Fun things to argue about at work

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.

TGIF to all

After my week, I needed a Friday!

So glad I'm not an NP at the Hotel, because there was all sort of debates this week about them and other midlevels. The doctors are restless, and they are starting to irritate our midlevel staff.

Happily, I got all my work done and I escaped. Dahey, Bubba and I went to our local fish fry with friends. It was fun.

Hope you enjoy your weekend wherever you are!

Every knock's a boost part 2

Patients are their practice (from www.latimes.com)

I work with some really awesome NPs. One has been in rehab at some of the most prestigious institutions for 30 years. Another has extensive neuro ICU and ER experience, which give her amazing depth when dealing with rehab patients.

And it doesn't really surprise me that the doctors mentioned in this story still don't want NPs to be used in primary care. When we have facts that people are not lining up in med school for internal medicine and family practice, what will we do?

It's like the line in Field of Dreams, "If you build it, they will come." They are coming to see NPs 'cause there's no other option (besides filling the EDs of this country).

Med schools take note: if you have more family practice docs out there, maybe they will really come your way, instead of to an NP.

Nuggets for October 1

Here are a few goodies I've encountered on my meanderings on the internet recently. Enjoy!

From the blogosphere...
Hell on White Clogs had this crazy scenario involving Google and residents on fhe floor of one unit. All I have to say is...I'd have to say no to that cath if I didn't see the "real doc" with experience, thank you very much!

ImpactEDnurse had this post about helminth therapy...ugh! I think I'll have to show my allergist this one. I'd be scratching my eyes out, too.

Code blog has this story of the Bigger Picture. Oh, yes, I go there so many times. What do they not understand?

Out in news land...
The Chicago Tribune had this recent article about ways to combat compassion fatigue (aka burnout) among nurses.

The NY Times is running a special section called Decoding Your Health. In today's installment the author discusses using the internet to get medical information. I particularly like this line, "The goal is to find an M.D., not become one."

TV station KTTC of Rochester, MN ran this article about nurse practitioners recently on their web site. It also points out that Nurse Practioner Week is November 9th through the 15th.

NursingLink has this article about avoiding back injuries, which is a good thing, no matter what type of setting.

A subject near and dear to a rehab nurse's heart...bowel routines. Since it was recently National Rehabilitation Awareness Week, this article discusses how one Delaware hospital works with patients to relieve constipation.