Could a Registered Nurse hold their own when it comes to treating patients...?

royhanosn · Jul 5, 2011

make the patient comfortable. Dont do hero-ics. remember you have a lot of people watching you.

knowing how people are these days..paranoid, be careful. despite how much experience you have.

Let the doctor take the rap.

littleneoRN · Jul 5, 2011

I'll be the first person to admit that I have just a scrap of the knowledge that our docs do due to their education and experience. That said, I know what they will order/do in most of our daily situations with our typical patients. I feel confident that I could provide the basic appropriate care given no legal limitations, but I also feel confident that the situation turned atypical for any reason, I'd be VERY glad to have one of our docs there. And I'm perfectly happy to contribute my suggestions as part of the team...and have them right here doing there job.

Rob72, ASN, RN · Jul 8, 2011

I think it depends on the nurse more than anything else. Someone who went into case management straight outta school isn't going to be able to do much for a burn victim, other than tell them what their funneral will cost.
I'd think ED/ICU/Trauma nurses would be good in a pinch like the one you described. IDK, guess it depends on how much of a "Type A Personality" they have.

^The best answer. Expanded, if you have field(Turd World) and/or advanced/Wilderness Para training and experience, you could reasonably assess for hemo/pneumothorax and apply a chest seal. Witha little time, and some basic chem lab tubing and bottles, you could do a chest tube. Kings airway(or whatever the latest and greatest is), blades and a bag are realistic, but someone's gonna get tired w/o a vent. :eek:

Bleeds. Color, volume, location. Either you can stop it or you can't. QuickClot, etc., is great- if used properly. Know your gear.

Fractures secondary to bullet trauma. Getting really iffy, but a Hare traction splint, or a variation, and time.

Secondary infection is significant with bowel. Not so much elsewhere, if they were shot with ball ammo. Bullets are hot, and, to a degree, self-sterilizing. Infection comes from what is dragged into the wound, which is more common with hollow-points.

There is really no reason to attempt an extraction, w/o significant supportive care- you'll do more harm than good. If you can look at the expected exit side of the body, and if you see a significant bulge w/o significant tissue covering, and there is no particular indication of it being displaced bone, a simple incision for removal could be made for comfort, or if significant attached debris was reasonably suspected.

Slightly dated, but still one of, if not the, best resources for those in remote care: http://www.amazon.com/Ditch-Medicine-Procedures-Emergencies-ebook/dp/B0040QE1DM/ref=sr_1_1?ie=UTF8&m=AG56TWVU5XWC2&s=digital-text&qid=1310151739&sr=1-1

This has been recommended to me, but I haven't gotten around to ordering it yet: http://www.amazon.com/Medicine-Outdoors-Essential-Procedures-ebook/dp/B004EYSXRU/ref=pd_sim_kinc_1?ie=UTF8&m=AG56TWVU5XWC2

Rob72, ASN, RN · Jul 8, 2011

Cont. Hammerfall by Larry Niven and Jerry Pournelle, and (much as I am not a fan) Stephen King's The Stand are entertaining novels with realistic end-of-the-world-average-guy-trying-to-save-someone medical scenarios.

The one realistic threat we have would be an EMP nuclear attack. No one is really sure about the total impact, but at the least, the attacked country would be reverted to communicating by runners and crank telephones. With the flick of the proverbial switch, telemedicine, PHI, monitors, vents, etc., all squelch off. Healthcare providers capable of thinking outside the box and improvising would be assets, those that couldn't would be like 90% of the rest of the population, staring stupidly at their blank smartphones.

SamHill · Jul 9, 2011

Cont. Hammerfall by Larry Niven and Jerry Pournelle, and (much as I am not a fan) Stephen King's The Stand are entertaining novels with realistic end-of-the-world-average-guy-trying-to-save-someone medical scenarios.
The one realistic threat we have would be an EMP nuclear attack. No one is really sure about the total impact, but at the least, the attacked country would be reverted to communicating by runners and crank telephones. With the flick of the proverbial switch, telemedicine, PHI, monitors, vents, etc., all squelch off. Healthcare providers capable of thinking outside the box and improvising would be assets, those that couldn't would be like 90% of the rest of the population, staring stupidly at their blank smartphones.

One Second After by William Forstchen deals with an EMP attack. The story goes into great detail about medical conditions and health care without modern equipment(some hellish nursing home scenes). Slight spoiler...The protagonists daughter is a type 1 diabetic so the lack of medical supplies and electricity to store the ones available make for interesting read.

Rob72, ASN, RN · Jul 11, 2011

type 1 diabetic so the lack of medical supplies and electricity to store the ones available make for interesting read.

That's me. Call me paranoid, but I have my older model pump and supplies, with batts, in an improvised water-proof, air-tight Faraday. Disasters have a whole different meaning when you view them in 30 day blocks of life...

esther186 · Jul 18, 2011

I was looking for some volunteer activities and I came across the Medical Reserve Corps. Within your local area there are medical volunteers (drs,techs, rns, rts, dentits) that train together to respond to natural disasters and such. It looks promising. I needed to find something like this, especially after the recent tornados that came through alabama. I am going to call monday and volunteer. I'll let you know how it goes!

nrsjo60 · Jul 18, 2011

Hey thats great ..I'd like to volunteer too. I live in Illinois, but I have a week off in August. Ill check out the medical corp.. :nurse:

xtxrn, ASN, RN · Jul 26, 2011

For example, if some SEVERE devastating "end of the world" weather tragedy (earthquake, tsunami, hurricane) were to occur and there were numerous people in need of serious medical attention. Assuming medical supplies were available in their disposal, would a registered nurse with 5 years of experience in the ER or ICU be able to treat the the people on their own?
The reason for my question is that I have been watching a lot of medical television series (bad reference for information, please excuse me) and there was an episode where a nurse is checking out a victim's gunshot wound in a surplus store filled with supplies during a robbery. The surrounding spectators tell the civilian RN to do something while the wounded victim is bleeding everywhere. The nurse always responds "he needs a doctor." The nurse is unable to extract the wound by themselves?
Sorry if I sound misinformed. Could any other fields hold their own without being a doctor or consultation from one? (PA, NP, EMT, etc.) Not only limited to gunshot wounds, but other severe injuries, diseases, sickness etc.
Keep in mind, this is a hypothetical end of the world type of event, so losing your license/lawsuits do not really apply. Just people who are in dire need of your assistance in a rural region.

Possibly...but dealing with trauma with end of the world disasters would be tricky for a trauma team with 20+ years experience each... Would the nurse be better than nothing- probably. But internal bleeding that's missed because of some nuance symptom he/she didn't know about could be a problem.

For bandaging, and superficial wound care- yeah, I'd see that- but I'd still want a doc to holler to, and get a yea, or nay...... JMHO:)