August, 2007 Archive

September 27, 2016, 10:31 am

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Fluoxetine 60mg pills $128.00 This was my favorite skit on the old “Muppet Show”.

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We all expect our surgeons to be perfect.

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It’s no secret that surgeons have a reputation for being egotistical, fluoxetine 60mg pills $128.00 overbearing and intolerant.

We’ve all heard the horror stories of instrument tossed across the OR in anger.

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

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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, fluoxetine 60mg pills $128.00 what can a nurse do pro actively to make the preoperative experience a smooth one for themselves, fluoxetine 60mg pills $128.00 the patient and the surgeon?

Having dealt with surgeons as a nurse, fluoxetine 60mg pills $128.00 a patient and a family member, fluoxetine 60mg pills $128.00 I have a few ideas born out of my experiences. Fluoxetine 60mg pills $128.00 Your mileage may vary.

  • If you work with inpatients, fluoxetine 60mg pills $128.00 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. Fluoxetine 60mg pills $128.00 Paperwork can come later. Fluoxetine 60mg pills $128.00 The surgeon is not operating on the chart.
  • Having said that, fluoxetine 60mg pills $128.00 the more paperwork you have done, fluoxetine 60mg pills $128.00 the more efficient the process. Fluoxetine 60mg pills $128.00 Have alert patients fill out their own anesthesia questionnaire if they can.
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  • 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. Fluoxetine 60mg pills $128.00 Every surgeon knows it too, fluoxetine 60mg pills $128.00 but that doesn’t stop them from telling you to have the consent done before they get there. Fluoxetine 60mg pills $128.00 Fill it out so it is ready to go after the surgeon is done explaining.
  • Post-op: when you call a surgeon, fluoxetine 60mg pills $128.00 be concise. Fluoxetine 60mg pills $128.00 Tell them what you want. Fluoxetine 60mg pills $128.00 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.

Fluoxetine 60mg pills $128.00 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.

*****

Fluoxetine 60mg pills $128.00 It helps to remember that surgeons are just like us. Fluoxetine 60mg pills $128.00 They get tired with long hours, fluoxetine 60mg pills $128.00 they have no control over their workload if they are on-call. Fluoxetine 60mg pills $128.00 Yes, fluoxetine 60mg pills $128.00 they get paid well and yes, fluoxetine 60mg pills $128.00 they chose their specialty and yes, fluoxetine 60mg pills $128.00 being called in is part of the deal they signed up for but that doesn’t mean it is easy. Fluoxetine 60mg pills $128.00 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.

Fluoxetine 60mg pills $128.00 There is always room for understanding and for cutting each other a little slack.

Fluoxetine 60mg pills $128.00 That is why I can count the number of think-they-are-God surgeons on less than one hand.

Fluoxetine 60mg pills $128.00 Mutual respect goes a long way.

*****

(Epilogue: to all surgeons reading, fluoxetine 60mg pills $128.00 please understand that nothing undermines the care of your patient worse than an arrogant, fluoxetine 60mg pills $128.00 insulting attitude. Fluoxetine 60mg pills $128.00 If you are lucky, fluoxetine 60mg pills $128.00 the nurse will call you on it. Fluoxetine 60mg pills $128.00 Worst case scenario, fluoxetine 60mg pills $128.00 the nurse is afraid/unwilling to interact with you and that is never in the best interest of your patients.)

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September 27, 2016, 8:17 am

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12:07 am

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When I was little, cialis 100mg pills $428.00 I used to read the old Reader’s Digests in my great-grandmother’s room. Cialis 100mg pills $428.00 My favorite feature was called “My Most Unforgettable Character”. Cialis 100mg pills $428.00 Throughout my nursing career, cialis 100mg pills $428.00 I’ve met a few patients who would meet the criteria. Cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 As I printed up the instructions I realized that at the age of 97 he was probably frail, cialis 100mg pills $428.00 hard of hearing and I’d have to speak slowly and clearly to be understood. Cialis 100mg pills $428.00 There might be a bit of dementia. Cialis 100mg pills $428.00 He’d need help dressing and help out to the car.

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He wasn’t in the bed. Cialis 100mg pills $428.00 He was holding court in a reclining chair, cialis 100mg pills $428.00 attached to the cardiac monitor.

He was anything but frail; he was borderline stout! Far from hard of hearing, cialis 100mg pills $428.00 he picked up the slightest sound and responded to normal conversation.

Actually, cialis 100mg pills $428.00 he did not respond to normal conversation, cialis 100mg pills $428.00 he directed it! He reminded me of Sam the Snowman from “Rudolf, cialis 100mg pills $428.00the Red-Nosed Reindeer”. Cialis 100mg pills $428.00 He didn’t look like Burl Ives but he sounded like him. Cialis 100mg pills $428.00 Animated, cialis 100mg pills $428.00 jolly and full of life.

I had gotten out one sentence after introducing myself, cialis 100mg pills $428.00 something to the effect of “You get to go home!”.

And Mr. Cialis 100mg pills $428.00 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, cialis 100mg pills $428.00 that he had the gift of healing from God and had treatments and cures for just about anything. Cialis 100mg pills $428.00 Most of them had to do with poultices and iodine.

Pneumonia is cured by placing iodine on the chest. Cialis 100mg pills $428.00 Within 24 hours, cialis 100mg pills $428.00 you cough up all the phlegm in your lungs and the pneumonia is cured.

I did not know that.

Oh, cialis 100mg pills $428.00 and by the way…no dementia!

This guy was fascinating. Cialis 100mg pills $428.00 He took my hand as I passed by and had me sit down to tell me more about his gift. Cialis 100mg pills $428.00 Luckily, cialis 100mg pills $428.00 the department was not busy so I had a chance to listen.

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Mr. Cialis 100mg pills $428.00 Sam knew he had “the gift” from birth. Cialis 100mg pills $428.00 The midwife told his mother that he was born with a “double veil”. Cialis 100mg pills $428.00 This meant he was given the “gift” of healing. Cialis 100mg pills $428.00 He had healed many people in his lifetime. Cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 He showed me some neck exercises. Cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 He was quite specific about the number. Cialis 100mg pills $428.00 His friend, cialis 100mg pills $428.00 female and somewhat younger nodded as he spoke.

He did not just heal. Cialis 100mg pills $428.00 He would do “readings”. Cialis 100mg pills $428.00 He didn’t say tarot cards or palms, cialis 100mg pills $428.00 he “read” people. Cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 It was hard to tell someone things were not looking good.

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Lest you think Mr. Cialis 100mg pills $428.00 Sam was all spiritual and ethereal in demeanor , cialis 100mg pills $428.00 let me give you an example of one of his “readings”, cialis 100mg pills $428.00 as told to me.

A man, cialis 100mg pills $428.00 75-years-old, cialis 100mg pills $428.00 came to Mr. Cialis 100mg pills $428.00 Sam with a problem. Cialis 100mg pills $428.00 Mr. Cialis 100mg pills $428.00 Seventy-Five was in love with a twenty-something woman and was sure she felt the same towards him. Cialis 100mg pills $428.00 He had spent much money on his sweetheart and was considering buying her a new Mercedes. Cialis 100mg pills $428.00 Mr. Cialis 100mg pills $428.00 Seventy-Five wanted validation that the woman young enough to be his grand-daughter really did love him.

Mr. Cialis 100mg pills $428.00 Sam’s response? “YOU’RE STUPID!” he described himself as saying. Cialis 100mg pills $428.00 “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. Cialis 100mg pills $428.00 Seventy-Five did not buy the car, cialis 100mg pills $428.00 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. Cialis 100mg pills $428.00 Sam, cialis 100mg pills $428.00 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.

Average Rating: 4.4 out of 5 based on 244 user reviews.

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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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