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EP39 - Crazy ER Stories with Nurse Nikki! · Oh And One More Thing

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It's all friends facing our fears, laughing through the
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chaos and drinking some beers. So here's to the laughs, the
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crumbs and the cheers, all the awkward moments and we're still
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here 'cause in the end, we're just doing our thing.
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It's our crazy life. 01 more thing.
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One more thing. Oh, hi, I'm Brian.
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Welcome to. Oh, and one more thing.
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Hey everyone I am Rob how we doing?
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I'm doing great. Rob Yeah.
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So Brian, what? What hurts today?
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The question really should be what doesn't hurt.
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Today, Rob, it's very true. It's very true.
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You know, I'm actually feeling a little bit under the weather.
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Are you? Maybe you can hear it in my
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voice a little bit. I'm a little nasally.
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I've had a cold for a few days. Yeah, that's terrible.
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I know a typical symptoms, you know, stuffy nose, sore throat,
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watery eyes. I mean, clearly I'm dying.
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Clearly you are. That's funny though because I
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always Google my symptoms and self diagnose.
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I mean who doesn't? Oh right.
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I know I'm not a doctor or a nurse, but.
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Yeah, I know what you mean. But let's be honest.
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I mean as a guy like when I come down with anything like I can't
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function. I mean, no you can't.
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Seriously. I mean, I know that.
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So does my wife, but good thing I personally know a medical
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professional. In fact, my stepdaughter isn't.
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Yeah, Nurse, did you know that? I did know that.
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Yeah, I should ask her. Hey.
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Hey nurse, Nurse Nikki, am I dying?
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No. Perfect timing, Nick, right?
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Hey, today we're excited to have our special guest sign, who is
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none other than our very own nurse, Nikki.
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Have peeps? Hi.
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We're glad you're here. What's going on?
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Not much, just hanging out well. Tell us a little bit about
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yourself. Well, I'm a nurse practitioner
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over in the ER in South Dakota in a rural area.
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So I explained what a nurse practitioner is and does.
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So I went to undergrad and I was a RN so bachelor of RN so
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registered nurse and then I went to Graduate School so a master's
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degree for a nurse practitioner. So do you guys know what like a
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PA or physician's assistant is? Right.
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Yeah, I know that. Yeah.
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So kind of like the same level. So we're advanced practice
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providers. So we're mid level.
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OK, so you have doctor and then you have NPAPAPPSPAS and then
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you have like nurses. OK, so.
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But most importantly, you can prescribe drugs, yes.
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OK, cool. All the drugs.
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Well, we'll talk later. So how long have you been an ER
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nurse? I guess.
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Or ERNPNP because there's a difference.
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How long have you been an ER NP? So that'll be three years in
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July. OK, so I am still considered.
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I consider myself a baby and still.
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New in the in the field, yes. OK.
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So until usually we say until you're like 5-6 years in to
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whatever field you're in, you're still very much new.
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OK, well we we won't put you through the ringer too much
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today, but we want to learn a lot about the ER.
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Yeah. And I wonder like your your
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actual title like it's like on your business card, it's not
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just. Oh, like all my all my titles.
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It's not just Nurse Nikki like what is?
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It no. So like, 'cause we always have
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our RN, so I always have that. So I have my BS RN and then I
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have my FNP which is my family nurse practitioner, MSN, Masters
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of Science and Nursing and then my license which is like the
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APRN, so advanced practice registered nurse.
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So I can have like. You have like a whole alphabet
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behind your name. And I can get more.
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Really. Yeah.
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So the whole card fills up with just letters.
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Yes, but then you have like commas in between, so you know
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to delineate like this and. This it is impressive, but now I
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what I really want to know is it does it say Nurse Nikki?
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No, I actually brought my badge and it says nurse practitioner.
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Oh, but it says my full name and I I don't like that.
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Yeah, I don't like my government name.
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It's the way it is. Ma'am.
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So you said you can do more. Like what?
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What? What else would you do?
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So like, I could go get like a doctorate if I want, I could go
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get a PhD, OK. Otherwise I could specialize.
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So like right now I'm doing classes to specialize in
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emergency medicine. So if I get that certificate,
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that will also be added on to all of my letters.
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But in order to do that you would have to take like an
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organic chemistry class, right? No.
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No, you don't. No, I have to get to bypass
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that. If I want to go back to medical
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school, I have to take. That I've heard from numerous
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people that class is horrendous. Yeah, I've been there, done
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that. That's why I switched so.
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So if you get your doctorate, yes, then does that make you,
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what does it make you a a nurse, doctor, doctor, nurse?
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Nope. So it's a big, it's a big point
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of this. I understand.
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Doctor, nurse, what is it? It's a big point of contention
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in the medical field, actually. Is it?
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Yeah, do tell. So, well, because so doctors or
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physicians are MD, Yeah. So they go through all of that
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schooling, way more schooling than I have.
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And so they have that degree. And so if we get a doctorate, we
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still go through. So if we you get a doctorate in
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nursing, you're looking at at least four years for your
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bachelor's, probably another four to six years for your
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doctorate. So anywhere from 8 to 10 years.
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So you do do a lot of schooling, but it's not the same.
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It's. It's a doctor.
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In your in my field in nursing because we are trained different
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than a doctor. I got it than like an MD.
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Well, good. Thanks for clearing that up.
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I've always wondered that, yes. So it's a doctorate?
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Yes, in my field of nursing, OK. So got it.
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So you would or not be called doctor, nurse, sticky.
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No. Well, we would totally call you
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doctor nurse. Like that?
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That's totally. Fine.
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Yeah, no. So we're going to just fire some
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questions at you and we'll just see where it goes.
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OK, Does that work out? Go for it.
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OK, awesome. So here's the first one.
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Can you tell us a little bit about what goes on in the
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typical day in the ER? So it depends.
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So my so my shifts I do usually 24 hour shifts.
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So what I start at? How can you?
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Do 24 I can't stay up 24 hours Oh yeah I'm old though I just.
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I just did. It no.
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This body. Are you looking at me?
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I can't. Stay up 24.
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Like absolutely not dude My I have nurses that are older than
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you that do it. OK, well, we'll talk about that
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later. There's a lot of a lot of the
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issues involved with this. One of the issues, yeah, we're,
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we're covering off on all the issues through every podcast.
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OK, you need your 10 hours of sleep, you need your sleep mask,
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all of that, right? Sure, right.
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Yeah, I don't have a sleep. Mask.
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No, wait, I'm going to be that card.
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That card. Because in our during our show
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choir days, we were trailer dads.
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We had 24 hour days. I know and actually I loved it,
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but I don't want to talk about that 'cause I'm trying to talk
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about this. All right, so go.
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So yeah, your life, what is it like?
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Yeah. So I usually do 24 hour shifts,
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starts at 7:30 in the morning. We go 7:30 AM to 7:30 AM and it
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depends. I could have patience right away
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in the morning. If I don't, I try and nap or
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just chill. But if I have patience, then I
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just hand off from the previous provider and we just roll with
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those patients, either discharge them, transfer them, figure out
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what's going on, kind of all that stuff.
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And then my town is small so that I live in, it's anywhere
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it's like 10,000, but we have a College in there.
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So you have to that has all the college students too.
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So really it's not that many. So in my ER it's me and one
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nurse. OK, that's it.
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I see. There's no MD, there's no like,
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it's me. Oh, so you could.
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Do all of this fun so. I yeah, I do it all.
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That's cool. Yep.
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And then so anything that walks through that door, it's my
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responsibility. Wow.
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If it's a finger that needs sutured, if it's a runny nose,
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if it's a lady that's in labor, which scares me, but yes.
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Well, don't tell our audience that it scares you.
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I don't know. I don't think many of our
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audiences are having chat. Yeah.
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Probably not at all. So yeah, it just anything that
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walks to that door, that's my job.
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And then we're hooked up to a hospital and a clinic.
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So sometimes they have emergencies or questions and so
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they're like, call me and they're like, what's how do we,
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how do we deal with that? Because my job is to make sure
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you're not going to die today. Oh, well, that's good.
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Thanks. That's a win, yes, right.
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So you talked a little bit about, you know, how you became
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an ER and P like what, how did you get there?
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Like what brought you to that point?
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What? What kind of was your career
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path? So I got my BSN and then I got
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the opportunity to be in a like a cardiac specialty hospital.
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So that's all I did. So I did telemetry, which is
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like a step down unit and then I did cardiac ICU.
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So I was a nurse for a total of 6 years before or I was a nurse
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practitioner, OK, a little bit over six years, but yes.
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So in the height of my RN career, my job was to, if they,
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if a patient had open heart surgery, they came to me right
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afterward. So they were intubated, they had
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drips going, they pull 9 yards. That was my job.
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Or if you all of a sudden, like if you see somebody arrest, like
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out in the public, right, they're like, Oh my gosh, like
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start CPR, all of that. And they, they're like, we got
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them back, but they aren't moving.
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They come, they came to me and I dealt with all of that.
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OK, So very sick individuals, sure, and so very adrenaline
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filled high stakes, but OK. I loved it.
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OK, so you use some lingo that maybe I'm not always familiar
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with, but I figured it out. And you said drips.
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So as soon as you I hear something, I'll try to ask you
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what that means so we can clarify for people.
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Totally. I mean, I get it.
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A drip makes sense. Yeah.
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But, you know, just in case something comes, I'm like, what
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did she say? Oh, yeah.
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I don't know what that is. That might happen.
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So yeah, like drips like medications, like if we have to
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do medications in your IV, sure, continuously.
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So either if you need medications to help keep you
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asleep, 'cause you we don't want you to wake up with or with
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whatever you have going on, or medication is to keep your blood
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pressure up or down depending on what's going on with your body.
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Pain medications. Like all of it.
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Can I get some of that to help me sleep every night?
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That would be the Michael Jackson drug and.
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That's kind of a little. So that would be no Brian, no.
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Shoot, OK, well that check that off right, right, right.
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So I'm gonna stick on the ICU just for a couple of minutes,
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'cause I said I, I obviously known you for a while.
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And you've heard some of my. I've heard some of your stories,
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and so tell me about like you dealt your cardiac nurse, you've
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dealt with open like hearts, like you like, like in your
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presence, like an open heart. Yeah.
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How cool is? That.
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Seeing like a heart beating in a chest, Yeah.
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Open, yeah. Yeah.
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Oh, that's just amazing. Did.
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You ever have put your hands in there and massage it?
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No, but we did almost have to and we were all like, well, OK,
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this is how we do that. OK, like nervous.
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OK, like who? Who gets to get in there?
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Like both. OK, be like alright, alright, we
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need we need sterile gloves. We do this.
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OK, who? What's your sterile glove size?
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OK, put that on the desk. OK, what's right there?
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Alright, if this, if this goes down and they're right there,
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OK. But yeah, that's awesome.
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If sometimes in open heart surgery, there's complications
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with any kind of surgery, sometimes they can't close the
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chest cavity like they normally do, so they actually have to
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leave it open. And then so your heart and
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everything is just sitting there.
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You can see it plain as day. But they wrap it up in a sterile
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drape is kind of the ease or the sterile, it looks like Saran
10:39
wrap kind of OK, but it's all sterile.
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It's to keep it all protected. But you can see the heart
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beating. Cool, that's cool.
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That's cool. So how was that 'cause you were,
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this was a while ago, so you were there during COVID.
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How was that for you? That was brutal.
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Why? Tell us more.
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So my hospital was separate from the main campus, so we were
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considered the clean hospital, but we were their cardiac unit.
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So any kind of patients with any kind of chest pain, any cardiac
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issue, they came to us. And so usually we got the sick
11:06
of the sick because COVID, as we know, has many complications
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that can happen. And then we also have the
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vascular unit. So if you had blood clots in
11:14
your legs, blood clots in your lungs, things like that from
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COVID, you came to us too. I remember one of my one of the
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first patients, we didn't know if she had COVID or not, but she
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was intubated, everything and we were suspecting she had COVID.
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This is when it took four or five days to get that
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confirmation, OK. So early on.
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Yes. So if you thought that they had
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COVID, you tested them, they had to be in isolation until you had
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that test approved that they were not COVID positive.
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So we had to be full papers. I actually have.
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I don't know if I've ever showed you a picture of me in a full
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pepper. What's a pepper?
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So it's a full like kind of looks like a little hazmat suit.
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So yeah. So I, I have like you have
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specific gown gloves, like boots on your feet.
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Yeah. You have a specific like
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apparatus. So like you belt it, it's a belt
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and then it's, and it blows air into a hood that you wear.
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Oh. 'Cause I was just gonna ask, is
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it hot in those? Actually, no, it's actually
12:02
better to be in those because you don't have to wear a mask.
12:04
That would be OK. That's.
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So that you actually wanted to be in a papper because you could
12:08
be without a mask because then you got the cool air in there.
12:12
It's. Like masks get hot.
12:14
It did, but that in the cold, that's what it is.
12:16
Yeah. Life, that's life.
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I lived in that for two or three years.
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Yeah, Yeah, yeah. You.
12:20
OK. So next question, when should
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someone actually go to the ER versus urgent care?
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OK, so do you know the difference between urgent care
12:27
and ER I? Do not know the difference
12:29
between urgent care and ER. Well I mean I assumed ER is like
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really emergencies but I don't know.
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OK. Because I feel like a lot of
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people don't actually know the difference.
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Right like me. Yeah.
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So urgent care can be in your local clinic, like your family,
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like providers can totally be urgent care.
12:45
They can have urgent care hours, things like that where they just
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do walk-ins, where like, hey, I think I sprained my ankle.
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I would need to be seen like that kind of stuff.
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I cut my finger. Yep, totally.
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Like that would be like an urgent care thing, so.
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Check these nodules on my throat.
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Yeah, my, my, my, Yep. Sore throat for a couple days,
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all of that. You think you have like a
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urinary tract infection, ear aches, like a minor cuts, minor
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burns, that kind of thing. They can totally suture you up.
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They can deal with all of that. Same with like minor broken
13:13
bones, minor being like it's not sticking out.
13:16
Oh, sure. OK.
13:17
Well, yeah, I guess if I saw my bones sticking out first of all
13:20
in my conscious, I don't know, but I'd probably be like, OK,
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that's an ER visit. Yeah, Yep, yeah.
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I don't think I'm saying it that calmly.
13:27
You'd be. Surprised you'd be.
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Surprised the amount of people that have come in very calm and
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you're like, so you're gonna see a lot of people really quick
13:35
here because you are very, very sick.
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But like back pain, asthma attacks, like nausea, vomiting,
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those are all things that can or like rashes.
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I get rashes sometimes in the ER and I'm like that's usually not
13:45
an emergency unless it couples with like a fever 105.
13:49
Right. Well, and is it after urgent
13:51
care hours? That too, because there's
13:54
limitations. So sometimes then people just
13:56
have to go to the ER because that's all they have, right?
13:58
But those are the things that you would go to urgent care for
14:01
ERI would say like fever's above 104.
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Or if you have like little little kiddos, then that
14:06
threshold changes. Like newborns, like kids, less
14:09
than one, then that changes. But typically for the most
14:12
population, 104, if you get above that, you're like, OK, we
14:16
probably need to go get checked out.
14:17
Yeah, that sounds bad. Yeah.
14:20
But like if you have seizures, if you have like suicidal
14:22
thoughts with like intent to harm yourself, things like that,
14:25
definitely like the ER is the place to go because we can get
14:28
you into a safe spot, right? And make sure you're not going
14:30
to do anything any like concern for like a stroke.
14:33
So that is like slurred speech, 1 sided, like weakness where
14:36
you're like my left arm and my left leg aren't working.
14:39
It's dragging. Like that's not normal.
14:42
Is this normal? Should it?
14:43
Should it? Look like this or like you have
14:46
that slurred speech or things like that.
14:49
I always have slurred speech so I've been working on that.
14:52
Since when did we start this podcast?
14:54
Or what is absol 39 now so. I'm trying real hard.
14:56
There you go, we. Can do an NIH stroke scale on
15:00
you what I can tell you. Yes please do.
15:01
And also my hand goes numb all the time.
15:06
Because you're sitting on it. Stop shit.
15:08
That's OK, you were saying, but. Yes, like any head trauma, let's
15:13
say you like you fell your head, you lost consciousness, now
15:16
you're like vomiting and somebody looks at you and you're
15:17
like 1 pupil's this like huge size and one's like really tiny.
15:22
That's not a good thing. Definitely you need to be seen.
15:24
OK Any like this is helpful, right?
15:27
Yeah, like severe abdominal pain, like any kind of pain, but
15:30
like, please try something first, like.
15:32
Like what do you mean? Please try.
15:34
Something so like people come in all the time and they're like,
15:36
well, this hurts. I'm like, well, have you tried
15:37
Tylenol, ibuprofen, heat, ice? Have you tried like?
15:40
See, I thought you asked me to go poop.
15:41
That too. Because the amount of times that
15:43
people come in with abdominal pain, I'm like, when did you
15:45
poop last? And they're like 3 days ago.
15:47
I'm like, how about you poop? Might be a problem and.
15:51
I do this whole huge work up and I like I'll CT scan you and
15:54
everything and I'm like you're FOS, which is what is that full
15:57
of shit. It's a medical term, OK.
16:02
Is it really? You guys say that?
16:04
Oh, yeah. Oh, that's awesome.
16:05
Oh yeah. Depending on the report I have
16:07
with my patients, I'll walk in and I'll be like you're you're
16:09
FOS and they're like, Oh my God, like what is that?
16:12
I'm like full of shit. OK, so take that in context.
16:16
So she does work in a college town with lots of college kids,
16:18
right? Yes, right.
16:18
So. So yes.
16:21
Or vomiting blood. Not good.
16:23
No, I wouldn't imagine vomiting blood's.
16:25
Good, that sounds. Bad.
16:26
No, I don't think that's ever good.
16:28
You know, or yeah, or like I said, like major broken bones if
16:30
it's sticking out. OK.
16:32
That's gross. OK.
16:33
Oh, I've seen that. Yeah, I've seen it on TV.
16:35
TV. Yeah, so Speaking of TVI mean
16:37
you're and you're kind of ATV fan, Yeah, you watch a lot of TV
16:40
medical shows, right? What's your favorite right now?
16:43
The Pit. Right.
16:44
Oh the Pit is the best that show.
16:46
Watching it. Yeah.
16:47
Yeah, I know. We are.
16:48
Yeah. Is it, is it relatively really
16:51
realistic? I mean, what like what, what,
16:52
what, what myths are on there and kind of what makes you laugh
16:54
the hardest. I feel like it's very realistic.
16:56
It's just it not all of that happens in one day.
16:59
So they're condensing what probably happens like in days to
17:02
months in that kind of setting into like one day.
17:05
You're not going to get all of those patients, but still like,
17:07
it's very realistic, especially like the first season was very
17:11
realistic when they had one patient and like it was a
17:15
grandpa and like the kids didn't want to let them go.
17:17
So they wanted to do all this invasive stuff.
17:19
And like the the doc is just trying to really teach them and
17:21
educate and they just going through that grieving process
17:24
with those patients and be like, yeah, that's, that's, that's
17:27
kind of how we have to do it. And right.
17:28
And then with the MASH casualty, we're like, that is definitely
17:31
how it goes. We're like all, all hands on
17:32
deck. Like everybody, like get in
17:34
there, whatever you need to do, you do.
17:36
And then when, oh, I can't remember his name, one of the
17:39
guys just throws an IO, which is that one with the gun, the IV
17:43
with the gun right in that guy's shoulder, and he was awake.
17:46
OK. Yeah, you don't usually do that.
17:48
No. So a couple of things maybe are
17:51
not necessarily correct you. Can not advise because it does
17:55
hurt, but you can. I I had heard that they had to
17:58
go through like 2 week train training course for that show so
18:02
they could actually learn to do things correctly, correct and
18:05
have the real settings be all the settings are on the be real.
18:10
Yep. Yeah, that was fascinating to
18:12
me. Brian Noah Wiley's been a doctor
18:15
on TV for like 30 some years. I think he knows what he's doing
18:17
at this point. Yeah, but I don't know, was, ER,
18:20
the show, ER, as good as The Pit?
18:24
That's their different eras, but they're still amazing, yeah.
18:27
I I think, yes. It's the same crater, by the
18:29
way, for both of them, yes. So there's that.
18:31
OK, so I'm gonna say yes, all right, because I think it's that
18:34
good. Yeah.
18:35
OK, So what is maybe the strangest or weirdest experience
18:39
you had with a patient? Well, recently we had a patient
18:42
walk in. I can't even remember what his
18:44
complaint was. So walked in, He was in the ER
18:46
room. We walked in.
18:47
We're like, God, that smells weird.
18:49
And he's like, Oh yeah, I oops, poop seed in my pants.
18:52
No, we're like. No away.
18:54
Yeah, and he was like completely with it, knew exactly what was
18:56
going on, were like. He wasn't there for another
18:58
reason. No, he just was there for
19:00
whatever reason. He was there.
19:01
I and. I couldn't remember it 'cause it
19:03
was like, this was just like the thing and I thought I remember
19:05
about it. I'm like that is.
19:07
And he just crapped his pants. Yeah.
19:10
You know, that didn't walk to the bathroom, didn't ask to go
19:12
to the bathroom, just like was sitting on the stretcher.
19:15
And so it was. That just happens, huh?
19:17
That's that's really weird. First of all, my worst
19:19
nightmare. Are they poop my pants
19:21
somewhere? Oh, yeah.
19:22
Because what are you gonna do? Like, it's like I'm full of shit
19:25
now. I don't know.
19:25
Yeah. Figures till the end, literally.
19:29
Exactly of shit. Full of shit?
19:31
Oh yeah. Hey Brian, I was just outside
19:38
trying to enjoy the yard and the mosquitoes are driving me nuts.
19:41
Oh, you got to call Spring Green for that, Rob.
19:43
Spring green? I thought they just did my
19:44
fertilizer and weed control. Oh, they do that, and our lawn
19:47
looks amazing because of it. But their mosquito control is a
19:50
game changer. We can actually use our patio.
19:53
You know how bad the state bird gets in Minnesota?
19:56
I'm pretty sure that's the loon, but point taken.
19:58
So they do lawns and. Mosquitoes and total home pest
20:01
control. My house is completely mouse
20:03
free. They even do liquid aerations
20:05
and lawn insect control. Wow, I'm only using them for
20:08
half of what I could be. You should fix that.
20:10
Go to springdashgreen.com and get a personalized quote today.
20:14
That's spring dashgreen.com. And tell them.
20:16
Oh, and one more thing, Sancha. OK, we're back.
20:20
So Nikki, what's the most adrenaline filled moment you've
20:23
ever experienced on the job? Is this going to be good?
20:26
Good for me because like the medical field, if they were
20:28
listening, they'd be like, yeah, that's definitely like not what
20:32
we want to hear. Like, what do you hear over the,
20:34
like, EMS, like calling you? Sure.
20:37
Like, I don't know, it just depends.
20:38
Like, especially being in the ER, like you never know what's
20:40
coming through those doors. I could have like an
20:42
unresponsive kid. I could have like anything.
20:45
But the one that sticks out to me one of the most is I had an A
20:49
page out my EMS like a different EMS crew, not my local crew from
20:53
a different, so from a smaller town was coming in.
20:56
They were calling me and they're like, Hey, we have this report
20:58
for this patient you're going to get.
20:59
I'm like, OK, cool. I was brand new.
21:01
Like right off orientation. I was like, OK, this is, this is
21:03
all right, We got. This one this is great.
21:05
This is great. And it's Sunday morning, so it's
21:08
literally me, my nurse and one other nurse in the hospital.
21:11
That's all that's in this building other than a secretary
21:14
down in the clinic. That's it.
21:15
OK, it's like light day. Like that?
21:18
That's actually pretty typical. Unlike Saturday, Sunday, like
21:21
that's it. So all of a sudden I get this
21:22
call and this like crew is going, they're kind of talking
21:25
fast. I'm like, OK, like they're just
21:26
a little nervous, whatevs, it's OK.
21:28
Went through their whole spiel, Took about 5 minutes for them to
21:30
tell me about all this. And they're like, oh, by the
21:31
way, CPR is in progress. And I'm like, say what?
21:34
I'm like you're doing what in there?
21:37
And they're like, yeah, CPR in progress and we're a BLS crew so
21:40
we have nothing. What?
21:40
Do you mean they have nothing? What?
21:41
Is that so? BLS crew means they can only do
21:44
CPR and like bag them with a bag valves mask?
21:47
They can't intubate, meaning they can't put a breathing tube
21:50
and they can't put Ivs in. They can't push meds.
21:53
They can't do anything. So literally they're just
21:55
pounding on this lady's chest, running or like driving as fast
21:58
as they can to the ER. Wow.
22:00
And I'm like. And you're waiting there at the
22:02
earth like. Right.
22:03
Adrenaline just building. Up Yep, I have me, my nurse
22:07
who's she's like 410, four foot 10, so she's tiny and it's me
22:12
and her and then my other nurse. OK, I have no CRNA to help me
22:16
intubate. I have like nothing.
22:18
And I'm like, OK, we can do this, we can do this.
22:20
You got this. That was probably one of the.
22:22
OK, so now let's find out. Did she make it?
22:25
No. Oh well, that.
22:27
Was sad. Sorry about that, I don't mean
22:30
to be mean. The rate of actually getting
22:32
somebody back in the field is not actually very good.
22:36
So it's not like on TV where they all magically come back to
22:39
life, no. Not at all.
22:41
And that's it's, it's sad, but it's the it's just the way the
22:45
human body works. How long would you do CPR before
22:48
you call the time of death? And that's a very hard question
22:50
to ask because I get a lot of students who ask me that
22:52
question. OK.
22:53
It just, it depends on how long they were down before you
22:56
started CPR. Sure.
22:58
What interventions you were able to do kind of right away?
23:01
Like, were you able to intubate them, get them, get them
23:03
breaths? Like do compressions, like all
23:05
of this stuff, get them meds, and then it depends what took
23:09
them down. So was it a heart attack?
23:11
Was it a blood clot in their lungs?
23:13
Like what took them down? Like what caused that arrest?
23:15
Because of ultimately that has to be fixed.
23:17
And if we can't fix that, then. And you have a very short
23:22
window. Yeah, you do.
23:23
It's not very long before your brain starts not getting enough
23:27
oxygen. And that's, so that's really
23:30
when we're looking at like calling it not and not
23:33
continuing CPR is we might get them back.
23:35
I might get their heart beating again after 30 minutes, but
23:38
their brain is, is fried, their brain is not got enough oxygen.
23:42
So there's no set time. My shortest code was like 7
23:47
minutes and my longest code was 65 minutes just because you.
23:50
Worked on that person for 65 minutes because.
23:53
Because the family wanted me to. Oh Yep, it was more than just
23:56
the signs of. The signs were not good, but my
23:59
job in that situation, especially if the family's
24:01
present, is to educate them and be like, this is what I'm
24:04
seeing. These are the signs of life.
24:05
I'm not seeing. This is not good.
24:07
Like I'm if I get her back or whoever back, they're not going
24:11
to be them. They're not going to sit there
24:12
and laugh at you. They're not going to remember
24:13
your name. They're not.
24:14
They're going to be a vegetable. OK, So do you really want that
24:17
for your loved one? And sometimes like people have,
24:20
I've had that conversation with their family and they're like,
24:22
no, they don't want to live like that.
24:23
Please stop. And others are like, no, I like,
24:27
I'm not ready. And we continue for as long as
24:30
I'm like, OK, now we're eating up resources that I really can't
24:34
be eating up anymore. We we gotta stop.
24:37
So I'm asking these questions basically because I watched
24:39
medical TV shows and I'm trying to think about what do they do
24:42
on TV that I can ask a real person.
24:47
What is maybe the funniest coping mechanism that you've
24:50
seen among your ER staff? Our humor.
24:53
We have very dark humor. Oh, that's dark.
24:57
We have very like morbid and dark humor because that's how we
24:59
cope with our situations. They're very stressful.
25:02
They're that we see a lot of stuff that the general
25:04
population doesn't, OK. And so that's just how we cope
25:07
is we figure out like ways to laugh about things and just
25:11
yeah, that's how we cope. OK, Like one thing.
25:14
Do you know what DC to JC is? I do not do tell.
25:17
So DC discharge, so that's the acronym for discharge to JC,
25:22
Jesus Christ. So if you hear somebody say DC
25:28
to JC, they need to DC to JC or they are going to DC to JC.
25:33
Oh my gosh, that's not amazing at all, but that's funny to me.
25:38
See, it's, it's, and that's just like the tip of the iceberg.
25:41
But like that's, that's kind of our humor.
25:43
Like we have some people call the 5th presser, which is so we
25:46
have just so many medications to help with blood pressure, like
25:50
keep it up that in like really bad situations, we have just so
25:53
many that really work. We call it the 5th presser.
25:55
So we have it sitting in actually right next to me when I
25:59
work. It's, we have a little shelf or
26:00
drawer and he's sitting next to me.
26:01
He's a little syringe. It's Jesus Christ.
26:03
He's about this big, he's a little toy and he sits in a
26:05
syringe with some water, so holy water and so well, because he's
26:11
in there. So technically it's holy, sure.
26:12
So he's the 5th presser. In case we've tried everything
26:15
else, we'll set him in the room and.
26:18
Pray, have you ever seen Dogma? Yes, I'm getting you a buddy.
26:21
Christ for sure. Yes, right on your desk.
26:25
That's awesome. So what's one thing you wish
26:27
every patient understood before they came to the ER?
26:30
That our job is to make sure you're not dying, like to get
26:33
you good enough to like, you need to follow up with
26:35
specialties, PCPS, that kind of stuff.
26:37
Like I might not find out exactly what's wrong with you.
26:40
I'll make sure you're not going to die today, right?
26:42
Or like in the next couple days. But my job is not necessarily to
26:45
diagnose every little thing. Yeah, it's to be like, I think
26:49
you have this going on. I need you to see a cardiologist
26:51
or hey, I need you to see a neurologist because I'm.
26:53
I think this is what's going on. I need you to see this special,
26:56
right? So you might not get all the
26:58
answers you want going into a ER, because I know some people
27:01
do. And they're like, well, I've had
27:02
this for this many years. I've seen this many specialists.
27:04
Why? Why can't you figure this out?
27:06
I'm like, well. Yeah, yeah.
27:09
Yeah, that's not kind of what I'm there for.
27:12
Right. And then also, it's not a first
27:14
come, first serve. It's based on acuity.
27:16
And acuity means like how sick you are.
27:18
So if you have somebody who comes in, they're like, yeah,
27:20
I'm coughing. I've had this cough for a couple
27:22
days. I want to be seen.
27:23
OK, cool. I have somebody who just walked
27:25
in with chest pain. That chest painter is going to
27:27
get into that door a lot quicker than your cough.
27:29
Yeah. And that's what people don't
27:31
understand when they're sitting in that waiting room and they're
27:32
like, these three people went ahead of me, like, how dare you?
27:35
Like all that stuff. And it's like, no, that's, it's,
27:37
it's not that we're ignored bring you, it's based off of
27:40
what your symptoms are. You're less of a not priority,
27:44
but you're lower on the totem pole than the other people based
27:46
on what they're complaining about.
27:48
I call, I call party. Somebody's like bleeding out.
27:50
I think I want to take care of that first for somebody who has
27:52
a nagging cough, you know? Yeah, but you'd be surprised how
27:54
many people will. So we have double doors to get
27:57
an RER. They're both locked because
27:59
we're you can't just walk into ER because that's a safety
28:02
issue, right? So you have to pick up a phone
28:04
and you have to tell us what you want to be seen for.
28:06
We'll let you into the waiting room and there's another door
28:08
you have to get in to get into the actual ER that's locked as
28:11
well. Yeah.
28:12
The amount of people that will be like, OK, take a seat.
28:14
We'll come get you in a little bit.
28:15
The amount of people that will walk through that first door and
28:17
then come banging on that second door and say, well, I want to be
28:19
seen in the ER now. And we're like, yeah, that's not
28:21
how that works. Yeah.
28:23
Go sit down. Yeah.
28:25
So that we're not ignoring you, it's just based off of what your
28:29
complaint is. I might have a full ER and I
28:31
don't have a room for you or I have a patient that's sicker
28:33
than you that I'm dealing with. So that's what a lot of people
28:37
don't quite. Get OK people, please pay
28:41
attention. Just a little bit.
28:42
I know you're in pain or I know you're not feeling good, but
28:44
situational awareness a little bit.
28:46
So what do you think is the most difficult part about being in ER
28:50
and P? Either like not finding the
28:51
answer when patients come in and they're like, hey, this is going
28:55
on and you, you do all the scans, you do all the labs and
28:58
I'm like, they all look good. Like I I'm not quite sure what's
29:01
causing this. Get to the real.
29:02
Yeah, and it, and it sucks because we like being
29:05
detectives. We like being like, oh, OK,
29:06
let's figure this out. Like, OK.
29:08
But when you don't find that it's, it's, it's kind of
29:11
disappointing to be like, I've done everything I can think of.
29:13
That was a cool analogy. Just said right there,
29:16
detective. Yeah.
29:17
So you're a detective in the sense of that illness or that
29:20
medical situation. Yeah.
29:22
Just like a cop is looking for the right the guy who shot the
29:25
guy and you're taking care of the guy.
29:27
Guy got shot, yes. It's all circular.
29:32
Wow, mind my own. Because we ask a lot of
29:35
questions and some people get frustrated with that, but we ask
29:38
those questions because that helps us figure out what
29:41
pathways to take to be like, if you're complaining of this but
29:45
not this, I'm less suspicious of this going on.
29:48
I'm more suspicious of this. So it's kind of like, if you
29:51
think of like, like a tree like you want, like you need, you
29:55
have to figure out which branches to follow and which not
29:58
down to figure out what is that root cause?
30:00
And then kind of along those sides are those patient
30:02
expectations because people walk in and they they want those
30:05
answers or things like that. Or if I had to give worst case
30:07
scenario things as well, which really suck.
30:10
Like I had to give a patient, she came in because her abdomen
30:13
hurt and we thought, Oh yeah, this sounds very much like your
30:15
gallbladder. This is definitely your
30:17
gallbladder. Let's scan you.
30:19
We'll get you figured out. You probably have to see a
30:20
surgeon, you know, very. That's a very straightforward
30:23
kind of thing. Scanned her.
30:24
She had stage 4 cancer. She had cancer all over and she
30:28
didn't even, she didn't know, no idea.
30:30
So I had to go in there and be like, so it is your gallbladder,
30:34
but it's also your liver, your pancreas, your spleen, you.
30:37
Delivered the news. I have to, yeah, because I don't
30:40
'cause I she had to go to a higher level of care, but I was
30:43
the one who scanned her. I was the one that found it.
30:45
I have to tell her that in order for her to prepare to be like, I
30:48
need to go see these specialists now.
30:50
Sure, right. So that is never an easy
30:53
conversation. No, it's.
30:54
Not all right, So the best part about being working in the, ER,
30:57
crazy stories, you have to have some.
31:00
Oh I have, one of my favorites is so living in a college town.
31:04
Mm hmm. College kids do crazy stuff.
31:07
No, right? Right, so this guy was haven't
31:12
met him since, but I'm like, huh, lucky.
31:14
So what was happening? He he was drunk.
31:16
He was making surprise. No good.
31:19
Decision every college kids story start with he was drunk or
31:21
she was drunk. Making pizza rolls in a glass
31:25
bowl and I guess there was something on the floor that he
31:27
tripped and fell. The bowl fell.
31:30
He landed on the bowl but it had shattered.
31:33
He was naked for some reason. Making these pizza rolls well.
31:36
That's yeah, that makes sense, right?
31:38
Right, like 3:00 AM naked making pizza rolls in a glass bowl
31:42
sounds legit. Doesn't everybody, I mean.
31:45
Last weekend, right? That's a Thursday.
31:49
So cut his butt wide open. Oh God, and didn't even realize
31:54
it 'cause he was that drunk, went to bed in the living room
31:56
on an air mattress and his roommates came home a couple
31:59
hours later and like, Oh my God, it's a bloodbath in here.
32:02
Blood everywhere? Yep.
32:03
So they called 911 everything they brought him in and Yep, he
32:06
had a laceration. Like almost the span of his his
32:11
butt cheek. Well, it's been bleeding for how
32:12
long, I mean. Oh, but there's no arteries back
32:14
there. Like, not big ones.
32:15
So you're fine. You're like, you're not gonna.
32:17
Bleed out so you lost the little blood but not all your.
32:20
Blood. Not all your blood.
32:21
But now, is there a certain window of time like I've always
32:24
seen on TV that you can't sew it back together?
32:26
Yeah, usually you want to sew it back together within 24 hours.
32:29
OK, so it was. Less than that.
32:32
Preferably if we can do it within 12.
32:34
Damn that would be great, but some people?
32:37
Ruin it for me. Preferably I got I got put a hip
32:40
back in place the other day. What?
32:42
Yeah, really. I hip dislocated.
32:44
OK. So what did you have to do?
32:45
Push on it really hard or something.
32:47
Actually, it's called the captain, so the layman's term.
32:50
We call it Captains Morgan's technique.
32:52
OK, what does that mean? You know, Captain Morgan, he
32:54
puts his foot up on a barrel. Sure.
32:56
OK. That's exactly what you do.
32:57
So what you do is you put your foot, so your foot is on the
33:01
stretcher and you, you like like a barrel.
33:03
So it's like 90° angle kind of thing.
33:05
And you put their leg with the dislocated hip over your leg,
33:09
use it as like a pivot or like a hinge.
33:12
And then you have somebody hold two people hold the sides of
33:15
their hips, and then you pull that leg over your leg until
33:18
that hip goes back into place. OK, that sounds like it hurts.
33:21
The The patient's unconscious. We, we knock, we knock you out
33:24
for that. Don't.
33:25
Say that that is not. That's not comfortable at all.
33:28
Yeah, you get good payments, but I knew the premise of how to do
33:32
it, but I've actually never done it.
33:34
And so when in rural medicine. Well, good for you.
33:36
Right. In rural medicine, we just kind
33:38
of have to figure it out. So I had to YouTube it before I
33:41
did it. Really.
33:46
I'm like I've I know I've read it, I've I've this but.
33:49
I'll let everybody just hold here.
33:50
I'm going to watch this YouTube video.
33:52
Oh, the amount of times we've actually done that, yes.
33:54
Do you know all the WebMD people that are just loving you right
33:56
now? Like, oh, I self diagnose all
33:58
the time, Yeah. Like, if you know what you're
34:01
looking for, that's the thing, right?
34:03
And like, I know how to, like, I've read about this technique.
34:05
I know it works. I'm just like how?
34:07
Like I want to watch somebody do it.
34:09
So you do it right the first time.
34:11
Yes, so. Just like all of the repairs, I
34:13
do have my bath. That's my my plumbing the first
34:16
time. There you go.
34:16
And the why I don't? Know why I went there?
34:19
Plumbing, you know, plumbing, It ties together.
34:22
Sort of. Sort of, but the wife was asking
34:24
me the whole time. She's like, have you like,
34:26
where's the specialist? Have you done this before?
34:27
Like, Oh my gosh, where's the specialist?
34:29
And she was just freaking out. And finally I looked at her.
34:31
I had a student, not a student. She was training with me.
34:34
I finally looked at her. I'm like, well, before this, my
34:36
nurse had gone in the room to get vitals and everything like
34:38
that. And it was, he was a guy.
34:40
And she's like, Oh my gosh, is that the doctor?
34:42
And I'm like, no, that's the nurse.
34:45
Thanks. I'm the nurse practitioner.
34:46
I'm in charge here. That's my nurse.
34:50
Thank you. And.
34:50
You've done this hundreds of. Times, I know.
34:52
And she's like, why have you done this?
34:53
But I'm like, yeah. While you're shaking your head,
34:56
yeah. Yeah.
34:57
And if I was like, this is real medicine, we're going to figure
34:59
it out. We'll do what we got to do.
35:00
And she actually wrote us a letter, like when they got home,
35:04
they sent it to us. We're like, oh, that's so great.
35:06
Nice. That's nice.
35:07
You want another story? Oh yeah, yes, please.
35:09
Keep keep the stories coming, this is awesome.
35:11
So and another patient, I was coming on shift and I can see on
35:16
my phone, I have an app that I can see like the chart before I
35:18
come in. So I can and kind of prepare
35:20
myself to be like, oh, hey, Yep, like these are the labs.
35:23
This is kind of what I'm walking into before I start my shift.
35:25
Usually I do it like 30 minutes before.
35:27
And so I was watching these this pational.
35:29
Hazard reading before you work. Right, just to be like, Yep,
35:32
gotta I need to mentally prepare, Yep, how much coffee or
35:35
how much like what do I need to bring?
35:37
Some Red Bulls. Yep.
35:38
Oh Red Bull infusions from scooters.
35:39
Yes, I have walked in with the extra large before and my like,
35:44
one of my MD's has looked at me and he's like, and I'm like, I
35:47
need it. Just leave me be.
35:49
Exactly. But so I, I'm like, Oh yeah,
35:51
this lady's sick. Like she's sick.
35:53
Hopefully we're getting her out. Like are we working on transfer?
35:55
And so I walk in and my provider I'm trained trading out with is
35:59
well with a different patient. And my nurse is running around
36:02
in this patient room and I look in her room and I'm like, she's
36:04
a highlighter. Like she's looks like a
36:06
highlighter. Which means you have like acute
36:08
liver failure. Highlighter like you're.
36:09
Yellow. Yep, your skin is like your skin
36:12
is like yellow. Like a highlighter.
36:13
OK, well, that's not good. No, no, you not be that color
36:17
shouldn't be. Do not advise that as your as
36:20
your color of choice, especially like especially if it's your
36:22
eyes like your nail beds. Everything is that color.
36:25
I'm looking at my nail beds right now, right?
36:26
Should be yellow. Not yellow, not purple either.
36:29
Not purple, no. Nice.
36:31
Lightly pink. Aw, I'm healthy.
36:33
Sort of. As far as you know.
36:34
And anyway, could you see your story so, so rudely interrupted?
36:38
So not great. And all of a sudden I'm looking
36:40
at the vitals and I'm like, our pressures are kind of low and my
36:44
nurses hanging fluids. And I'm like, I'm gonna go order
36:47
some more meds for you, like some blood pressure medications
36:50
because this is not looking good.
36:52
And I'm like, OK, so finally the provider that I'm hanging off
36:54
with and I'm like, so have we called somebody to get her out?
36:57
Like, this is not good. And at this point my, I was
37:00
training again and she's a PA. She came in too.
37:03
And she was, I'm like, hey, she had not seen this kind of
37:06
patient before. I'm like, go assess this
37:07
patient. I'm gonna throw some more orders
37:09
in. Go check this patient.
37:10
So she went and did her physical exam and she walks out and she's
37:12
like, was there blood under the patient earlier?
37:16
And this providers like, well, she has her period and she's
37:18
like, this is not period blood. So I walk in there and like we
37:21
lift up the sheet. She's sitting in a pool of her
37:24
own blood. Oh, so liver failure, your liver
37:28
controls a lot of your clotting factors.
37:30
So if your liver is crap, you're not going to clot.
37:33
So you're just gonna bleed? Oh, so she was bleeding out and
37:38
all that's why her pressures were.
37:40
Yeah, crap. And we're.
37:41
Like, hey, well, that's gross, Yeah.
37:44
Yeah, so we're like, so we moved her to trauma, did a whole bunch
37:48
of stuff, but we're just like, it was just, she just lifted up
37:50
the sheet and we're like, this is This is why your blood
37:52
pressure is low. You have no blood.
37:54
Oh. That's an adrenaline like, so I
37:57
didn't know if I would like suturing just because I'd never
37:59
done it as a nurse. Like that just wasn't in my
38:01
scope and it's just something. What sewing up a a cut a a big
38:06
old gas that's. Everything, all of it.
38:07
Yep. So then there's different ways
38:09
to suture, there's different techniques, things like that.
38:12
And so just learning all those and it's, it's just a technique.
38:15
It's just how your hands move, how you hold the needle,
38:17
everything like that. It's just a very technical kind
38:19
of thing. OK, but it's all muscle memory.
38:21
Once you get it down, sure, then you can just like go to town and
38:24
you can just start suturing, like sewing kind of thing,
38:26
except it's just human skin. Oh, that's all right.
38:29
It's not a big deal. Not a big deal.
38:31
Did you practice on pigs When you like?
38:32
We're going to school. No, so, so we we actually bought
38:37
like kits off Amazon you can buy and it's like fake skin.
38:40
Oh, OK, but you can do it on pigs or like bananas.
38:42
Bananas work too. And then you just like they'll
38:45
the skin that we had did different gashes, like different
38:47
sizes different like if it was jagged, if it was deep, that
38:50
kind of stuff. And we could practice our
38:51
different sutures on that. OK, gotcha.
38:53
So we didn't just practice on people.
38:55
We practiced on non people. Non people.
38:57
Non people I would hope you had previously practiced before you
39:00
go to a person. But remember, I did the hip on a
39:03
person for the first time. Yeah, that's true.
39:06
So which sounded cool. It, it is what it is, right?
39:10
OK, eventually you just kind of do it.
39:11
I actually do really like suturing and I've actually got
39:14
some compliments on my sutures because I'm like, haha.
39:16
Oh, really? So yeah.
39:17
Awesome because I because I have to follow up and like the
39:20
providers that I know. They're like yeah, this looks
39:22
really good. It came together nice.
39:23
I'm like, OK, good, because I wasn't sure.
39:27
I had this guy come in his mom picks up the phone freaking out
39:31
at the front and she's like my, my, my son.
39:34
And he's like in his 20s or 30s was trying to cut down like a
39:37
little sapling or like a small tree with a chainsaw.
39:39
The chainsaw slipped and he got his leg and I'm, I'm like, oh
39:43
crap. I'm like expecting like his leg
39:44
to be like half off. And I'm like, great, great.
39:47
This is great. So we get him into the room and
39:49
his whole leg is just wrapped in this towel.
39:51
So I unwrap it and he had he had cut down.
39:54
He was lucky the chainsaw had went down his leg but it missed
39:58
the bone so it was just in the meat.
40:01
OK, so I had to. Great term it.
40:03
Still got hurt it it. He was, he looked at it and he
40:06
was ready to pass out. And I'm like, don't look at it.
40:08
Stop looking at it. But now, wouldn't a chainsaw
40:10
make that kind of a jagged? It does.
40:12
It makes it very jagged because it's not a night.
40:14
Yeah. Yeah.
40:15
Soda, Yeah. A clean cut.
40:16
Yeah, no soda suture. It took me over an hour.
40:19
OK. But it was how deep was it?
40:21
It's so I did 2 layers of sutures so so you.
40:24
Can go one inside. One inside and so that'll
40:26
dissolve over weeks to months. So that'll stay there.
40:29
And then the top side you cut off like anywhere from like 10
40:33
days to 14 days. But his stayed longer just
40:35
because of how jagged it was. So I had to do 2 layers of
40:38
sutures to get that to close. Wow, over an hour.
40:43
So how do you choose? I guess I'm probably answer my
40:45
own question as I asked this. How do you choose between?
40:47
Like if you're a staple or you're going to suture.
40:49
Depends on the location. OK, so like if it's on your like
40:52
head, like if you were to like bonk the top of your head, I'd
40:55
just staple the top of your head.
40:56
OK, easy peasy. When do we get to see that?
40:59
Get my head stapled. There's not a lot of hair there.
41:01
It'd be easy to see. Yeah, this is.
41:03
Where I was going, but I didn't want to say it out loud, you
41:05
know? You know I'm nice.
41:08
Yeah. So a lot of it is like location,
41:09
like where are you? Where, where's the injury that
41:12
will just staple it because really your hairline like, well,
41:15
not yours, but somebody else's? There's still a hairline, just
41:19
it's just very. Like.
41:21
Shut up. So let's say you've got this big
41:25
gash in your leg and it's all jagged like you say.
41:27
Is the guy out for this or is he just local anesthetic so he
41:32
can't feel? It local so he can't feel it.
41:34
But he can watch. Yeah.
41:35
Awesome. Yeah.
41:36
So I've had patients that like do like they want to watch.
41:39
So actually that reminds me. So I had a patient, he smashed
41:42
his thumb in a metal door. Yeah.
41:44
And he was only Spanish speaking.
41:46
So I had the interpreter on the line the whole time.
41:48
And I'm like trying to figure out how to suture this close
41:51
because it was like, so if you ever like smashed anything and
41:53
it like kind of looks like splits wide open.
41:55
Yeah. So that's what his finger did.
41:57
So it was like, it looked like, AY, kind of how it like split
42:00
open. So I'm like trying to figure out
42:01
how to suture this and I'm like talking to him through the
42:04
interpreter and everything. And finally, do you know the
42:07
meme? Is it from Family Guy or, or one
42:10
of them is like, do you, do you feel Bonita 'cause you look
42:12
Bonita? So that's all I could think
42:15
about 'cause I like, that's all I know in Spanish.
42:18
And so I just looked at his finger and I'm like, I'm trying
42:20
to make it Bonita. And he's just like laughing at
42:24
me. And I'm like, hey, that's I'm
42:26
trying in my I'm trying, man. Yeah, that's we.
42:29
Need to teach you how to use Google Translate.
42:30
I had a translator OK. Your phone is Google Translate.
42:33
I know, but medical? Yeah, it's Albano.
42:37
But yeah, but then I had another I did see a broken bone outside
42:42
of the body. Yeah.
42:43
When did that happen? That was a couple months ago
42:47
Summer. This little kiddo I think was
42:49
she was like on the playground fell and the way that she fell
42:52
she like landed just right. She broke one of the bones in
42:55
her arm and dislocated the other.
42:57
But one of that the bone that broke popped out of her arm.
42:59
So mom came running in holding this kids arm, just trying to
43:04
hold it as straight as she can with this bone sticking out,
43:07
right? And so this kid screaming, mom's
43:08
crazy, mom's crying because kids hurt and I'm just like, OK.
43:12
You're like that looks fascinating.
43:14
I'm like that looks like it hurts.
43:17
Let's give you some drugs. I'm like, how do I make this a
43:19
little bit better? And you definitely need to go
43:22
somewhere else. Like you didn't.
43:24
You didn't put that one back in. No, I do like putting bones back
43:30
though. That's actually pretty fun too.
43:31
If somebody has like a broken ankle, things like that, that's
43:34
actually pretty fun. So if if it's somewhat it's not
43:36
sticking on the skin you can like you pull on it if it's a
43:39
leg and it better reset it. Yeah.
43:40
It depends on the joint or it depends on like where it's at,
43:43
Yeah. So a lot of the times you have
43:44
to pull traction. So meaning like let's say you
43:46
broke your ankle, I have like my nurse or somebody hanging onto
43:50
your knee and I am yanking on your ankle.
43:52
I'm pulling it towards me because I'm at the foot of the
43:54
bed to try and get those bones to align enough.
43:56
And it depending on where the brake is, sometimes I'm pushing
44:00
on one side of your ankle to try and get that to like.
44:03
Stop in. Yep, and you can feel it crunch
44:05
the whole. Time Gross.
44:06
OK so I'm asking this because hello I watch television and
44:11
it's all true to me so I have to ask these questions.
44:13
It's on the Internet, it's true. Come on, Rob, I think we've had
44:17
this podcast before. OK, so you got one more story
44:20
for us. I do so like drunk college kids
44:22
again. No, they don't make great
44:25
stories. Right, right.
44:26
Of course, just like high school, college has like
44:29
homecoming, like things like that, all of those special
44:31
weekends, whatever. Sometimes when they get rowdy or
44:34
like college kids, they have a lot of stress, They have a lot
44:36
of anxiety. They need mental health help.
44:39
So sometimes the cops will pick them up and take them where they
44:42
need to go and that kind of stuff.
44:43
So one night I was busy like it was 1 other weekends where Yep,
44:47
they're partying all of that. I was a full ER and also in the
44:50
cops pull in to my ambulance Bay and usually they don't do that.
44:54
And what dispatch had called me and they're like, hey, we need
44:56
to medically clearance this patient because they're going to
44:58
go to jail. We just need to make sure
45:01
they're medically cleared to do that.
45:02
OK, so that's just to make sure that they're not going to like
45:05
pass out or die in the jail cell while they're sobering up or
45:08
things like. That right, that'd be bad.
45:10
Yeah. So we call it like medical
45:11
clearance. So I go out and they're like,
45:13
but they're not going to bring the patient in.
45:15
You have to go out to them. And I'm like, OK, I'm I'm busy,
45:18
but OK. So I walk out and here's these
45:20
three cops standing outside this cop car and I hear this patient
45:24
screaming their head off, kicking the door.
45:27
And they're like. Oh no.
45:28
Yeah, so we're not getting that them out.
45:31
Obviously they're like that. Here's a flashlight.
45:33
We'll open up the front of the door to the cop car and you can
45:35
go talk to them and medically clear them.
45:38
And I'm like, if you 3 grown men are not wanting to go near this
45:43
patient, why do you think I want to go near?
45:46
I'm like they're screaming and they're moving everything and
45:49
kicking stuff. I feel like they're fine.
45:51
Yeah, they're still breathing. Yep, they're obviously
45:53
breathing, they're obviously moving.
45:54
You can take them, right? I'm good.
45:55
I don't need to get any closer. Right.
45:57
Ohh gosh, that's. Crazy.
45:58
But I was just like, you guys don't wanna go near them and you
46:01
have Tasers. Yeah, you.
46:02
I wanna go near them. That's funny.
46:06
Like no. So did you ever pull anything
46:07
out of a butt? No, I don't forget to.
46:11
If you're going to do that, whatever your preference is, I
46:14
don't care. But flared bass people flared.
46:18
Bass because why? Because it's just like the way
46:21
the like rectum, everything works, it'll just like suction
46:23
it all up in there. So flared bass there, it doesn't
46:28
get sucked up in there. Then you can take it out.
46:32
OK, that again, maybe that's a little bit too much so.
46:34
Many things I don't need to know.
46:35
Right. Apparently though, you need to
46:37
know a flared base, A flare. Base.
46:39
Do you remember nothing? Else flare base.
46:41
Flare base exactly to all of our listeners.
46:44
Flared base. Our podcast, It's the one thing
46:46
they're gonna remember. Flare Base.
46:47
Flared base. That's Owen.
46:50
That's. Crazy.
46:52
OK, so being a health professional, what are some
46:55
things that people of our age, middle life, what can we do to
46:58
stay healthy? Just like diet and exercise and
47:01
not like diet. Really.
47:03
Just hang on, hang on. That's the worst.
47:07
He wants that. The.
47:09
Worst not like the crazy diets where you're like I can only eat
47:13
3 leaves of salad a day right and like.
47:16
This great but I'm not diet. No, you clearly.
47:19
Have not Hey, are you calling me fat?
47:24
Face OH. That's great.
47:27
You're Minnesota. Nice.
47:27
I forgot that's. Right.
47:29
Like not that kind of diet, but just like moderation, be like,
47:33
you know, like watch what you're eating.
47:36
Balanced diet. A lot of the times, like
47:37
Mediterranean diet works very well for people just because it
47:40
has that a lot of balance and variety in it.
47:42
So you can do the leaner meats like fish and chicken and stuff.
47:45
But in the Midwest, it's kind of hard because we like our beef
47:48
and our steak. Yep.
47:49
So. And our 4th meal?
47:50
Taco Bell. Yep.
47:51
I do watch what I eat. I watch it go in.
47:53
Yeah, you. Have the seafood diet.
47:55
I have the seafood diet, yeah. Right.
47:57
So a lot of it's just like moderation, like you don't need
48:00
the crazy fad diets and everything to make it work.
48:02
And then just exercise again. You don't need to go lifting
48:05
weights for two hours every day. Like it's 30 minutes a day so
48:08
many times a week, three to four times a week.
48:10
That's that's what you need. OK, Like you just need to get up
48:13
and move. Get up and move so.
48:15
Go for a walk 3-4 days a week Brian or do VR boxing.
48:20
Again, not gonna do that Well. This has been great having you
48:24
on. It's so fun to hear all these
48:25
stories that I don't get a part of.
48:27
Right. Yeah.
48:28
Thanks for hanging out with us. It was fun.
48:29
Totally. I know you hear all the stories.
48:31
I hear all the stories, but they're so fun.
48:33
Yeah. Hey everyone.
48:34
As always, please follow us on the socials at Oh and One More
48:37
Thing Pod on Facebook and Instagram for highlights and
48:39
news of our upcoming shows. And if you have any show ideas
48:42
for us or just want to give us some feedback, send us an e-mail
48:45
at 011 More Thing, pod@gmail.com.
48:47
We'd love to hear from you. Plus we have some awesome
48:49
merchandise, T-shirts and caps. Nikki is wearing a beautiful
48:52
T-shirt right now. You should all have one on if.
48:53
It's amazing. If you're interested, just send
48:55
us an e-mail. That'd be cool.
48:57
Ohh, one more thing, Rob. What's that?
48:59
The next time you have to go to the ER, remember, be honest, be
49:02
calm, and don't Google your symptoms while waiting.
49:05
You may arrive with a sprained ankle, but convince yourself you
49:08
have a rare 18th century disease.
49:11
That's so true. So bring your patients, bring
49:14
your ID, and bring your sense of humor because the wait may be
49:17
long, the chairs are uncomfortable, and the vending
49:20
machine will absolutely judge you for buying Skittles at 3:00
49:24
AM. That's what it does.
49:25
Yeah, absolutely. Bye, everyone.
49:26
Bye. Wait, you went to say Reese's
49:28
Pieces, right? Absolutely.
49:30
I meant to say Reese's Pieces.