Just dinner.

Lunch was cancelled. 

Dinner, was pleasantly, unrushed!  And a friend got to take a ride.

There is something about how a person holds on...  especially during a moderate speed turn that leans a bike way over... at least they leaned with me!

Lunch... and Dinner!

Two separate ladies!

There is a long term investment...

Tomorrow I will meet with and commune with two friends.  Both visits are going to be rushed.  Which makes me wonder...

I just smile...

When I work, I interact with many people... not just patients.

The other day, a family member stepped out of a room and began yelling,  "Help!  Help!  Somebody help!  He's having a stroke!"

It got my attention, as I was 10 feet away.  I turned to respond, then heard a peer, who happened to be in the patient's room, start to address the situation...

Knowing nothing, my immediate purpose was to respond and help, then quickly calm the family member.  The primary RN was present at bedside, addressing the immediate needs of the patient.  They were having a seizure.

What does one say to a panicking family member? 

I chose the abrupt intervention!

I said, "Stop it!" 


It caused a blank stare for a moment, then a deep breath.

Oxygen applied, suctioned the airway, a quick check of the Blood Glucose Level, then a trip to the PYXIS to get Ativan, seizure stopped.

About an hour later, the family member tried to apologize.  I wouldn't let them.  I apologized to them.

When things occur, the most debilitating position to be in, is that of helplessness.  It is why people call 911, it is why they come to the ED.  A seizure is a scary thing to witness, especially if one has never seen one!  Regardless, when a family member is in an extreme situation, no one can move fast enough.  I understand and can empathize.

I apologized for my abruptness.  I explained that my purpose was to end the panic and allow the staff to address the situation.

When the patient was admitted a few hours later, the family member came up to me and simply said, "Thank you."  I replied, "You're welcome."

Then I smiled.

Litigurically...

I am so far off...

Lent, doing without.  Vernal Equinox, start of the celestial spring.  Easter, a new beginning/rebirth.

It is describable, therefore debatable!  All I ask for, is at least an invite into a Tavern, a warm fire in the hearth, a warm grog to drink, and a corner to shelter in.


For some, sounds familiar!  For others vaguely so.


I have a hypothesis. 

Middle of Nowhere...

I can get to the middle of nowhere in under an hour, two hours is better for good measure.

For those who wish to take a ride, I caution you, it is a journey.  It mostly involves trust.  Trust that I will both get us there, and bring us back; trust that as you hang on to the strap, the backrest, or my waist, our combined safety is my number one concern; that pulling off the road and stopping for a few minutes, is just as valuable as throttling up; that the reason I am leaning to the right, closer to that semi being passed, is that in less than five feet we are going to be pushed to the left; that there is little difference in going 0mph or 35mph or 90mph, one can still let go and put there arms outstretched and still feel like they are flying (just keep one's feet on the pegs and knees in and locked to the bike)!

Just remember, we just took a container of flammable liquid, on top of a hot moving engine, and then put the whole lot between our legs...

Still want to go for a ride?

Lost knowledge

There is a Beemer parked next to me.  A Touring Bike, plates are from Alberta, CA.

I admire this person, as that is at least 1500+ miles.  One way, a long ride.  Too bad they don't know how to park a bike... might have got them a beer.  And the front wheel is to the right as well...

Should have pulled in behind me, offset to the left, slightly behind.  If not, at least take the front, right corner of the space.  Allows others to pull in and not impede.

When one fires up, there is often the backwards shuffle.  The backing out of a parking space, that in my experience, has more often than not, stopped others.  I wonder if it is a vague memory of the 1%'s.  Or is it a respect of it's own? 

Regardless, if I am the rider that you come upon, have solace! 

The rumble...

You have to admit, there is something about it!

It evokes an emotion, at least a feeling, in everybody.

That deep bass that one feels, not just hears.

As a nomad, I can fall in and ride with another individual or group.  Strength in numbers, right?!  Just as easily as another rider falls in behind me.  There are rules. 

A minor mechanical issue...

On my last ride, upon arrival I noticed a small oil leak.  It's from where the mid-controls used to be.

Unfortunately, I can not fix this myself, it requires a service.

So I am here until Saturday, when I can get in for a service appointment.

Some people would be upset, others anxious; there are appointments, schedules, meetings...  however; the only place I need to be, is right were I am, and not until Thursday!

I choose to live my life day by day.  Plans, are just that, plans.  Every now and then, I hear the chuckle... and I just smile and say "OK."  It sure beats the proverbial 2x4!

Peace

The other day...

I am old.  There, I said it.  I actually am proud of it.

However, being old means I have had some experiences, which is what has ultimately made me old.  The most important lesson I have learned in my life, is to STOP!  Stop, think, observe, plan.

My last shift, I came out of a patient's room, to see a bunch of people running into one of my other patient's rooms.  This caused some concern and I myself responded.

When I entered, there were several nurses and techs all moving and doing.  I simply asked, "What is the problem?"  As defib/pacer pads where being applied, a 12-lead EKG being done, blood pressure being cycled... I heard, "the heart rate is 250!"


I looked at my patient, Roger, and asked him how do you feel?  He replied, "Just fine.  What's all this about?"

I glanced at the cardiac monitor.  It was 'alarming' indicating a heart rate of ~250... yet a glance down at the SpO2, indicated a HR of ~100...  I announced "The HR is 110, look at the pleth wave."  To which I was shown a rhythm stip showing an Atrial Flutter, variable, 2:1 to 3:1...

As things were quickly escalating, I said, fairly loudly, "STOP!"  Everyone did.

I walked up to the bedside monitor, changed the EKG lead from II to I, and the alarms instantly ended.  HR was now ~100.  A radial pulse check (yes, I actually touched my patient, ungloved), confirmed.

I turned to everyone in the room and said, "The monitor was reading the 'flutter' waves as 'QRS' waves."  And then the sage advice, "Treat the patient, not the monitor."

I reassured Roger and his family that everything was OK.  I also apologized for the scare... as no one had addressed the patient or the family.  As I turned around, I noticed, I was now the only ED person in the room.

When a critical or emergent condition exists, I want my peers to react.  I only expect that they do so appropriately. 

Did you see that!?

I think it was a week flying by...


Although, it has been a bit strange.  Some shifts have been busy, some not so much... even got to leave two hours early one night, as it is sort of hard to justify having more nurses than patients.  Luckily, no last minute surge occurred.

Someone remarked the other day, that "the season" is beginning to sputter out.  If I see them tomorrow, I plan on punching them in the arm!

Last night was one of the busiest shifts I have ever had here.  For me: two, back to back, pediatric transfers by air, a total of seven admits, being pulled to start difficult IVs, cut rings off, assist with procedures...  let alone the countless discharges.  Now multiply that by all of my peers, all having a similar shift.  Even the Float Nurses, no assignment - just there to help, were themselves sinking! 

Come to think about it, I am going to wait a few hours, and punch them again in the exact same spot... just so they remember.

Stethoscopes

A tool used to auscultate, that is listen, sounds.

I have a stethoscope.  And I use it multiple times a shift during work.  Listening to lung sounds, heart sounds, abdominal sounds... and every know and then, I even listen to arterial blood flow.

What's interesting about a stethoscope, is that most people think about a device that has two ear pieces, at the end of metal curves, placed in the ears, which is attached to a plastic or rubber tube(s), ending in another metal device, which has yet another piece of plastic or rubber.

Have you ever used a broom handle as a stethoscope?

Everyone has two, by the way.  They are called ears!  Cupping one's ears with their hands, to focus sound, placing you ear on a wall to listen to a neighbor or the chest of a family member...

The true purpose of a stethoscope, is to eliminate clutter.  It is an extension of a human ear, in that the mechanics are the same,.  Yet it focuses sounds, and eliminates all of the background noise.  Ever tried to talk to someone using a stethoscope?  They usually pull one of the ear pieces out and ask 'What?'  Either that or they hold up the end and ask the same question.

Sometimes focus is needed.  Sometimes it is not.

Today, I did not focus on the landscapers cutting the grass.  Tonight, I focused on the birds chirping and singing.  Tomorrow, I will focus on others... both on my ride, and then at work.

And the broom handle, go ask a mechanic!