ERnurse1139

We saw a guy who got bit by a snake near water (in central Indiana-- I don't know of any venomous snakes here) and thought he should bring the snake into the ER for identification. While he was trying to catch the snake it bit him again! :chuckle :chuckle :chuckle The moron brought the snake, which he was finally able to kill, into the ER in a box! Horrors! Of course there was quite a stir among the nurses as the rumor of a snake in the department quickly spread and the most important fact-- is it dead or alive became uncertain. It was one of those surreal times when you feel like you're on a TV episode of ER, like this is so ridiculous it can't actually be happening! Oh btw, the patient survived. :)

Yes, I have that all the time, more so when we are busy. They come in with a mild complaint of something totally different, and when they find out it's going to be a long wait, they suddenly remember they are also having chest pain. That is so aggravating! I wonder if they think I'm really that gullible! Fortunately I can r/o many of them by asking them if the pain is sharp or dull pressure, if worse with cough, inspiration, palpation. Many patients who try the CP trick don't actually know the characteristics of cardiac pain versus bronchitis/smoker's cough and I make them wait their turn. Any doubt of course and I get an EKG, I do send several questionable patients back, but there are those you just know are being manipulative.

At first when I read that you put your stethoscope in the ties of your scrub pants I thought "wow, great idea!" Now I'm wondering how you get it out. Do you untie your drawstring in front of your patients? I have many patients who would enjoy that, but I can't imagine this is what you do! It does sound like a good idea, I'm just not getting it! Can you clue me in?

There are stethoscope waist band clips (arround $5) that you can purchase through nursing scrub catalogs like Jasco. I love the idea but I didn't have any luck with mine, the stethoscope kept falling off of it-- I was a new nurse, trying to have all the right stuff to be stylish, cool and efficient, and there I was dropping my stethoscope on the floor all the time. What a dork! I eventually lost the $150 Littman stethoscope due to it falling off and me not noticing it. Needless to say I'll never use that little contraption again.

R/r 911

I think our police force thinks (or maybe has been told by the hospital?) that they have to do this because the alternative is leave people stranded, either hanging out at the hospital or trying to drive or walk home which endangers innocent others. My feeling is, let them hang out at the hospital all night then. If this is their only option, I'm sure most of them would be able to find a ride pretty quickly. But this is what I thought might be perceived as heartless. Thanks for your input. It's good to hear that I'm not the only one who thinks it's ridiculous for cops to take patients home!

Thanks very much for the helpful info! I appreciate learning from you!:)

I don't want to sound dumb, so don't judge or attack me, I'm only asking so I can learn: What is this about giving a defasciculating dose? I've worked in a small ED for 2 years and we don't do RSI very often, patients who need it are usually intubated by medics prior to arrival, and I've only had the chance to participate a couple of times. I've seen patients fasciculate (short term muscle tremors after giving sedation drugs, right?) and was told this was normal. First, if fasciculations only cause myalgia, and possibly slight/insignificant rise in ICP, and we are in an emergent situation, is it necessary or even advisable to delay intubation in order to prevent this? I can understand why this would be done in the OR, in a routine surgical anesthesia-administration, to decrease post-op pain/discomfort and increase patient satisfaction. But the nature of emergencies doesn't allow us to be that "nice" and probably the patient will have more to worry about when he wakes up than sore muscles anyway. Secondly, even if it doesn't apply to the ED, which I don't think it does, I am curious, now, to know the process of giving a defasciculating dose, just so I know what it is, next time it comes up in conversation or something. My understanding for the reason to give atropine to peds is that it dries up secretions, reducing the need to suction? Correct me (respectfully, please) if I'm wrong. Finally, I have to agree with Larry77 about the attitude and patronizing and with everyone else who objected to your rude comments. This should be a place where we can relax, enjoy each other's company, and learn from each other. We deal with enough mean, hostile people in our jobs without having to do it here too! Disagree with posts, if you must, but do it respectfully please! I was taught to never assume you know everything, no matter how much education or experience you have. Doing so makes you a danger to your patients and alienates you from your colleagues. (Are you feeling that?)

I work night shift in a small rural hospital with a free ambulance service for those without private insurance. We have patients who come by ambulance for minor complaints, using the ambulance as a one-way taxi service to the ER, also bypassing the waiting room! These patients have no vehicle, no way home, and usually can't get ahold of anyone. The taxi only runs until 3am and patients claim (and I don't doubt) that they have no money for a taxi. Then there is, of course, the patients who were "dropped off and will call their ride when it's time to leave," and then the ride can't be reached. To withhold narcotics until a patient has a ride in the department would tie up the room, causing further delays to patients in the waiting room who need to be seen. This is such a common problem that we routinely call dispatch to have a cop drive the medicated patients home! This seems crazy to me, and is a pet peeve of mine (and the cops). The cops should be patrolling the roads and available to respond to calls, not playing taxi. Maybe I'm heartless, but I feel patients who either lie about having a ride, or who's ride has become unavailable/unreachable, or who came by ambulance for non-emergent complaints should just have to wait in the lobby until morning when they can get ahold of somebody. Of course the ones who drove to the ER probably would sneak out, and others would try to walk home in the dark, in which case our documentation would have to be adequate. I haven't voiced this opinion at my work because it does sound heartless and I'm afraid it would make me look bad to the higher-ups who are all about patient satisfaction and caring about the patient. I'm curious to know what others think: :confused:Am I heartless and mean to think this way? Or is the practice of using the cops to transport these people home as crazy as I think it is? Also, do your ED's use the police to transport patients home? Any suggestions?