The magical mystery land of community health

I don't make this stuff up!…but I do change identifying information.

A different job July 30, 2009

Filed under: Uncategorized — lesbonurse @ 2:03 am

Gotta love the girlfriend’s job, especially when she tells stories that end like this:

“…so then we had to call poison control. Oh, and we also realized that he had crapped in his pants.”

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Another important life lesson July 29, 2009

Filed under: Uncategorized — lesbonurse @ 1:26 am

If you happen to be a young person enjoying a night out in a club, and you happen to see someone that you have a problem with, and that person happens to “just walk up out of nowhere” and punch you in the face a few times, ask yourself these questions:

Did I lose consciousness?  Do I have blood pouring from my nose?  Did I just bite a giant hole in my lip?  Does my entire face hurt like a sonofabitch?

If the answer to these questions is yes, go to the ER.  Don’t wait a week and then walk in to see your friendly nurse practitioner with a complaint of “headaches and facial pain.”

 

Important life lessons July 26, 2009

Filed under: Uncategorized — lesbonurse @ 7:19 pm

This week I learned (or was reminded of) some important life lessons from my patients:

  1. A drunken backflip into a kiddie pool WILL result in severe bodily harm.
  2. If your therapist looks frightened when you talk about your suicidal feelings, find a new therapist!
  3. If a horrible rash doesn’t respond to 2 weeks of twice-a-day antifungal cream, it’s not a fungus.
  4. A month of vaginal bleeding after 10 years of menopause IS something to worry about.
  5. There is such a thing as a testosterone-secreting tumor.  Which could possibly explain a very high testosterone level.
  6. If your back hurts, wear sensible shoes.  Platform heels do not count as “sensible.”
 

Special “new intern” haiku July 25, 2009

Filed under: Uncategorized — lesbonurse @ 12:20 am

Intern, are you gay?

Or just a fan of the short

hair and manly pants?


Only been a month–

Too soon to be an asshole.

Earn some respect first.

 

Monday Haiku July 20, 2009

Filed under: Uncategorized — lesbonurse @ 11:18 pm

Weather turns humid

Not good news for people with

fungus in skin folds

 

Battling the burnout July 18, 2009

Filed under: Uncategorized — lesbonurse @ 1:35 am

A few weeks ago I was having a series of very bad days. Dozens of unfinished notes, news from the powers-that-be about increases to our patient schedules, constant talk about “productivity” and the seemingly endless needs of my patients had left me feeling crazed. For a day or two I even imagined what it might feel like to start looking for another job. I decided that something had to give. So for the past week I’ve been working on writing crappier notes. Not crappy notes, mind you, just a little crappier. There has to be a happy medium between the beautifully detailed–nay, lyrical–documents that I usually produce and the piece-of-shit-not-even-enough-documentation-to-satisfy-an-insurance-audit notes that some of my colleagues write. I’m working on it. I’m tossing out the description of patient’s social situations, substituting things like “significant social stressors” or “grief” in place of stories. Detailed neuro and ortho exams? Forget it. History of complex medical conditions? How about “See previous notes” instead. Does it feel good? Not particularly. But does it feel good to leave on a Friday with 8 notes pending instead of 28? It sure does.

My other anti-burnout strategy has been to farm out more work to the medical assistants and nurses. I’m sure that this has not increased my popularity in the office. Everyone likes the providers that do most of the scut work themselves. And I know that patients appreciate a nice phone call about a lab result or medication change. Sorry, everyone, the nurse will be doing that now. The nurse will be refilling your meds, calling to reschedule your appointment and letting you know that your potassium is low. I’d love to talk to you myself, but…you know how it is. Too busy!

It’s unfortunate that I am working in a system that prizes the number of patient visits over the quality of patient care. It’s unfortunate that the number of times I hear “How come you can’t be my doctor?” in a day has no impact on my salary. It’s unfortunate that I have to cut corners in order to keep myself from losing my mind. But it would be more unfortunate if I had to leave my clinic because of burnout. So I guess I’ll keep trying to be just a little less of a super-nurse.

 

Do’s and Don’ts of a bad economy July 12, 2009

Filed under: Uncategorized — lesbonurse @ 9:52 pm

Yes, times are hard and extra cash is scarce.  Here are some tips I’ve gleaned from the patients in my clinic:

  • Do buy the Family Dollar brand Loratadine for $2.50 for a box of 30 tablets.  Cheap!
  • Don’t buy the strawberry scented douche from Family Dollar.  Douching is bad for you…and why does anyone want to have a strawberry scented vagina?
  • Do use your disability check to pay the co-pay for your Spiriva
  • Don’t use your check to pay for a pack of cigarettes (or even worse, a carton of cigarettes)
  • Do be creative with your fundraising
  • But…Don’t sell your narcotics on the street outside the clinic
  • Do drink water from the tap
  • Don’t spend your money on those terrible little barrels of “fruit punch” that sell 10 for $1