Well research shows that a spoon is not is a spoon is not a spoon. Believe it or not these same researchers took a look at 71 kitchen teaspoons and 49 tablespoons and found that the actually measuring capacity was very different. Enough so that measurements of medication would not be delivering the amount prescribed, but could be under or over the recommended dose.

This is actually very frightening coming from a medical and nursing point of view. Children can very easily be overdosed, or even under dosed which can have serious ramifications as well. When dosing your child be sure to use the actual calibrated syringes that can be obtained from any pharmacy. And the syringes are much better than even the special medicine spoons.  More accurate and easier for the child to take.

It is not like parents have ever wanted to do any harm to their children. No! Of course not! But it is a matter of convenience. The spoon in the drawer is what is handy for the medicine to be given. That is why when you are at the pharmacy picking up the prescription, just remember to get one of the calibrated syringes and you will be all set.

And remember it takes practice to get good with measuring the doses and getting the child to take it. So be patient and you and your child will benefit.

To read this study and article in its entirety please visit me at Factoidz.

Technorati Tags: Health/Medical/Pharmaceuticals, Medical prescription, Medicine

Sometimes these people require confrontation by a physician to get them to realize their efforts are not going to work, but other times it is just too funny and there really is nothing that can be done. If you come to an emergency room with a specific complaint you WILL be worked up and treated for what is found related to that complaint.  If nothing is found, all your testing is normal, then you will not be treated.

The following is just a funny (or maybe not) video someone on YouTube put together to typify these kinds of folks that visit ER’s habitually.

You Just Never Know What Patients Are Going to Do Next

Technorati Tags: Drug Seeking, ER, nursing, patient care, Seiures

I was a new graduate and a little gullible, admittedly so. I was in my first job after graduation. And I was ready to make a difference. I wanted to help everyone. I believed anything… I cared.

In the small town that I trained there was a federal prison that was contracted with my hospital for patient care. I was on duty the night they brought in a male prisoner onto my unit with complaints of abdominal pain. Needless to say I was a little intimidated.

But he was a patient first, a prisoner second. I was determined to give him the care he needed. Of course they did all the usual tests and it was discerned that he was constipated. Worse yet, he was impacted with hard stool and the treatment was to manually disimpact him. All the medical people reading this, knows what that entails. Everyone else, I had to stick my finger up his rectum and pull out the hard feces….really.

I couldn’t believe it either…

But I was young, new and out to save humanity. I had a job to do and I was going to do it.

So I went into the patient. He was a very large tattooed bear of a man. Did I mention he was huge? Really scary. And unusually quiet. He did not respond to any attempts on my part to engage him in conversation. This was really okay with me since I was actually quite frightened.

I explained to the patient what it was I needed to do for him. He accepted the information and said for me to go ahead and do it. I proceeded to perform the procedure and received the shock of my life and to this day, 40 years later, has not been matched by any other experience.

I pulled from his bottom a hundred dollar bill!! And after that, more money… twenties, tens, fives and more hundreds. One bill after another, I was shocked. I didn’t know what to do. Should I tell him?

Well of course, he had to know they were there, so I told him what I had found. He asked me how much I had found so far, I quickly added it up and he said to keep going, I hadn’t gotten it all yet.

Really? Are you kidding me?

So I kept going…

To the tune of $5,460! Yep! More than $5,000. And you know what? He was a really nice man.

He told me why he had to go to prison. He had killed his wife’s lover. It was considered a crime of passion and he was probably able to be rehabilitated. And he was a model prisoner. (Which I learned from the guard that was outside his hospital room door the entire time he was in the hospital). He was more talkative now, He wanted to know what I was going to do with the money. I explained it was his money, I was going to give it back to him. But I strongly recommended he not put it back where I had found it, since his abdominal pain that had now been relieved would return. Also he was potentially going to rupture his bowel and the complications could include death. He agreed a new plan was needed.

I rinsed all the money in the bathroom sink and dried it with the paper towels and rolled it all up in a money roll and gave it back to him. He was very grateful and very sweet about it. He promised he would find a new place to keep his money.

I never said anything to the guard. In my mind, it was none of his business.

However, I just had to ask my patient why he had the money in his butt. He bashfully answered and said he didn’t have anywhere else to hide it and he was so big and mean looking that none of the little hoodlums would be brave or strong enough to try to sodomize him.

Well… I asked!

Technorati Tags: constipation, nursing outcomes, nursing patients, patient care

This is an extraordinary story of a miraculous recovery that occurred to a patient out in Denver, where I worked for about 10 years, about 30 years ago.

I was a nurse on a neurological floor at St. Anthony’s Hospital. There was a remarkable neuro-surgeon that worked there who was unrivaled in his skills and abilities.

One day, a hospital maintenance worker was up on the roof of the hospital at the helicopter landing pad. A copter had come in and a patient had been delivered to our hospital and they were getting ready to take off again.  This maintenance worker was unaware of their getting ready to leave and walked up to the helicopter just as the engines started, the blades began to whir and they struck him right in his forehead, above his eyes, slicing open his head. The top of his head was filleted backward. His gray matter had been sliced into as well. It was tragic.

The nurses and doctors on the helicopter jumped out immediately, getting to him in seconds, the man had seized and now lay very still as if dead. However, he had a pulse and was breathing. They called into the hospital, because the patient they had just delivered was delivered to the neuro- surgeon’s care that I spoke of earlier. So they knew he was there. They quickly apprised him of the situation and were told to take him directly to the Operating room, STAT!

They applied sterile wet saline gauze on is brain and head, and transported him right to the OR the surgeon was already there, scrubbed for another case. They took this man directly into surgery.

He was in surgery about eight hours. His family had been contacted and was waiting for him. Finally the doctor came out and told them that he had made it. But he was going to have a long road of recovery ahead of him, but he felt he would recover.

Now when you think about the damage that had been done to this man’s brain, the top of his head had been chopped into by a dirty helicopter blade. There was really no reason to think he would live, let alone recover. And if he did recover he was going to have such neurological damage, it would be surprising if he was not a vegetable.

I took care of this patient for three months. This surgeon saw him every single day. And everyday he would say it would take a little longer. The man couldn’t see, had to be fed through a tube, had tubes for elimination of bowel and bladder, and had to wear oxygen, although he did not require any assist to breath. And he was in a coma.

In the third month, he began to show signs of improvement.  For one thing he woke up! Slowly but surely he continued to improve. He was able to drink and eat. He was able to eliminate on his own, no longer required oxygen. And then he was able to speak.

He started physical therapy that first month, when he was able to eat and he slowly but surely made progress.

Well the ending to this story is the miracle. He left the hospital in the fourth month after his injury with absolutely no neurological deficit at all, except a slight lisp. He could walk, talk, eat and think like you or I. He continued therapy for several more months, and sometimes dropped in to say hello. But he was our miracle patient that proved that being in the wrong place but with the right circumstances could still turn out alright. And it didn’t hurt that he had the best neuro-surgeon on the planet either.

Technorati Tags: brain injury, Critical Nursing, neuro accidents, neuro surgery, nursing

Let me tell you about another of my fond memories. When I
was in nursing school a long long …long time ago, we were taught that you must
present reality to confused patients. You were to continually reorient them to
the reality of the moment, the date, the time, the place etc.  Well although this is the correct nursing guideline, it really is not the
reality of the situation.

This is the story of a young patient that I cared for who
had quite a problem with alcohol. In fact she had become dangerous to herself
and required restraining. This was back in the day when patient restraint was a
part of accepted practice. We used to use the restraint called a posey jacket.
It was a vest with long straps that you could tie under the bed or behind the
chair the patient was in to keep them safe and out of danger of falling.

This young patient (she was in her early twenties) was in
the hospital for detoxification and required medication to help control her
blood pressure, pulse and anxiety. She was easily agitated despite the
medications and proved remarkably adept at getting out of her posey jacket. In
fact we didn’t seem able to keep her safe as she was determined not to be
restrained. And let me tell you a patient that is determined, no matter how
well you believe you have them restrained, is not going to be kept in a
restraint. Period!

Well this was the case with this young woman. Well occurred to
me that I needed to figure out what it was that she felt she needed to be
doing, that she could not rest. As I was talking with her we got on the subject
of what she liked to do. She said when she was in high school she enjoyed
playing basketball and apparently she was quite talented. We talked for so long
about this she actually got tired and appeared to go to sleep.

It wasn’t even an hour later and she was untied and running
all around the end of the corridor and her room jumping and running and
pivoting. She had tied the long tails of her posey jacket around her body
several times and she had written a number on a paper towel from her bathroom
and she had taped it to her chest. When I came down to intervene, I knew right
away what she was doing. She shouted out, ”Free throw, Get behind the foul
line, cheater! Two points!” 

She was playing basketball. And having the time of her life.
My nursing companions didn’t see it exactly the way I did and wanted to add
chemical restraint to her regime. But I protested, explained what she was going
through, and said I would be responsible. After about 20 more minutes, she was
exhausted and was able to sleep without the posey being necessary.

It was remarkable to watch this young woman recede back
about 10 years into a time she was happy and under much less stress. We need to
all remember that alcoholics are people that were once NOT alcoholics. They led
normal lives and had people in their lives that cared for them. Many alcoholics
are aware they are doing harm to themselves. But the disease will not allow
them to quit without significant help.

Interestingly enough, this same young woman, the next time I
saw her, was no longer requiring her posey jacket. She no longer wondered away,
and was good about staying in her room. But she was quite confused and still
very disoriented. Unfortunately she had done a lot of damage to herself.

When I came up to her to say hello at the beginning of my
shift, she was so happy to see me, although she had no idea who I was. In fact
she immediately began a conversation that was relevant only to herself.  But she was very busy folding very carefully
paper towels from the bathroom into very neat and perfect little squares. She had
already done many of them. The nurse prior to me said she had been busy at it
for well over an hour. When I asked her what she was doing, she said she was
getting ready…that’s it, no other explanation. So I continued to observe her.
She really didn’t seem to know I was there.

 Well about an hour later she began stacking them all
together and then she headed for the door to leave her room, which she was not
allowed to do. I called to her, but she was not listening. She was very intent
on her mission. She was handing the folding paper towels to everyone she came
in contact with in the hallway, visitors, nurses, staff, doctors, anyone! And
with each carefully folded paper towel, she sincerely told each person that
they were invited to her wedding, and she hoped they would be able to come.

Not one person laughed at her or made her feel self
conscious. They also did not present reality to this confused very sick young
woman. Reality is sometimes the thing that causes people to become in the
condition they find themselves in. Fantasy was a better treatment for her at
that moment. Who knows what it is that drove her to start drinking. That made
her so sad and insecure and lacking in self confidence that she hid from
reality. We’ll never know.

Technorati Tags: alcoholic, alcoholism, critical thinking, nursing, Nursing Guidelilnes, patient rights

Back in the early eighties, it came strongly into focus about patient rights. It was decided by the Joint Commission, now known as JACHO (the accrediting council for hospitals) that it was no longer allowed to physically restrain patients.

You see it used to be a safety practice for confused patients if they were in danger of harming themselves or others we would put what was called a Posey jacket or wrist restraints on there person to keep them safe. A Posey jacket was a little front and back jacket with strings that could be tied to the bottom of the bed. Usually this was enough but sometimes they had to have their wrists restrained because they could get themselves undone with just the jacket. We called these patients Houdini.

Of course, we would include the family in the decision regarding patient rights and ask them to come sit with the patient to prevent this from being necessary. Sometimes they were willing, other times they would give permission for the restraints.

Don’t get me wrong, it was actually quite humane, patients that were confused were constantly pulling out their IV’s or falling out of bed, or pulling out their urinary catheters. All these things are dangerous and painful. So it was all good.

Well, it was to be no more, no restraints! Patient rights ruled over patient safety.

Well this one evening, I had a little 85 year old Alzheimer’s patient that was very very confused and disoriented. I had her bed in the lowest position, but she kept getting out of bed. She was very much in danger of getting hurt, I worried so much about her. Then I got an idea…

I asked her what she used to do when she was younger, she said she took care of her home and family. Well that is all I needed to hear. I told her I also had a family and home to take care of and that I was overwhelmed with how much I had to do and I wondered if she had time, would she like to help me. She was eager to help me.

I left her room and returned with a big box of towels and washcloths and pillow cases, all jumbled up. I told her it was just out of the dryer and needed to get folded. Her face was joyful. She had a purpose. She had something to do. She was somebody again.

She meticulously folded each and every piece and stacked them all up. It took her an hour. She was so proud when she offered her completed project to me. I thanked her profusely, kissed her cheek, went outside the room and messed it all up again.

I stayed gone for a few minutes to give her a little time to recoup and then I brought the next “load” in for her to fold. She looked at me and started folding. She did an excellent job. She finished again in about an hour.

I came in a third time with another “load” and her face looked a little troubled. Then she pushed the basket back to me and said “Honey, I’ve tried to help you, but you are going to have to learn to take care of your own home. I am not always going to be here for you. You need to stand on your own two feet now.” It was great! I tried hard not to smile, really I did. She then told me she was exhausted and she was going to bed.

She went to bed for the entire night, slept like a baby and was never restrained. From then on we just kept her busy with chores and never had to restrain her again. Her patient rights remain intact! What a memory.

Technorati Tags: medical patient, patient health, patient mental, patient rights, patient safety, patient treatment, patients rights, rights

Hello, my name is Susan, I am a registered nurse with a large variety of nursing experiences. I have been nursing for forty years. I have a sub-specialty in orthopedics, cardiology and alcohol and drug withdrawal and rehabilitation. I have also worked in most fields of nursing, and I am currently working in emergency medicine.

I love nursing. I have had the most amazing career in all different fields of nursing. I have met so many people. Wonderful dynamic and talented physicians, excellent technicians, memorable patients and so many friends along the way that I feel truly blessed

Many different emotions come into play when I think back over the years. Some memories are beautiful and very endearing while others are outrageous and some even make me feel the anger I felt at the time. Some are very humorous and cause me to laugh right out loud with the memory. Some other memories are even shocking and a bit disturbing.

No matter what, people are people and it takes all kinds to make the world go round. And most of those people, sooner or later, turn up in the hospital with one complaint or another. And that’s when I have been able to meet so many different people with all types of problems.

Some we were able to help, others may have had little hope, while some had nothing physically wrong but were dealing with different psych or substance abuse problems. But they are still all people deserving of respectful and loving care.

The purpose of this blog is to share these memories. A kind of tribute to the many people and events that have occurred in my career. Now I do want to give a mild warning here. I will be honest with how things occurred. Sometimes things could be a bit crude, or graphic, or even bloody. Or maybe you might not agree with some of the choices I made. But I will still record them here as honestly as memory serves me. Also none of the names mentioned in this blog will ever be the person’s actual name. I will also change other non relevant details to make the event less recognizable so as to protect the anonymity of the people involved.

I also want to impart any knowledge about diseases, conditions and health and wellness. My experience will help you learn about the things that could potentially  affect us. Hopefully will you will live long healthy lives and if anything I tell you helps in that journey, I will be continuing in my role of nurse and caregiver and it will make me happy for us both.

All the stories, tales and quips will be true life and as accurate as memory serves. All the medical information will be researched and as accurate as possible, but nothing on this website should be utilized as medical treatment or  in lieu of your physician and his care. This is not a clinic or hospital or advice center. Just information and entertainment.  So settle back and enjoy memories of forty years of nursing.

Technorati Tags: emergency nursing, Nurse, nurses, nursing care, nursing job, nursing patient care, nursing skills, professional nursing