Have a question for an ER/Trauma nurse? I'll give you my best answer

[Juddog]

The correlation between hand washing and staying healthy(and keeping my patients healthy) is just so large I'd be a fool to ignore it.

I found this interesting, since people I work with sometimes use the bathroom and don't wash their hands - something I never understood.

I'm a bit obsessive about washing my hands and have noticed the same thing - it seems like washing your hands more often than some might think is necessary really does help lower the incidents of getting sick. It started for me working a computer depot, and seeing all kinds of stuff on the keyboards that came in.

 

[TraumaRN]

do you ever get teased by family or friends for being a male nurse?

Honestly, never. My friends and family have the utmost respect for what I do. The people that do tease me are just ignorant of what I actually do, and how demanding of a job it actually can be.

how many people have you seen die?

Honestly, too many. Probably in the neighborhood of 500 people.

how much can you expect to earn as an ER nurse on average?
what's a realistic salary range?

I currently make a little over $31/hr after being a nurse for 6 years, but YMMV depending on where you work/live and what you do. Starting wage usually about $23-24/hr and at my current hospital, top wage is about 36.50/hr for just a staff nurse working on the floor.

Do you have medical students/junior doctors working with you?

How do you feel about their presence/what they do, and what do you think is their attitude toward you?

My current job we don't often have med students/residents, but previous jobs I did. I didn't mind them, however it does require the extra effort of being vigilant to what they order because sometimes they order the wrong things. Mostly it is an air of professional respect, they are generally taught by most attending physicians to respect nurses because we can, and will turn on you and make life hell for you. And most doctors nowadays I would say recognize that without a good relationship with nurses, then nothing gets done.

What % of people you encounter are malingering?

I'm not sure on percentage, but at my current job we see average 100 patients per 24 hours, and we usually have 3 to 5 malingering/drug seeking patients per 24 hours.

 

[T9D]

Do you ever give sponge baths?

And if so how much? :sneaky:

 

[Hugo Drax]

Ever encounter some kind of weird disease situation like in the movies.

 

[TraumaRN]

Ever encounter some kind of weird disease situation like in the movies.

Yes. Twice I've seen malaria here in michigan. Both went to Africa, didn't like the side effects of the antimalaria meds, stopped taking them, came back to Michigan and became symptomatic both ended up in ICU...

I've seen a parasitic lung infection in an emigrate from west africa.

I've also seen puffer fish poisoning from soneone eating puffer fish sashimi. Tetrodotoxin. Ended up intubated in ICU.

http://en.m.wikipedia.org/wiki/Tetrodotoxin

 

[TraumaRN]

Do you ever give sponge baths?

And if so how much? :sneaky:

No. Sorry to disappoint

 

[Hayabusa Rider]

So basically this is inspired by a thought I had.

I've been an ER nurse for over 5 years now, I've always wondered what people thought of health care, specifically the ER and I'm sure there are questions they have wanted to ask, but never did. So here is your chance. I can't promise I can answer everything perfectly but I'll give it a shot.

Hell I'll even debunk any rumors/myths if people bring them up.

Who's first?

So someone comes in with a complaint. He's had visual disturbances and mild headache which he attributes to migraine, but some confusion and disorientation which improves over half an hour or so. The cloudy head gets better but its still there to a degree after q day. No limb weakness. He's sleepy too. What do you make of it?

 

[Printer Bandit]

^ lupus

 

[Svnla]

Have you ever seen any weird/punky stuffs or deadly such as "brain eating" parasite or SARS/ebola/related diease? Anything that would make you think the end is almost here?

 

[Hayabusa Rider]

^ lupus

Toomah!

 

[TraumaRN]

So someone comes in with a complaint. He's had visual disturbances and mild headache which he attributes to migraine, but some confusion and disorientation which improves over half an hour or so. The cloudy head gets better but its still there to a degree after q day. No limb weakness. He's sleepy too. What do you make of it?

Possibly a mini stroke aka transient ischemic attack. But the differential for such symptoms is pretty vast, so dont take what I say as medical advice.

 

[disappoint]

http://en.m.wikipedia.org/wiki/Tetrodotoxin

The Serpent and The Rainbow
http://www.imdb.com/title/tt0096071/

Spoiler

Don't let them bury me! I'm not dead!

No. Sorry to disappoint

That's ok I didn't want one anyway.


So....is it ever lupus?
Would you ever work for House M.D.?

On a more serious note: I read recently that the newer bi-phasic defibrillators are 90% effective vs. 60% for the older monophasic defibs.

How often does a defibrillator work? In others words what are the chances for survival if someone goes into v-tach and gets shocked right away?

 

[OVerLoRDI]

I am curious about motorcycle accidents.

Are the riders typically the Harley stereotype, sport bike squids (new riders with little gear), or is it a pretty much evenly dispersed?

Do you think the motorcycle "Body armor" makes a real difference? I'm not talking about leather jackets, but the shock absorbing armor for back, shoulders, elbows, etc.

Any general recommendations for a motorcycle rider?

 

[TraumaRN]

The Serpent and The Rainbow
http://www.imdb.com/title/tt0096071/

Spoiler

Don't let them bury me! I'm not dead!

That's ok I didn't want one anyway.


So....is it ever lupus?
Would you ever work for House M.D.?

On a more serious note: I read recently that the newer bi-phasic defibrillators are 90% effective vs. 60% for the older monophasic defibs.

How often does a defibrillator work? In others words what are the chances for survival if someone goes into v-tach and gets shocked right away?

It's never lupus. But I've seen plenty of patients with lupus. And I'd love to work with House.

As far as your questions about biphasic defibs working better...well it's almost beyond my level of understanding, but simply stated biphasic alters the direction of the electrical pulses about every 10 milliseconds versus being a one direction flatten sinusodial wave that is monophasic, requires LESS energy to depolarize the same amount of cardiac mass, and has lower risk of external burns and internal myocardial damage from the shock.

Which brings me to the point of a defib, which is to essentially completely depolarize a 'critical mass' of your myocardial tissue which should terminate the arrhythmia and then allow your body's own natural pacemaker the SA node in the heart to restart in a more normal rhythm. That is the theory anyways. This is also why you can't shock asystole(aka a flat line) because there is no underlying rhythm coming from your SA node.

I hope that works for you, sorry for the delay in answer, I had to pull out my cardiac nursing and ACLS book to make sure I gave you the exact right answer, plus I worked yesterday.

 

[TraumaRN]

I am curious about motorcycle accidents.

Are the riders typically the Harley stereotype, sport bike squids (new riders with little gear), or is it a pretty much evenly dispersed?

Do you think the motorcycle "Body armor" makes a real difference? I'm not talking about leather jackets, but the shock absorbing armor for back, shoulders, elbows, etc.

Any general recommendations for a motorcycle rider?

Bike accident it tends to be a range of people coming in...from Harley dude to squids.

I'll be 10000000% honest, helmets save lives. Wear one please. I know you've heard it before but I've seen the consequences and I don't give a shit how tough you are, when a drunk driver bumps your bike at 35 mph and you skull hits the pavement, well there isn't much we can do but offer a closed casket.

Sorry for the tangent, but the body armor/extra padding DOES work. I worked with a guy, an ER nurse actually as well, rode a sport bike almost daily, including to work and he wore a full helmet, flak jacket, leather chaps, knees/shin guards and elbow guards. He'd dumped his bike or was hit by cars 3 times going freeway speeds and the worst injury out of all of those was a broken ankle. Dude had someone looking out for him but the equipment literally saved him all 3 times. It helps prevent road rash, helps prevent broken limbs and ribs. It's not a be all end all, but it certainly does help.

 

[disappoint]

I
I hope that works for you, sorry for the delay in answer, I had to pull out my cardiac nursing and ACLS book to make sure I gave you the exact right answer, plus I worked yesterday.

Thank you for the detailed answer. You didn't have to go to all that trouble. I was just curious as to whether modern defibrillators are actually as effective as I read about in an article somewhere. 90% just seemed optimistic. Still, it was interesting to read that the aim is to depolarize myocardial tissue in order to restore the natural rhythm so I appreciate your research and post.

 

[TraumaRN]

Thank you for the detailed answer. You didn't have to go to all that trouble. I was just curious as to whether modern defibrillators are actually as effective as I read about in an article somewhere. 90% just seemed optimistic. Still, it was interesting to read that the aim is to depolarize myocardial tissue in order to restore the natural rhythm so I appreciate your research and post.

The key point on that 90% is early CPR and early access to a defib. If you can shock them in the first 2-3 minutes you can definitely convert most rhythms unless there is some underlying electrical/conduction abnormality in the heart.

 

[PlanetJosh]

Oh good this stops me from having to post a new thread for this question. Is it a bad idea for a non emergency room nurse or possibly an er one to use an 800 number to make an emergency call to patients or their family? Meaning is there too much of a risk that the person receiving the call may not answer or listen to the message thinking it's a telemarketer calling from a non local prefix? If the 800 call came with a good desription on the caller ID that it's from a medical person/nurse then it would be no problem I think.

This get's a little more involved so try to bear with me. If it's a call about something important regarding my elderly father's health I wouldn't want to ignore it thinking it's some marketer. And if the caller description is not clear on incoming 800 numbers I simply don't answer and immediately erase the messgae without a listen. Which would be a very bad thing to do if it was a nurse calling with something important. My main phone number is my land line caller id phone not my smart phone. So maybe making my smart phone my main number could solve the issue, not sure. For example maybe the smart phone has more space or better caller's description, organization, etc.

 

[tynopik]

I'm not sure on percentage, but at my current job we see average 100 patients per 24 hours, and we usually have 3 to 5 malingering/drug seeking patients per 24 hours.

3 to 5%

how come word problems were never this easy in school

 

[OVerLoRDI]

Bike accident it tends to be a range of people coming in...from Harley dude to squids.

I'll be 10000000% honest, helmets save lives. Wear one please. I know you've heard it before but I've seen the consequences and I don't give a shit how tough you are, when a drunk driver bumps your bike at 35 mph and you skull hits the pavement, well there isn't much we can do but offer a closed casket.

Sorry for the tangent, but the body armor/extra padding DOES work. I worked with a guy, an ER nurse actually as well, rode a sport bike almost daily, including to work and he wore a full helmet, flak jacket, leather chaps, knees/shin guards and elbow guards. He'd dumped his bike or was hit by cars 3 times going freeway speeds and the worst injury out of all of those was a broken ankle. Dude had someone looking out for him but the equipment literally saved him all 3 times. It helps prevent road rash, helps prevent broken limbs and ribs. It's not a be all end all, but it certainly does help.

Thanks for the response. I've got full gear, and I recently got hit. Made me very aware of my vulnerability out there. I had all my gear on like usual, and walked away with nothing more than a bruise on my knee. ATTGATT