You can take the nurse out of the ER, but sometimes you just can't take the ER out of the nurse. Check these out :
http://jalopnik.com/5823167/the-ten-coolest-ambulances/gallery/1
http://jalopnik.com/5823167/the-ten-coolest-ambulances/gallery/1
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Showing posts with label er. Show all posts
Showing posts with label er. Show all posts
Tuesday, July 26, 2011
Monday, March 7, 2011
Mean People Suck
My oldest child is a middle school girl. Unfortunately I have recently noticed some "Mean Girls" type of activity going on at her school. This kind of behavior is pretty typical of adolescence. I'd like to think that most of these kids will grow out of it and mature into secure, compassionate, productive citizens. I have met too many petty, backbiting adults to take this for granted though. I would also like to think that nurses would be above this kind of childish behavior. In nursing school I heard the saying that nurses eat their young, blah blah blah. I figured I was too nice and too hardworking for anyone to want to eat me up. Wrong. I've encountered a few cannibals in my time, but I'm not so young anymore, not so vulnerable.
I talked to a nurse the other day, however, who reminded me of this issue. I FINALLY took the 12 lead class I have meant to take for like five years. When I walked in, there were already about ten people seated in the auditorium. I smiled in my generally smiley way at everybody, and only one nurse smiled back at me. I recognized her as an RN who used to work on our Orthopedic post surgical floor. I had encountered her in the past when bringing patients to her from PACU. She had struck me as extremely hard working, smart, and helpful. A couple of us had suggested she come to the PACU, but she would need some other experience first, either ER or ICU. So, as I talked to this woman, we'll call her Nicenurse, she told me how she had transferred to the ER to get some experience there in order to hopefully eventually work in the PACU.
I have to explain: like so many others across the country, our ER is a zoo. It is a chronically understaffed, inner city, outdated, underbudgeted, overburdened mess. Staff turnover is horrendous. It hemmorhages nurses like a torn aorta. I know several agency nurses who refuse to go back. They seem to get a new Nurse Manager on at least an annual basis. I already liked Nicenurse, but I know how chaotic our ER can be. Now my respect for her has gone up substantially.
She is so discouraged, though, she tells me. She has been in the ER for ten weeks and has no intention of quitting, but she says that the other nurses and the techs treat her like crap. This puzzled me, as I know she is hardworking and smart. Nicenurse told me that fellow ER staff criticize her positive attitude and are making bets on when she will quit and who can get her to quit. Apparently other staff have refused to help her at times and have told her incorrectly where items were located. I had no reason to doubt her story, but I just don't get it. In my mind more staff = good. I would want a decent nurse to come on board. Maybe if they could retain some more staff every nurse would not have to have 6 or 7 patients, including ICU holds.
I hope things improve for her. Do other professions treat themselves this way?
Wednesday, February 23, 2011
The Scary Dad
Whenever I work in Preop Holding, something weird or confusing seems to happen. Last week I had a patient coming from our ER. The patient was a 4 year old boy who had stuck a tiny Lego bit up his nose. The ER doctor and the ENT on call had been unable to retrieve the errant Lego in the ER, so surgery was scheduled for the little guy. Fishing out foreign bodies from various bodily orifices is a pretty common activity in the surgical suite, so as is the routine I called the child's ER nurse for a quick report. The nurse was obviously an intelligent woman, giving me an excellent detailed report. Now I admit I am biased towards ER nurses. They do it all, do it fast, and often do not get the repect they deserve. I started out in the ER and still see pretty much everything through that perspective. But this nurse went off on a lengthy tangent that freaked me out a little bit. She started talking for a while about how the father of the child was a militant "foreign" Muslim who hated white women and was disrespectful to the female nurses. "You know how they are." she said about male followers of Islam.
It was an unusual way to end the report, so I figured this guy must be a real terror. I immediately pictured a bearded man screaming in a foreign language at the staff. Imagine my surprise when the man in question turned out to be a pretty ordinary looking guy who spoke English well. The little boy was an absolute cutie pie. As I was getting him and his mountain of paperwork ready, I kept waiting for the dreaded misogynistic outburst from the Dad. I waited and waited. I am half Latina, with my Mom's pale Irish skin and my Dad's crazy frizzy/curly hair. So, maybe I did not count as an actual white woman. However, my coworker is a 100% lily white, sweet as pie platinum blonde Southern girl, so maybe he would direct his ire at her. Nope. He was complimentary and gracious to her as well. As I escorted him to the wating room, he thanked me and told me I had a nice personality. Religion was not mentioned by anyone at anytime. I really couldn't figure it out. I simply treated him as I would want to be treated if I brought in my child with a Lego up his little nose. Had the guy undergone a total personality change between the ER and Preop Holding? Had the otherwise smart ER nurse misinterpreted his behavior? I didn't know what was going on. It was weird.
It was an unusual way to end the report, so I figured this guy must be a real terror. I immediately pictured a bearded man screaming in a foreign language at the staff. Imagine my surprise when the man in question turned out to be a pretty ordinary looking guy who spoke English well. The little boy was an absolute cutie pie. As I was getting him and his mountain of paperwork ready, I kept waiting for the dreaded misogynistic outburst from the Dad. I waited and waited. I am half Latina, with my Mom's pale Irish skin and my Dad's crazy frizzy/curly hair. So, maybe I did not count as an actual white woman. However, my coworker is a 100% lily white, sweet as pie platinum blonde Southern girl, so maybe he would direct his ire at her. Nope. He was complimentary and gracious to her as well. As I escorted him to the wating room, he thanked me and told me I had a nice personality. Religion was not mentioned by anyone at anytime. I really couldn't figure it out. I simply treated him as I would want to be treated if I brought in my child with a Lego up his little nose. Had the guy undergone a total personality change between the ER and Preop Holding? Had the otherwise smart ER nurse misinterpreted his behavior? I didn't know what was going on. It was weird.
Tuesday, January 11, 2011
Piano Students and Astronauts
I had the pleasure right before Christmas of going to my two daughters' first piano recital. They hadn't been taking lessons long. I had just picked up our $250 piano off Craig's List in October, so they were still newbies. A large audience of parents and friends watched as kids ranging in age from roughly 5 to 15 with various skill levels approached the stage in the modest, old church and sat down to play their music. Towards the end of the recital, a student named Shirley was announced. I thought "Shirley... Hmmm you don't see many kids named Shirley these days". It turned out Shirley was in fact not a kid. Shirley looked to be at least well into her 50's and she played a beginner/early intermediate piece very nicely. I noticed some of the audience members kind of smirked at the older student. However, as I thought back on the recital later that night, I realized that I was pretty impressed. It takes courage and initiative to learn a new skill as an adult, especially in front of an audience.
A little over a year ago when I was still working in the ER, I had a patient on New Year's Eve who had been hurt badly in a fall. She was a local college student who, while attempting to climb from one 3rd floor balcony to another in the dorms (apparently a common activity), fell onto the concrete below. She had not been drinking, later confirmed with a negative serum ETOH. We'll call her Jane. Jane had multiple fractures in her left arm and left lower leg. Her head CT amazingly showed no damage. She had several lacerations, only one of which needed suturing. Her vital signs were stable. An orthopedic surgeon was called in to fix her fractures up. A general surgeon was to evaluate her as well for any possible internal injuries. My other patients were all waiting on rooms at that time, so I actually had a chance to talk to Jane and get to know her a little bit while she waited for the OR. She told me that she was in the Navy ROTC at the college. She wanted to be a fighter pilot and maybe even an astronaut. She was concerned because she said the orthopedic surgeon wanted to fix her limbs with metal hardware and apparently fighter pilots can't have metal in their bodies. She told me that the surgeon mentioned she may be able to get the hardware removed at a later date, so that she could be eligible to be a pilot. Soon she was whisked off to Preop and the OR. The last I heard of her she was going back into surgery for a lacerated spleen and then up to the ICU. With all the orthopedic surgery and the possibility of a splenectomy, I assumed her dream of being a Navy pilot and astronaut was over.
Fast forward to this past week. I was in Phase II Recovery with one other nurse. I had just discharged a patient and was tidying up the bay. Through the curtain I could hear a conversation between the nurse next to me and her patient, who was getting ready to be discharged. As I was listening to them talk, I realized the patient was Jane. I mean how many young female patients do we get who had a bad accident and want to be Navy pilots? At my hospital at least, not that many. I peeked around the curtain, and there was Jane. I introduced myself. Of course she did not remember me...I had given her a fair amount of morphine in the ER. She told me that she had been in surgery that day to remove the last of the hardware in her body. She was eligible to meet the physical requirements to pursue her dream career. The general surgeon had been able to repair her spleen without removing it. She was currently training for a 5k. Unbelievable.
Now bear with me here...I know a middle aged woman learning how to play the piano and a college senior wanting to join the Navy don't seem to have a lot in common. However, these women both struck me as being very courageous in their own ways. They were not content with simply maintaining their status quo. I'm over in my little corner of the world wondering if I should go back for my long overdue BSN or if it's too late, too hard, too expensive, etc. When I look at Shirley and Jane, I wish I were more like them. I want to go out on a limb, but am scared to venture out of my treehouse.
A little over a year ago when I was still working in the ER, I had a patient on New Year's Eve who had been hurt badly in a fall. She was a local college student who, while attempting to climb from one 3rd floor balcony to another in the dorms (apparently a common activity), fell onto the concrete below. She had not been drinking, later confirmed with a negative serum ETOH. We'll call her Jane. Jane had multiple fractures in her left arm and left lower leg. Her head CT amazingly showed no damage. She had several lacerations, only one of which needed suturing. Her vital signs were stable. An orthopedic surgeon was called in to fix her fractures up. A general surgeon was to evaluate her as well for any possible internal injuries. My other patients were all waiting on rooms at that time, so I actually had a chance to talk to Jane and get to know her a little bit while she waited for the OR. She told me that she was in the Navy ROTC at the college. She wanted to be a fighter pilot and maybe even an astronaut. She was concerned because she said the orthopedic surgeon wanted to fix her limbs with metal hardware and apparently fighter pilots can't have metal in their bodies. She told me that the surgeon mentioned she may be able to get the hardware removed at a later date, so that she could be eligible to be a pilot. Soon she was whisked off to Preop and the OR. The last I heard of her she was going back into surgery for a lacerated spleen and then up to the ICU. With all the orthopedic surgery and the possibility of a splenectomy, I assumed her dream of being a Navy pilot and astronaut was over.
Fast forward to this past week. I was in Phase II Recovery with one other nurse. I had just discharged a patient and was tidying up the bay. Through the curtain I could hear a conversation between the nurse next to me and her patient, who was getting ready to be discharged. As I was listening to them talk, I realized the patient was Jane. I mean how many young female patients do we get who had a bad accident and want to be Navy pilots? At my hospital at least, not that many. I peeked around the curtain, and there was Jane. I introduced myself. Of course she did not remember me...I had given her a fair amount of morphine in the ER. She told me that she had been in surgery that day to remove the last of the hardware in her body. She was eligible to meet the physical requirements to pursue her dream career. The general surgeon had been able to repair her spleen without removing it. She was currently training for a 5k. Unbelievable.
Now bear with me here...I know a middle aged woman learning how to play the piano and a college senior wanting to join the Navy don't seem to have a lot in common. However, these women both struck me as being very courageous in their own ways. They were not content with simply maintaining their status quo. I'm over in my little corner of the world wondering if I should go back for my long overdue BSN or if it's too late, too hard, too expensive, etc. When I look at Shirley and Jane, I wish I were more like them. I want to go out on a limb, but am scared to venture out of my treehouse.
Friday, November 19, 2010
A Pain in the Butt
"As soon as I leave here I'm going to St. XYZ's ER. If they tell me something different, I'm gonna sue. I'm on Medicaid so I can go to every ER in this city if I want to".
-My ER patient, who was told that his hemorrhoid did not require immediate surgery, but was instead advised to try a 2 week regimen of topical ointment and sitz baths before a follow up appointment with the general surgeon.
-My ER patient, who was told that his hemorrhoid did not require immediate surgery, but was instead advised to try a 2 week regimen of topical ointment and sitz baths before a follow up appointment with the general surgeon.
Saturday, October 30, 2010
Monday, October 18, 2010
It's Not a Freaking Spider Bite
When I first started in the ER, I was surprised at how many patients came in every shift with "spider bites". These bites seemed to have a special affinity for the buttock, breast, and armpit areas and tended to be teeming with pus. The patients usually insisted that a brown recluse spider had bitten them. Eventually I figured out that these were not in fact spider bites. They were abscesses caused by a staph infection, usually MRSA. The doctor or nurse practitioner would cut open the abscess and push, prod and dig until all the visible pus was evacuated. I learned how to properly irrigate, pack, and dress the ensuing wound, then hand the patient their prescription for Bactrim.
After a while as I became a more jaded RN, I started to get annoyed with the patients who were adamant that they had been bitten by a spider and were often quite offended and insulted at the insinuation that they actually had a staph infection. Apparently other staffers were getting tired of it too. One of our docs (my favorite) copied a news article and tacked it up in the wating room. It was about the geographic location of the brown recluse spider, ie. nowhere near where we were. Patients would still leave shaking their heads and insisting that the doctor had misdiagnosed them and their "spider bite".
Now I am out of the ER and in the surgical area. I assumed there would be no more spider bites. However, now patients coming in for an I and D of their abscess under anesthesia are telling me about their spider bites preoperatively, as I start their IV Vancomycin.
I had to roll my eyes the other day as my family was watching the show Dr. G on Discovery Health. Dr. G, a Medical Examiner in Orlando, Fl was describing the events leading to the death of her next subject. As soon as I heard the words "he was concerned about a spider bite on his back", I was like "For God's sake, Dr. G. You don't even have to do an autopsy. he died of MRSA". My kids were so impressed when the report of autopsy backed up my hypothesis :) The young man had neglected to see a doctor for his fever and malaise, not linking these symptoms with his "spider bite". The poor guy died of a treatable infection.
I hope I don't sound too much like a bi%$#, but just a little vent.
After a while as I became a more jaded RN, I started to get annoyed with the patients who were adamant that they had been bitten by a spider and were often quite offended and insulted at the insinuation that they actually had a staph infection. Apparently other staffers were getting tired of it too. One of our docs (my favorite) copied a news article and tacked it up in the wating room. It was about the geographic location of the brown recluse spider, ie. nowhere near where we were. Patients would still leave shaking their heads and insisting that the doctor had misdiagnosed them and their "spider bite".
Now I am out of the ER and in the surgical area. I assumed there would be no more spider bites. However, now patients coming in for an I and D of their abscess under anesthesia are telling me about their spider bites preoperatively, as I start their IV Vancomycin.
I had to roll my eyes the other day as my family was watching the show Dr. G on Discovery Health. Dr. G, a Medical Examiner in Orlando, Fl was describing the events leading to the death of her next subject. As soon as I heard the words "he was concerned about a spider bite on his back", I was like "For God's sake, Dr. G. You don't even have to do an autopsy. he died of MRSA". My kids were so impressed when the report of autopsy backed up my hypothesis :) The young man had neglected to see a doctor for his fever and malaise, not linking these symptoms with his "spider bite". The poor guy died of a treatable infection.
I hope I don't sound too much like a bi%$#, but just a little vent.
Monday, October 11, 2010
Man's Best Friend
Ok. This is not about my usual passions, nursing and food. This is another love of mine, dogs. I have a dachshund who is a spoiled princess, no not even a princess...she is the queen. I lost my beloved German Shepherd a year ago and still miss having a big dog around. A coworker who knows my love of big dogs offered me a dog she rescued 5 months ago. This nurse is moving into an urban apartment in another part of the country and is getting rid of both of her dogs :( This dog is roughly 6 months old, housetrained, up to date on shots, loves other dogs and kids, travels well, knows basic obedience, and loves to go on walks. She is also very cute. Perfect, right? Well, I'm not sure. I have a small child, and this dog is possibly a pure bred Pit Bull. I have heard all the stories of kids being mauled by Pit Bulls. I have also met people whose Pit Bulls would lay down their lives for the children of the family. I am very confused.
When I worked in ER and Urgent Care, I took care of many patients with dog bites. I never took care of any mauled by Pit Bulls. Maybe because they were in the morgue already? Sorry that is bad nurse humor. I met many people bitten by Chihuahuas. Seriously. The worst bites I ever saw were from a Golden Retriever of all things. Of course the lady waited a few days before seeking treatment, so the wounds were grossly infected, needing debridement and packing of pretty much her entire leg.
I really need some input on this. I have met the dog before, who seems very gentle and sweet. Is the backlash against these dogs justified? I would certainly get her spayed and never subject her to cruelty or dogfighting. Please tell me your thoughts.
When I worked in ER and Urgent Care, I took care of many patients with dog bites. I never took care of any mauled by Pit Bulls. Maybe because they were in the morgue already? Sorry that is bad nurse humor. I met many people bitten by Chihuahuas. Seriously. The worst bites I ever saw were from a Golden Retriever of all things. Of course the lady waited a few days before seeking treatment, so the wounds were grossly infected, needing debridement and packing of pretty much her entire leg.
I really need some input on this. I have met the dog before, who seems very gentle and sweet. Is the backlash against these dogs justified? I would certainly get her spayed and never subject her to cruelty or dogfighting. Please tell me your thoughts.
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