Sunday, August 29, 2010

Can I see some ID please?

Dr. Troubledyouth, the child psychiatrist I work with, is interesting. He’s probably forty, but he likes to spike his hair, roll up his shirt sleeves just enough to display his wrist tattoos and wanders the office corridors with a perpetual five o’ clock shadow. He looks like a college English professor who has yet to come to terms with the end of his fraternity days.

The first time he asked me to call in a prescription to a pharmacy, I didn’t know who he was (Yes, random guys do ask me to call a pharmacy and order Valium for them quite often. It’s one of the hazards of nursing.) and made him show me his driver’s license!

Friday, August 27, 2010

Patient quote of the week

53 year old woman: "I'm almost sixty, and I can't go 72 hours without sleep!"

Wednesday, August 25, 2010

Overheard at the staff meeting

“Phil Sheridan? Is this "babies in the sewer" Phil Sheridan?” one of the experienced therapists asked on hearing a new client's name.
“Babies in the sewer? What’s that all about?” a newly hired therapists asked.
“About five years ago, he was pounding on Sonny and Cher’s apartment door, screaming that they’d taken his baby and flushed it down the toilet and he was going to get in their house to get into the sewer and rescue it,” she explained.
“So after the cops came, we evaluated him and had him committed to the state hospital until he was stable again. Apparently he just got out of prison for something else and is back in town,” the crisis worker with the most seniority finished.
The new therapist still looked puzzled. “So was there a baby at all?”
The crisis team all started laughing, which is never a good sign. “No, no baby, just crazy Phil.”

Sunday, August 22, 2010

Conspiracy theory of the week

I called the local laboratory to ask them to send us Lillie Langtree's lab results.
“For her medication monitoring?” the lab technician asked.
“Yeah, just like every week.”
“My mother-in-law needs to be on that stuff,” she said.
I should have let the conversation drop right there, but I didn’t. “Oh?”
“Yeah, she keeps telling anyone who will listen that Chinese people are trying to invade the West Coast.”
This is admittedly strange, even by my standards. “What?”
“By going south through Canada, no less! Is that crazy or what?!”
“That’s pretty wild,” I agreed. “If they do, I know some Chinese people in California who’ll hide me.”
“I’ll be able to blend right in—I’m Korean!”

Thursday, August 12, 2010

Words you don't want to read in a chart

Usually medical charting follows a time-honored format: Situation (why they're there to see you) Background information, Assessment information, Recommendations (changes in medications, etc.) It's generally pretty dry stuff, but occasionally things jump at out me as I'm reading through the patient's previous visit notes.

(On a developmentally disabled client who lived in a group home:) "He was fired from work after he destroyed the mail box and ran naked through the streets."

(From a patient complaining of right-sided numbness that started three days earlier:) "I am worried that he has had a small stroke, and I told him he needs to see his PCP ASAP. Although, given his history of heroin abuse, I am also concerned that his condition may be due to peripheral nerve damage after laying on the floor for an extended period of time--essentially comatose."

(Concerning a woman who had a history of asking for early refills on her Xanax, claiming her purse was stolen, pills were lost, etc.:) "Ms. Histrionic seems to be making a full-time career out of requesting early fills on her meds and I told her in no uncertain terms that she needs to do a better job of keeping track of her belongings."

(On a gentleman who'd recently gotten out of jail and was required to seek mental health treatment as a condition of his parole:) "Legal history: Client was arrested at age 8 for possession of methamphetamine. He says he used to smoke it with his mother..."

Tuesday, August 10, 2010

This one's a dud

Recently there was a bomb threat at the Random County Courthouse, about a block away from our offices. Several of the other Random County Health Department offices were evacuated, but not ours.

I found out about the bomb threat as I checked my e-mail before the weekly staff meeting. After I finished calling my husband "just because" and made sure my conscience was right with my Maker, I headed to the staff meeting--only to find out that no one else had heard about the bomb threat. What's more, no one was very worried about the bomb threat.

Apparently this sort of thing happens a lot. The head of the crisis department summed it up best when she shrugged and said "If whoever did this isn't already one of our patients, he will be by the time the courts get through with him! And would everyone please park only in the designated employee parking spots..."

Wednesday, August 4, 2010

Glad I'm not a doctor

Dr. Warmnfuzzy just got back from a two week vacation. Here's what awaited her when she returned to us:

  • 10 days worth of e-mails from the crisis department
  • 23 requests from patients for medication adjustment or early refills
  • the minutes from at least six different meetings
  • a missive from the department head saying he'd discovered Twitter and wondered if any of us had heard of it
  • four different people tackling her in the hallway and saying "Fuzzy! You're back! Your patient Mrs. Namewitheld needs...."
  • an e-mail from the big boss casually mentioning that there is a bomb threat one block away, but no need to evacuate our building

"I feel like I need another vacation just to recover from vacation!"

Sunday, August 1, 2010

Drug-seeking fun

As with any medical doctor’s office, there are the occasional patients who come to us hoping that we’ll support their addiction to prescription medications. We generally refer to them (outside their hearing, as insulting them to their faces would be "unprofessional") as "seekers," short for "drug-seekers." We don’t prescribe narcotics, but we do regularly prescribe Valium, Xanax, and Ativan to patients who have legitimate anxiety problems.

Life happens, and people do lose their medications for strange reasons. (My brother used to have a disturbed German Shepherd that liked to snack on bottles of Percocet.) Our clinic's policy is pretty simple: The first mishap is a "freebie," but if you seem to be especially accident-prone, we will start to grow concerned.

This past week was especially noteworthy for lost meds. It seemed like three or four people called each day wanting us to authorize another prescription. After yet another patient telephoned to complain that someone had stolen her Valium (for the second time that month,) SuperNP got annoyed.

“My God, does no one ever steal these people’s blood pressure medication? Why don’t their antibiotics get flushed down the toilet accidentally? Do their dogs just not like to eat cholesterol pills? Why is it that only the entertaining drugs that get lost and need replaced?”