I have nothing in common with Pony-boy

I love my job! Once upon a time, I was a young, (well, semi-young) naive (really!), nurse, filled with compassion, empathy, and the need to serve others. Nine years later, I've become a bitter, cynical, walking bullshit detector. Case in point: my patient today. This young lady is a fair representation of our client base at Screwed-up-life General. You would think that labor and delivery would be all sunshine and roses, birds singing in the trees, and woodland creatures decorating the delivery room with gossamer bunting in anticipation of the joyous arrival. You poor fools. My little 19 year old patient comes in by ambulance. Most people that come in by ambulance are either A) one centimeter and not in labor, B) 10 centimeters and trying to spit out a baby in the rig (which paramedics do NOT dig) or C) suffering from the common cold and didn't have a ride in. You did know that AMR does not stand for American Medical Response, right? It is actually a code for "Ah, My Ride." I digress.

I had been really hoping that the ambulance would be an engine (firefighter) unit rather than a private service. (Paramedics share the same level of disillusionment and cynicism as I, where the EMTs from the private service are distressingly trustful.) AMR. There goes my day. The patient is uncomfortable and this is her 3rd baby. So, pretty good chance that she might actually be in labor. After she is transferred to the bed, one of the EMTs pulls me outside her room to let me know that the pt has a drug history and her family wanted to make sure that the baby was checked. I asked him if she admitted to any drug use recently, he said she denied using. I walk back into the room and this converstaion ensued:

Me: "Hi. Any alcohol use in the pregnancy?"

She: "Yeah, a little in the beginning."

"Okay, how about cigarettes?"

"Yes, like a half a pack a day."

"All right. Any history of drug use?"

"Yeah, in the past."

"Oh? When was the last time you used?"

"Last week." (Well, that was in the past.)

"What did you do?"

"Cocaine."

I think you get the drift. She then said that she had had seizures before. I inquired whether these seizures were the result of epilepsy, or some other cause. Yes, she informed me, she had epilepsy. "You know, it was the time I almost swallowed my tongue." As this was the first time we had met, I did not know, but, in the interest of keeping the conversation flowing, agreed with her. I then asked if she were on any medication to control the epilepsy, when she informed me that she wasn't because the seizures only occured when she did cocaine. Well, stop cutting your coke with Draino then. The sad part is that I now laugh at such things instead of being appalled by the tragedy.

After her epidural, I put in a catheter and sent off a drug screen, with her permission. I tested the urine before it got sent to the lab and lo, and behold, got the same results as if I had stuck the test strip in tap water. Had I not gotten this straight from the horse's....er...bladder, I would have thought she had given me tap water. As it was, she most likely over hydrated herself in an effort to dilute out any possible drug screen. And, as it turned out, her screen was negative. Worry not, we put a bag in the baby's diaper. Althoug CPS's new policy is to not get involved , even for a positive screen, unless the baby is ACTIVELY withdrawing from drugs. Okey-doke.

All this occured while the patient's mother and her boyfriend are tweaking all over the room. I was going to request a drug screen on them just on general principles. So, now you know why I am the way I am. My job rocks! I do, however, enjoy listening to what relatives are going in and out of jail, who broke probabtion, and what cut of beef goes best with MD 20-20