An open post to my community.
The following post in no way represents the opinions, policies or strategies of my employer. Nor does it necessarily represent the opinions or feelings of my colleagues.
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The US is currently experiencing quite a bad influenza season.
Healthcare services and drug supplies are being stretched to the limit in the United States as the authorities warn this year’s flu season is severe.
Official figures indicate that influenza is now “widespread” in 41 states, with high numbers of cases reported in New York, where state governor And...
Source: impactEDnurse - January 22, 2013 Category: Nurses Authors: impactEDnurse Tags: reflective practice. Source Type: blogs
Bootcamp.
I am thinking of going into business running a Medical Bootcamp.
You-know, to imbue a little cellular understanding of everything we put our patients through….bootcamp style.
Here is the draft program for Day 1:
0600: Registration & Roll-call. 6 AM sharp.
Teams will assemble at Medi-boot HQ, then wait around for 3 hours without much information as to what is going to happen next.
0855: The Pain-scale wall. Each team member will have a small elastic band wrapped tightly around their little finger. Pain scores will be assessed at regular intervals throughout the day. Anyone rating their pain 10 or above must leave boot...
Source: impactEDnurse - January 22, 2013 Category: Nurses Authors: impactEDnurse Tags: the funnybone. Source Type: blogs
2003 Canberra Firestorm remembered.
Today is the 10th anniversary of the Canberra Firestorm.
On Saturday 18th January 2003 a freak and devastating firestorm tore through our city.
4 people died and over 500 homes were destroyed.
It resulted in the 2nd largest single hospital disaster response in Australian history.
I was working that day.
2 days later I wrote this story.
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the firestorm.
It was bloody horribly awesome. Peeking out of the small window in the resuscitation room, it seemed the wor...
Source: impactEDnurse - January 17, 2013 Category: Nurses Authors: impactEDnurse Tags: ectopics Source Type: blogs
The mindful nurse.
Mindfulness is the awareness that emerges through paying attention on purpose, in the present moment, with compassion, and open-hearted curiosity .
Through cultivating mindful awareness, we discover how to live in the present moment rather than brooding about the past or worrying about the future.
Mindfulness, in my opinion, may just be one of the most important skills that can be taught to nurses (and other caregivers).
It is an easily taught skill that can help to strengthen resilience, improve concentration, decrease likelihood of errors, improve clinical performance, nurture empathy and lessen the effects of chronic st...
Source: impactEDnurse - January 17, 2013 Category: Nurses Authors: impactEDnurse Tags: tips and tricks Source Type: blogs
Hospital food: show and tell.
I thought it might be interesting to do a little ad-hoc comparison of hospital food.
You either love it, or you hate it.
What I am asking you to do is snap a picture of a typical tray of hospital food as it is served up to your patients.
Send it in to: ian@impactednurse.com and include the following.
You may or may not wish to identify which hospital is serving up this food.
Give it a subjective rating out of 5
(5 being excellent, 0 being antiemetic-stat) for each of the following categories:
Nutritional value.
Tastiness.
Aesthetic appeal.
You may also wish to make comment on how you feel about the overall standard of...
Source: impactEDnurse - January 16, 2013 Category: Nurses Authors: impactEDnurse Tags: ectopics Source Type: blogs
The Thunderbox Papers: Locating infarction on the 12-lead ECG
The Thunderbox Papers are a set of short pithy one page information sheets.
The idea is that you stick one on your toilet door for one week and commit to learning the information during each visit.
A Thunderbox refers to an old Australian ‘out-house’ or outside toilet. These toilets were often nothing more than a small drafty wooden shed containing a seat over a deep hole in the ground.
Toilet paper consisted of old pages from newspapers or magazines threaded together with string and hung on a hook.
I will post a Thunderbox Paper here every week or so. Stick it in your toilet at work (or home) and use your busi...
Source: impactEDnurse - January 15, 2013 Category: Nurses Authors: impactEDnurse Tags: the nurses desk: Source Type: blogs
How to develop a DRUG habit.
It was a busy shift. One of my colleagues came over to me and asked me to check her dosage calculations for a drug she was about to give a 5 year old girl.
I was doing about a hundred things ( a-hundered-and-five if you count what I was actually doing outside my head) but I said “sure…” and went over to do the quick drug check.
After all, she was an experienced nurse…everything would be good, so this would only take a moment.
One minute later I was back on my own task list, when I realised that I had not really checked her calculations at all. I had stood there and nodded in agreement. I had said “I concur…” ...
Source: impactEDnurse - January 12, 2013 Category: Nurses Authors: impactEDnurse Tags: clinical skills Source Type: blogs
Nurses are F*cking C*nts. Verbal abuse in our workplace.
There is an article published by Journal of Advanced Nursing, titled Mosaic of verbal abuse experienced by nurses in their everyday work that should be read by every nurse that has tolerated demeaning or verbally abusive behaviour whilst on duty, and also by every member of the public who has had a nurse care for them.
This was an observational study conducted over 1150 hours at inpatient and emergency department wards in a large acute metropolitan teaching hospital on the outskirts of a major Australian city.
It found an everyday, sustained ‘mosaic’ of non-verbal threatening behaviours, verbal insults, threats and p...
Source: impactEDnurse - January 10, 2013 Category: Nurses Authors: impactEDnurse Tags: reflective practice. Source Type: blogs
How to assess for swallowing difficulty in stroke patients.
In Australia each year around 60,000 people will experience a stroke. Half of them will be over the age of 75. And with out rapidly ageing population it has been forecast that over the next 15 years there will be an 70% increase in the number people who will have a stroke.
An national audit conducted in 2010 found that 47% of stroke admissions included a diagnosed dysphagia. These patients have an increased risk of aspiration, particularly within the first 72 hours.
Most of us swallow around 2000 times a day in order to empty the saliva from our mouth, and intake nutrition & hydration. In fact this act of swallowing wh...
Source: impactEDnurse - January 7, 2013 Category: Nurses Authors: impactEDnurse Tags: clinical skills Source Type: blogs
This nurse and my coffee.
It is inhumane, in my opinion, to force people who have a genuine medical need for coffee to wait in line behind people who apparently view it as some kind of recreational activity – Dave Barry
When not at work, I wish my days rounded with the ambiance of ritual caffination.
Working in the emergency department is distastefully instant. You are simply not afforded space amongst the catastrophe to let your lips simmer over molten-gold creme. To pause and feel the weight of your favourite chipped clay mug cupped in your hands. Or perhaps porcelain. Or earthenware.
To lean in and feel the swirling warm steam feather your...
Source: impactEDnurse - January 6, 2013 Category: Nurses Authors: impactEDnurse Tags: ectopics Source Type: blogs
The Thunderbox Papers: ECG 1
The Thunderbox Papers are a set of short pithy one page information sheets.
The idea is that you stick one on your toilet door for one week and commit to learning the information during each visit.
A Thunderbox refers to an old Australian ‘out-house’ or outside toilet. These toilets were often nothing more than a small drafty wooden shed containing a seat over a deep hole in the ground.
Toilet paper consisted of old pages from newspapers or magazines threaded together with string and hung on a hook.
I will post a Thunderbox Paper here every week or so. Stick it in your toilet at work (or home) and use your busi...
Source: impactEDnurse - January 5, 2013 Category: Nurses Authors: impactEDnurse Tags: the nurses desk: Source Type: blogs
Tranexamic Acid (TXA).
Around 25% of severe trauma patients experience acute coagulopathies associated with increased morbidity and mortality rates.
Recently, we have seen an increased understanding of the relationship between trauma and alterations to the coagulation system. A little ironically, this knowledge has been gained largely from battlefield experience including Iraq and Afghanistan.
Tranexamic Acid (TXA) is an antifibrinolytic. That is, it inhibits the activation of plasminogen (and plasmin) thereby preventing the breakdown of existing clots.
One of the negative responses to an acute traumatic event is the muting of the bodies plasmin...
Source: impactEDnurse - January 1, 2013 Category: Nurses Authors: impactEDnurse Tags: the nurses desk: Source Type: blogs
Managing a ventilated patient: vent settings.
I have already shown you a very good short introductory video on using the Oxylog 3000 ventilator.
And now here is something a little more advanced for those of us who are more experienced with managing ventilated patients.
Scott Weingart, an ED Intensivist from New York City and author of the eminent EMcrit has produced a set of 2 videos (also available as podcasts over on his site) on ‘Dominating the Vent’.
For those of you who think you have a fairly good grasp of the basic concepts of ventilation, I strongly recommend you take the time to watch these 2 videos. Like…..do it.
There is also a handout to accompany th...
Source: impactEDnurse - January 1, 2013 Category: Nurses Authors: impactEDnurse Tags: clinical skills Source Type: blogs
When nurses talk to the dead.
I talk to dead people.
Tara Nipe wants to know why.
And she wants you to help her gain a better understanding of the reasons.
A PhD candidate at the University of Melbourne’s Centre for Health and Society, my research interests are informed by my clinical practice as a registered nurse on a mixed medical specialty ward at one of Melbourne’s most acute tertiary hospitals.
A few years ago I undertook an empirical research Masters in Social Health, where I investigated why ICU nurses who speak to their brain-dead patients do so – the available research indicated it was because ICU nurses didn’t understand the idea...
Source: impactEDnurse - December 30, 2012 Category: Nurses Authors: impactEDnurse Tags: the nurses desk: Source Type: blogs
