June 25, 2006, 1:47 pm

The Answer Nurse Speaks

coke

Ladies and Gentlemen, it’s time for The Answer Nurse!

Having posed the idea in a previous post, The Answer Nurse never thought she’d get so many questions in such a short time!

She thought it best to answer the ones she has received, but do continue to send them. The Answer Nurse lives for these inquiries and hopes someday to have a life!

********************

Some questions are serious, some a farcical, but all require a professional look at the world through the eyes of The Answer Nurse!

If you are disappointed in the answers, The Answer Nurse suggests re-evaluating the nature of the submitted question and increase the quality accordingly.

And so, let us all strike a pose by our nearest Coke machine and fresh flowers, grab a patient’s chart and begin….

******************************

Question Number One:

  • Why would a mom with a rash also sign in her 2yo and 4yo [to the ER] with matching complaints of “insect bite?”
  • The Answer Nurse Speaks: The average human has approximately 60 trillion synapses in their cerebral cortex. The Answer Nurse knows this because she looked it up on Google. Your particular patient obviously had only three synapses; one for herself and one for each child. One can only hope that said patient had a tubal ligaton.

Question Number Two:

  • From the UK: Who would turn up at 7am on a Monday morning after a weekend of agony with toothache….abscess, plain as paint. “How long have you had toothache?” “Errm, about a month, Nurse.”
  • The Answer Nurse Speaks: Greetings from the Colonies! The Answer Nurse is a sucker for a British accent. But she does wonder, doesn’t The Prince of Wales have his own dentist?

Question Number Three:

  • If your left toe has been hurting for 3 months, why would you decide to come in at 3:00 in the morning on a Friday night????
  • The Answer Nurse Speaks: It seems to The Answer Nurse this poor soul has no life and that when he attempted to ask a woman if she rented by the hour, she stomped on his foot with her 4-inch pumps. It has take him this long to swallow his pride and obtain care. The Answer Nurse notes that the silver lining to this pitiful cloud is that the patient has nine other toes with which to work.

Ouestion Number Four:

  • I’m graduating in December, sitting boards in January. Tell me why I should consider ER nursing.
  • The Answer Nurse Speaks: The Answer Nurse notes that this inquiry is in the form of a command as opposed to a question, but she deems it significant enough to respond none-the-less. Here are the reasons The Answer Nurse would consider ER nursing:
    • Never the same job two days in a row
      • you will alternate hours of sheer terror with moments of pure boredom
      • unless you work in a small ER at which point you would reverse the above.
    • Nurses gravitating to the ER are out-spoken, in-your-face personalities.
      • This makes the ER a very lively place to work.
      • Of course The Answer Nurse, being of genteel breeding would never reveal this side of her personality in public.
      • May the Lord have mercy, however, on her family.
    • You will learn technical skills and assessment skills rapidly.
      • The Answer Nurse feels that the ability to prioritize is the epitome of the skills required in an ER.
      • Should the candidate for the ER have no prior experience in the nursing field, this prioritization can be learned by working initially in med/surg and/or ICU/CCU prior to transferring to the ER environment.
      • The Answer Nurse also acknowledges that some of the best ER nurses she has had the honor to address as “colleague” have been new graduates.
    • Working in the ER is fun – and that is the best reason The Answer Nurse can provide!

Question Number Five:

  • Where do ya’ll ER nurses get all your adrenalin?
  • The Answer Nurse Speaks:
    • Legally: usually via caffeine in the form of coffee, chocolate, Coke, Pepsi
    • Physiologically: via the adrenal medullae by the enzyme phenylethanolamine-N-methyltransferase (PNMT). The Answer Nurse knows this because she looked it up on Google.
    • (Now aren’t you sorry you asked?)

Question Number Six:

  • Why do some ER staff members (doctors, nurses, techs, secretaries) get so darned JADED?
  • The Answer Nurse Speaks: As The Answer Nurse does not suffer from this condition, she can only assume the facilitating factors are that ER workers are:
    • Overworked- much overtime is done
    • Underpaid – in most of the country
    • Not appreciated – taken for granted
    • The distinct tendency for every homo-sapien to want what they want immediately combined with the inability for said health-care givers to be two places at once. The Answer Nurse does not see a cure for this particular factor in the near future.
    • The requirement to occasionally miss “American Idol” because they are needed on the schedule.

Question Number Seven:

  • Ok, so, you have often explained that your facility is superior to the one that you use as a patient. Why do you go there? Is it just that the desire for privacy outweighs the benefits of a superior facility that happens to know you, or is there something more?
  • The Answer Nurse Speaks: Ah, The Answer Nurse has asked these very questions and here are some of the reasons Inferior Medical Center has been utilized:
    • The Answer Nurse lives approximately 22 miles from her place of work.
    • The Answer Nurse must cross a loooong bridge to get to the Superior Medical Center in which she works. Travel time at 75 miles-per-hour on a good day at a good time with no one getting in her way takes 35 minutes.
    • The Answer Nurse lives in a different county than where she works.
      • Medics will not cross county lines to take The Answer Nurse to where she really wants to go.
      • During the chest pain experience, The Answer Nurse thought it would not be prudent to drive herself that far and so ended up at Inferior Medical Facility.
      • The Answer Hubby now has instructions to drive just across the bridge and then dial 911 to get that county’s medics to take The Answer Nurse to Superior Medical Facility.
        • Should The Answer Nurse code on the way across the bridge, she assumes it will no longer be an issue,
        • and will be happy to say hello to all those family members who have gone before her.
    • During The Answer Hubby’s experience with his gall bladder:
      • The Answer Nurse figured the Inferior Medical Facility would diagnose him with gas and place him on Protonix, as that seemed to be the diagnosis/medicine-of-the-month.
      • Had she known the severity of the illness, The Answer Nurse would have dragged herself out of bed and personally driven him to the Superior Medical Facility.
    • Privacy is never an issue with The Answer Nurse, in a true emergency she wouldn’t care if the attending was Harrison Ford, himself. In fact, she would prefer it.

Question Number Eight:

  • Have your recent experiences from the “other side” changed any of the ways you do your job?
  • The Answer Nurse Speaks: Yes.
    • She makes sure patients are updated on a regular basis about what labs are back and what they are waiting for.
    • She makes sure that holding orders are written ASAP once the diagnosis is made for admitted patients and works with ER docs who share this goal.
    • She has no trouble telling the hospitalist the patient is on their way and can be evaluated upstairs (said very politely, of course)
    • She writes and faxes report as a priority so the patient can get up to their room 30 minutes after that is done.
    • She is less toleratnt of excuses as to why the patient cannot go upstairs, although she is willing to work with the floor nurses on extenuating circumstances.
      • To Superior Medical Facility’s credit, the floor/unit nurses are totally about gettting the patient as fast as they can.
    • While all this was already a part of The Answer Nurse’s mode of practice, she is now more empathetic with the family and patient.

Question Number Nine:

  • Given your years as an ED/critical care nurse, what would you say is the percentage of people who present at the ED of your hospital who really shouldn’t be at the ED (i.e., those people don’t have “emergencies”)?
  • The Answer Nurse Speaks:
    • 70%
    • 69.9% of those are pediatric patients with fevers, runny nose, vomiting x1.
      • (Yes, The Answer Nurse is being sarcastic, despite her impeccable manners.)
      • The other .1% are constipated.
    • The Answer Nurse does not include those with abdominal pain, possible DVTs, large lacerations or obvious fractures in the 70%.

So, that concludes this session of The Answer Nurse Speaks! Thanks for all those who participated.

The Answer Nurse must now get ready for work so that she can accumulate more blog material and an aching back.

Who says you don’t get anything out of nursing?

(PS: The Answer Nurse also apologizes for the sudden inability to de-bold her print. She has tried four times and will now be late for work. She apologizes for any eyestrain.)

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18 Comments

  • Linda
    Linda

    June 25, 2006 at 2:23 pm

    That was great Kim! When are you going to do it again? I’m storing up my questions :)


  • Hannah
    Hannah

    June 25, 2006 at 3:28 pm

    So much fun. I will go back and re-read it, too.

    I haven’t even sent you my questions yet, so there will be more!

    Hh


  • may
    may

    June 25, 2006 at 5:18 pm

    the Answer Nurse sounds very much like Miss Manners… did she get inspiration from her? :)


  • d
    d

    June 25, 2006 at 6:14 pm

    Having just gone to the ER today for what felt (and still kind of feels) like a stupid reason, I’m glad to see abdominal pain on the 30% of your equation. (My boyfriend is an EMT and knows just enough to make him annoying. He was convinced I might have an AAA and was going to die in 3 minutes. Six months ago he had never *heard* of an AAA.)

    So here’s my Ask a Nurse question: if you weren’t a nurse, what profession would you seek?


  • Mel
    Mel

    June 25, 2006 at 6:23 pm

    Here’s my Ask a Niurse question: Not really looking for specific medical advice, but when would you advise a parent to bring a child to the ER? What don’t you consider part of the 70% non-emergencies?
    The last two times I took kids were for lacerations outside the office & urgent care clinic at our peds office. One simply needed stitches. The second actually nicked the growth plate on a bone & ended up with pins in it. I have no doubt those were legit emergencies, but what else would be?


  • Melissa
    Melissa

    June 25, 2006 at 6:55 pm

    Funny post. Thanks for the laugh.


  • Karen
    Karen

    June 25, 2006 at 8:30 pm

    LOVE the Answer Nurse feature! Great stuff. :)


  • Cassie
    Cassie

    June 25, 2006 at 8:42 pm

    Kim, you made my night! Thanks for the great Q and A.
    Cassie


  • MotherJonesRN
    MotherJonesRN

    June 25, 2006 at 11:08 pm

    To the queen of Q&A…….Bravo! You put a smile on my face. I worked another long weekend on my psych unit. After dealing with demanding addicts and their crazy family members, I needed a good laugh. Thanks!

    Mother Jones RN


  • Jodi
    Jodi

    June 26, 2006 at 2:03 am

    Heehee, good stuff!
    I know I should be sleeping ….but I can’t. NCLEX in T-minus 10 hours!
    At least it’s afternoon and I can sleep in…a little.


  • Chele
    Chele

    June 26, 2006 at 7:39 am

    Great post! I just worked all weekend (nights) at my ER, but I had to read you before I went to sleep. And yes…working in the ER is FUN!!!!!


  • punchberry
    punchberry

    June 26, 2006 at 9:09 am

    Thanks Kim! Like always, you manage to add just the right amount of humor and interesting information!


  • Julie
    Julie

    June 26, 2006 at 1:55 pm

    As ever a wonderful post. I just love the idea of answer nurse, well done!


  • LoD
    LoD

    June 26, 2006 at 9:02 pm

    Awesome post, Kim! I love when people have Q&A’s :)


  • RevKrull
    RevKrull

    June 27, 2006 at 12:01 am

    Thanks for answering my question! In the past 8 months I’ve been to the ED at my local hospital twice. On both occasions they seemed very busy given the time of night (after 1:00 am – I work 2nd shift). I’ve read stories about ED departments around the country overloaded with patients who lack a regular doctor and show up for routine things (e.g., colds, headaches, sprains). But I’d expect most of those folks to show up during the day, not in the wee hours of the morning. But what do I know? I drive a fork lift in a warehouse. Perhaps I live in a dangerous part of the country.


  • difficult patient
    difficult patient

    June 27, 2006 at 7:17 am

    Great Q&A Kim . . .now I’m thinking of some Q’s for you! ;o)


  • kt
    kt

    June 27, 2006 at 10:00 am

    that was awesome kim!


  • Jen
    Jen

    June 28, 2006 at 7:45 pm

    Kim, I sooooooo want to work a shift with you!! You had me laughing and agreeing the entire blog post!


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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