No, really - what is your EMERGENCY?

This used to be the journal of a nursing student at a prestigious 4 year university that will still remain unnamed. This is now the journal of a Registered Nurse working in an Emergency Department in a major US city. All names have been changed to protect the stupid and the mean. There is no educational value in this journal, sometimes it will be downright mean and catty - this is where I come to vent!

Wednesday, June 01, 2005


Well, I have been working on the floor at my hospital for the past week and a half. I've been doing mainly nurse aide (NA) stuff which is a lot of hard work. Let me tell you, if you ever meet a NA compliment her/him on doing their job. It is hard, thankless, and smelly. I can't even count how many bed linen changes I've done, how many adult diapers I've changed, and how many urinals I've emptied. You know it is really going to be a great day when you have your patient up on his side and are cleaning up his backside and he starts having another bowel movement right then. Don't get me wrong, the RN's work very hard and do a lot of dirty work, but at least at my hospital, the majority of the disgusting jobs are done by NA's.

So, I've been working five 8 hour shifts a week. I'm beat! I have had a wide array of patients, from nice older men, young guys, and the occasional mean, crotchety old man. Some of the latter group have suffered strokes and this has changed their personality. We had one patient for about 6 days who would point his finger at us and call the women bitches and he threw his doctor's out of his room daily. It was quite the show. One morning he asked me to draw him a picture of a vagina. I wasn't quite for sure how to respond to that so since he didn't need any immediate care, I left.

Finally, several of the patient's have family members who visit. This is wonderful, for most of these guys (99% of my patients are men), it is the highlight of their day. There have been some cases where the family member was not welcomed by the patient and having them there created a non-therapeutic environment and we had to ask the family member to leave. The only problem I have is that some of the family members are very demanding. I understand very well that you want the best possible care for your family member, so do I! But I also need to provide that same level of care to all of my other patients. Sometimes I can't just drop what I'm doing (especially if I'm up to my elbows in feces), to get water for you father. I am more than happy to show you where the ice/water machine is and maybe you could help me out by getting it yourself.

Some things I've learned this past week:

1. C. diff. can make feces smell really bad. Not that it doesn't already.
2. It is hard to get a good stool sample from a patient on continuous tube feeding.
3. Duoderm will pull loose skin off, that probably hurts. I almost got kicked in the head because of this.
4. Make sure the blood glucose monitoring machine is working right BEFORE you do the finger prick. (Ok, this one wasn't my fault, it was working fine up until the part where you put the blood on the strip)
5. The soiled utility room really, really smells bad. Either breathe through your mouth or take a big breath and hold it before you go in.
6. They make saline soaked gauze pre-packaged. This stuff is great for wet to dry dressings and much less messy than a boat of 4X4's.
7. Condom catheters are a blessing and a curse. They make a nice non-invasive way for a patient who is not very mobile to void, but they are difficult to put on, can cause irritation, and come off at the most inconvenient times.
8. Don't let an ostomy bag get too full before you empty it, it just might explode. We had a patient who was transported via ambulance to the hospital and it wasn't checked before they left and it exploded during transport. He was a mess when we got him, but I'm glad I didn't have to ride in the ambulance!


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