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When calculating I&Os

Especially when they’re on a fluid restriction. 

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My acute pancreatitis, DKA patient, “Can I have something to eat?”

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When my 90 year old patient is immobile & unresponsive and the family wants to Trach & PEG...

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When I tell my patient they can’t have their Dilaudid for another hour

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Sometimes the doc’s pager breaks and it’s a pain in the ass to get a hold of them...

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When I blow a super easy vein

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When your patient’s blood sugar drops to 17

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Nursing Video : Cervical Spine Clearance Demystified

Nurses who take care of trauma patients run into this all the time. “The cervical spine is cleared,” they say. But who is “they?” How did “they” do it? What is the patient now allowed to do? And what’s the deal with this funky collar?

This 11 minute video will provide the answers to these questions and more! Enjoy!

Click here to check out other videos on my YouTube Channel

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Friends and family who don't understand that if I'm working nights and I go to sleep at 0700, it's not okay to call me at 1130.

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(I started an IV in a dude's stomach vein the other night and we pushed adenosine through it to get him out of SVT... Pretty proud of that)

Admiring your perfect IV on a hard stick no one else could get

[traumabae]

On Your Watch

It doesn’t matter how inevitable it was or how much was done to stop it. A patient dies on your watch, you find a way to blame yourself.

Yeah, his troponins bumped 20 points in a day and he was on multiple pressors, too unstable for the cath lab, and his transvenous pacer wire became dislodged and wouldn’t capture, and then when it would again his left ventricle was so damaged by the infarct that even a good VPR at a rate of 80 generated no blood pressure. The logical reasons for his body’s failure.

But your nurse heart says:

If I had just titrated his pressors more effectively If I had just turned him more gently If I had just noticed his decline sooner If only he had been assigned a better nurse……

…..and what? Nothing would have gone differently.

But still, the sick feeling, the unrest.

You still have to hear the distraught cries of the family over the phone, and watch them shuffle into the room in tears to say goodbye.

You still have to go to the utility room and choose the appropriately sized shroud (fancy word for plastic body bag.) You still have to put a patient sticker on a tag and tie it his toe. You still have to zip that bag up over his face in a way that seems so undignified no matter how much respect there is in doing it.

You still have to look at the lifeless body and know that you were assigned a living patient, and that patient is no longer living. On your watch.

“Reason and heartache don’t speak the same language.”

–Jim Butcher

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TO ALL THE PEOPLE ENTERING NURSING SCHOOL THIS YEAR:

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Giving report knowing you're off the next few days

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Does anyone else want to go out to breakfast with us after work?

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When I'm trying to convince my buddy to help me clean up an isolation patient

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When my previously unresponsive patient starts waking up and following commands

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The optimism of ICU and ED nurses