Prog Blog’s Flickr Photostream

Those Emergency Blues: The phrases junior nurses and most staff do not care to hear from senior nurses…

…or the negativity they can spew….

“You wouldn’t know what to look for in that type of patient assessment anyways…”

How do you know I don’t know what to assess for? Are you the textbook I read from? The online periodicals I continue to educate myself with? Are you every patient I have assessed in the last 8 years? Did you teach me? Were you my preceptor in some nightmare? Well since you are none of the previous and you’re not a bound textbook (despite how wound up you are all the time) please do not assume that since I

. . . → Read More: Those Emergency Blues: The phrases junior nurses and most staff do not care to hear from senior nurses…

Those Emergency Blues: Do Not Fold, Spindle or Mutilate the Nurse

An unpleasant, no, ugly and unfortunate situation at Victoria General Hospital is preventing a woman from seeing her son. From the National Post article:

A 73-year-old woman who travelled to Victoria from South Africa to care for her seriously ill son has been banned from Victoria General Hospital after she says she tapped a nurse on the head to get her attention. Shirley Spence, originally from England, has been sitting in her rented apartment in Victoria since mid-May, barred from seeing her son, Gary Abbott, 52, who was found to have a brain bleed after falling ill. Instead, every . . . → Read More: Those Emergency Blues: Do Not Fold, Spindle or Mutilate the Nurse

Those Emergency Blues: A Nurse Contemplates Leaving the Profession

Dinner last night with an old friend who toils in the mines of Labour and Delivery. She has worked there for four years. She told me of an incident not too long ago working the night shift, faced with a post-partum patient who was bleeding, hypotensive, and tachycardic, in short, showing all the signs of going into hypovolemic shock. She was running around, starting IV lines on flat veins and hanging blood products. Packed red cells. Platelets. Cryoprecipitate. And by-the-by, saline by the bucketful. She called for help from her colleagues. Apart from this patient and another who was walking

. . . → Read More: Those Emergency Blues: A Nurse Contemplates Leaving the Profession

Those Emergency Blues: Fat Nurses Need Not Apply Revisited

More on the Texas hospital, Citizens Medical Center, which banned fat people from being hired. Citizens Medical Center, you might remember, made it policy to exclude new hires with a body mass index >35, and explicitly stated employees appearance should “fit with a representational image or specific mental projection of the job of a healthcare professional . . . free from distraction” for patients. Medscape has a video (sorry, couldn’t figure out how to embed) from a medical ethicist named Art Caplan with another point of view. Partial transcript:

Look, I’m all for trying to set a good example and . . . → Read More: Those Emergency Blues: Fat Nurses Need Not Apply Revisited

Those Emergency Blues: Fat Nurses Need Not Apply

A Texas hospital has declared war on the scourge of obese nurses:

A Victoria [Texas] hospital already embroiled in a discrimination lawsuit filed by doctors of Indian descent has instituted a highly unusual hiring policy: It bans job applicants from employment for being too overweight.

The Citizens Medical Center policy, instituted a little more than a year ago, requires potential employees to have a body mass index of less than 35 — which is 210 pounds for someone who is 5-foot-5, and 245 pounds for someone who is 5-foot-10. It states that an employee’s physique “should fit with a

. . . → Read More: Those Emergency Blues: Fat Nurses Need Not Apply

Those Emergency Blues: Arizona is Where Educating Patients is Bad, Bad, Bad: An Amanda Trujillo Update

Just a few words about Amanda Trujillo. Jennifer Olin at RNCentral.com has detailed at the latest twists and turns of her case. I won’t repeat everything, but I want to comment instead on the Arizona State Board of Nursing’s latest action. The BoN has added a further charge that Trujillo has misrepresented herself as “an end of life” specialist because she counselled and educated patients about end of life care, using the materials provided by her employer, Banner Health.

This is pretty outrageous, and I think, an abuse of process. Let me elaborate from my point of

. . . → Read More: Those Emergency Blues: Arizona is Where Educating Patients is Bad, Bad, Bad: An Amanda Trujillo Update

Those Emergency Blues: Just Lie Back and Think of Florence — Or Not

Nurse K, possibly the doyenne of nurse bloggers, gives her two cents on Amanda Trujillo. Her advice is to surrender:

Yes, I’m going to say it: Forget advocating. Be humble. Be honest and consistent. Go through the process. Listen to your attorney. Your most important asset as a terminated person is an unrestricted nursing license and lack of bitterness. Get advice from your attorney and mentors about what to say in job interviews about your termination. Rehearse your answers to the question of “why were you terminated from Banner Health.” Don’t decide that you’re never

. . . → Read More: Those Emergency Blues: Just Lie Back and Think of Florence — Or Not

Those Emergency Blues: Doctors Are From Mars, Nurses Are From — Oh, To Hell With It

News flash! From Fierce Medical News, here’s the shocking headline:

Docs, nurses miscommunicate on respect, job role

When you guys pick yourselves off the floor from laughing, here’s the money quote:

In particular, the survey found differing views of how doctors treat nurses. According to 42 percent of nurse leaders, physician abuse or disrespect of nurses was common, whereas only 13 percent of physician leaders said it was common. Fifty-eight percent of nurse leaders considered disrespect for nurses uncommon, while 88 percent of physician leaders said it was uncommon at their healthcare organizations.

“I do believe nurses and physicians

. . . → Read More: Those Emergency Blues: Doctors Are From Mars, Nurses Are From — Oh, To Hell With It

Those Emergency Blues: Nurses are Like Howler Monkeys, Poo and All

When I was a young, inexperienced nurse, I quickly learned one lesson: the cliché that Emergency nurses are fabulously assertive, mouthy, in-your-face pitbulls is absolutely true. I don’t mean ED nurses are bitchy or backstabbing eat-their-own-young types, though this was true also, at least for some of them. I mean this: the Emergency department is a ballet of constrained chaos most days, with many competing claims for attention for the physician, the charge nurse, and your colleagues; if your patient is sick, you need to be assertive, walk right up to the physician and say, “Doctor, this patient is sick. You

. . . → Read More: Those Emergency Blues: Nurses are Like Howler Monkeys, Poo and All

Those Emergency Blues: Why Nurses are Furious about the Amanda Trujillo Case

The case of Amanda Trujillo has generated a great deal of passionate commentary across the nursing blogosphere. Trujillo, as you may well know, is the nurse who was fired by Banner Health Del E. Webb Medical Center for requesting multi-disciplinary hospice care case management consult for a pre-transplant patient with end-stage liver disease. The request angered the patient’s physician — not the transplant surgeon, incidentally, nor someone with any knowledge of transplant surgery — who complained to Trujillo’s manager. After her termination, the hospital subsequently reported her to the Arizona State Board of Nursing for exceeding her scope of practice. If

. . . → Read More: Those Emergency Blues: Why Nurses are Furious about the Amanda Trujillo Case

Those Emergency Blues: A Little Nurse Bashing to Start Your Day

For breakfast, how about some outrageous libel from physician-blogger Terry Simpson (Twitter: @DocSimpson). File this under how not to blog about a serious issue in health care:

The Arizona State Nursing board has asked that this nurse [Amanda Trujillo] undergo a psychiatric evaluation. The board is charged with protecting the public. The public needs to be protected from “angels of death,” and needs to know if this is the act of an illiterate nurse, or someone who will tend to rogue behavior beyond the bounds of the profession.

Screen shot of yourdoctorsorders.com. Note the gratuitous "psychiatric evaluation" reference.

. . . → Read More: Those Emergency Blues: A Little Nurse Bashing to Start Your Day

Those Emergency Blues: What the Amanda Trujillo Case Tells Me About Nurses Behaving Badly

Amanda Trujillo can take cold comfort that her situation is not unique. In the two years and odd months I have posted on this blog, I have written about six other cases where nurses (or nursing students) have been bullied and hounded:

the nurse whose hospital fired her for mouthing off to the police the Seattle nurse who committed suicide after a fatal med error the nursing student expelled from her school for posting a photograph of a placenta on Facebook the Texas nurses arrested for reporting a physician’s negligence University of Manitoba nursing students victimized because nursing faculty failed . . . → Read More: Those Emergency Blues: What the Amanda Trujillo Case Tells Me About Nurses Behaving Badly

Those Emergency Blues: The Persecution of Amanda Trujillo

In the ugly, grey world of hospital balance sheets it’s almost a commonplace that physicians generate revenue while nurses represent a cost. Fancy procedures and sub-sub-specialties bring generous income streams, in terms of charging (and profiting) from the provision of a multitude of related services, such as nursing, while nursing itself, because it generates no revenue, is a burden the bottom line.

It’s also commonplace, that in certain health care institutions, the power structure, the hierarchy of heath care, is so rigid (and fragile) that any challenges to that hierarchy — such as a nurse questioning the God-like omniscience of

. . . → Read More: Those Emergency Blues: The Persecution of Amanda Trujillo

Those Emergency Blues: Karma Sweet Karma

The latest instalment of Nurses Behaving Badly featured the night charge and the day charge (i.e. me) getting a status asthmaticus organized in Resus 1 a few minutes after shift change. It’s probably reasonable to wonder why the two Resus Room nurses weren’t attending (and attentive to) the situation, especially after we paged the physician and the RT in quick succession for a possible intubation, and especially since both of them were less than twenty feet from where we were working.

We thought at first they were getting report on the only other patient in Resus, but after 10 minutes

. . . → Read More: Those Emergency Blues: Karma Sweet Karma

Those Emergency Blues: Under Construction

Meaning me, of course.

I worked a (rare) Night 12 a few days ago. It was the usual dog’s breakfast of high acuity, walking wounded without end lining up at Triage, and the particular Emergency Department hell of having no beds for, you know, emergency patients, the department being a stunt double for a med-surg unit. But there was a small ray of hope. Or rather it was okay news-sucky news situation. We were to get a bed, the element of suckiness resting on the fact the bed was on 5 North, my perennial nemesis, where, I swear, reside the

. . . → Read More: Those Emergency Blues: Under Construction

Those Emergency Blues: Sometimes Things Ain’t What They Seem

Niagara Health is taking a beat down lately. First it was an uncontrolled C. difficile outbreak, then a provincial administrator was appointed to deal with the outbreak, and now this: When Doreen Wallace fell and broke her hip in the lobby of a Niagara Falls hospital, she figured at least she’d get help — and fast. But [...] . . . → Read More: Those Emergency Blues: Sometimes Things Ain’t What They Seem

Those Emergency Blues: Andrea Horwath has a Complaint about the Health Care System.

For my American friends and readers, we’re having a provincial election here in Ontario. Since health care is deemed a provincial responsibility (though funded extensively by the federal government), it’s naturally a hot topic of discussion. At the televised leader’s debate a couple of days ago, New Democrat leader Andrea Horwath managed to step in [...] . . . → Read More: Those Emergency Blues: Andrea Horwath has a Complaint about the Health Care System.

Those Emergency Blues: O Why O Why Did I Pick Up The Phone?

Phone rings. I look around. There is no ward clerk in sight. Damn. I answer. “Emergency, Charge Nurse.” “Can I ask you a question?” The voice on the other end sounds flat and tired. “Sure,” I say warily. “I came to see you guys a three days ago and I had a sore chest and [...] . . . → Read More: Those Emergency Blues: O Why O Why Did I Pick Up The Phone?

Those Emergency Blues: In Which TorontoEmerg Discourses on Some Aspects of Human Nature

It’s probably more than little trite to say the Emergency Department is a microcosm or laboratory of humanity, but like most clichés it has an element of truth. We see all types in the ED, the good, the ugly, and the purely despicable. (And then I could talk about the patients.) We’re human, after all. But in [...] . . . → Read More: Those Emergency Blues: In Which TorontoEmerg Discourses on Some Aspects of Human Nature

Those Emergency Blues: In Which I Swear, Repeatedly, or, TorontoEmerg Gets Bullied

I write this blog for a number of reasons: my own amusement, to educate, to share various random thoughts, to tell stories, to stimulate discussion on topics important to nursing, to provoke thought beyond the superficial, to challenge assumptions, and lastly, to rant. Today I am going to rant. Those of you with delicate sensibilities may want [...] . . . → Read More: Those Emergency Blues: In Which I Swear, Repeatedly, or, TorontoEmerg Gets Bullied