Tink RN

Had another great one this past weekend. Tell me if you ever got this one: middle age female presents to ER with c/o generalized rash (looked like eczema) for 2 weeks (yep - 2 weeks) asked why she didn't see her PMD, she states she "didn't have time". VSS, no acute distress - as she watches me mark her chart "non-urgent" she asked if we were busy. I replied, "Well, it is the weekend and this is a trauma center - we have several high acuity patients so you may have to wait for awhile." (I figure honesty is the best policy - why mislead her?) Well, I'll be darned. As an after thought, she suddenly remembers that she is also having chest pain. Ofcourse that bought her the LAST mon bed and a cardiac work up (which was negative) but hey - she got seen quicker ... never mind that the work up took even more of her time and she complained the whole time. I guess the "chest pain" BS call has unfortunately became public knowledge as a means of getting seen quicker. Geez ...

I think one of the most rediculous was for a pregnancy test. Min cost of $500.00 for the ER visit when they could have bought one at Walmart for like $7! Or even have one done free at the health dept ... I'm sure that bill didn't get paid anyway.

Sorry ... poor wording on my part - I should have been more specific because I certainly didn't mean to offend any of you guys. I was making light of an on going situation where I work. SOME of the male nurses that work with me brag about not having to "go there" on the little ladies with Alzheimers from the nursing home that come in the ER for septic work-ups. (Usually UTIs ofcourse and some are not even responsive) But anyway, when a cath U/A and Cx is ordered, they look at the female staff and smile as they say, "Hey - it's a female! Guess you have to do it!" I always quote my original post to them, but ofcourse I by no means mind doing the cath ... it's just one of those things we give each other a hard time about. For the record - I totally understand and agree with honoring the gender request from alert and oriented patients when able to do so.

Well ILoveSnoopy - Thats the beauty of this forum. Ofcourse none of us would voice these opinions to our patients ... but being able to vent to others that understand exactly where you are coming from is therapeutic for us as healthcare providers. I guess thats how we are able to put on our "game face" and go to work to "fluff and puff"! haha :roll

Just call me canoehead Jr. - I didn't get it either.

Rule #1 guys - If female nurses can hold urinals and cath men, then male nurses need to get used to the idea of helping ladies with bed pans and cath'ing women!

Have you ever found yourself feeling the urge to wrap a phone cord around someones neck? Scenario #1 - EMS brings in a patient non-emergent with no apparent distress, (in report they clued you in that patient said she has not had family members visit in awhile) and before you can even get the patient from the EMS stretcher to the ER stretcher, the phone in the exam room is ringing off the hook. The patient insists on answering the phone because, "That's probably my family". So there you are - EMS is getting another call as they look at you and tap their foot, and triage just brought you 2 more patients as this one is on the phone saying, "Yeah. I had to call the ambulance. I just don't feel good today ... Yeah, ya'll can come see me - call Boo and tell him I am in the Emergency Room so he can call everyone else." Scenario #2 - You are working in the non-critical area ("urgent care" pod) on a slamming Sunday. You already get to look forward to 2 hours overtime to finish all the paper work/incident reports on all the patients that left without tx because they were "Tired of waiting". You walk in an exam room with discharge papers for Mom to sign that basically state "OK - nothing was wrong with your child AGAIN today - but should they become ill, come see us" and there is Mom ... on the phone just as she has been during the whole visit - and as you stand there thinking of the 100 other things you need to be doing, she just leisurely continues her conversation about her date last night as if you aren't even standing there! Scenario #3 - Grandma was an emergency - she is very ill, and seems to feel comforted by her grand daughter that arrived shortly after her at the ER. Grand daughter gets on the phone calling various family / friends and tearfully shares, "Grandma is very sick". You truly feel empathetic for this young girl as her tears continue to flow ... and you over hear her calling her job - (still sobbing very heavily) to let them know she won't be in to work because, "Grandma is very sick and I don't know when I'll be able to come back to work because I have to stay with her". Then ... presto! No tears as she approaches you and says, "So are ya'll going to keep her or what?" After explaining that Grandma is very unstable, and IF she survives, she will be admitted - grand daughter proceeds to say, "Oh - ok - well, I'll check back in a couple of days if we don't hear anything." And she proceeds to leave. What the ...

LOL ... you guys have to check out the "travel trunk" site! You can buy a nurses hat, a maid hat or even a waitress hat all at the same convenient location. Kind of offers some perspective on where the whole hat thing originated. (Nurse = Dr.'s maid) Not to mention the pictures! UGHHH! ( I am not cracking on you, Mint Julip ... I just found the site amusing!) My nursing hat has sentimental meaning to me as well ... but I like it as a memoir in a case ... not on my head. It more or less serves as a reminder of all the hard work and humiliation I suffered during nursing school. We looked like fruit bats parading around in those "Mary Poppins" dresses and marshmellow hats! Thank goodness the college I graduated from finally evolved to having pant uniforms and students are no longer required to wear hats in clinicals. Unfortunately it happened to late to change my perspective on "the hat". Even if it became main stream where I work to wear them ... I still wouldn't! Ofcourse those of you who enjoy wearing "the hat" are entitled to do so and I am by no means suggesting that you shouldn't - just over look me when I chuckle as you walk by. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I can relate. I had a female patient yesterday that had been in the ER all night ... every test known was done, but no etiology found for her complaints. VS were normal and all labs WNL. Another nurse had unhooked her IV so she could walk to the bathroom ... minutes later her mother came running to me stating, "She needs her medicine! It is not going and she is starting to hurt again!" I checked her chart to confirm the IV med/rate and restarted her fluids for her. She said, "Oh ... I feel better now. As long as my medicine is going, the pain goes away." What was this miracle pain controlling IV drip? NS@KVO. Geez ...

I did see one foley malfunction (in 13 years) in which the balloon apparently was defective and would not inflate. We were working on a trauma and the other nurses were giving the nurse that put it in grief about, "Why didn't you check the balloon before you inserted it?!?" Ofcourse that was the least of this poor guys worries, BUT it only takes a couple of seconds to check the ballon and this does not contaminate anything - however, removing and reinserting another foley definately increases the risk of infection. Another poster posed an interesting point I didn't even think about! It would suck if the darn thing wouldn't deflate!

Bless your heart ... I am sorry to hear that! First of all, I hope your Grandmother is doing well. Perhaps the instructor did feel this was best, maybe she knew you were stressed and needed to be with your family. Or not ... based on your stating she "has it in for you". I can relate to that as well. My suggestion would be to keep a written journal and if you see that she has intentions of interferring with you graduating, then approach the program director. You are graduating soon, your grades are excellent, and you have not missed to many clinicals - so don't sweat it yet. Even if you feel her sending you home was a malicious intent, I'm afraid she would be able to justify this incident and convince the director that it was the compassionate thing to do. ("She just looked terrible - I could tell she had inadequate sleep" or "Her ill Grandmother had a decline in her condition and I felt her family needed her") Furthermore, you would have to disclose the fact that your previous absence was due to an interview which (no offense) indicates poor planning on your part. I understand - I realize that must have been the only time you were able to set it up ... but I remember how it was expected of you in school to put school first in everything from eating to sleep. You get the picture. As for only 4 hours of sleep being "unsafe" ... please! Wev'e all went to work on 4 or less hours of sleep - so don't let her make you feel as if that was a lapse in judgement. If anything, this proves your dedication. I hope all works out for you! Keep us posted!

LPN a waste of time? I don't think so. I was a LPN for 10 years before I returned to school and became a RN. I think that was the best option for me in persuing a career in nursing. Opinions will vary on this subject - there are several threads from the past you could read that offer various perspectives. As far as no one responding to your thread ... you may want to consider not referring to LPN education as "a waste of time". I understand this was stated TO you and not BY you - however, I found it a little offensive. My LPN cap from graduation sits in a glass curio right beside my RN graduation cap, and I am very proud of both of them. I also have several friends that are practicing LPNs that have no desire to become RNs and there is nothing wrong with that either. If you are interested in finding out what the difference would be for you as far as practicing, contact the State Board for Nursing in your state and they could answer any questions you have because those will vary from state to state. Good luck! I wish you the best in nursing school in which ever program you decide to enroll. Keep us posted!

In defense of the LTC nurses calling 911 for a 90 year old DNR patient ... first of all, DNR does not mean "Do not treat". As an ER nurse, I am surprised I continue to maintain this mentality but it is something I have always believed in. Granted quality of life may not be desirable at that point, but thats not my decision to make. Second of all, if the Dr. gives you an order to have an emergent transport to the ER or the family so desires, that LTC nurse risks her license if she decides to take it upon herself not to go through with it. With that said, the EMS personnel in my area are wonderful to work with. I pretty much get along with most of them, but I have noticed that some like to compare nurses and paramedics (who is smarter, who can do more, blah blah) and some think the pay difference is unfair. I guess you have to encounter a$$holes in all walks of life.

Where I work, it is a hospital policy thing. If they are over 24 weeks and present to the ER with an OB complaint, they are to go directly to the LDRP unit. The ER Docs don't want the liability for one thing; and we are usually short staffed as it is - so we do not have the staff to tie up with a delivery. I'm sure you are well aware that OB nurses get sued more than any other type of nursing ... and with all the things that can go sour with a delivery - I'm not to proud to say that I would be afraid I would miss something that a seasoned LDRP nurse would notice right away. It truly is safer for the patient. (both of them!) As for sticking around after we transport ... for what? I'm going to get out of your way so you can do your thing!