Monday, March 31, 2008

Sunday, March 30, 2008

...and who prescribed these medications?

In our ER, we try very hard to use the med rec forms despite their uselessness. Here is a med list as recorded by a 7 year old girl. This wasn't my patient, so I'm not quite sure why they had to be transcribe phonetically by a 7 year old, but I was sure to get a photocopy of the list because I had such fun trying to figure out just what Pioglitazone really was. Enjoy:

Metfin
Ergocalise
Pioglitazone
Pyridosiine
Gabatienin
Glizpized
Lisinopri
Depakote
Indonetaine
Methocardoln
Oxydutynin
Omprazile
Cholorhphienierm
Zenlasacine
Chlonide

PS - kudos to the 7 year old for giving it a brave go. I give these meds and still have a hard time spelling some of them. Double kudos for at least getting the correct spelling on one of them.

Saturday, March 29, 2008

What is an ER Nurse?

An ER nurse is a person who has worked long and hard to get a BS education so that they can regularly determine if a person is an SOB or a HOH.

It's a lovely life.

Words patients can never get right

Prostate - Prostrate
Alzheimer's - Oldtimers, Alltimers
Atenolol - Atenonol
Hydrochlorothiazide - (most don't even attempt this one...)

No, the gown opens in the back...

I never cease to be amazed at how often I walk in a room to find a patient sitting on the bed with the gown opening in the front, giving the world a free show.

Um, excuse me ma'am, but, um, perhaps you should put the gown on the other way...

Of course, when I try to counter this as I give them the gown by saying "...and the opening goes toward the back" I get the "What, do you think I'm dumb?" look.

The answer: yes, I assume you are dumb until you can prove me otherwise.

It is always disappointing how few people can prove me otherwise.

Emergency Nurse Rap

In reading my nursing blogroll I came across this post from a blog that hasn't been updated in forever. Rather than try to be creative, I'm just going to lift it straight from their blog and land it here for your enjoyment. No I don't feel bad about it - I'm giving them credit. Watch this video and you will know why we ER Nurses are so cool.

Here is the video in question: It is available in Quicktime format or in Windows Media format.

In 2004, Craig Barton, RN, and other ED staff at the University of Alabama at Birmingham created an irreverent one-minute rap video, in response to a hospital-wide nurse recruitment video contest. They won. Their low-budget video is a clever and infectious slice of the life of an urban ED nurse, with a focus on nurses' life-saving skills. There's nothing angelic, maternal, or handmaidenish in it. And the joyous video gives viewers a better sense of what modern nursing is really like.

Here are the lyrics:

Ka-boom! We're the emergency room!
And we treat every single patient from the womb to the tomb!"

Any kind of patient is accepted, our skills are well-perfected.
We expect the unexpected, that’s why we’re well-respected.

We’re ER Nurses. medications, we disperses.
When things get the worses, our talents just emerges

"Room 10, there's a patient with a hurtin' in the belly,
Look, there goes the intern with the KY jelly!"

Got a cat scan in room 6, xrays in room 8
there’s a chest pain in room 1 that really cant wait

He’s got a positive history, get a 12 lead EKG,
Better draw some blood for labwork when you start that IV

Got a migraine in room 2, room 3 has the flu,
Room 4 can’t pooh pooh. room 5 is plain Cukoo.

Lots of traumas on the way, right into the trauma bay
It can get a little loud, but yo, we like it that way

Yes it’s hectic, yet it’s clear, there’s no job that can compare
But don’t sweat it, have no fear, yo, we’re saving lives up here


Yeah were state of the art , so, yo, come be a part
Of this one-of-a-kind family that's 100% heart!"

The worst pain of my life!

I named this blog 20 out of 10 in reference to the pain score most of my ER patients give me. This is especially frustrating because when I introduce the pain scale to them I tell them that a 10 is "the worst pain you can imagine".

Then they tell me that they are having 20/10.

So this is worse than the worst pain you can imagine? Please tell me how that is possible.

Invariably, these same patients are at the same time asking for something to eat, wanting to know why we don't have TVs in our ER, casually telling jokes to their friend who came along for the ride, and asking for the strongest narcotics they know of, because "it is the only thing that works."

Now I'm not one to deny that somebody is in pain just because they are laughing, and I know that hidden pain exists. I am always telling jokes and laughing, even when I'm in pain or tired or depressed or whatever, but if you are showing me absolutely no signs of pain and then tell me that you pain is so severe that the scale doesn't even contain it, then you are going to have an uphill battle to really convince me.

If you want my sympathy, then tell me that your pain is very severe, give it a realistic number on the pain scale and keep me up to date with how the medications and treatments are working. You be cool with me, and I'll be cool with you. Cool?