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?

The men and women who flew old rag-and-string biplanes were called "pilots." The men and women who fly Mach 2+ super-sophisticated air superiority fighters today are called "pilots." Discounting the immense value inherent in the title of "nurse" is a mistake, in my opinion. I personally wonder if the people who are pressing for the title change are forgetting that changing our titles may cause the people whom we serve to become more confused about the qualifications and credentials of the nurse. The title of "Nurse" clearly delineates us from all other medical professionals. There is immense prestige in holding that title. If we are looking for better pay, better bennies, better pensions, better standards, and better opportunities, we will not find these things any more attainable by changing our titles. We will find them more attainable by changing the attitudes of the healthcare and media systems, and the stereotypes that they perpetuate.

It depends on who is pushing for the change and why. A nurse by any other name is still a nurse, just as a "public sanitation engineer" is still a trash collector. I personally view the drive to change our title as just more PC rubbish meant to make someone with an inferiority complex feel more important. If you don't like what you do, change what you do- don't try to change everyone else's world just to suit your own. Pushing this in spite of the majority, who desire that it be left alone, is closing your mind to the world around you. I am a nurse, and I enjoy that title immensely, and I worked very hard to be called a nurse, thank you very much. Those who don't like being called "nurse" can call themselves whatever they desire, but should refrain from imposing their agendas on those who are not interested- which, according to the accompanying poll, is the majority.

I wear Adidas or Spalding running shoes. Great arch support and heel/toe cushioning. I tried Klogs and hated them. They kept flying off my feet when I responded to codes, and I got tired of arriving sans one shoe. I also get my shoes from a discount sporting goods store. There is usually something decent on sale.

I went through the insanity of school to become a NURSE. I am a NURSE. I am not a "patient care specialist." I am a NURSE. I am not a MALE nurse. I am a NURSE. I wonder how well it would go over if I referred a patient to that LADY doctor. When my dad went to nursing school in the 1970s I was ridiculed endlessly- mostly by girls. "What does your mommy do- drive a bulldozer?" Being the sarcastic little monster that I was, I would answer, "No, my mom is a construction foreman who moonlights as a martial arts instructor." I got into a lot of fights when I was a kid.

Bingo! You got that right!

I have heard the same from a host of L&D and LC RNs. But ironically, one of the major risk factors for NEC is early enteral feeding (Wong et al., 2002). In light of that, I wonder if it is possible that the preemie's gut at a certain point simply may not be mature enough to tolerate anything, including mother's milk? I could be wrong on that, and I am open to correction. But again, evidence of the certainly supports the benefits of the practice of providing preemies with mother's milk when and if at all possible. And back to the issue of LCRNs: I met some fantastic LCRNs during my OB rotation in school (I didn't shadow them for obvious reasons). They were very good at presenting all the information to moms, including the benefits of formula feeding when breastfeeding simply was not possible. I don't know if there are a certain percentage of militant LCRNs at every hospital, or if certain hospitals draw them. The LCRNs at the hospital where my son was born 15 years ago were all feminist brutes, and I got the "It's all your fault" look from them quite a bit. But 15 years was a long time ago. Nurses- saving the world, one life at a time:cool:

Dude, highlight the everlovin' crap outta that book. You won't get nearly what you put into it, anyway. Besides, nursing is a continuous educational process. Hang on to the relevant material. Ditch the nursing history.

In the ER, I once answered the call light of a woman in her sixties for whom I had been attending. I asked her what I could do for her. She answered, "I'm just planning my trip to Mexico, and I was wondering if you would be interested in coming with me and being my 'boy'." Now, if this had been a fine young lass in her mid-twenties, I would have been flattered. But 40-year-old salts like me do not make good 'boys.' I also had to consider that fact that I was married, and I answered the woman to that effect. The real kick was that her twenty-something-ish daughter, who was no slouch in the appearance department, just sat there and grinned at me. I shook my head and left the room, feeling as if I had just been subjected to some twisted cosmic test.

My wife calls lactation consultants "milk nazis." When she had problems breastfeeding our son, and was considering switching to formula, the LCRNs treated her like she had tried to stab our kid with a fork. Breastfeeding is wonderful, ladies. If you can do it, go for it. But please, for all love, don't let anyone pound on you for doing it in your own way. It is a great gift for the mom to give to her child. As if having to deal with the difficulties of carrying the kid for nine months wasn't enough... My hat is off to all you moms out there. I respect the heck outta ya'll.

Who watches the kids while I work? My wife does. She stays at home and does so because she wants to. She does 99.99% of the work anyway.