Living in Las Vegas
- Thread starter SixFive
- Start date
Priapism and a penile fracture
A Patient we had last night presented to th ER with severe penis pain after sex. I'll paraphrase the official H&P on the chart. I can't believe it was actually on the chart :mj07:
"Patient reports he was having sex with his girlfriend. His girlfriend was in the reverse cowgirl position going up and down. His penis exited her vagina, and when she went back down the penis collided with her buttock causing it to bend backwards in a painful and damaging manner."
A Patient we had last night presented to th ER with severe penis pain after sex. I'll paraphrase the official H&P on the chart. I can't believe it was actually on the chart :mj07:
"Patient reports he was having sex with his girlfriend. His girlfriend was in the reverse cowgirl position going up and down. His penis exited her vagina, and when she went back down the penis collided with her buttock causing it to bend backwards in a painful and damaging manner."
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:scaredPriapism and a penile fracture
A Patient we had last night presented to th ER with severe penis pain after sex. I'll paraphrase the official H&P on the chart. I can't believe it was actually on the chart :mj07:
"Patient reports he was having sex with his girlfriend. His girlfriend was in the reverse cowgirl position going up and down. His penis exited her vagina, and when she went back down the penis collided with her buttock causing it to bend backwards in a painful and damaging manner."
Priapism and a penile fracture
A Patient we had last night presented to th ER with severe penis pain after sex. I'll paraphrase the official H&P on the chart. I can't believe it was actually on the chart :mj07:
"Patient reports he was having sex with his girlfriend. His girlfriend was in the reverse cowgirl position going up and down. His penis exited her vagina, and when she went back down the penis collided with her buttock causing it to bend backwards in a painful and damaging manner."
:scared:scared:scared
Clint, you're the man. This thrrad is great and i check it daily for new posts. I will probably be in vegas this summer for wsop, would love to treat you to a beer or something :toast::toast::toast:
Not much of note lately. I have been severely under the weather, and I'm just now getting better. I don't know how it's possible for one person to [emoji90] that much. Fever max of 102.6 as well and the associated way that makes u feel. I fortunately missed no work. The rodeo is in town; maybe I'll check that out one night? I have a few pics leftover I'll post.
Common sight at the casino, and a great way to get robbed and discover after you wake up from your alcohol induced passing out.
This was made in my hometown, so I thought it was cool to see in Vegas showcased at Ballys as a prize.
I need to call this place. Maybe they are hiring? I could rock out some IVs on some drunk, hungover tourists for some extra $$. I'm serious about this, and I have been meaning to investigate for a few months now. With my experience and being a man (hard to send a little female nurse into a strange hotel room by herself I would think), I should be a good fit. Makes perfect sense that getting IV fluids and B-vitamins or whatever they give you would really diminish hangover time.
Home in a few weeks then Haiti then back to Las Vegas until summer is the upcoming schedule. I'm not sure if I can post from Haiti yet or not, so it might be binge writing and picture taking when I get back. We are very excited about the trip!
Sent from my iPhone using Tapatalk
:toast:Not much of note lately. I have been severely under the weather, and I'm just now getting better. I don't know how it's possible for one person to [emoji90] that much. Fever max of 102.6 as well and the associated way that makes u feel. I fortunately missed no work. The rodeo is in town; maybe I'll check that out one night? I have a few pics leftover I'll post.
Common sight at the casino, and a great way to get robbed and discover after you wake up from your alcohol induced passing out.
This was made in my hometown, so I thought it was cool to see in Vegas showcased at Ballys as a prize.
I need to call this place. Maybe they are hiring? I could rock out some IVs on some drunk, hungover tourists for some extra $$. I'm serious about this, and I have been meaning to investigate for a few months now. With my experience and being a man (hard to send a little female nurse into a strange hotel room by herself I would think), I should be a good fit. Makes perfect sense that getting IV fluids and B-vitamins or whatever they give you would really diminish hangover time.
Home in a few weeks then Haiti then back to Las Vegas until summer is the upcoming schedule. I'm not sure if I can post from Haiti yet or not, so it might be binge writing and picture taking when I get back. We are very excited about the trip!
Sent from my iPhone using Tapatalk
Security probably woke that guy up not too long after you saw him like that. I've been there. :0003
Maybe start your own handover IV business. I'd be all into finding out what is required to make that happen. All the equipment and necessary fluids and vitamins are available to purchase, correct? This seems like a great business opportunity and I'm sure can be very profitable and with charging a lot less than those guys charge.
"H"
H stands for heroin, but it also stands for honesty. Getting report last night, the first patient encountered is 47. She is obviously filthy dirty (looks like she has been rolling around in a bucket of coal), and she has been admitted because she has a large painful abcess on her left outer thigh. Side note; administration likes nurses to do "handoff" communication or report. This means that both nurses enter the room, make introductions, and give report about the patient right in front of them. This can be a little awkward at times for numerous reasons (saying a person is a heroin skin popper which has caused a terrible abcess right in front of them to me qualifies). Anyway, the nurse fills me in on the patient but leaves out the obvious info about her drug abuse.
On a quick cursory exam, the patient is completely covered in scars, so this is not her first rodeo. I asked her, "why do you keep getting these abcesses?" She looked me in the eye and said, "shooting dope". Why would I ask such an obvious question that anybody in my field would know the answer? Because it tells a lot about the patient; their demeanor, their outlook, their desire to get better, their state of mind, and their willingness to cooperate. Even in her condition and her terrible destructive lifestyle, I can respect a person who can tell the truth because telling the truth is never a given. I had a patient with an almost identical history and exam findings tell me last week that her landlord wouldn't spray and spiders kept biting her at night. get out of here with that obvious lie.
Anyway, I had a lot of interaction with this woman last night. I had to do cultures of her nares (for a MRSA screen), rectum (VRE screen), and abcess (to determine the bacteria causing the infection and to assure proper treatment). Her IV was in her neck, and I quickly found out it had failed. This is horrible news because I know she will be next to impossible to start an IV on, and she must have IV access for fluids and antibiotics. I'm already stressed bc I have a heavy patient load, and I know it's on me to get this done because there is nobody else available at night to do it that will be better than me (please don't take that as cocky; I have 23 years experience, and the bulk of my last job was starting tough IVs that nobody else could get).
My first attempt failed. I borrowed the "vein finder" from another unit. I generally don't like the vein finder bc I'm old school and I feel it is not reliable, but I'm finding nothing. Both of her arms are pocked with scars and old healed abcesses. She looks like a burn victim she has so many. The vein finder shows the shadow of a vein where anatomically one should be under the biceps muscle. I need at least a 20 gauge IV because of the strong antibiotics we will be using, so that makes it even more difficult. I stick her and probe. It isn't causing her pain, but I don't get it right away. I don't like to dig and keep digging because it is so painful to the patient, but she was comfortable, so I could be patient. I finally adjust the angle just a small bit, and boom! I'm in! Sweet! We are both very happy. I cautioned her to be very careful and protect that site, and I secured it double what I typically do.
Through this process I learn a lot about her because of her willingness to talk and tell the truth. There's more to my job than slinging medication and starting IVs. Patients need to talk sometimes and express their feelings. I often don't have the time for this but because of all the work required, I had to be in the room, so I made the most of it. She is married. Her husband is also a user, and they do not have a home. They assist each other/shoot each other up. She says he is not abusive, and I see no signs of that. She is from Alabama, and she has been using on and off for 20 years. She takes Methadone and sometimes stays clean for extended amounts of time. She still has contact with her adult children and her parents which in my experience I have found to be rare. I encourage her when I learn this and asked if she had ever considered going home. She said she thinks about it all the time. I asked her how much her habit was, and she told me $50 a day. When asked how she gets this money, she said by hustling and pan-handling. I asked her point blank, "what do you think is going to happen to you if you do not stop using"? She looked me right in the eye and said, "I want to quit; God knows I want to. I have tried and tried, but I can't. I can't believe I am still alive, and I know I am going to die if don't stop". I told her I would do everything in my power (sadly not much I can do but refer her to people/programs and encourage her) to help. I made sure she was fed and comfortable last night, and I was as encouraging as I know how to be. I truly hope she can make a change. She doesn't have much, but even in her abhorrent condition, she can still do what so many can't, and that is be truthful.
H stands for heroin, but it also stands for honesty. Getting report last night, the first patient encountered is 47. She is obviously filthy dirty (looks like she has been rolling around in a bucket of coal), and she has been admitted because she has a large painful abcess on her left outer thigh. Side note; administration likes nurses to do "handoff" communication or report. This means that both nurses enter the room, make introductions, and give report about the patient right in front of them. This can be a little awkward at times for numerous reasons (saying a person is a heroin skin popper which has caused a terrible abcess right in front of them to me qualifies). Anyway, the nurse fills me in on the patient but leaves out the obvious info about her drug abuse.
On a quick cursory exam, the patient is completely covered in scars, so this is not her first rodeo. I asked her, "why do you keep getting these abcesses?" She looked me in the eye and said, "shooting dope". Why would I ask such an obvious question that anybody in my field would know the answer? Because it tells a lot about the patient; their demeanor, their outlook, their desire to get better, their state of mind, and their willingness to cooperate. Even in her condition and her terrible destructive lifestyle, I can respect a person who can tell the truth because telling the truth is never a given. I had a patient with an almost identical history and exam findings tell me last week that her landlord wouldn't spray and spiders kept biting her at night.
get out of here with that obvious lie.Anyway, I had a lot of interaction with this woman last night. I had to do cultures of her nares (for a MRSA screen), rectum (VRE screen), and abcess (to determine the bacteria causing the infection and to assure proper treatment). Her IV was in her neck, and I quickly found out it had failed. This is horrible news because I know she will be next to impossible to start an IV on, and she must have IV access for fluids and antibiotics. I'm already stressed bc I have a heavy patient load, and I know it's on me to get this done because there is nobody else available at night to do it that will be better than me (please don't take that as cocky; I have 23 years experience, and the bulk of my last job was starting tough IVs that nobody else could get).
My first attempt failed. I borrowed the "vein finder" from another unit. I generally don't like the vein finder bc I'm old school and I feel it is not reliable, but I'm finding nothing. Both of her arms are pocked with scars and old healed abcesses. She looks like a burn victim she has so many. The vein finder shows the shadow of a vein where anatomically one should be under the biceps muscle. I need at least a 20 gauge IV because of the strong antibiotics we will be using, so that makes it even more difficult. I stick her and probe. It isn't causing her pain, but I don't get it right away. I don't like to dig and keep digging because it is so painful to the patient, but she was comfortable, so I could be patient. I finally adjust the angle just a small bit, and boom! I'm in! Sweet! We are both very happy. I cautioned her to be very careful and protect that site, and I secured it double what I typically do.
Through this process I learn a lot about her because of her willingness to talk and tell the truth. There's more to my job than slinging medication and starting IVs. Patients need to talk sometimes and express their feelings. I often don't have the time for this but because of all the work required, I had to be in the room, so I made the most of it. She is married. Her husband is also a user, and they do not have a home. They assist each other/shoot each other up. She says he is not abusive, and I see no signs of that. She is from Alabama, and she has been using on and off for 20 years. She takes Methadone and sometimes stays clean for extended amounts of time. She still has contact with her adult children and her parents which in my experience I have found to be rare. I encourage her when I learn this and asked if she had ever considered going home. She said she thinks about it all the time. I asked her how much her habit was, and she told me $50 a day. When asked how she gets this money, she said by hustling and pan-handling. I asked her point blank, "what do you think is going to happen to you if you do not stop using"? She looked me right in the eye and said, "I want to quit; God knows I want to. I have tried and tried, but I can't. I can't believe I am still alive, and I know I am going to die if don't stop". I told her I would do everything in my power (sadly not much I can do but refer her to people/programs and encourage her) to help. I made sure she was fed and comfortable last night, and I was as encouraging as I know how to be. I truly hope she can make a change. She doesn't have much, but even in her abhorrent condition, she can still do what so many can't, and that is be truthful.
Tell her to go to WESTCARE, it may be tough to find a bed but get on the waiting list....if she is 'truthful' about wanting help that is the best place for her....I don't believe they charge for the treatment...I am trying to get my daughter to go there, but I cannot force it one her....she has to want it
A lot of addicts want help but don't know where to seek it....where to begin....etc....
When you described her in the first paragraph, I pictured my daughter when I went to pick her up in front of the Orleans on June 27th....she was dirty, hadn't showered in days, had changed the tire on her car to the spare and then back to the original flat tire she took off....brought back memories that will haunt me forever....
Now she's on METH....haven't seen her in over 6 weeks....my wife made plans to meet her for lunch yesterday at Noon....when she went to pick her up at 12:30 my daughter wouldn't answer the door, her phone....nothing...I just texted her 'boyfriend' and told him I am worried about her...the fact she said she was coming over for Thanksgiving and no showed, then last week for my birthday...same thing....then yesterday....he told me she is fine, they just had lunch and she is in the shower....he would have her call me later today...he said she told him about it but they both fell asleep yesterday afternoon for a couple hours....in a half hour she went from wanting to have lunch to NOTHING?? This situation stinks and I am close to taking it to another level by going to knock their door down.....my wife knows this and will not give me the address cuz she said it is in a very bad area and doesn't want me to get shot....especially by them who have turned into a paranoid mess.....
the hardest part of being associated with an addict is the willingness to help in any way and not being able to....knowing they are in trouble and you are left helpless...
I'm not struggling with it as much as I used to, but this will not have a happy ending and when I read these stories of 40 somethings doing such destructive drugs for so many years makes me have to dig in for the long haul....
keep up the good work Clint!! Her name is Kelsea Kilmer in case she crosses YOUR path someday....
A lot of addicts want help but don't know where to seek it....where to begin....etc....
When you described her in the first paragraph, I pictured my daughter when I went to pick her up in front of the Orleans on June 27th....she was dirty, hadn't showered in days, had changed the tire on her car to the spare and then back to the original flat tire she took off....brought back memories that will haunt me forever....
Now she's on METH....haven't seen her in over 6 weeks....my wife made plans to meet her for lunch yesterday at Noon....when she went to pick her up at 12:30 my daughter wouldn't answer the door, her phone....nothing...I just texted her 'boyfriend' and told him I am worried about her...the fact she said she was coming over for Thanksgiving and no showed, then last week for my birthday...same thing....then yesterday....he told me she is fine, they just had lunch and she is in the shower....he would have her call me later today...he said she told him about it but they both fell asleep yesterday afternoon for a couple hours....in a half hour she went from wanting to have lunch to NOTHING?? This situation stinks and I am close to taking it to another level by going to knock their door down.....my wife knows this and will not give me the address cuz she said it is in a very bad area and doesn't want me to get shot....especially by them who have turned into a paranoid mess.....
the hardest part of being associated with an addict is the willingness to help in any way and not being able to....knowing they are in trouble and you are left helpless...
I'm not struggling with it as much as I used to, but this will not have a happy ending and when I read these stories of 40 somethings doing such destructive drugs for so many years makes me have to dig in for the long haul....
keep up the good work Clint!! Her name is Kelsea Kilmer in case she crosses YOUR path someday....
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Scott, I will be on the lookout. The heartache and powerlessness you feel really tugs at me as a father. I pray her situation.
Sorry you're going through this, Scott. Keep trying because deep down she wants to be back to normal and have her family back and one day that will happen. Sorry man.
"H"
H stands for heroin, but it also stands for honesty. Getting report last night, the first patient encountered is 47. She is obviously filthy dirty (looks like she has been rolling around in a bucket of coal), and she has been admitted because she has a large painful abcess on her left outer thigh. Side note; administration likes nurses to do "handoff" communication or report. This means that both nurses enter the room, make introductions, and give report about the patient right in front of them. This can be a little awkward at times for numerous reasons (saying a person is a heroin skin popper which has caused a terrible abcess right in front of them to me qualifies). Anyway, the nurse fills me in on the patient but leaves out the obvious info about her drug abuse.
On a quick cursory exam, the patient is completely covered in scars, so this is not her first rodeo. I asked her, "why do you keep getting these abcesses?" She looked me in the eye and said, "shooting dope". Why would I ask such an obvious question that anybody in my field would know the answer? Because it tells a lot about the patient; their demeanor, their outlook, their desire to get better, their state of mind, and their willingness to cooperate. Even in her condition and her terrible destructive lifestyle, I can respect a person who can tell the truth because telling the truth is never a given. I had a patient with an almost identical history and exam findings tell me last week that her landlord wouldn't spray and spiders kept biting her at night.
Anyway, I had a lot of interaction with this woman last night. I had to do cultures of her nares (for a MRSA screen), rectum (VRE screen), and abcess (to determine the bacteria causing the infection and to assure proper treatment). Her IV was in her neck, and I quickly found out it had failed. This is horrible news because I know she will be next to impossible to start an IV on, and she must have IV access for fluids and antibiotics. I'm already stressed bc I have a heavy patient load, and I know it's on me to get this done because there is nobody else available at night to do it that will be better than me (please don't take that as cocky; I have 23 years experience, and the bulk of my last job was starting tough IVs that nobody else could get).
My first attempt failed. I borrowed the "vein finder" from another unit. I generally don't like the vein finder bc I'm old school and I feel it is not reliable, but I'm finding nothing. Both of her arms are pocked with scars and old healed abcesses. She looks like a burn victim she has so many. The vein finder shows the shadow of a vein where anatomically one should be under the biceps muscle. I need at least a 20 gauge IV because of the strong antibiotics we will be using, so that makes it even more difficult. I stick her and probe. It isn't causing her pain, but I don't get it right away. I don't like to dig and keep digging because it is so painful to the patient, but she was comfortable, so I could be patient. I finally adjust the angle just a small bit, and boom! I'm in! Sweet! We are both very happy. I cautioned her to be very careful and protect that site, and I secured it double what I typically do.
Through this process I learn a lot about her because of her willingness to talk and tell the truth. There's more to my job than slinging medication and starting IVs. Patients need to talk sometimes and express their feelings. I often don't have the time for this but because of all the work required, I had to be in the room, so I made the most of it. She is married. Her husband is also a user, and they do not have a home. They assist each other/shoot each other up. She says he is not abusive, and I see no signs of that. She is from Alabama, and she has been using on and off for 20 years. She takes Methadone and sometimes stays clean for extended amounts of time. She still has contact with her adult children and her parents which in my experience I have found to be rare. I encourage her when I learn this and asked if she had ever considered going home. She said she thinks about it all the time. I asked her how much her habit was, and she told me $50 a day. When asked how she gets this money, she said by hustling and pan-handling. I asked her point blank, "what do you think is going to happen to you if you do not stop using"? She looked me right in the eye and said, "I want to quit; God knows I want to. I have tried and tried, but I can't. I can't believe I am still alive, and I know I am going to die if don't stop". I told her I would do everything in my power (sadly not much I can do but refer her to people/programs and encourage her) to help. I made sure she was fed and comfortable last night, and I was as encouraging as I know how to be. I truly hope she can make a change. She doesn't have much, but even in her abhorrent condition, she can still do what so many can't, and that is be truthful.
Man, you see so much depressing crap, it's a wonder you can keep your own head straight. But then again, maybe that actually helps you keep it straight.
65,,,I am in the Birmingham area of Alabama,,,If you think this woman is for real, and if her daughter is anywhere within reach, I would not mind calling or reaching out to her daughter to see if her daughter wants her mom to come 'home' for Christmas,,,and if so, I would be glad to purchase her a ticket to BHam and get her a ride to her daughters ? God has blessed me with a life that is not monetary but hopefully a heart that gives back. Let me know ,,,:toast:
Thanks for that offer. I'll talk more to her tonight if she is still there. She talked more to me last night, and it was mainly about her husband. She raved about him in glowing terms, but I'm quite sure he's a huge part of the problem. I highly doubt she would leave him here to go home. I'm definitely not a psych nurse, but working out here and my other jobs has really kind of put me in that field (especially with regards to addiction, Borderline Personality Disorder, and Co-Dependency). This lady is definitely in an unhealthy co-dependent relationship in addition to her horrible addiction. She's deluded to thinking her husband is a great man and they have an awesome relationship probably because he doesn't physically abuse her. That might be her only criteria. Living in squalor, having terrible abcesses, looking like a burn victim and pincushion, and being filthy dirty might be easily discarded. I'll update tomorrow. Thanks.
The lady I wrote about is going home later today. Apparently she does have a residence even though she was admitted in such a filthy condition. She said she is going to try to go to the Methadone clinic. Apparently she can't get a prescription for the Methadone. She has to go every day around 6 am and get a day's worth of Methadone, and she has to do this every day :wtf:
I had no clue it was that laborious of a process. She has to catch two busses to get to the clinic, and she also has to have the money for the Methadone every day. This is the plan for now, but all she can talk about is her husband. He is supposedly getting on the Methadone plan too.
Hopefully she makes an effort and stays off the H.
I had no clue it was that laborious of a process. She has to catch two busses to get to the clinic, and she also has to have the money for the Methadone every day. This is the plan for now, but all she can talk about is her husband. He is supposedly getting on the Methadone plan too.
Hopefully she makes an effort and stays off the H.
