NurseWilliam

OK. Laughing my orifice off now. Thank you very much.

I just got a call tonight from an Aid Unit: Aid Unit: "We have a patient who has come to your ED for the last two nights for pain secondary to a motorcycle accident. We are not sure how to deal with him. It seems that his main isue is pain control, but we suspect he is a drug seeker. What do you want us to do?" Me: "You are asking me?!" AU: "Yes." Me: "Well, what makes you think he is seeking?" AU: "He says he has not received a prescription for pain medication in his previous two visits, and he wants to get one." Me: "Oh." AU: "He is also very intoxicated." Me: "Oh. And what does he want?" (pause) AU: "He wants Oxycontin." Me: "Ah. I see. Why does he want Oxycontin?" (pause) AU: "Because nobody will give him Dilaudid anymore." At that point, I deferred to the MD.

Wow. I love my job. I wouldn't trade ER nursing for all the tea in China. This was an exceptionally nice piece. thanks for sharing it.

"I said I wanted a BUD light!" :rotfl:

I had a woman bring her child to the triage desk and tell us that the child had "big scissors". She meant seizures, of course, but pronounced it "scissors."

Live brain tissue also has a semi-liquid, tapioca-like consistency (sorry for grossing out the tapioca thing). In an open head injury, it's not like the brain or parts thereof just sort of plop out of the head in perfect formation. It either drools out of the wound or is spread over the surrounding area, depending on the nature of the trauma. I know this from personal experience. Before I became a nurse, I was first on-scene at a horrific MVA in which the driver had her brains literally bashed out. I mean they were just everywhere- on the windshield, all over the cab of her van, and out of the massive hole in her head. It was a creamy pink-white color. I remember distinctly ( I wish I could forget) that it was runny. So you may very well have seen brain matter coming out of this woman's nose and mouth, if the HI was catastrophic enough- which seems to be the case.

First, please accept my most sincere sympathy for your loss. Having read the posts of others who mentioned it being a coroner's case, I concur that it is important to leave everything on /in the body. However, IMO more care could have been taken by the care team. Simply covering him up to the chin with a clean sheet would have made a big difference. I personally cannot give you an answer why that was not done.

I think that as long as a solid preceptorship program is in place, having a new grad join the ER is fine. But if no such program is in place, I feel that it is certainly better to have some experience in practice before "coming down." The hospital in which I work has an RN Residency program for the ED, in which they bring aboard 2 graduate nurses per 6 months. It has done quite well, and I speak from experience, having been one of those graduate nurses at one time. IMO, had such a program not been there, I would never not have been able to hack it. But I had a fantastic preceptor with tremendous experience who was VERY patient with me. Hospitals that have such programs benefit in training new RNs to their particular way of doing things.

As a general rule in my ER, we keep C/S trauma patients on the board until we see a negative CT/MRI result. It's really better to be safe than sorry, and while it is uncomfortable for the patient, it sure as shootin' beats being paralyzed from the neck down.

And oh, by the way... IMO, if we've become a gender-fixated society with regard to nursing, we have the feminist-oriented ANA to blame for a great deal of that problem. Men were nurses LONG before women were. And while I tip my hat to ANY nurse who advanced the practice to where it is today, I will not pay homage to those who drove men from the practice and now treat us like we are freaks of nature.

I know what you're talking about! My dad got his BSN from Alderson-Broaddus College in Philippi. I used to get teased mercilessly from other kids- "Your daddy's a nurse? What's yer momma do, drive a truck?" And now, I'm a nurse too. And wouldn't you know, my wife drives a truck! (kidding!):rotfl:

I don't have a problem caring for a female patient. However, if the patient prefers female assistance with certain procedures, I respect the patient's wishes if at all possible. I know female nurses who have asked me to perform procedures for their male patients who preferred male assistance. It's not a bad practice to do that. It's respecting the autonomy and privacy of the patient. In a few cases, female nurses asked me to perform the procedures because the male patient was being inappropriate. Female nurses have sought me out for that purpose far more frequently than I have had to seek them out to perform procedures on female patients- and they do not seek my assistance in order to protect themselves from litigation; they do it simply because they find the patient's behavior personally distasteful and would rather avoid it if they could. Is it ethical for a female nurse to refuse care for a male patient simply because he is inappropriate? I don't think so. I would even say that if a male nurse was not available, she would have to go in and do it anyway. The presence of a male nurse on the floor should not be the the determinant for the female nurse's choice to refuse to care for an inappropriate male patient any more than fear of litigation being the determinant for a male nurse's decision to refuse to care for a female patient. And if we are discussing the issue of a nurse's refusal to care for a patient of the opposite sex, the conduct of both female and male nurses should be discussed, as it is not a matter exlusive to males.

You're absolutely right. I have wasted enough time on this. I will not spend any more time dwelling on it. Now if those who were expending so much energy trying to change our titles would do the same, maybe we could get the important things done.:deadhorse

I simply do not agree with the assertion by some that this is a critical issue. I think this is really a silly thing for college-educated people to be so preoccupied with. I just think that in the bigger picture, there are many, many more important things for us to be concerned about, and the issue of changing our title is really a waste of time, talent and ingenuity that could be put to better use elsewhere. Let us deal with the more pressing issues- like the shortage of nursing faculty, for instance- and when we have dealt with the really important things, then we can sit around thinking up new ways of telling someone "I'm a nurse."

I understand what you're saying. But we aren't talking about changing uniforms or standards. We are talking about changing our title- as if changing what we are called will somehow magically transform the art, science, practice, and profession of nursing, which I maintain it will not. I am not saying "Leave nursing be." I am saying, "Leave the title be." I should have articulated my position as "If you don't like being called a nurse, call yourself whatever you like. I for one am a nurse, and prefer to be called 'nurse'." You can call yourself 'professional poached egg' if that is what you prefer, but it will not make you a different person or somehow make the already-important job that you do more important. What you are called does not determine what you do, but rather identifies your function in the healthcare continuum. And I admit that 'nurse' is a very general term considering the mind-boggling variety of things that we do. But that is why we have qualifying credentials such as ICU RN, CCU-RN, ER-RN, etc. And when a patient loses his/her call button, are we going to admonish them for not calling out "Bachelor-prepared Professional patient care specialist! Oh, Bachelor-prepared professional patient care specialist!"? Whatever those among us who are not satisfied with what we are now called decide, I submit that while they may succeed in changing our professional title, the patient will always call us "nurse." Do you intend to admonish them for so doing? And as far as Florence Nightingale goes, I understand and appreciate what she did to advance the cause and practice of nursing. She was also quite outspoken in her position that men had no business being nurses. Shall we follow her in that regard as well?