(This event occurred a significant time ago and has been waiting in the "draft" folder until details of the event have become obsolete in context to protect the privacy of those involved.)
A paramedic may have saved my life. I wasn't sick. I didn't call 911. I'm a nurse in a rural hospital who was working an ER shift in the wrong place at the wrong time. A voluntary psych patient walked into our doors with police escort. The patient wasn't under arrest and didn't want to be seen. Legally, that patient has a right to walk out that door. A quick assessment of the situation told me that the patient was both a threat to self and others. Threatening statements, aggressive stance, diaphoresis, verbalizing ideas incongruent with reality; I needed to get this patient out of our packed lobby and away from the other patients. So I did my job. I used my limited psych nursing skills to lure and coax the patient back into our pseudo psych room.
I say pseudo because I work in a tiny emergency room and we don't have the space for an official psychiatric ER room. This room is our back up gyno room for pelvic exams, sutures and general emergency department patients as well. There are scalpels, stitch cutters, razors, wires, tubing, monitors, metal tray tables, IV and oxygen supplies, suction tubing, IV poles and other supplies that can all be used as weapons against us. Even the wire shelving can be ripped from the wall and used to hurt us. But like I said, the patient arrived in the waiting room without warning, so the room wasn't emptied prior to arrival.
The officer had no back up. He was a friend of the patient's family and really just wanted to get this patient some help. Let no good deed go unpunished. The situation escalated quickly to the point of out of control. An ambulance, by chance, had just dropped off a different patient. In 3 seconds time, all of the cording in the wall had been ripped out, an ER stretcher thrown, a cop and RN locked behind a glass door with the unstable patient loose in the middle of the ER. That fast. In a millisecond, I realized this psychotic patient was in control and the gravity of the situation took hold.
I'm not going to lie. It was the most terrifying moment of my nursing career. I never saw it coming, I thought I was following all of the safety guidelines. I was keeping the officer between me and the patient, I was aware of my space and exits, I was thinking ahead of what needed to be removed from the room. But it was THAT fast. The patient could have killed me. That patient could have killed everyone in that ER. All of the could haves, would haves and should haves went through my mind in an instant. I don't know who unlocked the door. I don't remember getting out. I remember calling the front desk and asking for police backup "NOW" and the paramedic grabbing his radio and saying, "I've got it," some arguing, a taser sound and the same paramedic lunging across the ER to help the officer take this patient down. Police back up walked through the door and it took 6 strong men to hold this patient down until the medications began to take effect 40 minutes later.
Yes, people. That is your mental healthcare system. FYI: there really isn't one. The system is overloaded. When we called facilities for a psych bed, we got put on a waiting list 48 hours out - which means this patient was going to be staying in the ER for 2 more days with 1:1 nursing at the bedside. It means the 7 bed ER is now down to 1 nurse and 6 beds with a very valid threat looming near. It means that the patient experiencing the first real psychotic break in their lifetime isn't receiving the ideal psych care or medical treatment. It means that everyone who walks into that ER is walking into harms way; patients, nurses, doctors, lab, radiology techs, respiratory therapists, visitors, housekeeping, kitchen staff, paramedics, etc.
This wasn't a drug induced psychosis that would wear off like with the "bath salts" being laced into meth. This was a real, textbook, schizophrenic psychotic break. Alert and oriented to some extent with grandiosity, delusions and violent threats escalating to violent behavior. There is no reasoning, bargaining or placating. This person is the most dangerous patient we see in the ER because they are unpredictable and have no limitations to the acts they are willing to commit for unknown reasons. Bargaining and rationalizing go out the window quickly when attempted with someone with limited comprehension of reality. They can be easy going and cracking jokes while strangling you with electrical cords.
But it's the ER. There's no time to stop. There's not time to think. We all stuff it into that bottomless pit of a place that allows us to keep going and we move on. There's no time to think about anything but your next patient, your next order. We were busy resetting a hip, orthoglassing a fracture, oxygenating an overdose, transferring a hemorrhage, ruling out a pulmonary embolism and triaging every patient that walked through our doors in 3-5 minutes or less while attending our psych patient and doing our best because each of us can imagine ourselves in the place of our patients, or their families, and we just want to do our best for them.
I'm writing this knowing very well that I won't be able to share it until the specifics of the event are blurred to protect the privacy of the patients. We aren't allowed to discuss events like this, even with fellow coworkers that weren't involved in the case. We can't tell our spouses. We can't discuss particulars or specifics. The patient that threatened to kill me, attacked a cop he knew on a friendly basis and destroyed an ER room has more rights than I do and I can't share any information about anything without a subpoena and even then, a lawyer needs to review with me what I can and can't say. So I mixed a few facts up here just to keep it legal.
I feel for the psych patient. I feel for the family. I can't even imagine how frightening an event like this must be. But mostly, I am grateful. I am grateful for the paramedic that literally jumped across the ER to save my ass before a cop could even unholster his weapon. I know how much worse it could have been. I can't tell you how many times the scene has played out in my mind with different endings and bigger headlines.
I'm hoping our psych patient gets the appropriate care. I'm hoping our administration understands the need for more security and a better intake system for these patients. I'm hoping that law enforcement takes a closer look at their "voluntary" transport and drop off protocols. I'm hoping to educate the general public about how messed up our system is and that some of you will get involved and make changes. Just because we aren't allowed to discuss these issues doesn't mean it isn't a huge problem. It is. HIPPA and privacy protection laws just prevent anyone from knowing about it.
I'm so thankful for our EMS crews that keep us safe. It could have been so much worse. If you want shorter wait times and an ER that has room to actually care for people with REAL emergencies, help us reform the mental health care system. Help us get drug users, dealers and meth heads out of our ER. Help us educate the public that an ER is not a place to get free bandaids, Tylenol, Sierra Mist or a note to get out of work. Help keep us healthcare workers safe so we can do our jobs because you or a loved one might just need us someday.
Friday, August 15, 2014
Saturday, July 26, 2014
Antler Light Fixture
I have been working on lots of little projects to make our house into the home that fits us. When we built it in 2004, we had a different future in mind. We designed this house to raise a family. Life has a way of changing plans in spite of our greatest efforts. We adjusted. We got busy. The house got old and it's time for some updates.
So, I've been working to make this happen. Not only was this my first real house but it was custom designed by a collaborative effort between me, Jeff, my dad who drew up the plans and Rocky, the builder -- plus anyone else who was willing to give advice along the way. I love it too much to leave it but there are lots of little things I would do differently next time.
We have an awesome wrap around porch but the lighting has always bothered me. So much, in fact, that I'd rather just leave the burnt out bulbs in place and ignore them. I've been keeping my eyes open for something that would speak to me. After our trip to Jackson, Wyoming last winter - I knew exactly what we needed, I wanted a new antler light fixture for the deck. I waited for the right fixture to go on sale for the right price and pulled the trigger.
Light fixtures are easy to swap out. It's a matter of unscrewing things, matching like colored wires, screwing them back in and calling it good. Usually. Until there is an extra wire. And a mismatched colored wire. And the ladder barely reaches. And you have to perform all of installation tasks 16 feet in the air with one arm because you are holding the 30 pound fixture with the other hand. But after a 911 call to my favorite electrician, an impromptu trip to borrow my brothers ladder and a little bit of blood, sweat and tears -- the fixture was up -- and it's beautiful.
Before:
After:
So, I've been working to make this happen. Not only was this my first real house but it was custom designed by a collaborative effort between me, Jeff, my dad who drew up the plans and Rocky, the builder -- plus anyone else who was willing to give advice along the way. I love it too much to leave it but there are lots of little things I would do differently next time.
We have an awesome wrap around porch but the lighting has always bothered me. So much, in fact, that I'd rather just leave the burnt out bulbs in place and ignore them. I've been keeping my eyes open for something that would speak to me. After our trip to Jackson, Wyoming last winter - I knew exactly what we needed, I wanted a new antler light fixture for the deck. I waited for the right fixture to go on sale for the right price and pulled the trigger.
Light fixtures are easy to swap out. It's a matter of unscrewing things, matching like colored wires, screwing them back in and calling it good. Usually. Until there is an extra wire. And a mismatched colored wire. And the ladder barely reaches. And you have to perform all of installation tasks 16 feet in the air with one arm because you are holding the 30 pound fixture with the other hand. But after a 911 call to my favorite electrician, an impromptu trip to borrow my brothers ladder and a little bit of blood, sweat and tears -- the fixture was up -- and it's beautiful.
Before:
After:
Tuesday, July 8, 2014
The Salad Planter
I needed it to be a bit bigger so I adapted the plan. The hardest part was recalculating the leg length with the angle that I needed. It brought me back to algebra, trig and geometry high school classes. I was excited because this was my first project with my new pneumatic staple gun.
I stained it, blinged it out with some glass pebbles and landscaping cement. I lined the boxes with plastic and drilled holes in the bottoms for drainage. Filled them with moisture control potting soil and seeded them with different varieties of loose leaf lettuce mixes.
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| The top left photo is from Shanty-2-Chic's site and the size of the original planter. |
Sunday, June 22, 2014
The Tomato Tower
Another Pinterest Project: DIY Vertical Planter Garden with instructions found on RufflesandTruffles.com. (I really like her blog - she's smart AND funny!)
I tweaked it a little to maximize my space and accommodate large planters.
The risers are prefab and available at most home improvement stores. They are around $25 each. I used treated 2x4s and 2x6 for the frame because I knew that I'd be using plastic planters that would not come into contact with the wood. I used screws and bolts to stabilize the frame. I knew it would get heavy with soil, water and plants. The planter boxes I purchased were extra large and I needed to cut the back edge down for a secure fit. I also drilled holes in the bottom for drainage. This wasn't a thrifty project. With $50 for the risers, another $40 for the planter boxes, lumber, hardware and stain; I believe it was around $115-125 to build but it has certainly optimized space and has been a great way to add portable gardening space around our home.
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| Mid July |
Wednesday, May 28, 2014
No News is Good News
I don't watch much news on TV. Part of that has to do with only getting Portland's news stations. I just can't relate to them. One week the greater good of Portland is pissed off that their roads are falling apart. The next week, the same people are pissed off that road construction is going on around them. Citizens speaking out on the news continuously demand for someone to be held accountable and for someone to correct some sort of problem.
It's not really like that in rural America. I don't mean to imply that we don't have a long list of our own beefs, yes, pun intended. We do. We are inherently independent. We don't really have a "someone" to blame or "someone" to fix it. It's more "us" and "we" than "them" and "they" out here. When our electricity goes out, we grab the binoculars and scan our neighbor's places for functioning irrigation sprinklers or lights to see how big the outage is before we call the power company so we can give them an idea of which power pole went down. When our water pressure drops, we troubleshoot it ourselves. We test our own water. If it goes bad, well, it's our own problem and we just pray it's not the well going bad. That's on us. Nobody calls. Nobody is expected to call. Honestly, we likely won't even test the water until everyone in the house is sick - and doesn't get better - for maybe weeks... We certainly aren't going to make a stink about being notified more than once or outside of a 4 hour window. And we aren't going to demand a costly, city investigation of any of it. That's time, money and resources that are needed somewhere else.
When a storm wreaks havok on neighbors fields, we get out of our trucks to help move their irrigation lines, equipment, cows, horses and goats; back to where they belong. We don't sue them or boycott them or call the news station to come video us carrying poster board signs out in front of their homes. On the flip side, we don't go cut down their trees for a better view - er, ah, at least without asking. Turn-a-bout is fair play. Anyone who has had their lush, green lawn oversprayed with ground sterilizer knows that The Golden Rule is real out here, and you never know when you may need a neighbor to come pull you out of an irrigation ditch or loan you some duct tape.
I understand that having a neighbor's home 6-8 feet away from your own is much different than living a half a mile away. I get that all the rules, regulations, laws and home owner association codes are disabling within the city limits. I can only imagine the frustration level reached for a 2 mile drive taking 3 hours. The city is a different animal. Part of me is envious. It might be nice to have the luxury of blame and condemnation. It might even feel good to assign culpability and demand an outside entity correct the latest issue. At the same time, I get to live in a world where my coworker's husband was championed this winter for plowing local streets, not because it was his job but because he had the equipment, made the time and had the desire to make things better for everyone. (Thank you, Josh Tolman!) I get to live in a world where balance is a way of life and understanding cause/effect and action/consequence is ingrained in our existence, not explained in a college course. It's not easy nor is it fun but it makes us independent and accountable for our own selves, lives, families and home -- and it keeps us from making asses of ourselves on the local news. Frankly, we're too busy and none of us get the local news station anyway.
It's not really like that in rural America. I don't mean to imply that we don't have a long list of our own beefs, yes, pun intended. We do. We are inherently independent. We don't really have a "someone" to blame or "someone" to fix it. It's more "us" and "we" than "them" and "they" out here. When our electricity goes out, we grab the binoculars and scan our neighbor's places for functioning irrigation sprinklers or lights to see how big the outage is before we call the power company so we can give them an idea of which power pole went down. When our water pressure drops, we troubleshoot it ourselves. We test our own water. If it goes bad, well, it's our own problem and we just pray it's not the well going bad. That's on us. Nobody calls. Nobody is expected to call. Honestly, we likely won't even test the water until everyone in the house is sick - and doesn't get better - for maybe weeks... We certainly aren't going to make a stink about being notified more than once or outside of a 4 hour window. And we aren't going to demand a costly, city investigation of any of it. That's time, money and resources that are needed somewhere else.
When a storm wreaks havok on neighbors fields, we get out of our trucks to help move their irrigation lines, equipment, cows, horses and goats; back to where they belong. We don't sue them or boycott them or call the news station to come video us carrying poster board signs out in front of their homes. On the flip side, we don't go cut down their trees for a better view - er, ah, at least without asking. Turn-a-bout is fair play. Anyone who has had their lush, green lawn oversprayed with ground sterilizer knows that The Golden Rule is real out here, and you never know when you may need a neighbor to come pull you out of an irrigation ditch or loan you some duct tape.
I understand that having a neighbor's home 6-8 feet away from your own is much different than living a half a mile away. I get that all the rules, regulations, laws and home owner association codes are disabling within the city limits. I can only imagine the frustration level reached for a 2 mile drive taking 3 hours. The city is a different animal. Part of me is envious. It might be nice to have the luxury of blame and condemnation. It might even feel good to assign culpability and demand an outside entity correct the latest issue. At the same time, I get to live in a world where my coworker's husband was championed this winter for plowing local streets, not because it was his job but because he had the equipment, made the time and had the desire to make things better for everyone. (Thank you, Josh Tolman!) I get to live in a world where balance is a way of life and understanding cause/effect and action/consequence is ingrained in our existence, not explained in a college course. It's not easy nor is it fun but it makes us independent and accountable for our own selves, lives, families and home -- and it keeps us from making asses of ourselves on the local news. Frankly, we're too busy and none of us get the local news station anyway.
Wednesday, May 21, 2014
Burlap Wreath
If you are going to go to the trouble of staining the front door - know in advance that it likely won't stop there. I think maybe I was spending too much time staring at the fruits of my labor because it started to look very, well, empty. I searched home décor sights for something, though I wasn't sure what. A few clicks at Pottery Barn gave me some ideas but the prices! Yikes!
(I spend money in time allotments now. I don't see dollars and cents. I see units of work. How many shifts is that pretty, somewhat fragile, organic, welcome wreath really worth to me, anyway? Yah. It just wasn't THAT awesome.)
I perused Etsy and I still couldn't do it for the price. The cheap ones were, well, CHEAP and the items I liked seemed to still be in the $100+ range.
So I cruised over Pinterest just to see if something - caught - my - eye... If you don't know Pinterest that likely won't make sense but for those of us that do, we know all too well that it can take you into an alter-universe where time simply disappears. One moment it's 8 pm and you are waiting for a commercial to end before your favorite TV show starts. You remember a recipe you saw the other night and take advantage of the break to look it up so you can pick up the ingredients in the morning. You look up, the house is dark, the TV is off. Everyone is asleep. It's 2 am and NO... You never did actually make it to the ingredients list of that recipe -- what was it anyway? And who will have time to cook! You need to get to bed because there are 13 super cool projects that you just found and must absolutely start working on first thing in the morning!!!
Ah, but I digress... This is about a wreath, right?
Yes, you can find tons of instructions on Pinterest. So many, in fact, that I'm not even posting the link. There are thousands.
Mine is made out of a straw wreath base and about 2 yards of burlap cut into 3.5-4.5 inch squares and hot glue gunned into place. I may have burned most of my fingertips past the nerve endings because eventually they quit hurting. I found a cardboard letter and wrapped it with twine, holding the twine in place with a fair amount of glue. (Also seen on Pinterest, of course.) Then I embellished it with a bandana and USA flag and called it good.
It took about 6 hours from start to finish and about another 4 days to get all the tiny burlap particles out of the house. It cost about $20 in the end and it discouraged me from starting any new projects for a few weeks -- and THAT likely makes it worth it's weight in gold.
Tuesday, May 20, 2014
The Outdoor Wine Bistro
A friend of mine posted this photo on Facebook - and I immediately fell in love with it! I found a link on Pinterest and went to work!
I didn't find specific instructions but it seemed pretty self explanatory. I cleaned two small wood pallets, added a 2x4 for both additional support and extra shelving, stained them, used metal plates and screws to secure them together, and landscaping cement to adhere concrete pavers to the top.
I used the glass pebbles (from a floral department) with the same landscaping cement to add a bit of bling to the edges and added some "feet" made from a 2x8 to reinforce stability and make it child/dog proof.
The total cost of the project was around $25 but I had a few things on hand that I didn't have to purchase:
I didn't find specific instructions but it seemed pretty self explanatory. I cleaned two small wood pallets, added a 2x4 for both additional support and extra shelving, stained them, used metal plates and screws to secure them together, and landscaping cement to adhere concrete pavers to the top.
Pallets - free
Stain - I used left over stain I already had
2x8 - I used scraps I already had
2x4 - $3
Pavers - $6
Screws, Metal plates - $4
Landscaping Cement - $6
Glass Pebbles - $5
We love our table and use it much more than I anticipated. This was an easy and very rewarding project!
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