Eric01

In our Emergency Room, we do try to take care of our patients with migraines. If I encounter a patient who tells me they are having IV what is a typical migraine for them, I will often start an IV and run a bolus of 1L NS (assuming no contraindication, and according to our department protocol) while waiting for a doc. If I can flag down a doc and they are comfortable with the story, we usually accompany the NS with 10mg Maxeran (metoclopromide) IV. For many that I have encountered, NS (sometimes even without the Maxeran) can do wonders. My wife does not get migraines/headaches usually. Now that she is pregnant and doesn't want to take any medication, I'll usually just encourage po fluids (H2O), and that often makes her feel better.

I had a confused little-old-lady a couple weeks ago who was upset that she kept getting hemmoroids in the mail. I suggested she stick them back in the mail marked "Return to Sender". I had another patient who had ECG electrodes on and was dressing for d/c. Her visitor (both individuals were bright lady's in their 40's) asked what those stickers were, and actually believed me when I explained that they were the new anti-shoplifting tags, and that the doors wouldn't open if the patient had any on her.

I currently work on a surgery floor where we occasionally get APS orders for PCA's. Our pre-printed orders from APS include a narcan protocol. They just revised it recently. Now for RR about 8 and rouses briefly with difficulty, we give one amp narcan straight IVP; for RR

Just a hint, as well. I currently work burns/plastics. We are the burn referral centre for the Martime provinces. A number of our burns come to us already tubed. A lot of facilities will cut the excess off the ETT after securing it. 24 hours later, due to the burn injury, the patient's head and neck have swelled considerably. Sometimes to the point of extubating the patient with no extra tube to advance and a 0% chance of re-intubating due to airway edema. All that is left to due is trach emergently.

At the facility where I work now, "Code Black" also means bomb threat. At the facility where I did my schooling, "Code Black" meant 'there is a situation that staff needs to know about; the emergency briefing will be (Dept A, via email, etc)'. Most often, it meant that the ER was overcrowded with patients awaiting an inpatient bed, in which case each nursing unit was to send a staff member to ER to get a patient. Admin figured the patients could just as easily wait in the hallway of a nursing unit as in ER. In fact, the last couple months that I was there, there was a "Code Black" virtually every day, and on the couple days that there was not one actually called, it was threatened.

I work in the burn unit of our local hospital in Halifax, NS. It is on the fourth floor, immediately below ICU and the OR, and several floors below the heli pad. There are two entrances to the floor, plus one stairwell. Our unit has two large private rooms, and two semi-private rooms (not counting the plastics beds around the corner) that are monitored, and can take vents. The burn unit beds are rarely full. Rumour has it that when President Bush was finally visiting Halifax post 9/11, our unit was scouted out to accomodate him in the event that he needed emergency medical care. Apparently our unit could meet almost any forseeable medical need that he might have, yet was the easiest to secure from a Secret Service point of view. He never came, but I wonder how many of our other patients would have been disrupted for his sake.

I remember taking offence to this in high school, but my chemistry teacher said that it has never been absolutely proven that smoking causes lung cancer. He said that there have been numerous cause and effect studies, but no quantitative/qualitative randomized and stratified experiments. He said that to have a 'beyond a doubt conclusive' study would involve following a group from birth, and ensuring that everyone in the experiment smoked their allotment of cigarettes a day (zero, in the case of the control group). He said that an experiment such as this would be unethical because where smoking is strongly implicated in lung cancer as a causative factor, it would be like seeing how much cyanide was safe for long term use, or something to that effect. Or compare it to Supersize Me (that movie where the actor ate nothing but McD's 3x/day for a month; his health was very adversely affected), and ensuring that someone (possibly against their will, and certainly without informed consent) put their health in such jeapordy. Anyway, I agree that smoking is VERY STRONGLY linked to lung cancer.

My facility (in Nova Scotia, Canada) is comlpetely smoke-free, and has been for about the last year. I think that it is great (I'm a non-smoker). Anyone who wants to smoke must go off of hospital property. Nicontine patches are provided to patients very regularly. On another note, the province next to NS, New Brunswick (on the eastern border of Maine) went completely smoke-free back in October. It is no longer permitted to smoke in any publice place, province-wide. This includes your home if the public has access (ie, home office, etc). Not sure how enforecement is going, but I like the idea.

My wife and I met when we were in first year of nursing school. We were married the summer before our final (4th) year. Now, we've been married for 14 months, and are working at the same hospital, though different units. We're lucky; both of our units do self-scheduling, so we just request the same shifts, and hopefully we'll get most of them, or at least we hope we'll get the same days off. Being married to a nurse, it's certainly a major part of our lives that we share (our profession, that is), so we find that a lot of our conversations revolve around work and nursing topics. We keep thinking: 'our poor kids', they won't be able to get any sympathy :chuckle . Anyway, bottom line: so far, so good. Just wish I got tos spend more time with her. She's great :) .

There is one nurse in particular on the floor where I work as a student who never seems to respect or pay attention to anyone with fewer than 15 years experience, especially a student. She always refuses help with patient care, no matter how busy she is and how available I am, then she will complain to the Nurse Manager about how I can be idle at times during my shift. I asked her a question one time about a patient situation, which she responded to rather condescendinly, I thought. However, since then, she has at least been saying hi when I see her, rather than just ignoring me. I bet if I asked her if I could borrow her nurses cap for my wife to get her grad pictures done she would even aske me how things were going at work:roll