The Sweetest Thing…

Monday, September 14th, 2009

We have a patient who has a terrible time complying with his diabetes diet. This came up in conversation after I checked his fasting sugars and found them to be 300+!!!

Thinking this was the ideal time to do some patient education, I started talking about his food choices. It turns out he had a real passion for baked goods: donuts, crullers, danishes — if it came out of an oven, it was likely to go into his mouth.

So we’re talking about this, and he keeps insisting that all of these items were ‘safe’. Dunkin’ Donuts wouldn’t sell him anything unsafe apparently! And so I’m patiently trying to explain this, and he’s insisting that it’s all safe and finally his wife loses patience and says, “Yes, dear — all of that’s safe — right until you put it into your mouth!”

I’m glad SHE said it, so I didn’t have to!

Name withheld by request

What’s the funniest thing a patient’s ever said to you about their diabetes? Or anything else, for that matter? Send them to us at Cindy@journalofnursingjocularity.com — let us know if you want us to use your name or keep you anonymous!

Laughs from L&D

Monday, August 17th, 2009

As a young nurse, I worked in a small hospital where it was easy to know the entire staff — from the docs and nurses to the dock workers and volunteers.

One morning when I was hurrying down the hallway to circulate for the next C-section, I saw a tall young man in scrubs looking somewhat lost.  “Must be the soon-to-be father,” I thought.  Out loud, I asked, “Are you looking for the C-section?” (more…)

The Student Nurse, The Experienced Nurse

Monday, April 13th, 2009

A Student Nurse will spend an entire shift trying to re-orient the patient.

An Experienced Nurse will chart that the patient is disoriented and restrain them.

A Student Nurse spends 2 hours giving a patient a bath.

An Experienced Nurse lets the CNA give the patient the bath.

A Student Nurse values the chance to ‘work with the whole family.”

An Experienced Nurse avoids the entire family.

A Student Nurse always answers their phone.

An Experienced Nurse can’t find their phone on their days off.

A Student Nurse wants everyone to know they’re going to be a nurse.

An Experienced Nurse doesn’t let anyone know they’re a nurse.

As Summer Approaches…

Monday, April 6th, 2009

How do you save a doctor from drowning?

Start by taking your foot off of his head…

Strangely Appropriate For Some Patients’ Rooms

Monday, March 23rd, 2009

sy-fyEarlier this week, the Sci Fi channel has announced a new branding initiative, in the hopes of broading the station’s appeal to a larger number of viewers.  No longer will the station, which features programming ranging from space opera to good old fashioned monster movies, be known as Sci Fi.

Instead, it will be known as the purpotedly catchier name Syfy.

One would imagine that this name was thoroughly researched, with Sci Fi’s legions of marketers — not to mention lawyers — doing due diligence to ensure the name wasn’t used in any other capacity.

One would be wrong. (more…)

Well, Duh!

Monday, March 9th, 2009

Sign seen on the lawn outside the drug treatment center:

Keep off the grass!

Being Med Compliant CAN Hurt You!

Monday, February 16th, 2009

Jack: “My brother was sick and went to the doctor.”

John: “Is he feeling better now?”

Jack: “No, he has a broken arm.”

John: “How did he break it?”

Jack: “Well, the doctor gave him a prescription and told him no matter what happened, to follow that prescription. And the prescription blew out of the window.”

John: “How did he break his arm?”

Jack: “He fell out of the window trying to follow the prescription.”

Waiting for the Other To Drop

Monday, February 16th, 2009

As a student, I was assigned to a patient: after a bed bath, it was time to get her out of bed. Try as I might, I could only find her right shoe. A fellow student who walked into the room found me on all fours, looking under the bed for the elusive second shoe.

I told her what I was doing, and then it hit me. The patient had a left AKA!

By Amy Nemetz

Health-Care-Associated Confusion by Bina Simon, RN

Monday, February 16th, 2009

I don’t think I like this business of changing the name “nosocomial’ to “health-care-associated.” Yes, I get the point: to also include all health care settings, and not just hospitals, under one heading. But see, first of all, this new name is in plain old, you know, English! Health care consumers can even understand the term, which is supposedly the exact opposite goal of medical lingo. And worst of all doesn’t the term say outright, in that plain old understandable English, that basically we health care providers messed up?

You never hear patients, including your Aunt Helen whose gall bladder was removed last January, talking about their ‘nosocomial infections.’ They may know they ‘got an infection in the hospital,’ and maybe even realize it’s sort of related to the hospitalization itself. But that’s it. ‘Nosocomial infection’ is—oops I mean WAS– a term kind of shrouded in mystery. Thank goodness for that.

But now? Good grief! It’s like we’re announcing that it’s our fault!! “Health-care- associated- pneumonia?” We may as well wear t-shirts proclaiming “I am carrying germs right into your lungs.” It’s telling the entire mankind that we, members of the most highly thought of and trusted professions in the world (at least until now), are the cause of these bugs.

I can already see the guy with the stuffy nose in bed 3052– who really only came in with intractable back pain but now has this uncomfortable nasal congestion that we all get every allergy season, now telling all his friends and neighbors and maybe even his lawyer that he has a “health-care-associated pneumonia.”

Boy am I glad I have my own malpractice insurance. I suggest you get your own.

Granted, I may have once or twice been the source of a nosocomial– I mean healthcare associated- infection or two myself. I really never told this to anyone before, but once we’re announcing this health-care- associated pneumonia bit, I may as well be the first to give my confession: I definitely recall only scrubbing my hands vigorously for only 14.2 seconds instead of JCAHO- required 15 in between taking the BP of the guy in E.D. Room 3 (c/o sprained arm r/o fx) and checking on the lady in bed 8 (c/o cephalgia).

Who’s next? Come on, it’s coming out in the open anyway. Let’s all let our hair down. (Although loose and/or long hair breeds germs and should really be kept short or pulled back away from the face.)

And now that the world will be hearing that “health-care-associated” infection bit, you can imagine what will be going on in hospitals health-care-associated sites now. Patients will be suspiciously studying every single health-care-associated staff member. Not just the nurses and MDs and CNA’s but now every housekeeper and mop, every dietary worker bringing trays and clearing them off, maybe even the volunteers bringing their mail. Can’t you see these patients tucking details in their heads as they mentally note, “Thaaaaaat’s what’s causing all this ‘health-care-associated pneumonia’ I hear about. That volunteer just delivered my get-well card–without gloves!!”

Actually, once we’re embarrassing ourselves and being completely honest with this confessional new term, let’s go all the way. That physician who doesn’t wash his hands between one patient and another– and you find it unsurprising that his patients get MRSA more than the rest of the unit….well, we could name the infection “Dr X- acquired MRSA,” but there’s always that libel and defamation of character suit. (Which is probably not covered under your malpractice insurance policy.) How about ‘poor-handwashing-technique-acquired infection?’

How about some other stuff we see– will they be named things like “Poor-suture-technique associated wound dehiscence?”

And what about us? How about ‘insufficient-betadine–pre-Foley-insertion -associated UTI?’ ‘Faulty -IV-technique-associated phlebitis?’ And something a few of my own patients might have suffered during my first six months out of nursing school: ‘Poor- injection -technique-associated ecchymosis?’

Then again, maybe it wasn’t my fault. Some of them- especially those geriatric ones- were really “insufficient -subcutaneous- tissue- associated ecchymosis.” That’s better. See, it’s not always the fault of the health-care- associated-providers, is it?

And waittttttttttttt a minute. Now that I think about it, lots of conditions are not our fault. Why do we have to be honest about our health care flaws, but the patients don’t have to be? Why can’t we ALL be honest here? Patients included?

For example, I think it’s time for a NEW classification of MIs. ‘STEMI,’ ‘Non Q,’ ‘Subendo,’ ‘anterior wall,’ blah blah– outdated. Let’s go for it: The guys who sit home for 3 days not believing it’s an MI: Denial-associated MI. The chain-smoker who eats at McDonald’s every day for lunch after breakfast at Burger King– is Unhealthy-lifestyle-acquired MI. And the poor folks who really take care of themselves but have MIs mostly because of family history: “No- fair- it’s- only-DNA-associated MI.” Insurance companies could have a FIELD day with this.

OK well, um,………So maybe this idea is NOT a good thing. Well, then….. how about making up a NEW term that would include all health-care-associated-settings, without publicly humiliating ourselves? Let’s think. Um, well….. maybe some acronym or something? Oh hey, I’ve got it! How about “NOSOCOMIAL?”

Now they’ll all be happy at JCAHO (Just Clean All HOspitals), and HCFA (Hospitals Cause Fevers and Ailments). Oops my mistake– I think the idea was the CDC ‘s(Caregivers Don’t Contaminate). Of course we still get to keep that nice mysterious hard-to-understand-and-even-spell ‘nosocomial’ term, and no one will know what it stands for, except us. You know, the guilty parties. Nurses/Nursing homes, Offices/Outpatient Settings, Other Caregivers Or MDs Infecting ALL.’ See, that’s more all-encompassing.

Music to Our Ears

Monday, February 9th, 2009

All around the world today, from the largest symphony halls to the smallest chambers for chamber music, there was much rejoicing! A terrible medical scourge, long the dread of the woodwind section, has been terrorizing musicians for years — but no longer!

What is this dreaded disease? What foul ailment makes musicians quake with fear? (more…)