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Happy emergency nurses week from your favorite ER nurse! 😘

#nurblr #nursblr #emergency nurse #emergency departments #emergency room #emergency #ER nurse #ED nurse

Fav moment from being in hospital

Nurse comes in to tell me I’m finally allowed to get up and walk. I’m mostly just excited I don’t have to deal with bedpans anymore. She tells me “just buzz before you get up” but in my drug addled brain I turned that into “just buzz if you need help”.

So little ol’ me swings my legs off the bed, pops on my flip flops and goes for a walk to the toilet. On the way back the nurse walks by. She spots me, ass out in my gown, loping across the room like a crippled hunchback. She freezes, I freeze. “You didn’t buzz!” She exclaims. Looking at her through a fog of endone I just laugh and mutter a very slurred “whoops”. She watches me go back to bed and then walks off shaking her head.

Sorry nurse.

#personal #broken back #fractured spine #ED nurse #orthopedic nurse #like imagine being that nurse #im the youngest patient in the ward and have a broken back #finally cleared to walk but obvi need supervision the first time because what if something happened and i fucked my back worse #and my dumbass just skips off to the toilet unattended #well not completely unattended #i had my 90 year old room mate there #but she was gone with the fairies and just talking to her teddy bear sooo

#nurses #nurse #nursing #ed nursing #ed nurse #senator walsh #walsh #cards #playing cards #hospital #funny #humor #nursing humor #medical humor

Sept 2, 2019

Our first ever Critical duty together!

Kasi minsan lang kami magkasabay ng schedule.

Pero yung "minsan" ay naging isang buong linggo. LOL

#personal #gpoy #work #myface #life #ed nurse #emergency department #emergency room #makati medical center #makati med #er nurse #nurse #filipino nurse

I just want to talk about the absolutely FANTASTIC day I had in the ED recently! (As a short back story, I previously had a terrible day in the ED and I wanted to leave, quit, and never go back. I was actually hesitant to try again.)

First of all, most of the hospitals in my area are on saturation. That essentially means that we are all full and then some. That means we have boarders (patients staying in the ED who have been admitted to the hospital but we don’t have any empty beds). I am so thankful for the Flex ICU nurses who came and helped us - THANK YOU. I know there can be a “beef” between ICU and ED nurses but we all worked together and it was beautiful.

As always, my preceptor asked what my goals were for the day. A little scarred from last time, I said, “I would like to take on my own patients again.” She said, “Okay, let’s go get report.” Since we had extra hands, we were only assigned two rooms. Now, we were actually assigned the most critical of the rooms in the ED, so don’t think that sounds easy.

Room 1: level 2, sad case (ineffective breathing), difficult family, ineffective coping/grieving.

Room 2: level 3, acute pain, received terrible “customer service” overnight and insisted we cater to every need.

Alright. I can actually handle this. I’m in charge. The only task I cannot do alone is medication administration, so my preceptor just charted and did homework until I asked for help. Let me tell y’all some things I did for the first time (in the ED):

1. I stayed on task. Usually in the ED, I am running around with my head cut off with no sense of direction. I learned the art of writing things down and setting alarms on my watch. I delegated to our awesome, amazing, wonderful tech’s. They all deserve a raise.

2. I called/paged doctors and used SBAR on the phone. I have never actually done this. They teach it to us all the time but I have always been afraid to do it. My tip? I wrote down my talking points. Doctor did exactly what I recommended and I felt like a superhero.

3. I got involved in hospice/palliative care. Some of you ED nurses out there might be like...wtf..? Well you know what. The situation warranted it. Saturation = no where else for this family to go. I cried with the family. I sat with them. I took extra time with the extremely uncomfortable patient to make sure the bed was made perfectly, all trash was picked up, and that the family always had fresh ice water.

4. I confidently asked for help from my preceptor. Instead of saying, “I don’t know what I’m doing,” or, “I’m really sucking today,” I said, “Hey, it’s time for morphine, could you pull that for me please?” and “Could you please page respiratory?” She knows my limits, and I FINALLY felt like a real nurse.

5. Targeted patient education. How often have I ever stopped to thoroughly explain something to a patient? Never in the ED...that’s the RN’s job, or I let the doctor do it. Well gosh. I can explain insulin/blood sugar during illness. I can explain a sliding scale. So yes, that sounds so simple, but I’ve always been afraid to take that initiative!

I am absolutely SO proud of myself for this shift. I really needed to take this time to reflect on it and put it into words. And you know what? I’ve been rating how my day is going by how many IV’s or sticks I hit or miss. That is such a stupid way of assessing my own nursing skills. I got some, missed a few. I definitely still need practice regardless. I also caught a murmur that the doctor missed, so that was kinda fun.

I love this life 💉❤️

Well, Monday is my first day back to work since having baby Madeline in October. I’m happy to start using my nurse brain again, in addition to my mom brain. I also accepted a charge nurse position so I have that to look forward to in the ED.

I’m going to be enjoying this last weekend with my sweet little family, and return to the trenches Monday.

#cardizembolusrn #nursing #nurblr #ed nurse #emergency nursing #nurse #er nurse

How did she not die. Still don't know

It was in the middle of summer and I was working my first (and only) EMS job at a local amusement park. I was as green as they come. As you can imagine, in the summer, we get a large amount of people complaining of heat illness. It is up near 100 degrees Fahrenheit and people aren’t eating or drinking enough. If they are drinking, they usually are not drinking water or gatorade. But, I digress. A call goes out for a guest near the bathroom only a little way away from First Aid. I arrive on scene to see a well-appearing elderly lady with her family sitting on a concrete planter/bench.

I introduce myself, and start my interview. The lady, who appears to be of good health, states she was using the bathroom and was hovering over the toilet (because germs) when she felt a split second of numbness and tingling that spread throughout her extremities and resolved immediately. She felt slightly light headed and nauseated. I asked what she had eaten and she reported that she had some Sprite zero and some crackers. This was midday and it was hot. So I had her take a ride in the wheelchair so she could lay down in an air conditioned place. Really, I just wanted to get her to my paramedic supervisor and tell him that something wasn’t right. I had not made it 300 feet before she started vomiting. I veered to the planter and she threw up there while I grabbed an emesis bag. After shoving the emesis bag into her waiting hands, we were off again at a quick pace to First Aid. I got her into a cot and immediately got my supervisor and relayed the signs and symptoms, along with my concerns.

My supervisor grabs an EKG. Now I am an ER Nurse and know exactly why he did this. But back then, I was so frustrated because something wasn’t right and I did not think it was her heart. I wanted to scream “it’s neuro! Those are neuro symptoms!” but I knew he was more experienced and I would have to trust him with his workup.

This lady did not take medicine on a regular basis and had no health problems. EKG was negative. My supervisor got a line and started fluids. Meanwhile, the patient was continuing to vomit. She didn’t stop. She would dry heave more than anything else. She was waffling on whether or not to go to the hospital, which my supervisor was advocating for. I sat there on the cot with this woman, speaking with her and her family. She then abruptly grabbed my arm, looked into my eyes with fervor, and stated “I never throw up. I have had two children and I didn’t throw up.” At that point, I told her there was to be no more discussion, she is going to the hospital and we called the ambulance.

A week later, my supervisor told me that the lady was found to have a subdural hemorrhage in the brainstem. This was found at the receiving facility and she was air-flighted to a major learning institution for emergent brain surgery. A week later, the lady was out of the ICU and at home. I was told at the time that this particular problem only has a 20% survivability rate. I was told that I saved that lady.

Sure, I didn’t do the EKG or the fluids but I knew something wasn’t right. I advocated for her. My supervisor looked at me and told me (and the higher ups who did not like me and thought I was too green and asked too many questions) that if it had been any other EMT working at that amusement park who received this patient, they would have laid her down on a cot and she would have died there. But today, he expounded on this. He stated, “Your inquisitive nature is what saved that woman’s life.” Note that he did not say how bright I was and that knowledge saved this patient. No. He did not say unwavering confidence saved this patient. He acknowledged the power of learning, of asking questions when things do not make sense.

He has also told me that every EMS class he teaches starts with this story. I asked him what his take away was from this story. He told me that he tells his students that this is “how EMTs can save people. How they save paramedics. Pay attention to details. And be a patient advocate (like you).”

But what did I learn? What did I take away from this? (1) Listen to the patient. Not every patient is dire but be ready. (2) Don’t have your blinders on. There was so much that matched heat illness…but there was the nagging suspicion that wouldn’t let me let go of that neurological symptom. (3) You don’t have to have ANY idea about what exactly is wrong but you DO have to know general body systems and know when something isn’t right. (4) Care about your patients. So many medical professionals stop caring and then they stop paying close attention or listening to their patients. Here, my inexperience was an asset. I still cared. I still questioned.

Knowing what I know now and looking back on the unfurling of her symptoms, I am scared shitless for that lady. I do not know how she did not die. I have no idea. I think of every minute I spent with her bleeding into that tiny space, compressing her brainstem, and it terrifies me. I know she survived. I know she survived because of me. But holy crap. HOLY. CRAP. She said her neurosurgeon said the exact same thing.