All hospital nurses know about that silence in the parking garage after your shift, the one where you shut the door and sit in your car and just zone out after your shift.

Here’s a little known secret that the ER holds dear.

Waiting for a helicopter to land is AWESOME.

You take the gurney out, stand by the wall, and wait as the noise of the rotors grows louder and louder and the little dot becomes larger and larger. Sometimes leaves and gravel blow against your face and exposed skin and it stings but you don’t even care. The noise of the chopper makes everything else obsolete. You can’t hear alarms beeping. Or your radio. Or the call lights or the phones or that family member that’s put at the desk again.

Hi there everyone!

Soooo sorry for the lag – it turns out finding a new and cheap (yet good! and functional!) email service was harder than I thought.

This is our first ‘to everyone’ test email – and this will be our new provider, over here at buttondown, which is a smaller operation but seems to be ethically sourced ;). (And I never thought I’d be in the business of needing to find an ethically sourced newsletter provider but here we are in the year of our Lord 2021, heh!)

I’ll be making a post from substack tomorrow, to sweep up any people I might have missed, and also to remind people to cancel their subscriptions to us over there.

Hey people, sorry that it’s been a bit — L’Erin’s still on her well deserved vacay, and I’ve been recuperating/happily dealing with book release things.

Unfortunately, recent news has come to light about substack (this newsletter platform here) secretively funding anti-trans authors to make their platforms appear bigger than they are and/or giving them advances to generally help them to survive authorially and….

EFFFFFF THHHHATTTT.

Cassie again!

I know y’all follow L’Erin and I for the exciting hospital action, but the entire reason L’Erin and I even know each other at all is because we’re both writers off shift, outside the hospital.

What do we write in our free time, when we’re not at the hospital, you ask?

Well…what write…is REALLY GOOD (and also v. steamy) paranormal romance — and just came out today!

This is Cassie, and I’ve prescheduled this post to go live on 3/14, which is the first day I took care of a covid patient at my hospital last year. I know it was 3/14 because I made it my pinned tweet on twitter, the same twitter thread I made walking on my way into work that day.

This is likely going to be a mess of a post, so bear with me.

Have you ever died before?

(Jesus wept, Cassie, you’re a morbid fuck, you think. WHELP THERE’S A POINT TO IT…this time.)

((Also, I have recently had my Wellbutrin dose upped, thank you very much.))

So I’ve kinda-sorta died three times.

Cassie here again (and I’ve prescheduled some posts and L’Erin’s on vacation soon, so the next few will likely be from me, too.)

Had my first real interaction with a family under non-covid circumstances yesterday.

They were only allowed to visit because their loved one was dying, and our visitation procedures are still really hard core…but eventually there were four strangers in the room with me, along with their loved one.

It’s been so very, very long since I’ve seen a ‘normal’ death, that I’d almost forgotten what to do.

So here’s the link to pt one of my EKG overview for laymen, in which we covered the P wave on the EKG, which indicates atrial action.

Now it’s time to talk about ventricles! (Remember, again, I’m not your cardiologist ;))

Let me start by saying this—mental health care and substance abuse care in this country needs a MAJOR overhaul. Inpatient psychiatric beds are extremely limited, outpatient and aftercare programs are hard to get into, and funding just keeps getting slashed and beds eliminated.

I could go on and on and on, but I really want to talk about acute crisis and why emergencies departments struggle to meet the needs of patients suffering acute psychiatric and substance abuse issues.

They often go hand in hand—people self medicate because their brain is on fire and they don’t know how to make it stop. 

So, you have a lot of “dual diagnosis”, or depression with a side of alcoholism. Both problems require treatment, are complex and difficult to treat in an emergency setting, and often require lifelong care and attention. 

Hi all, Cassie here, and it’s been awhile since I’ve neeped out on a particular teaching topic. This one is near and dear to my heart (*ba-dum-ching!*) so here we go, with the usual caveats — I am neither your cardiologist, nor am I a cardiologist, this is just an armchair overview for people who’ve wondered what the hell EKGs show and how the heck they work.

(Someone has told me this is especially timely now, given how many personal heart trackers, etc, there are out there on the market, so hooray! Happy to be of service.)

My last few posts have been pretty heavy, so here’s some lighter reading fare today. The black cloud phenomenon. It’s a real thing, just like Murphy’s law. You know, the one that says if something can go wrong, it just definitely will. The one the Emergency Department runs on. If nothing ever went wrong, we wouldn’t have jobs. 

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Recently read a post on a nursing Facebook group bitching about floor nurses not taking report because they were on a lunch break. In fact, one poster said it happened to her coworker and her coworker told the nurse “well, we don’t get breaks in the ER so your patient will be up shortly.”

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Banging this drum one last time!

If you’re a writer, a nerd, or both (like me!) — I’m giving a free talk (although donations accepted) for Dream Foundry (a non-profit org for new writers)!

Injuries in Fiction and Writing About Other Medical Topics — via zoom, 1 PM PST today!

Tuesday was a shit day, from start to finish. 

It was bitterly cold, 16 below zero when I left for work. The roadways were frozen solid. I almost hit a car that spun out on the highway and came back heading directly at me. I dodged that bullet and made it in and I KNEW this did not bode well. 

We had something like 17 car crashes in the first two hours as well as a pretty horrific trauma unrelated to the weather. The biocom (radio that EMS calls to notify us of incoming patients) was barking nonstop. This is medic so and so coming to you with two patients, rollover at highway speed, airbag deployment, no seatbelts, heavy damage. And on and on. 

Thankfully no one died, and most had minor injuries, but they just kept coming. And coming. And coming. 

People on twitter say this to me ALL THE TIME when I brawl about masks and hypocrisy.

Like they think they’re going to hurt my feelings.

I started off with a (very short) career in sales before I went to nursing school. This was before Air BnB was a thing — the place I worked for had a business model based around renting out people’s unused vacation homes in Cabo San Lucas. There were twenty of us in the office, and we all worked for one rich guy who had several homes himself.

It was an interesting experience — I doubt they’re still around now — and it taught me a lot about how to be circumspect.

You see, I’d never been to Cabo personally.

We had a DOS program, where you’d put in how many rooms people needed, and dates, and we could go off of available inventory, figuring things out — and there were photos I could look at, and that I could send to the clients, online.

This is a 100% true story — but let me preface this by saying I don’t actually like geraniums.

I love a ton of plants, but geraniums don’t do it for me — I don’t have the patience to deadhead them when I’m supposed to so they always wind up looking scraggly.

But I still have a bunch in my front yard, from this home’s prior owner. I had my gardeners cut them back when I was going All Succulent All The Time…but the effers grew back anyways. Around my succulents. So now there’s a whole hostage situation going on, where I can’t water one without watering the others, and on some level I have to respect that.

All of us!!!!!!!!!

Went to bed at 10, up at 3. Story of my life. Don’t sleep much between shifts anymore thanks to COVID related and capacity related stress. Thinking about what a resident once said after listening to me and my coworker talk about going to dinner after work, maybe thirty minutes after a bad trauma. It was probably his first grotesque experience, but for us it was just another Tuesday. And he turned around and said “Jeez, does anything ever bother you guys?”

He was only half kidding. And I thought something along the lines of ‘boy, you’ve got a long road ahead of you if you don’t learn to compartmentalize a little bit, bud.’ This isn’t even going to be the worst thing I see this week. Sure, they might be missing a few pieces, but they’re going to survive.

Cassie again, with a fun (depending on your definition of fun!) opportunity :D.

I love to do education, I love being a nurse, and I love being a writer — and this is where those things all get to intersect!

I’m doing a Webinar with Dream Foundry about Injuries in Fiction and Writing About Other Medical Topics on 2/20 at 1 PM PST!