September, 2005 Archive

September 26, 2005, 11:12 am

When Chicken Soup Just Doesn’t Cut It

Here’s a picture from an old Curad bandage ad. Looks like the poor guy was cornered by his sister’s “Nurse Club”. No boys allowed unless they’re patients! Reminds me of my old skills lab in school. This must be what it feels like when you first come into the ER. Moments of activity punctuated by hours of sheer boredom.

Everyone winds up in an ER one way or another, either as a patient or a visitor. I know what patients can do that makes it easier on the staff, but what can patients do to make their visit easier on themselves? Having experienced the ER from the “other side” of the siderail, I’ve come up with a few ideas.

Right now:

  • Make a list of all your medications. How much you take and when, including vitamins, herbal preparations and over-the-counter medications. Include your allergies.
  • Make a list of past medical problems and surgeries. Be thorough.
  • Put this information in your wallet, so that you can hand it to the triage nurse should you need to visit the ER. It’s hard to remember everything when you are ill. (Women, keep track of your last period. It’s important and will be asked). Keep your list on a computer so that it is easily revised as needed.

Before you leave:

  • Decide if you really need to visit the ER. Most of the time it will be obvious, other times not so clear cut. Fever? Vomiting? Diarrhea? Congestion? Migraine recurrance? Call your doctor or utilize the advice line of your clinic if available. They can give you advice over the phone that can save you the time and expense of an ER trip. Doctors, if they know you, can call in any needed prescriptions. There is always a doctor on call. Yep, even at 3:00 am. If you are concerned enough to be considering an ER visit in the middle of the night, it’s worth a call. This is especially good to do for kids, who never seem to get sick during office hours! Unfortunately, ERs are not allowed to give advice over the phone. It’s a legal thing. They will tell you they will be happy to care for you if you come in, but they cannot help you make that decision.
  • Find someone to go with you if possible. If you are given pain medication, you won’t be able to drive home. Bring one person. Try not to bring the whole family, it gets very hectic in the ER and most have strict visitation policies that would keep them sitting in the waiting room anyway.
  • Wear something easy to get in and out of. The first thing you will do is get undressed, so leave the complicated stuff at home. Leave your jewelry there, too.

While you are there:

  • Bring a book, magazines, your iPod, something to keep you occupied. You will be waiting, and then you will wait which will be followed by waiting. It is the nature of the department and inevitable. ERs are notorious for out-of-date reading material and the waiting room TV may be stuck on C-SPAN. Save yourself an attack of acute boredom.
  • Bring a small blanket or afghan. ERs are freezing. You will be practically naked. Most ERs have blanket warmers, but those blankets don’t stay warm for long and they don’t hand them out in the waiting room.
  • You won’t be able to eat or drink until it is decided you do not have a surgical problem. You will, however, have a dry mouth. It’s like your saliva evaporates on arrival, or it’s a side effect of medications you will receive. You may want to bring a bottle of water to sip, but don’t open it until you get the green light from the nurse.
  • Make sure you have your call bell on the gurney. Don’t be afraid to request what you need to make you comfortable. You aren’t “bugging” the nurses, they are there to help you.

After you leave:

  • Follow the discharge directions. If medications are ordered, take them as directed.
  • Make an appointment with your doctor to follow up.

An ER visit is never fun, but by thinking ahead and using the suggestions above, it can be easier.

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September 25, 2005, 4:44 am

The Write Stuff

I am so past tired I can’t even move, which is why this ad for K-Y jelly has me giggling. Look at the concentration with which our professional nurse applies the sterile, water soluble substance to the ice-cold metal speculum. Acknowledge the physician, who doesn’t trust her to apply it without direct observation. Pity the patient, for no particular reason. Pity me, who is so far gone, this ad is the epitome of hilarity.

Why is it that when I am not working I have a thousand topics for this blog fighting for prominence in my brain, but when I am working I get writer’s block? Maybe because I just finished actually writing for twelve hours.

Many, many years ago I took a class on the legal aspects of nursing. The attorney was discussing the importance of good nursing notes and mentioned that nursing notes, in a malpractice trial, would be blown up into the size of a poster for all to see. It must have struck a nerve because ever since then I chart as though it is going to be billboard size. I am a meticulous charter. To the point of being obsessive. To the point where my nurses’ notes are my masterpiece and it bugs me to have anyone else write on it. I have been known to re-write a triage because even one error drives me up the wall. I’d rather pile up my charts so that I can sit and chart without interruption rather than chart “on the fly”. I must have just right pen. A gel pen, with a smooth, even, medium-point flow. No scratchy feel. The perfect weight in my hand. And blue ink. I must write in blue. I will not work for a place that requires black. With the perfect pen I can put to paper the drama that is the life of each patient, recording for posterity their encounter with the unexpected that is the emergency room visit. I AM SHAKESPEARE.

Somebody help me…..

Actually, I reallly do enjoy charting. I must be a frustrated novelist. Either that or I get a strange rush from filling in boxes and blank lines on paper.

Speaking of watches (and I was going to any minute), the Cherry Ames watch that I displayed a few posts back is wonderful in person. It arrived yesterday and I wore it to work today. The picture did not do it justice. I get a kick just looking at it.

One more 12-hour shift and I’m a free woman for a week. If I wasn’t so numb from exhaustion I’d get excited about that.

(oh, and I really do hate to write in black……….)

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September 21, 2005, 7:54 pm

Singin’ The Time Clock Blues…

Oh, this is weird. I tried to load this as large as possible so the caption is legible. This is an ad for an amphetamine, of all things. Look at the caption on the top….”and there’s a BRIGHT SIDE for your patients, too!” Does this mean the ad was targeted for nurses? Sluggish at work? Just thinking about the surgical ward make you tired? Pop a Dexamyl and have energy to spare! Look at the nurse on the right, she looks like she is belting out an aria from “The Barber of Seville”. The poor patient looks like he’s still under anesthesia. I thought it was for post-op patients. Then I read the header. Hyped-up nurses. Pardon me while I remove my jaw from the keyboard…….Hell of a way to pull a double shift.

My hospital is starting a time clock system. Punch in and out. I like paper time cards. There is something about punching in and out on a clock that makes me, as a professional, feel rather insulted.
Like Fred Flintstone, I’ll slide down the back of a dinosaur at the end of the shift yelling “Yabba dabba dooooooo!” That’s what punching in has always reminded me of. The beginning of the Flintstones. I bring this up because it means that I have to go in early tomorrow when I am already doing a twelve hour shift. We have to be trained to use the machine. Now, any time clock that takes an entire hour to learn how to use is already bad news. I can swipe my badge as well as anyone, what in heaven’s name takes a full hour to learn? I guess I’ll find out tomorrow. The bright side is I got a new ID badge with a new picture. In the last one I had a fat face and lopsided short hair. This one shows me with a fat face and symmetrical, longer hair. Two out of three ain’t bad.

Why on earth I decided to do three twelve-hour-shifts in a row is beyond me. I always want to “help out” and it never sounds bad six weeks in advance. I work 3p – 3a, which means all I will be doing starting at 1230 tomorrow is work-sleep-work-sleep-work-sleep. I should be 110 pounds. But somehow I always manage to fit food into the schedule.

I guess I have the most flexible schedule because I don’t have small kids, or maybe I don’t have a life and I don’t realize it, but it always seems I am helping someone out by doing extra on short notice, but when I want to get a day off at short notice, there aren’t too many takers. There are some nurses who absolutely will not vary from their posted schedule or ever pick up a night shift. And there is something about being asked to work 3p-3a that makes some nurses get the freakin’ vapors just thinking about it!

Ah, I’m just whinin’. I actually get everything I ask for if I ask for it in advance. Of course, there are some things that are NOT negotiable. The night of a Journey concert, for instance.
I am SO there and I don’t care if you have to dig up Florence to cover for me. You know, little things like that…..

Speaking of concerts, allow me to divert from the ER for a moment. I am taking my 15-year-old daughter to a rock concert with me. We are going to see Rob Thomas in November. This was a GREAT sacrifice on my part because everything I do embarrasses her and I’m sure this concert will be no exception. I don’t go crazy at concerts or anything but I did have to lay down some ground rules. She cannot tell me to: sit, stop singing, stop dancing or stop drooling. I’m joking about drooling. She has agreed. We shall see.

There are many fascinating topics surrounding the world of emergency nursing and in the next post I might actually talk about them. For some reason, it is after 0300 and I am finding myself quite articulate and witty. Not a good sign. Time for bed……thank god I don’t have to punch in for that!

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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