Sunday, April 13, 2008

From the "Strange Tales" Files

Patient complains of abdominal pain x 5 days and comes to the ER.

Since said patient was wearing pink zip up hoodie with some kind of girlie logo, pony tail with pink scrunchy, and named Kelly, I naturally asked the date of the LMP and was told "I don't have periods, I'm male".

Pregnant pause.
Oh. Sorry.

Thirty-odd years of nursing intuition should have told me that if it looks like a duck, walks like a duck and quacks like a duck, it must be a...rooster. Damn, I'm a bad mind reader after all!

Tuesday, April 8, 2008

Salt 'n Pepper Nursing

EDNuresesauras' gradution photo, circa 1888. That's me, top row, 4th to the left.

The caps that we used to wear, once the hallmark of the profession, have been obsolete for longer than many of the nurses I work with have been on the earth. I can remember wearing my cap for the first few years. I can also remember sailing said cap into a corner as soon as the nursing supervisor left. I don't miss the cap, they were probably pretty germy, but I do wonder at the changes since I started doing this job.

A young colleague, a nurse with two or three years of experience recently asked my opinion on how to deliver a complicated bit of nursing care. After I had explained what he needed to do, he looked at me admiringly and said, “You salt and pepper nurses know so much, I hope I have that someday”. I thought he was referring to actual gray hair, although I have none. He explained that he was speaking of “my years of accumulated wisdom”(haha!), clinical excellence, a desire to share it with others, and a non-threatening way in which to share it. This meant a lot to me, and I was quite touched to have been thought of in this way. The respect of colleagues is a pearl beyond price.

So much in nursing has changed over the years. ERNursey hit the nail right on the head with her back to basics nursing observations. I do think that we, as nurses all want to do what's best for patients, but there are so many obstacles to providing even basic care well that it has become increasingly frustrating. Dealing with difficult patients, demanding family members, unruly drunks, drug seekers, and violent psych patients are only part of the problem. What breaks the heart and ultimately the spirit is the "do more with less" mantra from MBA's who don't know a bedpan from a party hat. What we are hearing is "we don't care about what you do, you are only as important as high satisfaction scores". Good nurses are leaving the bedside in droves because they are sick and tired of compromising; literally the care is being forcibly extracted from nursing care. You can only do so much before something has to give.

So, excuse me while I "close the curtain for privacy" and shed a tear or two over the poor prognosis for nursing care.

Tuesday, April 1, 2008

Human Piggy Bank

I really thought it was an April Fools joke.

The father of an 18 month old in triage stated his child had swallowed a coin.

18 month old promptly vomits 28 cents. One quarter and three pennies.

"I feel all better. Can I hab gum now?"