mbess02

I don't yell at my nurses. When I am called to see a patient, I see the patient. Whether I follow the RN's recommendations or not is based on my clinical judgment of the scenario. I expect that you will not scream at me or roll your eyes if I do not change my orders based on your call, and you in return can expect that I will not scream at you nor roll my eyes when you call me to see a patient. It's a two-way street. As many of you have said, my job is to assess the patient when you feel something is wrong; your job is to carry out my orders so long as they are not putting the patient in danger; our job together is to be on the same page and take care of the patient.

Actually, when physicians are using call rooms at night, it's not because they are sleeping on the "night shift." When a physician takes call, they are generally in the hospital for 30-36 hours at a stretch. It's not like we're working 12's overnight, and sleeping through them. We're trying to get a tiny bit of rest so that we can keep going through our 30 hour shift without vomiting. Physicians who work night float - ie, who DO have night shifts and are at home during the day - don't get call rooms, and don't sleep during the night. Nurses should recognize that most physicians are not shift workers the way RN's are. Would you want a doctor taking care of your family member to stay up all night in the middle of a 30-hour shift just because you're awake, too? Or would you want him/her to get the sleep he/she could before rounding on your mother/operating on your father/making critical care decisions on your child the next day?

just a note of correction - podiatrists are not medical doctors!

For a type 1 diabetic, they are much more insulin sensitive than a type 2, and less insulin will cause more violent hypoglycemia more rapidly. This is also because the type 1's counterregulatory process (ie release of glucagon) is impaired compared to a type 2 or a regular patient.

I went in to the ED once with a migraine and my nurse was wonderful, bless her heart, but I'm sure the attendings were skeptical, since it was a friday night and maybe they thought I was a seeker lookin' for a fix. The nurse told me they were giving me toradol and reglan IV. I felt 10000 times better in about 30 minutes and after vomiting up the last contents of my stomach, I felt refreshed and ready to go home. When I asked to be d/c, the doctor and nurse both came into the room and they were like, "you feel better? really? great!" and I said to them- duh. I'm not a seeker. The Toradol was great. Please note in my chart that I was relieved with Toradol so that if I come back in the future, you guys will know that I'm not a seeker! Hee!

I went in to the ED once with a migraine and my nurse was wonderful, bless her heart, but I'm sure the attendings were skeptical, since it was a friday night and maybe they thought I was a seeker lookin' for a fix. The nurse told me they were giving me toradol and reglan IV. I felt 10000 times better in about 30 minutes and after vomiting up the last contents of my stomach, I felt refreshed and ready to go home. When I asked to be d/c, the doctor and nurse both came into the room and they were like, "you feel better? really? great!" and I said to them- duh. I'm not a seeker. The Toradol was great. Please note in my chart that I was relieved with Toradol so that if I come back in the future, you guys will know that I'm not a seeker! Hee!

It would be highly unlikely that you would get HIV from this type of needlestick. Only 3% of exposures to HIV-positive "dirty" needles result in infection, and the chances are increased with hollow-bore needles that have been directly in the patient's vein. Your exposure certainly qualifies as a risk, but it is a low risk and since you are taking the prophylaxis, I don't think you should worry about it (easier said than done, I know!) You did everything right with regards to reporting the exposure and getting on the meds. Try to relax and get tested within the next three months- the new OraQuick tests are reliable within 3 months for >90% of the population.

I'm not a phlebotomist, I am a medical student, and I do phlebotomy as needed. I don't wish to argue with you. I don't think MD's are better than NP's, and I always say that when I'm sick, i'd rather talk to my FNP mother than my surgeon father- I just don't like your signature that implies that MD's are incapable of talking to patients in a collaborative way. Thank you for explaining your posts. I am not going to post anymore in this forum!!

I dont appreciate the condescension with the little "look it up" reply. I am a medical professional and you are NOT above me, dear- so don't act superior. My mother is an NP and my father is an MD. My mother would NEVER purport to have the level of expertise my father has. Perhaps doctors dislike NP's because the NP's do not give proper respect to the fact that in the treatment world, the doctor is their superior. I am done here, my wish is not to start a conflict, but people like MD terminator just perpetuate the idea that NP's are jealous of the privileges of the MD's, and have to make it known in hostile ways.

Your statement that NP's are equally as trained as physicians is simply inaccurate. I understand that you are proud o fyour profession, and you should be: you are an educated professional who is able to provide skillful and compassionate medical care to those in need. However, medically you do not have the training an MD has. I think the "attitude" goes both ways: you have "no use" for MD's, and you have all this hostility towards medical doctors, but then you balk when they seem to "mistreat" you. Maybe if you showed them respect, they would respect you in kind. They ARE superior in training to NP's, and that is why they have higher privileges. That doesn't make them smarter or better people. Bess

MD Terminator: I am surprised by your username. Why do you consider yourself to be an MD terminator? I am curious.

I would like to say that as a non-nurse, but having a mother who was a nurse in the ER for several years, I know what it's like for you nurses. I'm a diabetic and I get frequent sick migraines, so sometimes when I can't hold food down I need ER attention. I always appreciate the wonderful care the nurses provide and I always feel sort of badly for taking their time away from other more needy patients. The ONE time I have lost it on a nurse was in the following situation: I had a horrible sick migraine, was hypoglycemic from not keeping dinner down, and walked into the ER... signed up at triage, filled out all the forms. I noticed there was no one ahead of me in triage, the waiting room was empty, and the triage area was staffed with three nurses, who were all, apparently, taking a break. They were sitting there, laughing, talking, and ignoring the patient (me). I wasn't triaged for 45 minutes!!!! I work at the hospital in question, and I was outraged... I asked them why I wasn't triaged earlier, and they said that they were out of beds, so it didn't matter when they saw me, the answer would be the same: wait. And I said to them, I'M HYPOGLYCEMIC, what if I had passed out during the wait? When someone walks into an ER, they want to know that even if it takes some time, they WILL be taken care of. When you sit there for 45 minutes while triage is obviously not busy and have not one person ask why you are there, it is unnerving and upsetting. Anyway, most of the time, I love the nurses at the ER's I frequent. That one bad time left a poor taste in my mouth, but I know that most ER nurses are wonderful.

Thanks so much, guys. One question I have about engaging the tube before hitting the vein: I was taught when learning to draw that removing the needle with the tube in could collapse the vein due to the vacuum pressure. Are there similar dangers with having the tube engaged prior to piercing the vein? That would be my worry with engaging the tube before being safely in the vein. Thanks again. :)

Hope this is an okay forum to post this in. I am not a nurse, but I do blood draws in my line of work, and I have always used butterfly needles, so I have always seen a flash when accessing the vein. (I used butterflies exclusively because I was drawing a primarily pediatric population). I have a new position that will require me to draw adults, and I presume that straight needles are the preferred instrument for these routine blood draws. I am afraid, however, that since I have come to rely on the flash to know I have accessed the vein, that I will not be good at drawing with straight needles since I won't know when I'm in. can anyone offer tips/tricks or other advice to help me as I make this transition? I am very good at drawing with butterflies, but again, this is because I can see when I'm in. Thanks. Mbess-02