ToryAdore

Balsamic vinegar...?:roll

a "toy"...? Umm...maybe it was Mattels East Bake Oven. That'll do it

If the reason you're leaving was job related why would you mind them saying they wouldn't hire you back...? Would you go back if they wanted you...? If not, I can't see any reason to risk turning your new employer off by asking for another week.

Imagine residents doing every diagnostic procedure themselves..?. Last week the female resident performed a mammogram. I'm waiting for one of them to do a bed bath.

I could probably deal with the need to get the pt. into a gown but without paperwork or documentation...umm...are you supposed to take verbal instructions from the pt....? Heck, if you give them a local, they could even assist with the procedure.

Krissy, I'm probably wrong and this is going to sound way out of left field but, did he throw up in the ER..? Who determined that it was blood..? Was that checked...? Could an 18 year old with 7 beers + in him determine that it was blood or did he possibly mistake it for tomato sauce..? I know it's a longshot but I just thought I'd ask.

I think we may be overreacting a bit here. Krissy never said he entered the ED because he was drunk...but for vomiting blood. (as it turned out it wasn't due to health problems associated with chronic drinking but for a virus). He didn't hurt himself or anyone else. It wasn't even known if he was driving or being a responsible young adult by having a designated driver (if they even drove). Some people have a high threshhold for alcohol and 7 beers and one drink can be tolerated by many people. I'm not in any way condoning drinking but to call him a chronic drinker (granny) or that he was in a drunken fog (veronica) is making judgements not based on enough facts. He admitted to drinking on weekends but ONLY on weekends. If this was chronic, he'd be drinking during the week as well. He didn't hurt himself or anyone else nor would that be the case if he wasn't in fact drunk. Depending on the relationship with his mother, it would be a good idea to sit down with him and ask if it's a problem, especially given the family history. Or, if he agrees, to talk with a professional. This could be a wake up call to educate him to the problems associated with drinking but in my opinion, it's a bit premature to judge him as an alcoholic.

You did great in just walking away. I'm sure I would have said something (as I left to find another nurse) that bordered on "totally inappropriate" such as "it might be a good idea if I call Social Services regarding a "minor" getting so drunk that they need to be hospitalized". And then just smile. I know, I know...not a good idea but OMG, it would have felt sooooooo good.

From the responses, it seems that undergarments are removed "without" asking the surgeon first. Are there different proprietary rules at each facility about this..? I was trained (at my facility) to ask the surgeon "before" you do anything to what they, the surgeon, refer to as "their" pt. (funny...I think of the pt. as "mine" too). I can't imagine being written up for what I consider to be part of the prep routine. My thought is that there are sometimes unexpected emergent situations created during the surgery and I'd want umm...forgive the expression...."my" pt., prepared for without the needs for unnecessary time lost by removing anything.

Having a female nurse present during the PE is as much a safeguard to the MD as it is to the pt. I've read about the numerous frivilous law suits and allegations by pts. who accuse the MD of fondling or conducting themselves in an otherwise inappropriate manner when in fact, the exam was carried out by the book.

Digressing just a bit, I feel bad for the male pt. who, after requesting a male nurse (for whatever reason he's so inclined) is talked about behind his back in the nurses break room about why he doesn't want a female nurse. Most often he's suspected of having a small than average anatomy. It's the reverse double standard actually. If a female pt. requests a female nurse nobody even breaks their stride. I work with some gifted male nurses who have as much expertise as some of the interns we have. Just my .02c

And if you DID ask if she were pregnant, would the ER Director expect you to have put the (example) 4 chest pain pts. in their 60's or 70's aside...? Of course not. It seems that the Director has 20/20 hindsight. Second-guessing staff is just flat out wrong. It may seem cold but I'd rather see a miscarriage than lose a pt. to an MI. To a lesser degree, if she wasn't visably pregnant but knew she was, wouldn't you expect her to say something like umm..."I'm pregnant and bleeding and worried that I might lose my baby"? Or even if she didn't know, "I've been sexually active and haven't had a period in two months"..? Don't beat yourself up until they install crystal balls to triage pts. and you were at fault because you didn't have yours turned on.

We had a man in for a hernia repair yesterday. Not an inguinal hernia but upper gastric...about 2-3 inches above the navel. The warming blanket was on and after removing his gown from under the blanket, I noticed that he was wearing underwear. I mentioned that to the surgeon he said "it's ok, we're not going down that far". I wasn't sure if he said that for the pts. benefit because he was still awake at this point. I didn't say anything else. I was thinking of asking again when the pt. was under but changed my mind. Prepping was a bit more difficult than it had to be but we managed. No foley but prepping from nipple to navel where the shorts had to be moved aside to avoid getting the color changed from gray to "betadine purple". I'm only 8 months into this and haven't seen it before. What would you have done...?

You have to go by the numbers. If you have good feedback from 99% of your pts. or family members (sometimes even no feedback is good), then don't fret over the complaint from that 1%. Especially if there wasn't an incident that you could look back on (multiple sticks till IV inserted, etc.) to know that something gave them reason to complain. You'll never please everyone...that's a cold hard fact. And the family member's comment about you being the only nurse she had a problem with was probably said just to support her claim. It could have been something as simple as turning over your pts. to the next nurse and not going back into the room to say that you talked to the doctor and he'll be in with BP meds. Move on...this was a good experience...your skin will toughen. Best of luck. Tory

http://www.enw.org/Research-NGT.htm This site is pretty comprehensive about placement

I'm not one to try to change the course of history after only 8 months out of school but many of the techniques in school differ from the hospital. I can now understand most of those differences, given the pace and volume of pts. all looking to be treated immediately. But there's one thing that I think can be corrected at school. I think the male dummy needs a reality remodeling. I mean, that hole is so big, I can probably get a 32fr chest tube into it. And the anatomy overall would be the wish of most women and all men and umm.....err...maybe it's time to stop typing before I get booted by the powers that be.

Although I totally agree with TennNurse's thoughts, I still think I'll add her to my "do not ever "PO" list :lol2:

Or these: 1. When you start eating first thing in the morning and do not stop until you go to sleep, it's NOT considered one meal a day. Eat sensibly. 2. Doors are to be pushed open with hand not kicked with bare foot. 3. Never sit on a chair until all broken glass shards have been picked up. 4. Bring toilet paper on camping trips. Some funny looking leaves nearby can be poisonous (ouch).

Putting the actions of the nurse and the reaction of the wife aside for a moment...the reference to being as "sexless as a CRP dummy" is beneath contempt. The wife might have thought that her husband was the sexiest man alive. The Dear Abby writers need to get a grip on how they phrase their responses.

That's one of the things going against me because of my age. I've been told (by a pt.) that most men are more comfortable having this procedure done by a nurse in their 40's or 50's rather than one approaching 20. Especially with pts. my age who have control issues with a woman taking the upper hand so to speak. I do my best to remain clinical and professional yet I've been asked more than a few times to see if there's a more "seasoned" nurse available. The other nurses tell me to respond with "the other nurses are taking care of their own pts. right now and I'm your assigned nurse but I do make every attempt to fulfill their request. I feel bad that they're in for surgery in the first place and do not want to make their experience any more uncomfortable. And on the other hand, I do not want my collegues to take on the extra work that I'm being paid for. It's a big dilemma for me and I'm hoping to pick up a few tips with this post to make the going easier. Many thanks to all who've responded. Tory

That's another aspect that I could use a bit of help with. What if the pt "is" awake..? He assumes you're inexperienced or fumbling but actually you're not. What do you say while all this is happening to ease his mind that you know what you're doing. If the anatomy is small I wouldn't want to mention that and possibly make him feel even more humiliated.

I still need to work on the "blushing" part. Too bad Britney Spears didn't own a part of Bard. Foley trays might come with a small tube of concealer. Oh well. Thank you all for your responses. Any others would be welcome. Tory

Looking for words of wisdom from those who are more experienced with prepping a pt for surgery or catheterizing adult male pts with modesty issues. It has only happened a few times in the past year but it's still something I need to be able to deal with better. I hold a pts dignity high on my list of priorities. What do you do or say prior and during the procedure to ease their anxiety...? Any advise would be greatly appreciated. Tory