What are the most invasive procedures you do?

[arynberg]

Just trying to get myself as educated as possible before making a solid decision on what field to get into.

So, Ive read about the poop, urine, vomit and blood. I read the post about catheters and 5" of foreskin,......then googled for images (Yikes, looks painfull....wouldnt want to be on the receiving end). I have read about some of the stresses (patients, docs, paperwork, shortages). So what OTHER procedures do you do as nurses that you would say are difficult or hard to handle, or invasive?

What do you think the most difficult part of your job is?

PS - I understand that poop is part of the deal, but do you see less of it in certain areas or depts? I figure Ill just carry some Vick's in my pocket just n case. Ive never even changed a babys diaper but I guess, ya gotta start somewhere right?

Thanks!

Audrey

[MichaelFloridaRN]

Interesting question. Before I became a nurse I was worried about "poop". Now it does not even bother me at all, likely since I have cleaned so much of it. Sometimes it does smell very foul, but I think that everyone can get used to this.

As far as invasive procedures go I would say that repacking tunneling wounds is pretty invasive and likely painful to the patient. We had a guy with gangrene on his member a few weeks ago that left him with a partial gland and an 8 cm deep tunnel that needed wet dressings packed in with a swab, even after heavy pain meds was he not very comfortable.

Foleys, IVs, Bowel managements systems are a few examples of things that are invasive. Your everyday finger stick on diabetic patients is also not very pleasant. Hope that gives you some idea. You could always see about following a nurse in a hospital setting to get an idea of what it is like. Our hospital has a nurse camp every summer to give prospective nursing students some insight, check with your local hospital if they have a similar program.

[Dixielee, BSN, RN]

It is hard to know exactly what you are asking, but there are many areas of nursing that involve a variety of intervention. If you are an office or school nurse you may only have to give meds, bandage wounds, etc. If you are in labor and delivery, you obviously see a lot more blood. Dialysis nurses see all the patients blood as it goes round and round thru the artificial kidney.

ICU nurses see lots of invasive lines, tirtrate a lot of drips, have lots of patients on vents, change a lot of dressings as well as deal with infected, incontinent long term patients.

In the ER, we do all of the above as well as assist with chest tube insertions, NG tubes, quick preps for surgery in trauma patients, lots of splinting of broken bones, drunks who have passed out in their own vomit, urine and feces. Yes, we put in a lot of foleys as well.

As a nurse, you are going to see people at their worst. They are either too sick to take care of their own basic needs, or just don't want to. You will see young innocent people die, and it will break your heart. You will have to deal with the ranting and raving of maniacs, and that includes patients, families, docs and other nurses.

Then why do we do what we do, if it is so awful? I ask myself that question everyday. It is because occasionally, you make a real difference in someones life. You may actually be instrumental in bringing someone back from the brink of death. You may have the honor of helping bring new life into the world. You may be the one to comfort and support the wife of a dying man, the mother of a child who is seriously ill, or hold the hand of the lonely one who has no familly to care for them.

If you put it all on a spread sheet and balenced the pros and cons of nursing...the cons would always win. No one would ever want to be a nurse. But the reasons we do it are mostly intangible. I can't put my finger on it, but something keeps me going back day after day, year after year.

No one can adequately describe what we do and what impact we make. But if you ever need a nurse, I hope you don't have to look far to find one who can help you thru your time of need.

[LeesieBug]

The procedure I hate to do the most would be NG tubes. It's just so damn unpleasant for the patient. And doing them to frail elderly people just makes me feel like I am abusing them, even though I know it is for their benefit.

No matter how many times I do them I groan when I pick up a chart and see "NG" listed on the orders.

[anc33]

NGs and DHTs hands down for me. I worked on a neuro floor and it was a huge fight to get those things in a semi-conscious patient. I also have to second wound packing. I had a nursing student get sick on one of my shoes after one. I thought he would really like it since he wanted to work with vents and rehab patients. I don't know if it was the heat in the room or fact that you could see the patient's beating heart through the wound or both.

[Medic/Nurse, BSN, RN]

Hands down, I think femur fracture reduction with traction splint placement (although not technically invasive) is always a bit "squeaming" to me most of the time.

That pulling the bone into alignment (with considerable force at times) is a bit tough. Afterwards the patient usually gets significant relief, but YIKES! it does take some getting used to!

The last one I did was post 350mcg Fentanyl/4mg Versed - given in the IO access I had placed in the humerus 2 minutes earlier --- and the patient STILL screamed like a banshee!

Gotta do it - so, you just DO IT!

So, I just do what I gotta do - EZ IO (with the drill) beats hand placement, chest tubes, central access - it all gets to me some of the time, but it can save the patient so I just get to it. Nasal intubation is bad, but realistically since we can RSI and place ETT via oral route, I don't have to do the nasal intubation thing too often now. Woo!Hoo!

In the ICU - hands down, the wound care has it! Being able to get my hand (to the elbow) in a wound on the backside is bad, bad, bad. Burns are also on the list.

Actually, I often think that a lot of what we do is torture at times.

No doubt, that having a patient recover takes away all the bad pieces and makes it all worth it! Necessary evils.

Practice SAFE!

[arynberg]

Yes, some of that definetly sounds like you just gotta grit and bear it. I was watching Trama in the ER the other day and a guy was pruning bushes.......fell off the roof and landed on this spikey bush. 4' long x 3" diameter branch went up the rectum....YIKES! But the crazy thing was that it didnt damage anything other than the entrance wound. The branch made it all the way up just before his diaphram.

Do you still do flight nursing.

Hey guys, just wanted to say that I really appreciate all of your responses. Its such a BIG decision going back to school when you have a whole family and house to run. Its like we are all going to school.

[Medic/Nurse, BSN, RN]

Hey there arynberg - you got it right - just gotta do what you gotta do.

Yes, I still fly - best job in the nursing world.

Don't sweat the necessity of the "tough stuff" - when the time comes you really do just get to it - no matter what it is.

Best of luck with school - it really is worth doing at any age - sure, it gets tough at times - but to get to do a job that you love is really great at any age!

[Scrubby]

[so what OTHER procedures do you do as nurses that you would say are difficult or hard to handle, or invasive?]

I work in the operating room as a scrub nurse so that's about as invasive as you can get.

Poo, sputum and urine are pretty easy compared to handling body tissues. Often i get handed chunks of what the surgeons call 'rubbish' which i have to dispose of later on. We have to handle specimens such as bowel, amputated limbs, mastectomies, and other interesting stuff...

[neygray]

The hardest thing for me to handle is a patient actively vomiting. I don't think I will ever get past that. I never actually 'join along' but I wretch several times trying to help them. Give me 'poop' all day every day over that!:lol2:

[stormforce]

I think the most invasive thing I have done and the most icky was inserting an intraosseous into a child with severe burns.

I'll never forget that crunch, it was many years ago and we had a run of about 3 of them that needed siteing, as I was an APLS instructor I was asked to watch one then do the next one.