Hard to sleep

I promise this is mostly related to the practice of respiratory care, and here's how.

Respiratory care also encompasses sleep medicine.

A diagnosis that may be arrived at during a sleep study is Restless Leg Syndrome.

RLS may be treated by Mirapex .

Mirapex may cause uncontrollable urges to gamble and have sex.

So I was delivering quality respiratory care the other night when a commercial for Mirapex came on. I was checking my vent and only half paying attention to what was on the TV. My attention was caught by a voice saying something to the effect of "... talk to your doctor if you have uncontrollable urges to gamble or have intercourse..."

HUH? I asked my patient, "Did that say what I think it said?"

Damn Diprivan.

So two days later I'm setting on the couch with my lovely wife speaking of things of great consequence. On pops the Mirapex commercial. I quickly hush her (bad idea) and intently watch the commercial. There it is! They actually said that this drug may cause increased urges for sex. Now, having just hushed my wife (and knowing I could look forward to a dry spell) I was wondering how I could make this information work for me.

Upon further research, I found that there is a class action lawsuit (big surprise) to benefit the people who have been hurt by Mirapex. I also found that this medication could cause sleeplessness. I guess so. If you're up all night tending to your pleasure/reward-seeking activities there is little time for sleep. Obsessive eating, gambling, shopping, and scrogging are not condusive to a restful night's sleep. I feel that I personally have been caused emotional distress by them and would be happy to settle out of court for free samples. I wonder if they will dissolve in my wife's next cocktail? Bwhahahaha.

RT

Bodies

So Body Works is in my town and I really want to go see it. I really think it would be interesting to see the human body in this way. My wife on the other hand thinks it's morbid and defiantly something she can miss. Now, in the course of my short professional life I've seen most of the important internal organs right up close. Why would I want to see more dead people? It's like a CPA going home and doing their taxes. What do you think doing these jobs do to us. Does it desensitize us to the point where we can say, "It's just another dead body?" What does that say for humans, or individuals? Sorry I'm being like this, I almost got in a fight today and that always makes me wax philosophical.

http://www.bodyworlds.com/en.html

RT

Rare gas

I must have worked at a small hospital too long. Tonight we have a patient on Heliox. It is so sweet. I've really enjoyed doing a couple of his checks because I like hearing him talk like Donald Duck. I know, It doesn't take much to get me excited. Otherwise it's a pretty slow night. I'm enjoying it because I know that soon we will have a multitude of sick people and not enough employees. If anyone wants a job let me know.

RT

My own personal Jesus

So I was attending a code the other night and had to run a ABG to the blood gas lab because the tube system was down. Of course I was on the 43rd floor (OK...a slight exaggeration) and had to walk 3 miles to the lab (not an exaggeration). I, being new, chose the worst possible route to my destination. As I walked through the front lobby I was accosted by two young men in ties. With a maniacal look in their eyes they asked if I had accepted Jesus as my own personal savior.

With Depeche Mode running through my head I told them I was in a little bit of a hurry and would have to get back to them with my answer. Still barring my way they proceeded to tell me that there was nothing more important than my everlasting soul. Smiling, I told them that there is a dead person whom I am trying to help resurrect who may wish to respectfully disagree. Further, I added, unless they had a personal invite to pass out their pretty little phamplets I suggested they leave. For as soon as I could tear myself from them I would be calling security. They parted like the Red Sea and I proceeded to the lab, ran the blood, and called the results. I then went through the lobby to see if I would need to make good to call the people with the badges and mace. Thankfully, they had made like the Ark of the Covenant and disappeared.

Now, what I don't understand is why these young men had been sent to the hospital. We have clinical clergy who are more than capable of handling the spiritual needs of our patients. If they need something that cannot be provided the people's own religious leader is welcome at the hospital. I find it hard to believe that anyone in their right mind would have their young people go out into a medical center and hand out propaganda at 9:30pm. The only thing my cynical mind can come up with is either these kids had their religions mixed up and thought they were racking up virgins, or they came from a poor church that was trying to bring in some tithes to pad their coffers.

At different times of the day there are different types of visitors in the hospital. During the day there are the elderly who come to visit their friends and bogart the coffee. There are the kids who are dragged there to Aunt Jane one last time. There are the adult children who haven't visited their parents in the nursing home for six months and then charge into the hospital demanding the moon. However, as the clock comes closer to straight up in the dark the people become desperate. Lack of sleep coupled with a very sick loved one makes people unable to cope with even the most basic decisions. I've seen visitors turn circles over and over trying to decided if they want vanilla or chocolate pudding in the cafe. The last thing they need is someone giving them a little piece of paper that tells them that unless they recite a silly little prayer right now they are in real danger of going to hell.

I guess my past life has made me consider these people predatory. I've never been a big fan of organized religion and this is why. If these people want to do some good why don't they go to a skilled nursing facility to minister to the elderly who would love to have visitors who had something uplifting to say. I'll tell you why. Their god is all about the Benjamens.

RT

P.S. OK...I'm just pissed that I had to listen to "Personal Jesus" in my head all night. Damn, I think I'll be listening to it again tonight.

Psychosis and COPD don't mix

So at my hospital we give very few breathing treatments. In med-surg areas the nurses give the Nebs. One of the few exceptions to this is a floor where they stick all of the patients with breathing problems. At least you don't have to run to different floors to hear, "No...you don't understand. I really can't breath. My breathing is much worse than these other people's." The drawback is you can't walk down the hall without someone requesting a treatment "while you're here."

So imagine my suprise when I encountered a patient who didn't want her treatment. I got in report that she had a history of mental distrubance and had suffered through about 385 pack years. Following is our exchange.

RT: "Good evening, I'm going to be your respiratory therapist tonight."
Patient: "NOOO-OOOOOOHHHH!!!!!"
RT: "Don't worry, it's not going to hurt. It's just your breathing treatment. You remember your pipe? No needles involved."
Patient: "NOOO! I don't want it." As she presses the nurse call bell.

I realize that she's going to tattle on me. I know that the RN will back me up and she just gets one more chance anyway. If a patient tells me they don't want the treatment three times, I feel pretty good about the refusal. Otherwise I always get called a few minutes later to give a PRN.

Secretary: "May I help you?"
Patient: LOUDLY! "This respiratory man is in here trying to put his thing in my mouth!"
RT: Under his breath, "Shit."
Confused Secretary:"...Can you repeat that?"
RT:"Hey, it's the respiratory therapist and I'm trying to talk her into taking her breathing treatment."
Confused Secretary:Sounding not at all convinced. "OK. Call if you need something."

So when I showed her the neb she immediatly got excited and could hardly wait for me to get the medicine loaded. She didn't give me a problem for the rest of the treatment. However, I was really glad she was scheudled for while awake. I don't think I would have wanted to go through the same thing at three o'clock in the morning. I really love this job and haven't been here long enough to get fired.

RT

Nature of the Beast

So I'm setting here listeing to Sirius radio on my charting computer. I only have three patients tonight. One vent, one bipap and one treatment. I don't want to use the "Q" word but I was really excited when I saw I had the code pager. Not that I want anything bad to happen to someone but if someone's heart is going to stop, can I scheudle it for 3am? That's my worst hour.

I hate when it's this slow. Unfortunatly the nature of respiratory care is that you will set on your ass until a 90 mile per hour, balls to the wall emergency. I really wish I could have a long discussion with myself five years. I don't know what I expected but it sure wasn't this. Not that I'm complaining. It's much better than delivering chicken wings.

RT

Greetings

Good Evening,
I'm a Respiratory Terrorist at a major medical center in the south. In fact, I work at the best place to practice respiratory care in the state. I've been doing this about three years and thought the world would love to be included when I berate myself for making a mistake. Hopefully I can keep it interesting.

RT