1. What exactly happens when someone coughs up a nasty trach plug? Is it sputum or gastric contents?
2. If you can't tell the difference in #1, should they let you graduate as a nurse practitioner? I probably p*$s% off our NP student, but last time I checked, lungs should not (regularly) contain gastric contents.
3. What does no really mean in any language (pick several, but we're all speaking English--American, anyway--here)? When you refuse to see my patients (or in our local speak: decline) and say no, I take it to mean, NO you will not see them. Yes, there is a communication gap here.
Sorry if you don't like what your boss says to you after that when I tell him/her. Not exactly my problem. If I could write orders for what the patient wanted, I'd be practicing medicine, not being a nurse.
The color of the sky, football teams, and crabby patients are all up next. We'll see how the week progresses.
Stay tuned.
1 comment:
Your links on clinical topics are great brain food for me - don't work in acute care or inpt care of any kind so these are links that make me think!
My trach story from early days - pt with track and continuous G tube feed, permanent vegatative state with ability to breathe on his own - had involuntary tongue thrusting movements and dry mouth. Spouse had trouble accepting dx, insisted pt was hungry and thirsty, had been found putting soft food onto tongue...promised never to do that again. She tried a grape lollipop one day..discovered when I suctioned his trach and the secretions were tinged with purple! I was panicky, didn't remember what purple secretions meant from nursing school. Flew out to the desk and asked experienced nurse to come in to room. She got same secretions, and was just as puzzled. Wife returned to floor - mystery solved.
Kudos for not just letting the NP student proceed but in pushing back at performance issues - graduating with a degree that is not solidly based in theory AND practice is like using inferior cement in the foundation of a house. It's just not gonna hold up! And in the NP case, it is both patients and the profession who are damaged.
Glad your hubby is back, for your sake and your son's. Work travel is hard on family life.
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