August, 2007 Archive

August 26, 2016, 10:31 am

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Metformin 1000mg pills $139.00 This was my favorite skit on the old “Muppet Show”.

Metformin 1000mg pills $139.00 Usually the “patient” would sit up and make some wisecrack to the OR team.

Metformin 1000mg pills $139.00 Can’t say much for their technique, metformin 1000mg pills $139.00 though!

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We all expect our surgeons to be perfect.

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Eternally patient, metformin 1000mg pills $139.00 never exhausted, metformin 1000mg pills $139.00 always in a good mood.

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It’s no secret that surgeons have a reputation for being egotistical, metformin 1000mg pills $139.00 overbearing and intolerant.

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I once saw a surgeon throw a chest tube full of contaminated blood across a trauma room in an ER.

And let us not forget the infamous Dr. Metformin 1000mg pills $139.00 Prissy Pants who intimated that no one in my ER was working because the patient did not have his consent signed by the time the Dr. Metformin 1000mg pills $139.00 walked in to see him!

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Surgeon stories.

We nurses have a million of them.

But how many of us have ever looked at the situation from the side of the surgeon?

Instead of dreading the idea of having to work with one, metformin 1000mg pills $139.00 what can a nurse do pro actively to make the preoperative experience a smooth one for themselves, metformin 1000mg pills $139.00 the patient and the surgeon?

Having dealt with surgeons as a nurse, metformin 1000mg pills $139.00 a patient and a family member, metformin 1000mg pills $139.00 I have a few ideas born out of my experiences. Metformin 1000mg pills $139.00 Your mileage may vary.

  • If you work with inpatients, metformin 1000mg pills $139.00 for pete’s sake make sure the patient is NPO! Nothing will make a surgeon blow up faster than finding out the patient can’t go to OR because they have eaten! I know of one incident that caused a six hour delay in the removal of what turned out to be a gangrenous gall bladder.
  • Make it a priority to have the patient ready for surgery. Metformin 1000mg pills $139.00 Paperwork can come later. Metformin 1000mg pills $139.00 The surgeon is not operating on the chart.
  • Having said that, metformin 1000mg pills $139.00 the more paperwork you have done, metformin 1000mg pills $139.00 the more efficient the process. Metformin 1000mg pills $139.00 Have alert patients fill out their own anesthesia questionnaire if they can.
  • After hours, metformin 1000mg pills $139.00 follow up and make sure the supervisor has called in the OR team and make sure you know the ETA. Metformin 1000mg pills $139.00 Hell hath no fury like a surgeon who walks in ready to take the patient to OR only to discover the team wasn’t called in.
  • If pre-op antibiotics/medications are ordered get them in – they are ordered for a reason.
  • Every nurse knows the surgeon must speak to the patient about the risks/benefits of surgery before the consent is signed. Metformin 1000mg pills $139.00 Every surgeon knows it too, metformin 1000mg pills $139.00 but that doesn’t stop them from telling you to have the consent done before they get there. Metformin 1000mg pills $139.00 Fill it out so it is ready to go after the surgeon is done explaining.
  • Post-op: when you call a surgeon, metformin 1000mg pills $139.00 be concise. Metformin 1000mg pills $139.00 Tell them what you want. Metformin 1000mg pills $139.00 Is more pain medication needed? Are you seeing signs of infection at the incision site? Is the patient now febrile? Don’t beat around the bush with a long-winded story.

Metformin 1000mg pills $139.00 Those are just a few of the ideas that come to mind when working with pre-op patients and their surgeons that contribute to a smooth peri-operative experience for everyone involved.

*****

Metformin 1000mg pills $139.00 It helps to remember that surgeons are just like us. Metformin 1000mg pills $139.00 They get tired with long hours, metformin 1000mg pills $139.00 they have no control over their workload if they are on-call. Metformin 1000mg pills $139.00 Yes, metformin 1000mg pills $139.00 they get paid well and yes, metformin 1000mg pills $139.00 they chose their specialty and yes, metformin 1000mg pills $139.00 being called in is part of the deal they signed up for but that doesn’t mean it is easy. Metformin 1000mg pills $139.00 Even though you work a night shift and are chipper at 0400 (raising hand here) the surgeon who is coming in early to fit your appy in before his full day in the OR might not be so upbeat.

Metformin 1000mg pills $139.00 There is always room for understanding and for cutting each other a little slack.

Metformin 1000mg pills $139.00 That is why I can count the number of think-they-are-God surgeons on less than one hand.

Metformin 1000mg pills $139.00 Mutual respect goes a long way.

*****

(Epilogue: to all surgeons reading, metformin 1000mg pills $139.00 please understand that nothing undermines the care of your patient worse than an arrogant, metformin 1000mg pills $139.00 insulting attitude. Metformin 1000mg pills $139.00 If you are lucky, metformin 1000mg pills $139.00 the nurse will call you on it. Metformin 1000mg pills $139.00 Worst case scenario, metformin 1000mg pills $139.00 the nurse is afraid/unwilling to interact with you and that is never in the best interest of your patients.)

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August 26, 2016, 8:17 am

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12:07 am

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I’ve also been messing around with some other internet activities and and I am happy to report that:

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When I was little, remeron 30mg pills $240.00 I used to read the old Reader’s Digests in my great-grandmother’s room. Remeron 30mg pills $240.00 My favorite feature was called “My Most Unforgettable Character”. Remeron 30mg pills $240.00 Throughout my nursing career, remeron 30mg pills $240.00 I’ve met a few patients who would meet the criteria. Remeron 30mg pills $240.00 Here is the story of one of them.

*****

Ninety-seven years old and he was actually going to be discharged from the ER.

Nothing a few Tums wouldn’t cure.

I had just started my shift and the nurse who started at 1900 was going on her break. Remeron 30mg pills $240.00 Would I be so kind as to discharge the patient in 4A?

Sure! Show me an ER nurse who isn’t all about discharging patients!

I took a quick glance at the chart to see what had gone on with the patient and what discharge instructions I would be giving.

I expected the discharge to take a bit longer than usual. Remeron 30mg pills $240.00 As I printed up the instructions I realized that at the age of 97 he was probably frail, remeron 30mg pills $240.00 hard of hearing and I’d have to speak slowly and clearly to be understood. Remeron 30mg pills $240.00 There might be a bit of dementia. Remeron 30mg pills $240.00 He’d need help dressing and help out to the car.

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He wasn’t in the bed. Remeron 30mg pills $240.00 He was holding court in a reclining chair, remeron 30mg pills $240.00 attached to the cardiac monitor.

He was anything but frail; he was borderline stout! Far from hard of hearing, remeron 30mg pills $240.00 he picked up the slightest sound and responded to normal conversation.

Actually, remeron 30mg pills $240.00 he did not respond to normal conversation, remeron 30mg pills $240.00 he directed it! He reminded me of Sam the Snowman from “Rudolf, remeron 30mg pills $240.00the Red-Nosed Reindeer”. Remeron 30mg pills $240.00 He didn’t look like Burl Ives but he sounded like him. Remeron 30mg pills $240.00 Animated, remeron 30mg pills $240.00 jolly and full of life.

I had gotten out one sentence after introducing myself, remeron 30mg pills $240.00 something to the effect of “You get to go home!”.

And Mr. Remeron 30mg pills $240.00 Sam was off!

*****

He was ecstatic that he did not have pneumonia and proceeded to explain to me that he was able to cure people, remeron 30mg pills $240.00 that he had the gift of healing from God and had treatments and cures for just about anything. Remeron 30mg pills $240.00 Most of them had to do with poultices and iodine.

Pneumonia is cured by placing iodine on the chest. Remeron 30mg pills $240.00 Within 24 hours, remeron 30mg pills $240.00 you cough up all the phlegm in your lungs and the pneumonia is cured.

I did not know that.

Oh, remeron 30mg pills $240.00 and by the way…no dementia!

This guy was fascinating. Remeron 30mg pills $240.00 He took my hand as I passed by and had me sit down to tell me more about his gift. Remeron 30mg pills $240.00 Luckily, remeron 30mg pills $240.00 the department was not busy so I had a chance to listen.

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Mr. Remeron 30mg pills $240.00 Sam knew he had “the gift” from birth. Remeron 30mg pills $240.00 The midwife told his mother that he was born with a “double veil”. Remeron 30mg pills $240.00 This meant he was given the “gift” of healing. Remeron 30mg pills $240.00 He had healed many people in his lifetime. Remeron 30mg pills $240.00 People with pancreas trouble and heart trouble and back trouble.

I laughed and told him that he would have a line of nurses out his front door if he had the cure for back pain! He had me turn around so he could show me how he could cure back pain. Remeron 30mg pills $240.00 He showed me some neck exercises. Remeron 30mg pills $240.00 His neck was supple and moved easily.

Mine cracked six times.

He assured me he did have the power to heal and that there were 150 angels working with him. Remeron 30mg pills $240.00 He was quite specific about the number. Remeron 30mg pills $240.00 His friend, remeron 30mg pills $240.00 female and somewhat younger nodded as he spoke.

He did not just heal. Remeron 30mg pills $240.00 He would do “readings”. Remeron 30mg pills $240.00 He didn’t say tarot cards or palms, remeron 30mg pills $240.00 he “read” people. Remeron 30mg pills $240.00 Eventually he had to stop because he often became emotional from what he saw in the future of the people who asked him for insight. Remeron 30mg pills $240.00 It was hard to tell someone things were not looking good.

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Lest you think Mr. Remeron 30mg pills $240.00 Sam was all spiritual and ethereal in demeanor , remeron 30mg pills $240.00 let me give you an example of one of his “readings”, remeron 30mg pills $240.00 as told to me.

A man, remeron 30mg pills $240.00 75-years-old, remeron 30mg pills $240.00 came to Mr. Remeron 30mg pills $240.00 Sam with a problem. Remeron 30mg pills $240.00 Mr. Remeron 30mg pills $240.00 Seventy-Five was in love with a twenty-something woman and was sure she felt the same towards him. Remeron 30mg pills $240.00 He had spent much money on his sweetheart and was considering buying her a new Mercedes. Remeron 30mg pills $240.00 Mr. Remeron 30mg pills $240.00 Seventy-Five wanted validation that the woman young enough to be his grand-daughter really did love him.

Mr. Remeron 30mg pills $240.00 Sam’s response? “YOU’RE STUPID!” he described himself as saying. Remeron 30mg pills $240.00 “She wants you for your money! How much more stupid can you be? Don’t buy her the car and watch how fast she runs the other direction! YOU’RE STUPID! And you’ll be dead of a heart attack in six months.”

Now that’s a reading with a ton o’ common sense attached!

Guess what? Mr. Remeron 30mg pills $240.00 Seventy-Five did not buy the car, remeron 30mg pills $240.00 the young woman dumped him and he died of a heart attack within six months.

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It took forty-five minutes to discharge Mr. Remeron 30mg pills $240.00 Sam, remeron 30mg pills $240.00 who dressed himself faster than I can take a blood pressure and walked out of the department under his own steam.

He said if I ever wanted a reading to come and see him and he made me write down his number.

I could have sat there and listened to him for hours.

Something tells me he would have obliged.

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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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