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Tag Archives: Funny

Videos to Watch

Had to share a couple of videos. One has repeatedly entertained our staff. One repeatedly entertains my kids. One video has been circulating around our ED staff e-mails for a few weeks, although it has been circulating on YouTube since 2006. Totally bizarre. Lots of swearing and f-bombs, so you have been warned. But still funny. Allegedly this guy was dropping acid and sitting in a closet when his roommate taped him … or not. Now we’re all making little quotes in the ED from this throughout the day. Not once, not nevah. Not my chair, not my problem, that’s what I say. Then a video forwarded to me a couple of days ago that my kids play over and over again. Kung Fu Panda has nothing on this bear. Amazing. Finally, can you say “Do NOT Touch Me“?

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Placebo Power

This is a repost from a couple of years ago. I actually had a new post planned, but had to reference something on this post. When I moved from my old blog to EP Monthly, this post apparently didn’t get transferred. Some fond memories below. —– The effect of a placebo is based on someone’s belief that an inactive substance is going to help them. This belief can actually cause the brain to release chemicals that mimic the effect of antidepressant medications and/or analgesia. Some placebos are not just “sugar pills.” For example, some people with viral upper respiratory infections must have antibiotics to make them feel better. Physicians know (or at least they should know) that using antibiotics for viral infections is a useless proposition. Like spraying Raid on dandelions. But some patients swear that the antibiotics make them feel better and will seek out physicians who inappropriately prescribe antibiotics for their head colds and bronchitis. By the way, this placebo effect wouldn’t be a big deal except that now we have made many antibiotics less effective because we prescribe them so much. MRSA is proof that single cellular organisms evolve faster than the prescribing practices of some physicians. Vitamins. Supplements. Energy drinks. They all may help cure what ails ya, but is there a scientific basis for the improvement? Or is it the placebo effect? Who knows? Who cares? If you feel better, it doesn’t matter whether you’re popping a couple of M&Ms or chugging quart of snake oil. Go for it. Lately a lot of patients have shown dramatic improvement in their pain symptoms with the placebo effect in our ED. An issue some of our nurses have is that they have to get the patient to believe in the effectiveness of the placebo in order for it to work. If you give someone a shot and tell them that it is just some “saline,” you probably won’t get much of a response. If you give someone a shot of “obecalp” (which is “placebo” spelled backwards), and tell them that this is a medication for their pain that may make them sleepy, it might work. Therein lies the problem. How to you get the patient to buy into the placebo effect without lying to them? OK ….. shhhhhh. Can you keep a secret? If a patient is looking for pain pills, hand them three regular Tylenol pills. If the patients ask what they are getting, they are told they are getting “Tylenol …. number three.” Not a lie. They really are getting three Tylenol pills. Good placebo effect. Probably half of the patients who get “Tylenol … number three” get significant relief with three plain ol’ acetaminophen pills. One 19 year old kid with chronic back pain (how does pain become chronic at age 19?) came in the other day after running out of his pain pills. The ED doc gave him a shot of Toradol. When that didn’t help, she had the nurse give the kid a couple of Tylenol tablets. He asked what medication he was receiving. The doctor told him it was “acetaminophen.” He asked her “is that like the pain medication in Vicodin?” She replied “Of course. Acetaminophen is one of the active ingredients in Vicodin.” He was happy and pain-free 30 minutes later. The most profound placebo effect I have ever seen actually occurred in a little old lady that I saw about 6 months ago. She was dancing around the waiting room complaining of severe pain in her hip. Howling (literally) in pain. Like if she kept it up, a rain ...

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Guaiac issues

JCAHO apparently requires that the doctors show nurses results of all hemoccult testing. I can’t find the actual requirement anywhere, but then again, JCAHO hides its patient safety requirements and makes anyone who wants to learn about patient safety purchase their books. In addition, whomever interprets the test must take a certifying exam every year to show that they are able to properly interpret the color change on the hemoccult card. Kind of like taking a certifying exam each year to prove that you can determine when a traffic light turns from green to red, I suppose. Apparently physicians are competent enough to manage a multi-trauma patient, intubate, insert chest tubes, and calculate the doses for vasoactive medications, but, on that same multi-trauma patient we lack the fundamental knowledge to determine whether a piece of paper impregnated with resin from the Guaiacum species of plant on a hemoccult card turns from white to blue. Did you also know that one of the other uses for the guaiacum species (pictured at right) is to create guaifenesin for cough syrup? Don’t tell JCAHO that. Otherwise we’ll have to keep the cards under lock and key in case someone with a cough decides they want to chew on the cards instead of taking cough medicine. Patient safety, you know. Oh, and then for patient safety reasons we have to log each and every test result not only on the patient’s chart, but also in a log book. No one ever says what the log book is for, and no one has ever used the log book other than to log results from the hemoccult testing that the doctors are unable to interpret — and to show JCAHO investigators that we are actually keeping the log book — but woe be to the nurse who took care of the patient where a hemoccult was done, but a result (including lot number of the card, a lot number on the bottle of developer, and respective expiration dates) was not logged. Major nursing demerits on you! That was an interesting mind melt that had nothing to do with the actual post. Getting back on track … During one recent shift, we had a run on abdominal pain patients — as in I was managing 7 patients all with some varied form of abdominal pain. Because I do a rectal exam on most patients with abdominal pain, we were going through a lot of stool guaiac cards. One nurse started giving me a hard time for doing too many rectal exams. Then she did it. She called me a “turd tickler.” Them’s fighting words. So I hatched a plan. I went into the break room, found some A1 Steak Sauce, and put a little on the edge of my gloved hand. Then I put some on the back of a hemoccult card. I walked into a room, asked the patient how she was doing, then came out of the room and handed card to nurse, telling her to make sure that she logged the results in our JCAHO-approved stool sample logging book . When she grabbed the card, she immediately felt the moisture, looked at her hand, gasped, dropped the card, and ran to the sink. She watched me as I looked at my gloved hand, made a face, and rubbed my hand on my scrub bottoms. Then I took the glove off, grabbed the next chart, and walked into the room. I heard the nurse say “eeeeeewww” as I was walking away. She was pale and had this disgusted look on her face when I walked ...

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More Stuff My Dad Says

Relatively quiet day. Only had a couple of memorable quotes: [Expressing frustration over TV political commentators] “Oh, right. HE’s a great source for information. These people disimpact themselves, look at their hands, then wave to the camera and expect you to take everything you see as gospel truth. Critical thinking isn’t part of their thought process.” [Describing joint replacements] “Artificial joints don’t do sh*t. You’re born with only so many movements in your joints. When they’re used up, you’re through. End of story.”

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This story was recently forwarded to me in an e-mail. Walter Olson had it up at Overlawyered.com weeks ago, but I missed it for some reason. So I had to re-post it as yet another example of why we need a “loser pays” law in this country. Some upstanding Texas attorney named William Ogletree left his “expensive black leather coat” in a pizza joint a Dallas Airport. When he came back, the coat was gone. This wasn’t just any coat, though. It was an extra large POLO leather coat … with a plaid lining. Billy then got mad because the City of Houston, Continental Airlines, and the pizza joint didn’t “collect the coat and keep it in a secure place for a reasonable time.” So he sent the above places a letter threatening to sue them for $800 because they failed to properly “manage lost and found items.”  All of the prospective defendants are probably still quivering in their booties. I was going to create an ad on eBay listing an “extra large black leather Polo coat with smarmy plaid lining found in Terminal C of the Houston Airport on December 30 containing several pairs of oversized lace panties and an unknown lubricant in the inside pockets” then forward it to his office e-mail, but then I thought that he might bid on it. I don’t want to be the next victim of his poison pen …

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Double Entendre

ERP here from Erstories.  A little quick post while I am out skiing. Yes, I admit I get a little juvenile on occasion during a shift.  Other staff members do as well and I think this is a good thing.  It lighten things up.  A little silly laugh because someone said something that conjures Beavis and Butt-head – style snickering helps our blood pressures come down.  Of course there is a fine line between jokes and harassment but if everyone laughs when someone says something that is unintentionally of sexual connotation, who would complain? Some of the things I have heard or had said to me: “Hey ERP, do you have a measuring tool”? “Who was that new doctor? He pissed me off by getting all up in me.” “Holy Moly, it is busy. I have never seen such a patient load.” “Yes, Doctor Newbie, I can help you get that DVD into the slot.” “Hey ERP, the new patient in room 5 has priapism, go help him take care of it.” People need to lighten up in the work place.  Sometimes things are just funny!

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