This site contains the highly fictionalized ramblings of a raconteur looking for a place in the medical world. The vignettes presented are cobbled together from various and sundry places.  Any resemblance to actual people, places, or events is purely coincidental.

And, I like to photograph things in lieu of words some days.


We Make Zombies

I was orienting in triage yesterday, and experience which pretty much scared me to the point I had to evacuate my bowels q4h.

Don't you hate pooping at work?

ANTYwhey, my preceptor for the day was amazing. During a rare moment of downtime she took me outside for some fresh air to enjoy the springtime-ish breeze and show me the decon showers. We also ventured into a hidden room with all the disaster stock. I desperately wanted a selfie with a black disaster triage tag, but alas, none were to be found during our brief moment in the scary room. Juice-boxes of water, emergency batteries, tackle-boxes full of angiocaths and emergency meds, and an army of 1950's style respirators made it all seem real.

I really do work in an ED. Praise the Lord and pass the potatoes.

After several hours, during which I swear I lost a few pounds, I was nervously triaging patients under her watchful eye. In truth, our population is full of The Diabesity, The Pressure, and various Pains and Hurtin's that “I been havin' for two weeks now, doc.”

The patients call me doc because I'm a man and obviously must be a doctor. I always gently correct them. Always.

The beauty of being in the box, which is what I call triage, is that once the patient exits the box, you're done. Translation? Ain't really nothin' to give nobody at shift change as far as report goes. In two minutes you're done. Lit-tra-lee.

As I was strolling out of the box heading to float for my final four in the ED core (I was 11a-11p) in wheels EMS doing chest compressions.

Side note: In my three and a half years working in hospitals I've seen two kinds of patients receiving chest compressions. Those who are struggling to hold on and those that are dead. I wish I had words to describe exactly how you can tell, but I think it's a lower-brain, reptilian, millennium-old ability we have as living beings to detect other living beings. I can feel when someone is dead and we're pounding on a chest vs. compressions on a living human, even if I'm not touching the patient. That's a bit meta, but if you experience it, you know what I mean. End side note.

EMS was pounding on the chest of a dead person.

Zoom-zoom, I'm in the core, helping to cut clothes, attach pads, place leads, the typical oh-shit-get-the-good-toys dance, when I see the patients' eyes. Suspicion confirmed, he be dead. D e a d. Internally I said a quick prayer. Two people got access, we started the ACLS tango, and as the tubes went into the proper holes, we raised the dead.

Let me repeat. We raised the dead. Zombie. Spirit gone, flesh animated. A bag of magical juice, flowing through a hollow metal tube directly into a vein, succinctly irritated a group of heart cells just enough to mechanically convulse fast enough to push blood around a dead body. A second tube, larger, firmly wedged in the airway, was bellowing air into the lungs at the whim of a mechanical box on wheels; a wizards' apprentice know as The Vent.

Raised the dead faster than them fabulous bitches on AHS:Coven.

The eeriest thing after any congregation finishes invoking the spirits of all medical knowledge at the altar of trauma is how quickly the ceremony ends. The participants remove their gloves and depart, some with relics taken from the body in tubes, destined for analyzers and incubation closets.

The floor is strewn with the detritus of the gathering, often bloody.

At the center of the tornado's path is a body with eyes glazed, tubes running to and fro, and a chest that rises and falls with a rhythmic precision that any metronome would envy.

I wasn't primary on the case but given all how full the core was, I assumed care with another nurse. Spent the balance of my shift adjusting drips, monitoring pressures, organizing lines, and playing ICU nurse.

About an hour after the big show, with a gentle swipe of my gloved hand, I closed the unfocused eyes of the living dead. Not because it was good for the patient, but because I felt guilty as my adrenalin high wore off.

Mary Shelly would be proud of our selfishness.


Ativan with a side of Haldol

And so it came to pass that I found myself withdrawing a mL of oily lorazepam into a syringe using the longest 18Ga I could find. In the bed nearby, a PCP patient was thrashing under the weight of two nurses, two cops, and a tech, each of them double my size, trying their best to secure the four-point restraints.

If the patient weighed less than 300lbs I'd be surprised.

Savage. Strong. Full of vim and vigor. PCP is a hell of a drug.

So is Ativan with a side of Haldol.

And you're gonna hear me roooaar.

Stabbity-stabbity, and within minutes, the mass of flesh that was once trembling with angry confusion lay serenely still, HR 85, NSR, breathing 16, pressure 128/86, POx 100% RA.

Fuck me. I'm an ER nurse.


I'm Here!

Well I'm here in Washington, D.C. The city that isn't in a state yet part of the union, the capitol of the world. I mean the capitol of the United States. Home of el Presidente, FLOTUS, and a whole bunch of people I'd love the chance to meet. Or even see. I'm lookin' at you Ruth Bader-Ginsburg (I think I'd pass out if I met her.)

First impressions...

An inch of snow freaks this town out. Five inches is borderline panic. And they don't know what cold weather is up in here, up in here. 32F is lovely to me, awful to them. I walk past people cocooned in their faux hooded-down coats every five feet with my buzz-cut and 180s wearing thin leather gloves.

The architecture is new and old, beautiful and less than so, and a heady mix of very short buildings and not so short, but hardly tall. Apparently nothing can be taller than the Capitol building. I already miss skyscrapers.

I keep confusing capital, capitol, and Capitol. And Columbia with Colombia.

So far I've only had good food. That was a huge concern. Tacos that hit it out of the park, a Cubano sandwich I'm currently craving, Chinese that was delicious, and a French bistro that I need to get back to soon. All win. Next up, Korean, Greek, and hopefully some good Japanese (not sushi).

The Metro is terribly convenient but far more expensive than the CTA. The buses are way more comfortable than Chicagos'.

It's like I'm in a combination of Evanston and Hyde Park with a side of Uptown everywhere I go. That makes me feel truly comfortable.

The MUSEUMS! EHR-MA-GHERD there is some breathtaking stuff here and I've barely scratched the surface.

I've only been at my hospital for a single day and only in the ED for an hour or so. The pulse and the energy set my mind a-buzz.

Holy frakkin' shizz, I'm going to be an ED Nurse.


Wilson & Sheridan


To the District.

Well it’s happening.  I’ve finally gotten a job in a hospital.  In an ER.  I’m going to be an ER nurse.

Slight hitch.  It’s going to happen in Washington D.C.

So I’m leaving my hometown of Chicago, packing up my life, and wandering east until I find myself in the nation’s capital.


I’ve left The Home.  Meaning the nursing home I was slaving, err, working in. Gone will be the days of 29 patients, 15 g-tubes, 7 traches, all mixed with a few admissions and a handful of narcs that need to be scheduled down to the minute.

I’ll say this much for learning about working in a nursing home; you get your time management skills down.  I also have a newfound appreciation for exactly what it means to be on hospice.  Sadly, to most of the nurses and staff I met along my journey, being on hospice largely means ignoring that patient for most of the shift.  God help anyone who doesn’t have a family or friend who comes to visit them.


So yeah.  About the ER.  It’s a Level 2, adult facility in one of the low-income areas of the district.  By the numbers they do quite a large amount of visits each year.  Since I’m a relatively new RN, this will be a great learning opportunity.  I couldn’t pass it up.

But I’m terrified.  Absolutely terrified.  There’s so much I don’t know.  I’ve just started going through Sheehy’s Manual of Emergency Care and my mind is already spinning with details.  Everyone keeps saying that’s normal, but in all honesty I just want to get it started.

It all starts in a couple weeks pending my D.C. license.

In the interim, I’m playing a game with my belongings.  Sorting them into various piles of keep, bring to the temporary housing, or save for the big move.


I’ve been to D.C. once, the week before last, for four days.  It’s a beautiful city, rich with history, layered with a lot of amazing sights to see and places that are definitely on my agenda.  However, I couldn’t fathom choosing a neighborhood to live in having just a few days to see the town.

Moving into temporary housing seems the wisest thing to do. Perhaps not the most cost-effective up front, but I can’t move to a town I don’t know and choose an apartment in just a few days.  I want to feel out the town, get my commuting pattern in order, and basically figure out which neighborhood has the best amenities.  If that takes me a couple weeks, that’s fine.

A bit of planning up front is never a bad thing.


I’m going to miss my cat.  He’ll be staying with my parents for the first month or two while I search for places.  I don’t want to bring him to the temporary place, and ultimately I’d like to be done moving before I bring him to his new home.

Thankfully Mom & Dad are thrilled to have the little one winding his way around their ankles in their house.  He stayed there during my few days in D.C. and apparently he was the belle of the ball.  It’s only fitting that I get my life sorted out properly before bringing him over.


I’m going to miss my city.  Chicago has been very good to me.  It has raised me, taught me, fed me, and made me a nurse among other things.  It’s entertained me, toughened some bits of me, softened others, and let me discover who I am and the kind of stuff I’m made of.

Rockefeller said “If you want to succeed, you should strike out on new paths, rather than travel the worn paths of accepted success.”  I couldn’t agree more.

I’m going to finally be a nurse in a hospital.

But oh shit, it’s going to be in the ER.

Here we go.


Peter's Screamin' O Feta Dip

I am Greek.
Food is love.
Are you hungry, here, have some lamb.

Okay so the last line was partially a joke, but seriously, that's how I grew up.  Food is the most important thing in the world. It's the key to living well.  Sure, exercise and fresh air are great things, but food is the fuel that stokes the fire.  And in a Greek household, food is undoubtedly love.

And with love in mind I share this dip with you.

A little background.  This dip is a modified version of a recipe found in The Grecian Plate, one of the better Greek-American cookbooks out there.  It's written by a group of church ladies and the recipes are pretty damn authentic if you're looking for the kind of Greek things you might get in your local Greek restaurant or diner.

Be warned, you'll use lots of pots and pans if you start cooking Greek food.  There are very few shortcuts in Greek cookery.  Lots of hearty, braised, well seasoned layers of flavors which take time and effort to develop.

But back to the dip, which uses only the food processor.

The first time I made it for my family I riffed on the books' recipe quite a bit.  I changed a thing here, added a dash of something there, and generally made a bowl of creamy goodness that I wanted to rub over every possible food item in the world and devour it immediately.

The family loved it.  Then I brought it to the hospital where I worked at the time.  Every single nurse, doc, clerk, etc. who tasted it on a cracker, veggie, fill-in-the-blank-dippable item, immediately made their O face (yep, I went there) and exclaimed "oh GOD this is SO good!"

And thus it was named Peter's Screamin' O Feta Dip.

This is neither a low-fat nor low-sodium recipe.  Using the good stuff, full-fat ingredients, makes the best dip for various scientific reasons having to do with fat emulsions and whatnot. This is not the dip to give to grandma or grandpa with congestive heart failure.  This is not the kind of dip you can stop eating unless you loathe feta.  And if you loathe feta I'm not sure we can be friends.


Peter's Screamin O Feta Dip


8oz feta, room temperture
8oz cream cheese, room temperature
8oz cottage cheese, room temperature
1/2 t dried oregano
1 clove of garlic (or two), crushed
a big pinch of ground cayenne (optional)
1/2 t fresh ground black pepper, more if you like
kosher salt**


N.B. The cheeses should be room temperature so everything blends properly. You can microwave them gently to warm them if you need, but don't cook them.

1. Blend everything (except salt) in a food precessor together until very smooth.

2. Taste. It will probably need salt to taste like more like feta. Add 1/4 t salt. Blend well and taste again.

3. Keep adding salt 1/4 t at a time and blending until it's as salty as feta. It may take 3/4 t or more until you get there, depending on how salty your feta is initially.

4. Refrigerate for at least six hours for the flavors to fully blend. Overnight is best.

**If you don't use kosher salt, be very careful when adding regular table salt. The grains are very fine and you can add too much too quickly. I use kosher salt because it’s non-iodized. I don’t like the taste of iodized salt in this recipe (or any really) because it gives food a metallic tang I find unpleasant. But if all you have is table salt, don’t skip this recipe.


The Home

Tap...tap...tap...  Is this thing on?

Or maybe I should be rapping myself on the head a few times, to see if that thing is on.  Why oh why don't I write more.

Maybe 'cause I'm finally working as an RN.  In a nursing home.  Five eight-hour shifts a week.  Something like four on, one off, three on, rinse and repeat.

This is not where I intend to end up.  But it is where I am and I'm making the best of it.  These here lemons are making the best damn lemonade I can.


Yes, I'm a nurse.  Nope, I'm not working in a hospital.  Yes I'm working in a nursing home.  Nope, that's not what I want to do with my career.  Yet often on a new journey, the beginning can have the rockiest of starts.

I'm on the skilled floor of a long-term care facility.  I have hospice patients, g-tubes, traches, the occasional IV drip, and often lots of medications to pass within an insanely short eight hour shift.

I've been there something like eight weeks and already I've been allowed to train two people.  One I graduated with, one from a similar nursing program in the area.  I could infer that the fact I'm training people might mean they feel like I know what I'm doing.  But on each shift there is the sheer moment of panic when I realize I'm a nurse and I'm expected to know a lot about what I'm doing.

I'm not sure that's always the case.

My fellow coworkers are helpful for the most part.  When somebody gets overloaded we work it out.  That's not the hard part though.  Getting to know the patients takes time.  This is their house.  This is where they live.  Their baseline is in front of me every day (hopefully) and it's up to me to learn their ways of living, taking medicine, interacting with others, etc.

It's so very different from a hospital.


Basically I've been nursing a population of about 90 people, 30 at a time.  Yes, you read that right.  On any given shift I can have somewhere near 30 patients.  When you know your patients, it's not as rough as it sounds.  But when you don't know them, every cough, sneeze, sound, smell, and question about their status can send you into a tail-spin, trying to navigate for relevant information.

In fact today, I added another 30 people to that number.  So that makes 120.  I know most of the 90 folks well by now, and I'm officially working on two floors of the facility, both skilled and semi-skilled.  It's all about time management, safety, and prioritization.  Eight hours goes by quick.  Two med passes, the occasional admit, sometimes a transfer to the ER, and lots of charting takes up the full shift and then some.

If there is anything positive about what I'm doing as a nurse at the moment, it's the immense amount of manual skills I'm doing on a daily basis.  Foley's?  No problem.  Straight-cath?  Sure.  G-tube feedings, flushing, medication administration, I got that covered.  Tricky trache changes?  Yup.  Suctioning whatever body part needs suctioned?  Mmm hmm.

Timing treatments, keeping pain meds on schedule, making sure people are fed, vitals assessed, blood sugars monitored, and insulins given?  I'm getting my internal organizational tools in order and getting it done.  I'm bad at starting IV's but there isn't much chance to start them.  I'm also pretty fumbly with big-time dressing changes, but again, that's not often in my domain so I can't get the practice in.

In short, I'm doing "nursing" with the volume turned up.  And while it may be a little too loud at the moment, I'm making all sorts of motions to change my work situation.

I see a tiny spark of light at the end of this tunnel.  Soon it'll get closer.  In the interim, I've got 30 people on my watch.


I'm a nurse




Είμαι νοσοκόμα.
Soy enfermero.
I'm a nurse.

Damn, it feels good to finally say that. Of course I'm still a n00b. Job hunt is in progress. But after graduating and passing the NCLEX, it's over. I'm officially joining the ranks of one of the best professions in the world.

"Patience and perseverance made a bishop of his reverence." (to be said in a high-born British accent)
-Clarissa Dixon Wright from an episode of "Two Fat Ladies"

To anyone who might have stumbled here on their own journey to Registered Nurselandia, stick with it. You'll get there. Hills and valleys abound, but you'll make it.

And maybe Sister Flo said it best:

"Were there none who were discontented with what they have, the world would never reach anything better."
-Florence Nightingale


Three Weeks

Last week we went, as student nurses, to our state capitol to learn about the legislative process as it relates to nursing.  The commercial aspect of all the NCLEX prep exam vendors aside, it was pretty informative.
And pretty frackin' scary.

It's amazing how legislative policy designates what is and what is not considered patient care.  The scope of X Y and Z nursing procedures are determined by people who are not, and never will, be nurses.  Even worse, it seems that there are very few RNs in my state who actually stand up and attempt to make a difference in the law as it relates to nursing.

Where I once found apathy in the GLBT community, now I'm seeing it rear its ugly head in nursing.

The speakers at our conference were quick to point out that we, as a group of soon to be new graduate nurses, need to take our time and focus on becoming skilled practitioners.  Then, once we have a handle on the actual practice of nursing, we need to step up to the plate and help control the destiny of nursing as it relates to our careers and our professions.

A heavy task indeed.


I've signed up for summer school.  No time like the present I suppose.  I'll be taking Child Psychology online in order to round out my entrance requirements for an online RN to BSN program.  Somehow I know that if I put it off I'll be in big trouble.

Momentum is momentum, right?

The course only runs eight weeks, but I suspect it'll be a heavy dose of writing.  Which, to be honest, I haven't done much of in nursing school.  I feel like my skills are slipping.  Outside of this blog I seldom write much.
That needs to change.


In three weeks I will be graduating from college.  The original plan was to graduate in 1998 from University of Illinois at Chicago with my BSN and move right into my PharmD work.

See how well that worked?

This time it's so different.  I'm more me than I've ever been.  Focused, engaged, and ready to challenge myself with the kind of career that will, for ever and ever, evolve.

Two years ago I started this crazy journey, one of many along the path of a pretty good life thus far.  In a few short weeks it will end and a new cycle will begin.

The real question, the one I keep asking myself, is where will I be two years from now?

Four Weeks


Organ donation is a sort of slippery slope.  On one hand you're saving lives.  On the other hand, you're discussing a pretty grisly set of procedures.  And in general, the conversations are happening while people are grieving.

I don't envy the coordinators.

I attended my second AACN presentation last night.  The topic was the organ procurement process and the events, both pre and post, surrounding the process.  It's a pretty sophisticated system here where I live.  I'd assume it's as sophisticated in other places, but I couldn't say for sure.

The eerie part of the evening was where the organ coordination agency described their organ harvesting facility.  Apparently they have an ICU and several ORs where they can transfer vented patients that are completely brainstem dead and eligible for harvesting.  Granted, that number is very small, but it conjured up images of the film "Coma."

It also made me think of potential jobs.


One month left.  Isn't that scary.