Friday, February 29, 2008
Thursday, February 28, 2008
We get lots and lots of calls from people who are looking for advice, as I'm sure most ER's do. Here is today's top ten:
10. "How long is the wait?"
9. "If I took Tylenol at 2 hours ago, how soon can I take Motrin?"
8. "How long is the wait?"
7. "I cut my finger with an Exacto knife, do I need stitches?"
6. "I saw Dr. Dewshe Bagghe last week for my back, and my prescription for Percocet ran out, can he just call me in a script for more?"
5. "What are the symptoms of food poisoning?"
4. "Should I bring in my 2 year old for a high fever? It's 100 degrees"
3. "Can you talk to my husband and convince him to call an ambulance? He twisted his ankle yesterday and it's swollen and black and blue. Yes, I have a car, what does that have to do with it?"
2. "Can I make an appointment?"
1. "If I can't make an appointment, can I put my name on the list so I don't have to wait so long? Like at Chilli's?"
Wednesday, February 27, 2008
Friday, February 22, 2008
This could be the next big thing in ear lavage
I have never understood what compels people to come into a busy ER for a problem with earwax, never mind be willing to wait for a couple of hours to have them blown out. These are people who do this regularly. There is generally no infection, just diminished hearing. What?
Do PCP's not offer this service?
I really hate to irrigate ears, at my last job I simply refused to do it. Is squirting warm water into an ear with an 18 gauge IV catheter really a nursing task? Is there not the potential for perforating the ear drum? Hmmm?
You can soften up those big hunks of black gunk all day with mineral oil, the juice of two freshly squeezed ripe Colace gelcaps, or Debrox, whatever is lying around. You will still need a big honking squirt of warm water to make that puppy exit the orifice. Really, after more than 30 years there are few tasks I hate more than irrigating ears.
This guy has all the answers (and seems to enjoy it) so if you want to avoid a trip to the ER, check it out.
Sunday, February 10, 2008
Saturday, February 9, 2008
It is also good to see how the other half lives. I am responsible, in part, for getting the ER admits out of the ER, in addition to floor to floor transfers and direct admissions. I have identified quite a few items which will impact my own practice when I work shifts in the ER. It puts a face on the nurses who get my faxed report. It puts more human in the interaction process, if you know what I mean. I have a better "global picture" of the hospital and it's workings, which is good since I've only been there for about a year. The only bad ("only" ha!) is the micromanageing bean counters and their Ambush Debriefings. Talk about being thrown under the bus. I will have to relate that tale in Part Two.