May, 2007 Archive

May 10, 2007, 3:27 pm

Look What They’ve Done to My Meds, Ma!

urodonal

Ouick! Get this man his medication!

Isn’t this the most dramatic representation of pain you’ve ever seen in an ad?

My back aches just looking at it.

Urodonal is for victims of uric acid.

It dissolves the uric acid.

It’s for gout, rheumatics and arteriosclerosis (I think).

I’d like to tell you I know all this because I can read French, but actually I ran the words through my handy-dandy Mac Widget translator.

Up until now I only knew: “Moi?” (from Miss Piggy), “au revoir” (from the old Lawrence Welk ending-theme song – hey, I was a kid) and “Oui, oui madame” (from stereotypical French waiters in movies).

And now I can say “uric acid” in French.

Who says you can’t have it all?

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

Two notes from my last post re: nursing education.

  • An LPN commented that you can obtain your LPN education through a trade school. That should have occurred to me, but I was focused on the RN.
  • Western Career College really does produce RNs. I have it from a reliable source that they are offering an LPN to RN bridge program in Sacramento. I stand corrected!

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

Hmmmm….

Something is happening in the world of medications and I’m not sure what it is.

Once upon a time, we gave Compazine for nausea. And lo, it was good.

Then they told us not to because the side effects could be, well, uncomfortable. Stiff jaw, tongue hanging out. Major bummer.

Then they told us to give Phenergan. And we did. And lo, it kinda helped.

Yet, something better came along! It was called Inapsine and in tiny does it kicked nausea’s butt! And lo, it was hella good.

But… in big doses it caused a nasty heart rhythm called Torsades de Pointes (what, is it French day today?).

So they took it away. And lo, some nurses were sad.

They told us to give Phenergan. Again. And lo, it sorta worked. Again.

But Phenergan can cause necrosis if it is in a tiny vein! Bad Phenergan! Many cautions were put forth in its administration.

Ah, we still had Tigan! Either in the derriere or up the derriere, it worked its marvels on those tiny sprites who were unable to keep down any fluids.

Then they told us we couldn’t use it any more. Like aspirin, it can cause/worsen Reye’s Syndrome.

So all that we have left to give is Zofran.

What happens when they decide Zofran is bad for you?

*****

Once upon a time, there was a potent narcotic called Dilaudid. Small amounts of medication could take away very large amounts of pain.

I learned, however, patients in sickle-cell crisis could need much, much more. Often four-to-eight milligrams intravenously.

Most folks, though, would get relief from 0.5-1.0 milligrams intravenously.

Gradually things have changed.

Now, you might give two milligrams. Or four. Or six. Or eight. Or twenty. For headaches. I’m not exaggerating.

What happened to Dilaudid?

Did they change the formulation?

Did they dilute it down to nothing?

Or have drug seekers become immune to the “Big D”?

*****

For five bazillion years, “Fleet” has been the name in enemas. They even have a mascot: Eneman! Why, I personally have administered enough Fleet enemas to clean the colon of an entire county.

But now they have told us to stop.

I guess some folks had electrolyte disturbances.

I feel for them. I really do. But now I have no buffer between myself and the soap suds enema the ER doctor invariably orders at the height of the busy shift.

When you can’t count on Fleets anymore, what is the world coming to?

*****

And what is up with Levophed?

Besides blood pressures.

When I was a new nurse, barely off Florence Nightingale’s knee, the mantra of the cardiac set was:

“Levophed leaves ’em dead.”

If we pulled out the Levophed, it meant the patient not only was “heading for the light”, he had made it to the light and had set up housekeeping!

Now, it’s the go-to drug for septic shock. I recently hung it for the first time in probably twenty years.

Go figure.

*****

And finally, the eternal question that every nurse asks the first time they have to count the drugs.

(After they ask why they have to count narcotics when the Pyxis keeps track, anyway….)

Why do we have to count the Lomotil?

Is there a high street value on anti-diarrheal medication?

Oh, wait, a quick check of that invaluable medical source known as Wikipedia shows that diphenoxylate is chemically related to Demerol!

Don’t let that get around to the drug seeking population or the ER will see a massive rise in the amount of diarrhea issues as opposed to constipation complaints!

Well, I guess that solves my Fleets issue…

Read »

May 9, 2007, 8:37 pm

Learn at Home, in Your Spare Time!

smooshedcap

It can happen to any nurse.

At any time.

When you least expect it.

Your co-worker may not even suspect she suffers from it.

Male nurses may be immune, but it is the scourge of the nursing professional.

Smooshed Cap Syndrome!

Oh, the horror!!!!!!!!

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

I’m caring for a young woman with a touch of the flu. She is accompanied by her boyfriend.

Nice kids.

The young man looks at me and asks, “Are you one of those ‘practitioners’?”

I look up from the IV and answer, “I’m a registered nurse.”

“How did you do that?”, he asks.

Hmmm….

“Well, I went to college and received a degree in nursing.” I explained that you can do a two-year or a four-year program, but that the two-year program was anything but two years; just doing the pre-requisites alone could take at least a year. I said that it was probably better to do the four-year BSN degree, as the ADN programs can take just as long.”

“Are you serious?” He looked shocked.

“Yes….you have to attend a college or university to be a registered nurse.”

“Oh man, aren’t there any trade schools out there that you can go to?”

Say freaking WHAT? Now it was my turn to drop my jaw. I think I kept my composure.

“Um…no…nursing education is definitely at the college or university level. You can’t do it any other way.”

This young man was too young to remember the diploma programs, so he wasn’t talking about those when he asked about “trade schools”.

I honestly think this kid thought you went to the “Bryman School” or “Western Career College” to be a registered nurse.

I’m not sure why his lack of knowledge was so surprising to me. He definitely left that night with the correct information.

I wonder how many other people out there have no clue about what it takes to be a nurse or even what being a nurse is all about?

Read »

May 8, 2007, 12:49 pm

Guess Who’s a Columnist for Nursing Jobs.org?

me

Me!

Yesterday, Nursing Jobs.org began a daily column written by nurses. Each day is devoted to a different topic.

Every Monday, yours truly will be highlighting an aspect of our past. The column is called “Reeling in the Years: A Look at Nursing History”.

Tuesdays belong to Susan McNicholas (aka “TC” from DonorCycle). She’ll be tackling nursing ethics in her column, “Penlight”.

I’m back on Wednesdays with a look at studies that affect our practice in “The Wind Beneath Our Wings: A Look at Nursing Research”. (I wanted to call it: “Doncha Wish Your Nurse Did Research Like Me?” but, really, that wasn’t too appropriate now was it?)

Terri Pollick (aka “Mother Jones” from Nurse Ratched’s Place) will be looking at the current leaders of our profession in her column “Follow the Leaders” on Thursdays.

And last but not least, I’m happy to report that Labor Nurse (aka “Labor Nurse” from “The Life and Times of a Labor Nurse”) will be putting up the best of the weekly nursing links in her Friday column, “You’re Being (WebPaged!)” I just saw she gave me a “hint” for a column on her blog! Thanks, LN!

I’ll add the column links as they come in this week. Right now you can find the current columns by going to Nursing Jobs. org site and clicking on the “NJO Blog” tab at the top of the page.

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

Shane insisted that we give him a photo for the column! I wanted to use my South Park character, but noooooo!

So…my daughter and I did a photo shoot. America’s Top Model it was not, let me tell you. The one above is of me “researching”. Those textbooks are over ten years old. They came with floppy discs….

But then I realize if the photos are really tiny, the wrinkles and the freckles don’t show! You can be close to fifty, but you don’t have to look it thanks to the wonders of photo retouching! I don’t look a day over 49 1/2….

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

The cap is out! That can only mean one thing!

It’s National Nurses Week!!!!! Happy Birthday to Florence Nightingale on Saturday! I may put on some crinolines in her honor and feed beef tea to my patients!

The only time I wear my cap is during this special week. I even have white scrubs this year! Alas, I am only working two days and then the cap returns to it plastic case until next year.

I don’t mind getting teased by my co-workers in the ER about the cap. They are used to my, uh, idiosyncrasies. It’s watching the looks on the faces of the nurses upstairs that is hilarious. Every time I admit a patient I have some “esplainin’ to do”!

So, go hug the nearest nurse you can find today. It might be helpful if it is a nurse you actually know, but hey! You can never get too many hugs…

Read »

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...

Continue reading »

Find Me On...
Twitter     Technorati

Subscribe to Emergiblog

Office of the National Nurse

Zippy Was Here


Healthcare Blogger Code of Ethics

  • Perspective
  • Confidentiality
  • Disclosure
  • Reliability
  • Courtesy

medbloggercode.com