This is by far the most frequent complaint in the Emergency Department. Why does everything take so damn long? It even SAYS Emergency in the name, so shouldn’t everything happen just lickety split? How come I’ve been waiting here an hour and that person was whisked back to a room right away? Why haven’t I gone for my CT yet? The doctor said they would come back and discuss my test results and I haven’t seen them once? Why can’t I have food if I have to wait this long?

Subscribe now

Once I got interviewed & asked if I was a character in one of the stories I wrote, to describe myself. I said I was a woman hovering on the edge of middle age who was sick of everyone’s shit. This was in 2019. As 2020 draws to a close, I *think* I’m officially middle aged (40), l’m fucking done with everyone’s shit, and I’m mad as hell.

My next post was supposed to be about violence towards healthcare. (Hey kids, do you like violence? Work in the ER!) but now Marco Rubio, Mitch McConnell, and Lindsay Graham have received the COVID-19 vaccine. 

Countless ER, ICU, and other frontline staff are still waiting. I’m lucky—I was vaccinated Wednesday, December 16th and I was proud and honored to receive mine. I worked my ass off for that vaccine. I need it, not just to protect myself and my loved ones, but my patients and my community. 

I know what you’re expecting. Some bloody traumatic injury, bones and gristle all exposed. Severed limbs. Open chests. Eyeballs on the cheek. Maybe a Christmas tree being extracted from a place it shouldn’t be. And I have those stories, dozens, if not hundreds of them. I’ve been doing this a loooooong time. Say I saw a terrible thing a month, so 12 times a year. Multiply by 18. Somewhere in that neighborhood. Probably more because of the law of threes and sevens. If you’re not familiar with that piece of superstition, it’s a common belief that bad things in our world happen in threes or sevens. So, if you have two codes in the department on day shift, there’s either one or four more to go before the cycle is broken. 

But you can find the gore in any horror movies with good special effects. We’ve seen that, up close, and it’s really not that cool. It’s disturbing and traumatic and horrible, so those aren’t stories we revisit very often. It’s more along the way of “remember that cop that threw up after he handed you that arm in a grocery bag?” I have seen every body part opened and every organ, or part of it, up close before. I’ve been there when chests are cracked open and seen more blood than I thought was possible, gouged myself accidentally on an exposed shattered bone, and seen things turned inside out that weren’t built for that.

Hey there, ICU RN Cassie here. Let’s break down how ICU capacity works and what effects it, m’kay?

BECAUSE I AM SEEING THINGS ON TWITTER THAT MAKE ME WANT TO STRANGLE PEOPLE.

(I’m usually brusque with idiots, but this is a very special late night ‘I’ve worked two very long 12s and have another long-ass 12 to look forward to tomorrow’ so there’s going to be extra curse with curse-sauce.

I have a (mostly) private journal that I write my thoughts and feelings down in sometimes, as I have them, and that’s important because other than anger I don’t often let myself have feelings anymore.

Subscribe now

The other day, a trauma surgeon and I were having a lively discussion about whether hangings meet criteria for trauma activations. See, back many, many years ago when trauma criteria was a new deal and lists were being made, a lot of hangings had cervical spine injuries and vertebral artery dissections. These are interventions that have a high probability of requiring surgical interventions, hence the need for trauma team activations. This is because many of the hangings studied were judicial, which is a fancy way of saying “executions.” There was certain way the noose was tied and there a significant fall prior to the noose “arresting” or stopping the fall, which had a much higher chance of death or causing the kind of injuries that require surgery. Most of us will never see these kind of events.

Suicidal hangings tend to be much more common and not performed from a significant height. This results in much less “trauma” to the structures in the neck, and injury/death occurs from asphyxiation; or suffocation. In this respect, I told him, they were much more like a drowning, something that isn’t a trauma activation. At which point, he said, “well what if I strangle you? Is that traumatic?” (Note: we have a good working relationship!!! This was not threatening or uncomfortable!) And I said “I don’t know, are you buying me dinner first?” And he just shook his head, and said “ER nurses. They always have something else to say.”

Hey peeps!

Some cool/interesting/poignant stuff caught my eye in the past 24 hrs and I wanted to share:

First off — check this tweet, it’s AMAZING. I recommend sound on!

It’s around 3 pm. I’ve been at work since 6:30 am. I haven’t eaten and have peed once. I gave up on getting everyone their 30 minute lunch somewhere in the last hour and everyone’s getting fifteen minutes, one at a time, to step away and grab a bite to eat. I’m walking down the first hallway to check on the staff in the back; I’m avoiding the second hallway because there’s a patient is extremely upset about being in the hallway. I’ve explained we are utilizing hallway space to make sure people receive timely treatment, rather than waiting longer for a private room to open up, that this way we can manage pain and nausea immediately rather than delaying treatment.  There’s also a very sweet elderly lady on oxygen, who needs the next open room because she has a significant cardiac history and needs telemetry monitoring. As I walk down the hall, I’m asking myself why the hell I’m still doing this ER thing anyway.

It’s a question I ask myself a lot these days, along with how much longer I can continue under the current circumstances. Our hospital has been packed since August, the ER is constantly full and holding admitted patients, and seeing a higher volume of sicker patients. Patients are unhappy, staff is exhausted, space is an ongoing problem. 

Subscribe now

I’ve been a nurse for 19 years, the last eight in the ER. I’ve had a love hate relationship with my job the entire time, which matches up pretty well with my romantic relationships, but that’s another series of stories. I love the chaos, the fast pace, the madness, the trauma and the codes, that one day everyone is critical and you’re saving lives one after the other. I hate the sense of defeat that comes with some shifts, I hate failing to save a life, I hate the way necessity dictates some people wait for a very long time because while their matter may be medical and require care it is not life or death, and mostly I hate the lack of control I have to fix everything in a timely fashion.

I meant what I said, and I said it because it’s true.

(So much for the soft launch, let’s just dig right in here!)

I’m writing this right now from my car in the Safeway parking lot near me, waiting for a prescription to be filled. I live in Oakland, CA, and my Safeway is on Fruitvale Ave, the same Fruitvale you may remember from the amazing (and sad, and anger inducing) movie Fruitvale Station that came out awhile back.

Many of my coshoppers – if not the majority – are black.

Welcome to twonursestalking’s newsletter by L’Erin and Cassie. We’re nurses who also happen to be professional authors, and as you can imagine we’ve got a lot we’d like to get off our chest right now.

We met on twitter, where the both of us have been continually frustrated by the limitations of the character count against an unrelenting tide of bad takes and covid-related stupidity.

Subscribe now

So, who are we?