Babysitting and it's Hot outside

So, as much as I had some cool stuff in April. May has made us a certified psych ward. I am not a pysch nurse, I don't like pysch nursing, why do I have to do it? Why can't people who are going home in 10 days keep their suicidal and homical thoughts out of their heads? Now, that's not totally fair. I'm not really that insensitive. We've had two soldiers recently we felt good for taking care of. K and I have never sat so long and listened to these individuals who really needed the intervention of hosptial admission. Most of the patient's we've had in the last few weeks truly have a disease and have really needed help. But, the fact that we are in a country that is less of warzone and more of a boring get-paid-more-for-doing-nothing in the desert doesn't help. I have experienced the lack of professional satisfaction that comes from seeing fewer battle injury patients than I would be at LRMC. I often feel that I could be doing better things had they kept me in Germany. These combat troops feel the same way if they'd been sent to a hotter spot. Now, I don't really want to have to feel professionally statisfied by shooting a gun outside the wire, but for many people who train for that job, that's what it means to them. When they're unsatisfied professionally it leaches into their personal life and people get in trouble and trouble brews back at home. It's perpetually frustrating. What has become of our society that people can't manage to occupy themselves with healthy outlets? Why must people smoke "spice", commit adultery, and threaten to bash their commands face in?

Seriously, I went to knitting club this week for the first time and there were 3 men there learning to knit. One of our docs is knitting a bright peach afghan. BRIGHT PEACH! There are productive outlets out there. But, this enviornment is a black hole. You can't help but feel hopeless at times. It's such a black hole that a soldier, who was on 1:1 watch already, snuck out at night when the guard fell asleep and shot himself in the head in a port-a-potty; and our Ambulance crew had to go pick it up.

We all came here wanting to help people, but at some point, you just wish you didn't have to. Psych admissions tend to provide more of the question, "What failed you? Where is the failure in the system? How did it come to this?" We have hours and hours and hours of suicide prevention training. The Army has spent so much money trying to answer the same question. I sometimes feel I am closer to K than to Joe because of the Army's battlebuddy policy, no one is ever supposed to be alone. These buzz makes the threshold is so low for admitting BH patients, it's "the soldier who cried 'suicide' ". This black hole and incidents like the successful sucide are why we are full of "Bravo Hotels" constantly. No one wants to be the doc that saw the soldier who said "the world would be better off without me", didn't take him seriously, and gets the call that that soldier is the next guy who shoots himself in the bathroom. I just wish the Army had a better way of realizing who NOT to deploy before they get here and decompensate. So many of our patients have a previous psych history, a previous family history, you can only think, "how did you get here in the first place?" At this rate, I can't wait until we all get out.

It's also become HOT. It's now hot all the time. The buildings still radiate heat from the day at 2 am. It's over 100 degrees in the day and doesn't get much lower than 90 at night. Heat is no fun. I will never take AC for granted again. The generator broke on Friday and by 1100 my room was as hot as it was outside. The only difference between outside and my room was outsdie there was a "breeze" of hot air and inside there wasn't any sun. I woke up at 1100 drenched in sweat. I got a cold can from my slowly melting fridge and laid with a can on my skin... it didn't last long. K and I checked oursleves in to the "hotel MCU" until the generator was fixed. I can't IMAGINE having to be here earlier when there were tents and NO AC.

This wasn't meant to be a ranting blog, but it kind of turned into one. One cool thing we did see in spite of all the behavioral health patients was a a patient with Malignant Hyperthermia. I gave him to K to take care of for the night. He went to the OR for a routine appy, was intubated using Sux and incuded and maintained with anesthetic gases. When they tried to wake him up after surgery he wouldn't breathe, narcan didn't help, his pH was 7.1, and his CO2 was in the 80's! They caught it quick, his temp only went to 99.9. We treated him in the MCU later one with Dantrolene Sodium, and rested him all night on the ventilator. We woke him up and extubated him in the morning. He did great. MH has a 50% mortality rate, but since we are so bored, everyone was in the OR and it was caught and treated QUICK

Like Joe says, it's not always what we're doing here, it's what we're ready to and might have to do at a moment's notice.