trace of African or Negro blood" was banned from marrying a white spouse.
"Roddenbery's proposed amendment was also a direct reaction to African American heavyweight champion Jack Johnson's marriages to white women, first to Etta Duryea and then to Lucille Cameron. In 1908, Johnson had become the first black boxing world champion, having beaten Tommy Burns. After his victory, the search was on for a white boxer, a "Great White Hope", to beat Johnson. Those hopes were dashed in 1912, when Johnson beat former world champion Jim Jeffries. This victory ignited race riots all over America as frustrated whites attacked celebrating African Americans [Rust and Rust, 1985, p.147]. Johnson's marriages to and affairs with white women further infuriated white Americans. In his speech introducing his bill before the United States Congress, Roddenbery compared the marriage of Johnson and Cameron to the enslavement of white women, and warned of future civil war that would ensue if interracial marriage was not made illegal nationwide:
"No brutality, no infamy, no degradation in all the years of southern slavery, possessed such villainious character and such atrocious qualities as the provision of the laws of Illinois, Massachusetts, and other states which allow the marriage of the negro, Jack Johnson, to a woman of Caucasian strain. [applause]. Gentleman, I offer this resolution ... that the States of the Union may have an opportunity to ratifty it. ... Intermarriage between whites and blacks is repulsive and averse to every sentiment of pure American spirit. It is abhorrent and repugnant to the very principles of Saxon government. It is subversive of social peace. It is destructive of moral supremacy, and ultimately this slavery of white women to black beasts will bring this nation a conflict as fatal as ever reddened the soil of Virginia or crimsoned the mountain paths of Pennsylvania. ... Let us uproot and exterminate now this debasing, ultra-demoralizing, un-American and inhuman leprosy"
Congressional Record, 62d. Congr., 3d. Sess., December 11, 1912, pp. 502-503.
"Spurred on by Roddenbery's introduction of the anti-miscegenation amendment, politicians in many of the 19 states lacking anti-miscegenation laws proposed their enactment. However, Wyoming in 1913 was the only state lacking such a law that enacted one.[citation needed] Also in 1913, the Commonwealth of Massachusetts, which had abolished its anti-miscegenation law in 1843, enacted a measure that prevented couples who could not marry in their home state from marrying in Massachusetts. In 1928, Senator Coleman Blease (Democrat of South Carolina) proposed an amendment that went beyond the previous ones because it required that Congress set a punishment for interracial couples attempting to get married and for people officiating an interracial marriage. This amendment was also never enacted."

Just some helpful info in case you've wondered why those "religious" arguments against gay marriage sound like they've been around before.
P.S. The Supreme Court struck down anti-miscegenation laws in 1967. Apparently they were "activist" judges...

http://en.wikipedia.org/wiki/Anti-miscegenation

How much is an OR nurse worth...

2008-10-04T18:48:00.002-05:00

A lot, if you're the individual/insurer/institution getting billed. If there's an extra RN in the room above and beyond what's normally there, my old institution billed at something like 45 bucks every 15 minutes. I'm not sure, but I believe what you can bill varies by location, which means my current employer probably bills a heckuva lot more.
On that note... Raises came around for the year. Almost everyone got the exact same piddling raise... Meanwhile, the traveling nurses get paid a lot more than staff RN's do. And the agency that pays the travelers is only paying the nurse 1/2 to 2/3 of what the hospital is giving them. So, the traveling nurses are making about $65-70 an hour, which means the agency is billing well over $100 an hour. Me, I make less (way less!) than a third of that. Small wonder no one can keep OR nurses on staff more than a couple of years. In related news, we're losing two experienced nurses and getting five brand-new untrained RN's. Ugh.
Don't get me wrong, I like new nurses. They bring a happy, ready to work attitude. But when you have experience, you're guaranteed to get s**t cases with horrid surgeons, while the new nurses do the easy cases with the laid-back doctors. As long as there are new people starting, you'll be stuck with the re-do infected spinal fusions with Dr. McSchitzo.

Edit: I'll edit the bitchy parts of this out later. Or maybe the whole whiny post.

Yessss.

2008-10-04T18:40:00.002-05:00

In the Big House today.... Heh.
"The quarterback's 431 yards of total offense for the Fighting Illini (3-2, 1-1 Big Ten) were the most any player has had at Michigan Stadium and it matched an opponent record against the Wolverines".

Arrrgh.

2008-09-27T20:32:00.004-05:00

Well.

Apparently I'm not screaming "NOOOOOOOOOO!" loudly enough when Illinois turns over the football. Because, you see, they haven't stopped doing it. Possibly it's because of the 800-mile distance from my average lungs to their ears, or that the ol' orange-and-blue is playing in the largest capacity college stadium in the world (this month) with a hostile crowd. But they are playing very hard, and I'm proud of them. GO ILLINI!!!

Alberta (Canada) had a job fair here two weeks ago. I'm wishing I had skipped work to go. The thing being, I can get a job there as an RN. I'm not sure that I can bring in my American significant other- though we can get married in Canada. I'm trying to figure out how to get more info about the other legal policies of "America's Hat". It sounds like they have fewer people trying to legislate religion, which certainly appeals.

Edit: Kudos to JoePa for coaching at age 104. Amazing that he's doing so well. (Yeah, I'm jealous.)

The Candidate

2008-09-26T20:48:00.001-05:00

Only one person was worth listening to tonight. One person that was calm, who made sense, who wasn't lying though his teeth.
Jim Lehrer for prez, apparently.

Overheard in E-town

2008-09-19T19:36:00.003-05:00

Overheard, more specifically, at lunch:
Anes attending: "This whole financial mess is Bill Clinton's fault. He signed the law into effect that made this possible."
Me: "Wasn't the Congress that wrote the law controlled by the Republicans?"
Anes attending: "This is all Bill Clinton's fault."

If you're a true believer, apparently nothing can bother you. I do wonder what would happen if American companies could be taxed on outsourcing IT work. Or what would happen if there was actual competition for military contracts. (When you only have two companies to build your planes, it ain't gonna be low bidding. Same with your other vehicles. Northstar's new trucks are obscenely expensive.)

Me, I say to heck with the bailouts. Pay the people what they're insured for by FDIC, but the tax burden from these bailouts is too great. The country is already overburdened financially by the Iraq War, and God only knows what will happen with Iran in the next 5 months. (I can see GWB starting an armed conflict immediately before leaving office, especially if Obama is elected.)

Perspectives

2008-09-14T11:34:00.003-05:00

So. I do own a handgun. I kept it in my apartment in Chicago, and now that I'm out in the burbs, I can possess it legally. I learned to shoot with my dad when I was 6 or 7 years old, shooting a .22 rifle at an empty beer can floating in a pond.
I recently had an unexpected conversation with a co-worker. I say unexpected, because this woman has been in the Navy for several years and I didn't expect this.
Orthette: ...and the only thing I appreciate about the republicans is their view on gun control.
Co-worker: I don't like guns. I hate guns. I don't think anyone should have them but the military.
Orthette: Haven't you been in the military for 12 years now?
Co-worker: Yeah, but I don't think anyone outside of the military needs guns. Look at Great Britain, they don't have a gun problem at all.
Orthette: They do have the occasional gun problem. And recently, they have anti-knife movements. Because as it turns out, if you don't have a gun and you want to be violent, you can still kill people.
Co-worker: I'm okay with that. You still don't have as many killings with guns over there.
Orthette: So you'd prefer to have knives banned and eat your steak with a spork?
What about hunters? You don't think they should have guns?
Co-worker: No. I don't think they need guns.
Orthette: You've lived in an urban area all your life, you haven't had to deal with a deer population. They're basically like giant rodents- they run out in front of cars, they eat crops, they cause problems in rural areas. You want to suddenly start paying more for your food?
Co-worker: No, but I'd put up with it to outlaw guns.
Orthette: You're not the only person who would have to pay more. It would be everyone. An unchecked deer population would wreak havoc on wheat and corn fields, and potentially spread disease.

I don't think this person is an idiot. I respect her service to the military, I know firsthand that she's a great surgical nurse, and that she's intelligent. I think her perspective is that the areas she grew up (Lawndale, Humboldt park, etc.) are some of the most violent areas in the country, where young children have been killed in drive-bys this year. Recently an 8 year old was shot while she was bent over tying the shoelaces of her 5-year old blind cousin. Introducing more weapons into that area won't fix anything.
So, apparently things are affected by perspective. Who knew?
The reason I absolutely will not vote for the McCain/Palin ticket, however, is their stance on gay Americans. At no point in history has there been a constitutional amendment specifically against one group. McCain and Palin support a constitutional amendment against gay marriage, and possibly civil unions. Gay marriage has been occurring in Massachusetts for years now, and guess what... Massachusetts has the _lowest_ divorce rate in the country. (The states with that have amended their constitutions against civil unions/gay marriages have the highest rates. Go figure.) The way McCain and Palin see it, I have no reason to want the same work-related benefits, healthcare POA, or inheritance rights for my significant other (female) that I would have if my significant other was male. I work just as hard as a straight person, and I have the same education as a straight person. Yet "compassionate conservatives" who have never met me are decrying me as a twisted person, unfit to commit to the person of my choice, and unfit to parent.
Sarah Palin's church is even hosting an event to "pray away the gay" next week. (Of course, her church has also hosted events that suggest that Israel is being punished for not being Christian and that people who voted for Kerry are going to hell.)
So, that's my perspective.

Exciting republican health care exciting plan exciting!!!

2008-09-08T20:05:00.002-05:00

Hey ya crazy peeps who think you're uninsured. John McCain's advisors have some great news for yous.
But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain's health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

"So, there you have it. Voila! Problem solved."

There. Wasn't that easy? Just deny that there are uninsured people, and they magically cease to exist! Yay!

(Courtesy of Dallas News, spotted at Movin Meat.)
( http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-Uninsured_27bus.ART.State.Edition2.4dce428.html )

huh.

2008-09-04T20:54:00.003-05:00

So Barack starts racking up primaries a couple of months ago, and at some point Mrs. Obama says it's the first time she's proud to be an American. Granted, it's an asinine thing to say.
A certain political group starts screaming and whining and screaming some more that Mrs Obama is horrible, and un-american, and how dare she, etc.
Hillary racks up some primaries, and the same group relishes calling her a ball-busting bitch at every step.
Months later, Mr. McCain chooses a female running mate. The VP candidate's husband is a former member (who dropped out when his wife entered politics) of a group endorsing a vote on Alaska's seccesion from the USA. The group's founder famously stated that the fires of hell would look like glaciers next to his hatred for the United States. The political group (that was screaming about how un-american Michelle Obama was) is mysteriously silent. And when the press asks questions about that, or about firing someone who wouldn't hire a relative, or about the efficacy of her refusal to teach birth control in school, the "Hillary is a ball-busting c**t" group goes batshit over what they see as sexism.
Hmm. Just hmmm.

Thoughts from downtown chi-town

2008-08-31T17:19:00.003-05:00

-and another day of scooter rallying. Whee!

-Having driven up Lake Shore Drive on the way home, it occurs to me that the Mexicans per square foot ratio in Lincoln Park is higher than most other places on the planet, like Mexico. I think it has something to do with the prolific soccer fields. It's too bad there aren't as many adult Americans wanting to get out and play a sport as there are Latinos.

-Germany's official currency is probably the Euro at this point. They also have the deutsche mark. The cubs hat, worm backwards with a logo'd Polo shirt, could possibly be labeled the official douche mark. There are a lot of idiot frat types in wrigleyville, and this seems to be their uniform.

-Un-chicago-related: If you love someone, but their entire family is bat-shit crazy and a financial black hole, you do not, absolutely do not marry them. Still, it's hard to find a way to explain that to the loved one.

What Orthette does on some of her nights off

2008-08-30T02:06:00.004-05:00

Pardon the grainy photo, but the picture was shot around midnight with a camera phone. This weekend is a big scooter rally in Chicago. Nothing on the scale of the cycle rally in Milwaukee, but hey, it's fun. I did get a mild scare tonight though. One of the more experienced riders took a turn too hard getting onto lower Wacker (those underground street scenes in the latest Batman movie were shot on lower Wacker), and hit a pillar. He'll be alright, nothing looked broken at the scene and he was fully conscious. Thankfully, he was wearing a helmet and protective gear. His vintage Vespa will need some work, though.

Where Chicago's money goes...

2008-08-26T07:06:00.005-05:00

...so, Chicago, like so many other towns, has enormous budget problems. Apparently, the employment of so many relatives and political patrons weighs heavily upon the city's treasury. Also weighing heavily upon the city's coffers is the issue wherein gangbangers point guns at (or shoot at) the police, get shot, and die. Not a tragic issue at first. But then come the phony "reverends" and the screaming, grieving families. "(Gangbanger) was a sweet, innocent boy! He was an honor student, and he was going to be a doctor, and cure cancer!" ...and so on and so forth. The family sues, on account of the "honor student's" abbreviated lifespan, and the city promptly settles for millions. It's amazing that the city won't fight the lawsuits, and it's a pretty shitty thing to do to the police who have to patrol these areas. (When I say "these areas", consider the fact that there are frequently up to ten people shot and killed by gang members on the weekends.)
So, the latest "honor student" pointed a gun at the police and got shot and killed. The family had started the standard "he's such a good boy, an honor student, a father, he's fallen in with a bad crowd but he'd never use a gun, it was planted by the po-lice" speeches to the media, and hired their attorney to sue. Lo and behold, the 16 year-old had his own webpage. With photos, natch.

Hopefully this family thinks twice about suing the city, given the offender had posted his own evidence for the world.

Tagged!

2008-08-22T21:20:00.002-05:00

Well, one of the two bloggers I know personally has tagged me.
So, six unspectacular quirks.
1. I stop every morning to get a bagel at the same grocery store. I always tell myself to get a healthy whole-wheat one, and get a chocolate chip one instead.
2. I spend an inordinate amount of time shopping for football tickets on teh internets, just to see if I can find them cheaper than the ones I already paid face for.
3. I refuse to get a Chicago-area phone number, just on principle.
4. I've owned many guns. Shotguns, pistols, and a revolver. I even had a handgun while living in Chicago. I've been on a competitive trapshooting team, but never once hunted. (I have great respect for the hunters I do know, for the record.)
5. I live close to Bob Chinn's Crabhouse. It's a huge restarant, one of the busiest independent restaurants in the country, (possibly the busiest). It's known for the fresh crab and seafood flown in every day via the airport across the street. So, I go there for steak. :)
6. I've been told not to refer to the hospital's residents as prancing asshats. I've been told this multiple times. Hasn't sunk in yet.

I'm not much for tagging. But I hope ER RN found the reply...

I'm still alive, by the way. But the hospital is currently paying double time for certain overtime shifts, and that money is a little too tempting to pass up. Possible eventual down payment dollars...
It's hard to decide what to do about deciding where to set down roots. The chicago 'burbs are relatively nice, but expensive. If I bought a house, then wound up losing a month of pay down the line, I'd never make up the mortgage. So, I may wind up moving back south eventually to where a nurse's salary can buy a small home and a coupla acres. Maybe even a pole barn if I'm lucky. Damned if I'm not a country girl at heart.

Whaddya mean, July??

2008-07-04T17:21:00.002-05:00

Eeesh. I was going to start posting regularly, but that was but a pipe dream, apparently.
Updates:
A. My hospital has been officially jettisoned by the medical school (#1) it was affiliated with. Talks are in progress with another medical school (#2) with a better reputation, and hopefully better residents. We have school #1's residents until the end of the year to "ease the transition". Yeah. Anyhoo, the hospitals that medical school #1 thought would jump at having residents are not all that interested. Look out Cook County, here they come!! (Don't fret, residents of school #1, it'll be just like ER on TV!)

B. I'm a temporary drop-out. Lack of good timing and decent funds. I shall return in the fall, I hope. I need to schedule a GRE. (Not, as I told my college buds after a few too many, my GED.)

C. I have a scooter. Yay! I love it, though I need to buy an armored jacket. I did buy the new helmet, and I feel somewhere between bad-ass and ridiculous riding the thing. But I love it. The significant other likes it too, and wants to ride it, but needs to start by not going out in a t-shirt and flip-flops. Skin grafts suck ass.
There are a couple of cool group rides in the future that I'm planning to go on, and I've been riding the scooter to work. Scary and fun at the same time.

D. I am very scared of the GRE. Honestly, why can't they just give a test on the math skills I'll need? (How to cover a floor of thirty patients with only two nurses and a tech, ha.)

Anyhow, that's a brief recap. Better post soon, I hope.

na na na, hey hey, goodbye

2008-06-05T17:49:00.002-05:00

Apparently my hospital is getting ready to split with the medical school it's currently affiliated with. This might be somewhat awkward, since the school has been affiliated with the hospital so long, it's the hospital's (partial) namesake. To make a long story short, two of the hospitals that the medical school uses are going to war to compete for patients and dollars. The medical school is more closely associated with the other hospital, so they're cutting our hospital loose.

People have mixed feelings about this in the OR. The residents are constantly around, and most OR cases use a resident for a surgical assistant. It's likely that our hospital will get more residents from another medical school, but there won't be as many. This means the hospital will likely lose some physicians, who prefer resident coverage... It's nice to have someone for the floor staff to page at 2AM about your patient's diarrhea besides you.

I can see issues in the OR due to a decrease in resident coverage. But honestly, I think the cases will go a lot faster once the physicians have been working with the PA's for a while. And the stunning, mind-blowing arrogance of the residents at the "prestigious" medical school won't be missed.

Lunches

2008-05-10T11:28:00.003-05:00

I'm wondering if all employers have the same issue our OR does. If someone orders food and has it delivered, and it's sitting in the lounge waiting for the people who ordered it, is it open season elsewhere too? We have a certain number of staffers who assume unlabeled food is theirs for the taking. (And in some cases, labeled food.)
The shitty thing about an OR job (well, one of several shitty things) is that you can't go to eat when you're hungry. You have to be relieved by someone who has been assigned your room and probably multiple others. So, you might eat at 11:00, you might eat at 13:00, you might eat anytime in between. And I haven't thought of any way to keep the lounge trolls out of food that's ordered in, while the food sits in the lounge.

Almost out

2008-05-02T21:18:00.002-05:00

....almost out of school, for a couple of weeks. The last month has been hairy, with work, lots of clinical, multiple powerpoint presentations to give for school, trying to drop a pound or two (bout to give up on that one), and keep the significant other happy. Tomorrow I have to work in the morning, and then I'll work on prepping for my final in the evening.

I'm still getting used to living with a significant other. I used to be able to sleep anytime, exercise anytime, eat anytime, etc. Now I have to coordinate all of that with someone else's schedule. I'm not walking away because of it... Just saying there's more pain-in-the-ass factor involved than I had anticipated.

Blogging are hard

2008-04-05T14:02:00.002-05:00

I've joined a gym, and with the goal of being slim for Vegas in six weeks, I'm trying to go every night. It hasn't started working yet, but any minute I'll wake up a size six... Ha.
Class is also getting intense. For a five-credit class, I'm doing eight hours a week of clinical. Not so hard for a full time student, but factor in the extra time for the classroom/online stuff, the full time job and the 8 hours of commuting, and it kinda sucks. Can't wait for summer!!!

This gave me a chuckle this morning...

see more crazy cat pics

Random Saturday Night Thoughts

2008-03-15T22:32:00.003-05:00

1. To the Lincoln Navigator on 294 with the "My child attends a (Very Expensive Private School) stickers on it: the tollway has been under construction for over a year. It's Illinois, so the tollway will be under construction forever. The fact that you have to drive inches away from a giant concrete barrier if you're in the left lane doesn't mean that you should drive 45 miles an hour. If you're uncomfortable going fast next to a construction barrier, then get out of the fast lane. The slow lane is perfect for you, "slow" in more than one sense of the word.
(Note: there is no actual construction being performed on the other side of this barrier. The barrier is about 8 miles long, with only occasional spurts of actual construction being done.)

2. I'm spending an inordinate amount of time driving to a different gas station to buy gas. There's a station about 4 miles from my house that I now go to, to avaoid paying the newly-increased Cook County taxes. Cook County's latest tax increase means that Chicago has the highest tax rate of any large city in the country. (That's what they keep saying in the newspaper, though the papers aren't defining "large city".) So, goodbye tourist and convention dollars. I don't know that my driving to Lake County to make purchases means anything by itself, but there were an awful lot of other cars in that gas station on the county line road... Maybe enough people refusing to buy anything in Cook County will make an impression. I don't think any voter in the suburbs is going to want to pay the higher tax while the County President keeps adding his relatives and friends to county payrolls.

3. A person who thinks they are an expert on urban gangs should probably try living in a major city before expounding on how gang members act. Having heard a Snoop Dogg song on the radio doesn't make anyone an expert on gang life or street crime. (And I'm definitely not an expert.)

OT 'n more OT

2008-03-14T23:56:00.004-05:00

I haven't posted in a long, long time. I don't have as much time as I once did... I work overtime almost every night, and I now go to the gym. (I can't fit in any clothes I was wearing a year ago, and it's getting to me).

I've put in for a new job at work. Well, kind of a new job. If I get it, I'll be a patient safety coordinator for the unit. Not a glamourous job, mind you, but I figure it could be an opportunity to make some changes in the OR. For instance.... Every OR suite is set up with different supplies. It would be easier if the rooms were set up in a similar fashion, but that hasn't happened because the older nurses say that "That's not how we do it at Our Lady of the Immaculate Rep." Although it's a stretch, I figure I might be able to push for standard supplies in each room by arguing that it would cut down the number of times the circulator leaves the room, or enters a different OR in search of supplies. The best infection control practice is to limit the number of times people enter and leaves a room with sterile supplies open, so hopefully I can make a good argument.

My eventual goal is to not have to hear the phrase "That's not how we do it here" anymore. I've seen a large number of things that make no sense to me, and when I ask why things are done the way they are, I get that phrase, "That's how we've always done it here". I want to hear a decent reason to keep things stored unsterile, and then make a mad dash to flash sterilize them when they're needed. I want to hear a decent reason to have two separate sterile processing centers. I want to hear a decent reason that only one service keeps all it's trays on the unit. (Although the fact that a SP technician stole some ortho drills and sold them on EBay is a decent reason, I'll admit). I want to hear a decent reason that the nurses have to clean all the cysto equipment between every urology case, and that we can only have 4 sets of urology equipment. Cuz "That's how we've always done it" is a useless, shitty reason.

A lynch mob is forming...

2008-03-01T12:32:00.004-06:00

Our Lady of the Immaculate Rep has a new charge nurse in the OR. We formerly had the Greatest Charge Nurse of All Time. The schedule sucked, but he did what he could with it. Greatest Charge Nurse of All Time is a former Marine. A man of honor, and incredible patience. A man who never took the ridiculous schedule demands (trying to run 11 rooms after hours with enough staffing for only three rooms) and the whining and demands of self-absorbed surgeons out on his OR staff. He frequently had to make rounds to ask people if they would stay late, but he respected that people were sacrificing their time and energy for the OR because he asked them to. He's not deceased or anything, he's out with intractable knee pain, and will be on light duty for 3 to 6 months.
In the abscence of the Greatest Charge Nurse of All Time, comes the Most Annoying Charge Nurse of All Time. MACNAT (she doesn't warrant the effort of spelling it out) thinks she's a Marine drill sergeant (no military experience there). She constantly changes assignments to ensure that her least favorite people get the worst assignments. For instance: An obnoxious spine surgeon that's disliked by the staff asked for one traveling nurse to be regularly assigned to his cases. The staff didn't care for his music/humor/temper issues, but the traveling scrub liked him. It would be a win-win situation, except that MACNAT decided that that undermined her nurse-assigning authority. She got overruled on that one by a higher power, thank God. But everything in her mind revolves around her new authority, and her desire to see everyone recognise how much authority she has. She's told a nurse not to help a new co-worker who was struggling. She's told nurses who run the various services when they're allowed to leave. She's switched nurses and cases in the middle of the day to fix a problem she denied existed that morning. And in her spare time, she sucks up, very very hard, to the OR manager and surgeons to ensure that she continues to keep her little rule going over our fiefdom.
I'm not a religious girl, but I'm gonna start having to pray for the miraculous recovery of the Greatest Charge Nurse of All Time, cuz the OR staff can't take this much longer.

Stop, thief!!!!

2008-02-21T23:18:00.002-06:00

I do occasionally borrow bits and pieces from other sites when my brain isn't able to come up with material for a post. So, an observation stolen from my brother's blog:

"Seen in passing...As I walked through the snow, I looked in the window of the vet's office, and saw a guy with a big husky. Which is sort of ironic... It's the one day of the year when you really _need_ your sled dog, and it breaks. :) "

Me, I have material, but I'm stuck working semi-mandatory OT right now and I have no energy. (Illinois says forced overtime for nurses is illegal, unless the employer requires overtime. Yeah, you read that right. Also forcing nurses to stay to finish "procedures" is legal. So employers don't have to fully staff that 3-11 shift, cuz they don't really have to relieve you.)

Nursing School

2008-02-19T18:33:00.003-06:00

So, I'm in school again. I started a program that is a RN-to-MSN program here in Chicago. No BSN, just straight through. I've pondered what field to end up in. There are the options (at this particular school) to major as a nurse practitioner, clinical nurse specialist, infection control specialist, or healthcare administrator. (No CRNA options are available.)

Right now I'm in a community health class. I don't really have a huge beef with taking a class in community health, I just don't like having to do the day of clinical every week. To be fair, my school did go the extra mile to find a clinical site close to me. I am grateful for that. My complaint is more with the organization that decided that community health should be a full semester course with lots of clinical time.

Obviously, someone who wants to get into community health for a living would appreciate that class. But most nurses don't go into community health. If they want to have a specialized class that runs a semester, fine. But let the individual nursing student decide what that specialty should be. For instance, it takes between 6 months and a year to get most nurses through OR orientation. If nurses could pick their "specialty" (OR, ER, cardiac) course, instead of getting sent through a mandatory community health course they won't use, nurses and their employers would both benefit.

Northern Illinois Tragedy

2008-02-18T21:19:00.005-06:00

There is a specific level of Hell (one assumes) for people who have waited less than a day to try to use the senseless tragedy at NIU to drum up support for their arguments either for or against gun control. There is a time for such arguments, but that time is after the families involved have had a chance to mourn their loss.
Please say a prayer for those affected.

http://www.niu.edu/tragedy/scholarships.shtml

Meal time

2008-02-09T20:12:00.000-06:00

A post from Julie at ER RN has me thinking about lunch breaks in health care. Julie's post points out that healthcare workers can discuss almost anything over lunch without losing their appetite.
Lunch in the OR is a little different from the rest of the hospital. Since the rooms have to be staffed with 2 people (a circulator and a scrub), you can't just leave the room and go to lunch. You might occasionally go between cases if the OR is severely understaffed, but the cost (lost revenue)of taking a room out of service for that half hour is too much, so generally someone will come in and relieve you. They don't consider what kind of case you're doing. If you're in the middle of a dead bowel case, and your mask is covered with peppermint oil to keep you from throwing up, you still have to go right then. It's pretty gross sometimes. Unfortunately, the alternative is to skip your lunch and go ten hours without a break. Sometimes this job sucks.

Lil' shot of something.

2008-02-05T18:31:00.001-06:00

I'm ashamed that I could not vote today.

Edit: Having seen the ties to Rezko, I'm gonna back off my support for Obama and re-evaluate. I don't think Hillary is bad, but I doubt she's electable. I don't know if I would want to vote for McCain or Obama. Is there a box for "do-over" on the ballot?

Orthette wants...

2008-02-02T21:41:00.000-06:00

After a day at a painfully large shopping mall, which includes a Bass Pro shop, I have come up with a list of demands, in order of likelihood. Well, really, none of them are likely.

1. A shiny new camera.

2. A shiny new SLR camera. (If you don't know the difference, don't worry.)

3. A gun safe. For the trap gun and other sundry valuables.

4. A V-hull aluminum boat for dat big lake over dere.

5. A place to store that boat.

6. Winning Mega Millions lottery ticket.

Surgi-Centers Vs The real OR

2008-02-02T20:06:00.001-06:00

Our Lady of the Immaculate Rep recently hired a new chief of Surgery. Instead of appointing one of the physicians already on staff, they brought in someone from outside the hospital. This has been a mixed blessing. The physician who was the expected successor in the hospital had a very self-involved attitude, and may have been difficult to deal with after being appointed chief. Unfortunately, the new chief (we'll call him Dr. Whipple), has a larger ego. Rather than take the time to learn how the hospital runs, and why it runs that way, he's decided to come in and make a number of changes. The administration is backing him, because they think the changes will improve their bottom line.

My personal issue with Dr. Whipple is his attitude toward the nursing staff. Dr. Whipple wants to have a dedicated nursing crew to do his specialty procedures with him. Apparently they should be his nurses, trained extensively so he won't ever have to ask for an instrument. Because asking for the instruments would slow him down too much.

Now, Our Lady of Immaculate Rep has a lot of OR nurses. Not nearly enough, but enough to staff 12 OR suites. But many of those nurses are part time, so they aren't going to come in on their days off for the arrogant, passive-aggresive Dr. Whipple. We have a number of nurses on orientation, and that means doing every service for up to a year. And whatever poor soul would get assigned to Dr. Whipple's team is going to take vacation days and sick days when they want or need to, not when Dr. Whipple wants them to.

It's unfortunate that Dr. Whipple's procedures are too high-acuity for his cases to be done in a outpatient surgicenter. Then he could hire his own nurses, and they would specialize in his procedure. But he does his procedure in a Operating Department that handles all types of surgeries, and he only does 4-5 cases a week. Which means that "his" nurses can't really specialize in his specialty procedures because they have to be able to handle the joint arthroscopy, dissecting AAA, transphenoidal, or whatever else gets thrown at them after Whipple's cases are done.

The fact that the nurses have to know many, many procedures doesn't seem to sink in with many surgeons. Dr. Whipple wants his nurse to anticipate what his next instrument will be before he asks for it. Which means that the nurse would need to know the procedure backwards, forwards, and sideways. If that standard is set for every doctor, then the OR nurses have to know every procedure as well as the surgeons do. Maybe if they wanna start paying us like the surgeons... Ha. But really, it's ridiculous to expect a OR RN to be able to anticipate every next move of every surgeon. Apparently, the administration is going to clear the way for doctors to hire their own scrub nurses. We'll see how badly Dr. Whipple wants his own personal scrub nurse when he has the option to pay for it himself.

Funny Forren Langwadj Names

2008-02-02T19:54:00.000-06:00

Illinois has one of the most frequently mis-pronounced names in the US. (The "s" is silent. Really.) You would think that people from Illinois would pronounce names of towns named after foreign cities the same way that the original cities are pronounced. Not so much. Illinois is home to Des Plaines (said exactly the way it's spelled, not "Dee Plain"), Cairo ("Kayro"), San Jose ("San Joe's"), even Bolivia ("Bolivay"). Only in this state...

Semi-fun fact: Illinois is the French explorers' word for the Native Americans that lived in Illinois in the 1700's.

No George Clooney here

2008-01-22T07:57:00.000-06:00

So, I did try to get to the old Cook County Hospital last weekend to get a picture of the old operating theater. I got to the site, and even found a gap in the gate, but chickened out. Between the random men roaming the site, and the dealer making a slow circle of the block, I figured I might as well stay outside of it. So, I took some pictures of the exterior. Chicago has an unusual way of preserving the front exterior wall of a building (the "facade") and demolishing the rest, then building the new building attached to the front wall. That way, the building looks old and historic but has modern floorplans and amenities. It's debatable whether or not this actually has any preservation qualities. County Hospital is being demolished from the rear, and I don't know if the facade will be preserved or not. At any rate, old Cook County did have some interesting architectural qualities.

Old cook county trivia:
First blood bank in the US- 1937
First trauma unit in the US- 1966
First AIDS clinic in the US- 1983

Gone soon...

The grass is always greener...

2008-01-19T08:45:00.000-06:00

So. I've voiced my unhappiness with my present employer before. And so I have begun looking for a new position, still with my present healthcare corporation. That way, I don't have the unpleasant job-hopping thing on my resume. I'm mystified by how people will complain and complain about their jobs, without doing something about it. I know a person who complains daily about how bad her job is, and it sounds like she's right. She has to get to work an hour early, and stay an hour late. Her boss is a jerk who yells at people, and terminates them without notice by overnighting a fed-ex envelope with a pink slip in it. She hates it, but isn't actively looking for a new employer. When I suggest a job search, I get a blank stare. Why be miserable?

I'll be the first to admit, I've made some poorly thought-out employment moves. I once decided that I was burned out on the hospital, and decided to quit the nursing job and go back to the ambulance. I gave two weeks notice, having had a previous job offer from the ambulance company I was working for part-time. When I came in to the office to discuss my schedule, I was told that I would be working that shift with that partner... eventually. But he had decided to schedule another medic for the first three weeks in that slot, maybe I could pick up some shifts off other medics?
Downstate EMS doesn't pay well enough that three weeks without pay is an option, so I ended up scrambling for shifts. And after a month of sitting in the burned-out, broken-down ambulances that my company used, I re-applied for my old nursing position. I had missed EMS when I was working in the windowless OR, wishing I could be out and about. But being in a ambulance that smelled like the previous two shifts had left their fast food sitting on the floor (because they did) made me miss the clean, climate-controlled OR. There were good, decent people at each place, but the people at the ambulance company were less happy with their jobs. I don't know if it was because of the income difference, or the enviroment. (I've really never seen a private ambulance company with nice quarters. Maybe I've just been looking it the wrong spots, but they usually seem to resemble the basement on That 70's Show. That particular company furnished it's quarters with furniture other people threw away.)

I guess what I wanted to say is that if people don't like their jobs, they should look elsewhere, carefully.

Like ER, but with real crackheads

2008-01-15T12:37:00.000-06:00

The old Cook County hospital is nearing demolition. It was actually a beautiful hospital at one point, covered with the terra cotta (sp?) that Chicago is known for. There's a link to dump site on the right, which has a couple of neat pictures of the hospital. Some of the side buildings have already been demolished, and I'm hoping to find a way to see the main building before it's torn down. Many movies and TV shows feature operating theaters. In reality, the theaters are a thing of the past. Cook county's old hospital has one, and I wanna get pics before it goes, though I have no idea how to get in. One of these days....

Best Campaign Ad, Ever.

2008-01-15T10:02:00.000-06:00

Makes me want to vote in the primaries.

Random Saturday Thoughts

2008-01-12T11:28:00.000-06:00

Random Thoughts on Saturday morning:
A. The OR I work in is chronically understaffed. There are lots of people on orientation, but they can't finish orientation because they have to staff the cases for the service they know how to do, and can't learn the rest of the services. (For example: Orientee "Bob" needs to learn how to scrub and circulate brain surgery. He has learned to scrub general surgery. The charge nurse is short 3 nurses on the schedule, so instead of putting Bob with a nurse in neurosurgery, she puts Bob in a bowel case that he can do on his own. Bob fills a hole on the schedule, but doesn't learn the skills he needs to move toward learning neuro and getting off orientation.) Because of the orientees getting pulled to do cases they know how to do, orientation seems to last well over a year.
That is bad by itself, but the OR is using nurses and techs with unfortunate personality problems to precept. Their main preceptor for scrubbing neuro has a nasty compulsive streak. She doesn't like to stand back. As soon as her preceptee does something she doesn't like, she pushes them out of the way and does the rest of the case herself. The orientees, myself included, wonder if she intentionally does a horrible job of precepting with the intention of making herself look good, or even indispensable. It makes neuro a pain-in-the-ass service, and it slows down the orientation process. I could at least do my job better if I had a logical explanation for how the service sets up their cases. The set-up for a neuro case is a confusing jumble of unnecessary and redundant instrumentation. (I might use about 20 instruments for a case. I have about 150 instruments on my back table, most of which are duplicates.)
B. Our Lady of the Immaculate Reputation has a couple of sister hospitals. One is a great deal closer to my home, and does more ortho surgeries. They do a lot of total joint surgery. I have thought occasionally about transferring to that hospital, but have held off. Lately, it's looking better and better. There are two things that make me hesitate- being seen as someone who can't stay at a job long, and the possibility that the management at the sister hospital could be worse. My opinion of my immediate manager is dropping quickly, so my chances of putting in the transfer request are rising equally fast.
C. On a totally unrelated note: a couple of my friends are on the list for the CFD. They are already medics for the fire department, and want to become firefighters. They are pretty upset with the idea of affirmative action. They blame minorities for the way the CFD's hiring list is being delayed.
The last hiring list was used for ten years, and was subject to a number of lawsuits. The most recent and well-covered lawsuit consisted of a group suing because the number of minorities hired off the old list hadn't met a quota. The minorities wanted a settlement that would have given them firefighting jobs, and back pay as if they had been hired as firefighters when the list came out. Never mind that they hadn't actually done well on the test.
My friends are pretty irate at the way the Fire Department is having to do their hiring. They feel that the best-qualified testers with the highest scores should be hired. They blame the groups suing, and the lawyers representing them, for the fouled-up system. The way the hiring is done represents a compromise, though. It recognizes that minority test-takers had been passed over on older tests, and less-qualified white men had been given those jobs. The actual fair thing to do, would have been to boot the less-qualified people on the job and replace them with the more qualified people from the old list. But the union firefighters weren't going to give up their high-paying government jobs, and many people on the list were too old to start training as firefighters. So the city (and a lot of other cities did this too) agreed to hire a percentage of minorities on future lists to protect the employment of the white firefighters already on the job.
I'm not arguing that the current system works. Firefighting is a dangerous job, and I want the best qualified firefighter hired. After all, the person hired may be the person that has to run in my burning home to save me or a family member. Regardless of what caused the current system to be put in place, I hope it's scrapped soon. I really feel that to test for a firefighter position, people should be required to have completed rudimentary firefighter and EMT training. You don't test random people off the street for most government jobs. (Wanted: Nurses/ Doctors/ Engineers/ Lawyers. No experience or education required. Will Train.) Firefighters (and police officers) should be required to have training for their jobs, like anyone else.
This only reflects my opinions... I'm not in charge of hiring anyone anytime soon!

Natural selection, really

2008-01-09T20:56:00.000-06:00

Reprinted from burbscopchicago's blog: (without permission. Mea culpa.)

Daily Herald:
Joliet man electrocuted
Authorities said a 20-year-old Joliet man died after coming in contact with an electrical wire and being electrocuted on Chicago's South Side. According to the Cook County medical examiner's office, R. P. was pronounced dead Tuesday at Mercy Hospital and Medical Center. Initial reports said he had touched a downed ComEd power line, but a ComEd spokesman said the accident involved a streetlamp owned by the city of Chicago.
Translation:
City: "Get out your checkbook, ComEd..."
ComEd: "Get out your checkbook, Chicago..."
City: "Seriously, it's on you...."
ComEd: "Uh-Uh, on you..."
City: "No, You"
ComEd: "No, You"
Bottom line... they'll end up splitting the cost of building the "next of kin's" new mansion. That, in turn, will be passed along to city residents and ComEd customers...hidden in the form of some obscure line tax and bottled juice tax...
A few things the public shouldn't have to pay for:
-People who tease the lions at the zoo
-People who point guns at the police
-People who feel the need to examine downed power lines

Priscilla goes to the hospital

2008-01-07T23:14:00.000-06:00

Apparently some San Francisco type is suing Seton Medical Center. A transexual has filed a lawsuit because they refused to do breast enlargement surgery on him. The Catholic hospital has refused, apparently stating, "God made you a man."
I don't know why it made the news. Catholic hospitals have refused to do certain procedures for years. You can't get an abortion, regardless of the cause. You can't have your tubes tied, and I don't believe they perform vasectomies either. This individual may be offended by the statement made, but he's wasting time and money (his and the hospital's) on this suit. No one has the right to force a hospital to perform an elective procedure... Hospitals were invented to heal the sick and injured, not tend to your sexual preferences.
(Jeez, I'm starting to sound like a conservative).

An Orthette

2008-01-02T20:59:00.000-06:00

Orthette (or-thet) n. : An OR nurse who works with orthopedic surgeons, who can identify the instruments used by surgeons, who will give the doctor what they ask for regardless of whether the surgeon actually wants or needs that instrument, and upon hearing the surgeon's phrase, "Give me what I need, not what I ask for!!", will patiently and sweetly tell the surgeon to shove that particular instrument up his ass.
(Long day at work, I'll most likely delete this later.)

Movie Watchin'

2008-01-01T11:37:00.000-06:00

I recently went to the movie "Awake". I admit, I've been a little worried that my patients would be sitting in holding asking if they would be awake through whatever procedure they were enduring. I had seen previews for it, and thought, "This is gonna be bad for OR's all over the place." Since it involves anesthesia, the AANA (the nurse anesthetists' association) had asked to preview the movie and been denied. Apparently, the movie was not being made available for previews anywhere.

As it turns out, the movie kinda bombed at the box office. The movie had an interesting idea for a plot (wealthy heir with mysterious cardiomyopathy needs transplant, meets girl, marries girl, turns out girl and cardiac surgeon are conspiring to kill wealthy heir), and it had an interesting plot twist at the end. The interesting plot factor, however, was overshadowed by the unrealistic factor. Wealthy heir is supposedly wide awake and paralyzed, meaning that of all the drugs received, only the paralytic worked. Anesthesia only works with a combo of drugs; the paralysis is complemented by the sedatives and painkillers used. If a patient is aware of what's going on, even if he or she is only paralyzed, the patient is going to react to the stimulation, even if it's only reflected in a high heart rate and blood pressure. The realism factor isn't helped by the fact that wealthy heir is eventually put on bypass for the transplant without a bypass pump or a perfusionist. Given, open heart isn't my specialty, but still... Geez.

Thankfully, none of my patients seem to have seen the movie or the previews. I'll be keeping my fingers crossed that it doesn't become a hit.

Round yellow drama Queen

2007-12-23T21:10:00.000-06:00

In case there was anything from the 80's that had not been made into a movie, yet, here's the Go! team on YouTube. If you haven't seen it, it will make you giggle. Clickkity!

Didn't see it coming

2007-12-23T11:32:00.000-06:00

I was raised in a fairly liberal family. I've always leaned toward the liberal side, as I see Republican politicians as being complete stooges for big business. I also am not fond of all the Republicans running around screaming about civil unions being the end of life as we know it and the the beginning of armageddon. (Anybody wanna explain Larry Craig? Ted Haggard? Mark Foley? Family values, my a**.) It's taken a lot of exposure to the Chicago way of doing politics to get me really fed up with the Democrats too. The Daley family is pretty much legend for their clout-riddled administration, and apparently Cook County government is just as bad. Since a couple of aldermen are starting a drive to register, and possibly ban, gun ownership in all of Cook County, I've done the unthinkable and actually joined the NRA.
Central Illinois, where I hail from, is hardly a hotbed of crime. There are burglaries and rapes with the occasional murder thrown in, I never really felt it necessary to join a political group that seems to dedicate itself to defeating every gun law, ever. But I have known how to shoot since I was about 6 years old, and I've spent time as a competitive trapshooter. I don't like the idea that I could lose my 30 year-old single shot (it can only hold one shell at a time) trap gun. I hope I don''t wind up regretting joining the NRA, but time will see.

A warning

2007-12-22T12:32:00.000-06:00

I don't want people reaching over my back table if they aren't scrubbed in. It creates a risk of contaminating my instruments and implants, and you really, really don't want to put a contaminated implant in bone. If an infection results, the bone will be destroyed, resulting in lots and lots of further surgeries and lawsuits. So, even though it seems so easy to reach up there, and put those xray films on the viewbox, and just reach over my sterile supplies for an tiny lil' fraction of a second, don't. Just don't. And,
If you are:
1) a resident
2) a medical student
3) a PA
...and you reach over my back table after I tell you not to, be advised that I will notify the attending that you touched something unsterile and contaminated yourself during surgery, resulting in the physician cussing you out and telling you to leave the OR approximately 0.2 seconds before the procedure that you have to write up commences. That is all.

Paramedics and Nurses

2007-12-22T11:30:00.000-06:00

Paramedics and nurses generally seem to get along fairly well in the ER. But there is always some underlying tension between the two professions about which is the better profession. Eleven years ago, I was taking my first EMT course (known then as EMT-Ambulance instead of EMT-Basic). We learned the very first basics of EMS, and we had some fun doing it. Most of the people in my class went on to the EMT-I class the next semester. The instructor was pretty proud of his students, and told us that some day, when and if we became experienced paramedics, we "would be smarter than any nurse or resident". (Before anyone takes offense, I didn't say this, and the instructor passed away two years ago.) I have no idea where he got this idea, as he had no experience as a nurse or a physician. This man did train about 30% of the EMT's in that county, as well as some EMT's that went on to become instructors. The attitude is still pretty common in that area, and I've seen it in others. The fact is, if you're a smart and experienced paramedic, you do know more about your field than other professions will. A physician can identify a fractured femur, but can't tell you to cut at the A-pillar or the B-pillar during extrication. A nurse can help you with an arrest, but she's not going to be the one hauling your 400 pound patient out of their attic apartment. But that knowledge relates to your chosen profession of paramedicine, and not to nursing or medicine. I had plenty of medics who decided to "help" me while I was studying my butt off for the NCLEX. Most of them gave up after two or three practice questions- apparently it hadn't occurred to them that I had to study a lot of things EMT's don't.
Nurses also seem to have the attitude that they know more than paramedics do. Just as I had a EMS instructor degrade nurses during class, so it was with my first nursing professor during her class. Apparently, an extremely arrogant paramedic had started classes and not done well. Every medic that followed this guy had to hear about how arrogant and useless all medics are. Great.
So, here's my statement as a medic-turned-RN. The two professions are different. Very, very different. EMS is alternately dull and stressful, with some skills that are hardly used but can be needed in the blink of an eye (think IO's on a infant arrest). Paramedics don't have a staff to back them up, and have to do their thing in an unpleasant array of environments (imagine opening a closet door and having 200 roaches fall on your head). Paramedics do learn a number of assessments and techniques. And they mainly work off protocol (but there are always calls that defy every protocol known to man). They have certain drugs available, and they need to know the indications and contraindications for those drugs.
Nursing is also alternately dull and stressful. Nurses, especially those in teaching hospitals, have to know the indications and contraindications for any drug they're going to administer. They take orders from physicians, but they have to be aware of what they are giving. Many medication orders result from requests from the RN's. ("Doctor so-and-so, patient x is complaining of these symptoms, would you like to order medication y for him?"). Nursing also has to take into account both the long and short term effects of treatment and education for the patient. Once a patient survives the "golden hour" of EMS, there is still a large amount of treatment to be done.
The fact is, there are some very, very experienced RN's that can do the work of a medic. There are some very, very experienced medics who could fill the shoes of an ER nurse. But the vast majority of nurses and EMT's could not switch jobs for an hour without a f***up. RN's with medic experience don't go around trashing either profession, because they recognize the differences.
If you are a paramedic who is smarter than any nurse, or a nurse who's smarter than any medic, then this blog is not for you. You may, however, be suffering from rectocranial inversion, so please seek treatment.

More details

2007-12-11T11:48:00.000-06:00

I currently work in a hospital in northern Chicagoland. That's right, it's not the Chicago area or the Chicago region, it's "Chicagoland". Which makes it sound like an amusement park, only the rides aren't quite so entertaining ( the El does have it's own amusement park thrills of rapid turns, high elevations, and wacky vendors).

I'm not in Chicago itself. I work in a Hospital that will known only as "Our Lady of the Immaculate Reputation". Note I'm describing the reputation, and not the actual performance of the hospital. I can't speak for the floors, but the OR isn't at the level of performance of my last employer (to be known as "anonymous downstate hospital"). I came to ImmaculateRep with some very high expectations, knowing that this hospital was associated with a well-known medical school. Apparently, having a good reputation makes it pretty easy to skate on actual performance. The residents from the medical school (to be known as Pretentious University) are smart. Book Smart. When it comes to the actual interaction with patients, not so smart. I've seen more mistakes in 11 months at ImmaculateRep than I saw in 5 years at Anonymous Downstate. For instance, in 5 years at Anonymous Downstate, I hadn't seen a uterus perforated in the operating room during a hysteroscopy. At ImmaculateRep, I saw 2 uterus perforations within a month. Wow. That's the gyne service, and the other services are just as bad. During the last joint replacement I did, the 3rd year ortho resident could only identify 30% of the instruments on the mayo stand.
Apparently when you apply for medical school, the only qualification is high grades and a high MCAT. Possibly, medical schools need to start refining the pre-medical requirements to include time spent dealing with patients in some shape or form. Can you imagine the physicians that would graduate if they had all spent time working as medics, nurses, radiographers, respiratory therapists, etc., before ever starting med school? It's great that they found people who can pass organic chem and physics, but the people they select aren't necessarily possessed of any empathy for their patients. I'm starting to wonder if the way the residencies at ImmaculateRep are done doesn't create some of the problem. The residents spend most of their time in the OR, and PA's employed by the hospital and the medical school see the patients on the floors. In theory, this means that the residents are becoming better at surgery. Well, in reality, they still suck at it, and they aren't interacting with their patients. They don't hear from the patient about the pain their surgery caused. Thet aren't explaining how to deal with the effects of surgery when the patient leaves the hospital. They lose the interaction with the patient, and the patient becomes less human to them. The person freezing on the OR table, with a family nervously waiting in the waiting room, who is terrified that they will feel pain through the anesthesia, becomes a lab rat to the resident, there to be operated on and learned from.
It would be untrue to say this applies to all the residents. Some do take the time to treat their patient as an individual. But there are many more who fail to see the person on the table, only a "case" to write up. I've had to stop residents who were trying to remove packing from a wound or jerking a patient's leg around with an external fixator pre-operatively, because the patient was still awake. To wait for two minutes would have given anesthesia the chance to complete their general anesthetic, and yet the resident was determined to yank the dressings as fast as possible, causing extreme pain to the patient. Apparently, saving time and getting the dressing off was more important than the patient's comfort. Someday, the OR staff will get the chance to "rate" the residents. I hope that day comes soon.

The next post will be less snarky, I promise.

About me

2007-12-07T21:47:00.000-06:00

I've been lurking around other blogs for a while now. I've read a large number of blogs dedicated to ER nursing and EMS, which tie into my former career as a paramedic. I don't know that I can be as entertaining as the blogs I've come to admire, but I'll try. Bear with me though, as I try to determine what's safe to post and what isn't.