January 18, 2010, 12:58 pm
This has me stumped.
What on earth is she doing?
She is drawing something up from a spoon, I assume it is a medication.
But what?
I usually associate this sort of activity with heroin addicts, but obviously this is a clinical environment.
Okay, all you nursing historians out there…
What medication would need to be drawn up from a spoon instead of a vial or an ampule?
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It’s carnival time at Emergiblog!
Not only is Change of Shift going to be here on Thursday, but I’ll be hosting Grand Rounds next Tuesday!
Nurses, get cracking for Change of Shift – I’ll be taking submissions until Wednesday night.
Those of you who forgot to submit last week, now is your chance for redemption!
For Grand Rounds, it’s all comers and submissions until Monday evening at 5 pm Pacific time!
There is no theme, I’m put one together out of the submissions that come in.
Click the “Contact” button to send your submission for either carnival!
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Migraine.
Three days.
Out of pain medication and vomiting so you wouldn’t keep it down, anyway.
Agony.
Emergency department.
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You’re in luck - no one in triage!
A bed opens up, the nurse takes you straight to a room.
Gown, blanket.
And….
Two minutes later you send your cousin out to ask how long it will be until you get your pain med.
Excuse me?
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There is an unrealistic expectation of just how long it takes to get pain medication in an ER.
A few procedures that need to occur before that shot gets to its destination.
- Registration – We must have the information. The admitting clerk is not trying to hassle by asking for your address and birthday and ID. We need that information to officially identify our patients when we give medication.
- Examination – There must be an evaluation by the physician or the nurse practitioner before medication can be given. There may be patients who arrived before you who have yet to be evaluated; there may be patients who arrived after you experiencing life-threatening issues. Either way, they will be seen first.
- Orders – The physician/NP writes the order for your medication. Your nurse, also responsible for other patients, may be busy in another room. They will notice that medication has been ordered and take the chart to prepare the meds.
- Medication Preparation - The nurse pulls the medications from the medication dispensing system. The medications are carefully drawn up and all syringes are labeled before they leave the med room. The nurse will bring them to your bedside.
And you get your shot.
It’s so basic, really. Organized. Logical.
But it is not instantaneous.
Nothing in the ER is instantaneous except CPR when you go into cardiopulmonary arrest.
So, understand that you will probably have to do a certain amount of waiting before you receive your pain medication. It’s okay to ask for an update if you aren’t sure of what is going on.
But at least let your cousin sit for longer than two minutes before you send him out to remind us that you are in pain.
We didn’t forget.
January 7, 2010, 11:27 pm
Happy New Year and welcome to the first Change of Shift of the new decade!
Are you still writing “09″? I’m not! For some reason I have converted to “01″. Lord knows how many of my charts have the wrong dates on them!
It’s a new decade and the new year finds the nursing blogosphere is still going strong. Let’s get started!
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Melody Stenrose is an RN and a writer. She and I graduated from nursing school together, and I am excited to announce her new book! Chronicling her 30 years as a critical care nurse and educator, Inside the ICU: A Nursing Perspective is now available. I knew the book would be great. What I did not know was just how hard it was to get published. Think bloggers face objections? Check out this page at Melody’s site for the full story.
Caroline at Brain Scramble, RN writes An Open Letter to the ICU. I can’t add a single thing; what a wonderful post!
Now let’s switch to a night in PICU as Laney of Nursing Student Chronicles notes that there is No Rest for the Weary! I’m pooped just reading it!
It’s unit time at Change of Shift! Jo at Head Nurse has completed her CCU internship and is now Off the Leash. Congratulations!
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This is freaking hilarious! Shrtstormtrooper at New Nurse Insanity: Fundus Chop! manages to blend myocardial infarctions, practical jokes, tires and the Burger King getting hit in the, uh, groinal region in Crisis Averted. Warning: remove all liquids from your oral cavity before reading!
And a huge Change of Shift welcome to (relatively) new nurse blogger The Muse, RN! This is a post I wish I had written! Find out about Nursing’s Image & Ability to Influence Politics. And then give yourself ten minutes for your BP to return to normal.
The nursing blogosphere continues to expand as we give another first-time welcome to Voice of Reason, a nurse from Australia and author of the blog, Shades of Grey. This first submission is a beautiful poem on caring for a dying patient, entitled The Nurse’s Heart.
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Nurse Practitioners Save Lives looks at the practice (or non-practice) of Using Nurse Practitioners to Reduce Emergency Room Waiting Times. Preachin’ to the choir here, honey! LOL! I think all EDs should utilize NPs! Read for yourself at The Nurse Practitioner’s Place.
Dr. Dean, hubby to nurse and writer of the MillionaireNurse.com Blog has some observations about nurses who just can’t seem to stay on a budget in Blood From a Turnip: The Millionaire Nurse Way! All I can say is that I would die without RaceView during the NASCAR season…really…
Mother Jones has been busy lately. Snowed in! Twelve hour shifts! Dogs and cats, living together…okay, not that last part. So I thought I’d dig into her archives and pull up a classic Nurse Ratched’s Place post. This is one of my favorites. See if you don’t agree after reading The Abandoned House.
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Nosokomaniac is starting his nursing career as a CNA and gives a great description of Week One, the Awakening. There is something about getting tied to a bed and a practice massage, but don’t take it from me. It’s over at Nosokomania.
Over at Code Blog, Geena has A Rambling and Some News and Some Other News! I don’t want to spill the beans here, but I will say a HUGE Happy Blogiversary as she enters her SEVENTH year as a blogger! Seven! Holy cow! Gina was one of the first (if not THE first) nurse blogger I ever read! She blazed the trail upon which we hike! <– very poetic, yes? : )
I think we all better get over to see Max at It Shouldn’t Happen in Health Care, STAT! In Welcome to 2010, he’s making predictions and one of them is that he may stop blogging! I don’t think so, buddy! Don’t make me fly all the way to Australia and smack you!
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Thanks for reading this edition of Change of Shift! If you would like to host an edition, drop me a line – I’ll be in contact with those who have expressed an interest already! The next edition will be here at Emergiblog – submit using the contact button above or Blog Carnival. If you have issues with either one of those routes, you can always DM me through Twitter (@Emergiblog).
(Remember, Change of Shift now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available. Many thanks to Walter Jesson at Highlight Health for setting those feeds up!)
1:32 pm
I love this doll!!!!
She’s so cuuuuuute!!!!!!!!
I should buy her. Found her at Ruby Lane, which has a bazillion shops, but if you type “nursing” into the search box you will find a treasure trove of nursing ephemera. Diplomas, pins, yearbooks, prints, journals – I’ve found stuff I didn’t even know existed.
Bought an entire year of the American Journal of Nursing (‘58) and it is in my closet, just waiting for me to scan!
I see a resemblance.
Must be the freckles.
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Looking to hire nursing staff?
You might want to check out All Health Jobs and All Nursing Jobs. They will post your job openings for free – just use the coupon code “Emergiblog”.
Are you looking for a new job? They’ve got hundreds of positions listed. I know, I’ve checked it out. Not that I’m looking for a new job, or anything. Just like to keep an eye on what is going on out there.
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The discussion regarding the entry level for nursing has been ongoing for decades. I have articles written in the 1940s extolling the virtues of the BSN long before the first ADN program opened in 1952.
Every now and then, someone broaches the topic of making the BSN the entry level and BAM! the flames that ensue make the health care reform debate look like Mr. Roger’s Neighborhood.
Why the rancor?
Well, if one states that the BSN should be the entry level for a registered nurse, then it follows there must be a reason why an ADN should not.
That does not sit well with ADN graduates.
It sure didn’t sit well with me.
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Now, 5 months away from graduating with my BSN, I see a difference.
Or, I guess you can say I feel a difference.
I am a different nurse than I was 2 1/2 years ago.
Notice, I didn’t say “better”.
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My clinical skills are the same.
If you want to define nursing as the ability to put the right tube in the right orifice using the right technique, the BSN gives no advantage. Clinical skills for the ADN and the BSN are taught in class but honed in practice. While the ADN program may include more clinical hours, it has been my experience that neither program produces nurses ready to “hit the road running”.
My understanding of nursing has broadened.
Some disdain nursing theory and say it has no basis in daily practice, but have they really looked at what theories are out there? All nursing programs are based on one. For me it was Sister Calista Roy’s Adaptation Model. Theories give a framework, a way of approaching assessment and care, a nursing philosophy. You can argue that it’s useless, but you are using one every day, whether you realize it or not. Now, it will be a cold day in Hades before I use “Energy Field Disturbance” as a nursing diagnosis but until I studied theory, I had no idea that Rogers’ Science of Unitary Human Beings even existed. When I saw Jean Watson’s Theory of Human Caring, it was like getting hit by lightening. Watson’s theory, to me, is nursing.
Do my patients know which nursing theory I adopt? No. Do they care? No.
But I know. And I care. My nursing care has more depth, more perspective and a greater meaning to me because of the wider knowledge obtained through an in depth study of nursing theory.
I didn’t get that in my ADN program.
The nursing profession is more diverse than I imagined.
Okay, yeah I knew there was home health and public health was something done “out there” somewhere and some nurses worked 9-5 in a clinic, but like a horse wearing blinders, all I saw is what was right before me. Bedside hospital nursing. That’s what I was educated to do. Anything outside of bedside nursing required a BSN, minimum. No way was I going to do that! Blech! I lived nursing full time as it was.
As a result, I was never able to take advantage of opportunities that were there when I was so burnt out at the bedside I left crumbs when I walked.
Case management, nurse practitioner, becoming a nursing professor, home health, nursing research, school nursing and lord almighty, public health!!!! I had no idea about public health – I thought it was visiting people in homes and running immunization clinics. It’s is that, but it is so much more!
You can advocate for patients, thousands at a time, in so many ways!
I was not exposed to that in my ADN program.
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I guess you could say the last 2 1/2 years have been a transforming process for me. The BSN program has enriched my life, my practice and, although they would never know it, my patients.
So, do I think the BSN should be the entry level degree into nursing?
Well, if I said yes, I’d need Secret Service protection!
I would say if you are just entering the profession and it’s at all feasible for you, go the BSN route from the start.
I think it should be required – BUT (hold your fire!) there much to be said for being an ADN grad and then going for the BSN. In fact, I would almost recommend that. I know that I have gotten so much more out of the BSN education with many, many years of clinical practice behind it.
When you are an ADN and you are studying for the BSN, you have perspective, a place to assimilate what you are learning into your current practice. Subjects like nursing theory and research take on a clearer perspective, as opposed to being vague ideas and dull methodologies.
The BSN is worth getting. I know I have developed both personally and professionally.
(Now, if I can just get through this last semester…)
