Hanging out with paramedics is always fun, because they all seem to never run out of great stories. From scrotal lacerations to decapitations, they’ve seen it all. Here's another story I picked up when I shadowed paramedics.
There was a patient who had a cardiac arrest during intercourse. The paramedics picked him up, and revived him on the way to the hospital. When the doctor phoned his wife to tell her that her husband was going to be OK, she said, “What? My husband’s in the hospital?”
Think about it... then you'll get it.
Wednesday, July 11, 2007
Paramedics have great stories
Monday, July 09, 2007
Grand Rounds v3.43 ::: Call for Submissions
Vitum Medicinus is proud to be hosting Grand Rounds, Volume 3 Number 43, on July 17, 2007.
The opportunity to submit posts is now closed. Thank you for your submissions! Check back for Grand Rounds here on July 17.
Receive an e-mail notification when Grand Rounds v3.44 is published
What is Grand Rounds?
Grand Rounds, originated and still overseen by Dr. Nicholas Genes, is a medical blog carnival, or a collection of the best healthcare-related posts of the week.
Anyone can submit a blog post; the post being submitted is to be healthcare-related but can come from blogs of patients / healthcare workers / students / writers / anybody.
Past editions of Grand Rounds can be found here.
Submissions Due:
The deadline has now passed. Thank you to those who submitted! Check back on July 17 for Grand Rounds at Vitum Medicinus.
Late submissions will have to be pretty epic in order to be included.
Send Submissions To:
vitum{at}VitumMedicinus{dot}com; subject line "Grand Rounds"
Vitum will send a confirmation e-mail for each submission received.
Submission Format:
- Subject line: Grand Rounds
- Submitted Post Title
- Submitted Post URL
- Submitted Post Description
- Submitting Blogger's Favourite Food
Preferred Theme:
Vitum is crazy about stories of drama, action, and humour; so this week's suggested theme is stories of interactions with patients or healthcare providers. Hopefully your stories contain drama, action, humour, or all three.
- Your post will get preference if it fits the theme, but I'll make efforts to include all submissions that don't adhere to the theme as well.
- Recent posts that are no longer than 1000 words are preferred.
The Original Submission Guidelines:
Find ideas / additional guidelines at the original Grand Rounds submission guidelines.
Thursday, July 05, 2007
Geez, what a dumb nurse.
Make sure you read this post to the end before you make any quick judgments! End quote.
I was in the emergency department this week shadowing a doctor, and I was surprised when an older nurse came up to the doctor and said,
"I don't usually have trouble putting in catheters, but I have no idea why putting one in this guy is so difficult. Could you help us out?"
When I looked over at the patient she was pointing at, I gasped. How the heck could the nurse be that stupid?
I had to interrupt. Looking her right in those dim-witted beady little eyes, I said, "Excuse me, but are you trying to be funny?"
The patient was a 67-year-old male who had come in with a chief complaint of "I can't pee because my prostate is flaring up again."
No kidding you're going to have a hard time putting a catheter in, and what do you mean you don't know why?! The guy's got BPH (Benign Prostatic Hyperplasia). When the prostate has swelled up to the size of an softball, seeing as how the urethra runs right through it, of course it's going to pinch that urethra right shut. Especially when the internal zone of the prostate is the part that increases in size due to BPH.
I mean, come on - how could the nurse be that stupid?! I'm a flippin' first-year medical student and I know this basic stuff; she's been on the wards for decades and you're telling me you're clueless? Haven't you seen how big an enlarged prostate can get on gross pathology?
Okay, I'll stop this little anecdote right here and tell the truth - this didn't actually happen. I've never called anyone "dumb" and meant it, and don't intend to start now.
But it might have, had I not read what Kim at Emergiblog wrote after seeing BodyWorlds 3. (yeah I'm bringing up Kim again! can you tell I've found a new blog I love?) Don't forget, this is being written by a nurse of 28 years:
"I’m sure my mouth was open through the entire exhibit. There was so much I did not know or had forgotten over the years. I knew what was there, it was the proportions that astounded me.
"Are you kidding me? You didn't know the spinal cord was 1/2" thick? You didn't know that smoking turns your lungs black?? I wouldn't have been surprised by ANYTHING on that list, and I'm just finished my first year! She's been a nurse for 28 years and STILL doesn't know all that stuff?!"
I suddenly looked up from my computer screen and felt a rush of shame come over me. I realized that if I had said that out loud, it would have no doubt come across as a jackass thing to say. The next thing in a rant like that could reasonably have been something like, "Geez, she is SUCH an idiot!"
How could I have thought something so rude? Me, of all people! After all my posts on interdisciplinarity and treating nurses with respect, after saying that I love and will always respect nurses because some of my good friends and my mom are nurses, and after pumping that same nurse who wrote that just this week, after having the purest and most idealistic of intentions, here I am pretty much bashing nurses already!
Then, I remembered something.
"That's right! I always knew that the nurses I went to undergrad with never really got the chance to work on cadavers and take pathology like I did."
And that's what I had been missing. Until now, I had never made the connection that unless you have taken pathology, or held a human kidney in your hand, it's actually pretty hard to visualize what an enlarged prostate looks like, or how thin the spinal cord is, or how small the kidneys actually are.
If I hadn't made that realization here, today, perhaps the little scenario I made up at the start of this post actually could have happened in a couple years when I'm on the wards.
I'm no better or smarter than Kim is. In fact, put me in a hospital or in front of a board exam right now and I bet you anything that Kim would answer more questions correctly and save more patient's lives than I would, after all those years of clinical experience under her belt. But already, after one year of classes, I was thinking thoughts that if spoken, could easily be interpereted as superiority, or simply being a jackass.
Yes, some doctors are assholes to nurses just because they think they can get away with it, because they have their own issues to deal with, because they're just assholes, or maybe because since orders have always been called "orders" they think it's okay to actually "order" other health professionals around. And after being through a year of medical school, I can almost sympathize with a doctor who stands up for him or herself and comes across as being a jerk, because after being through those first-year finals -- the most intense, trying time of my life -- I have a lot more confidence in myself, and quite frankly, after four years of this, I won't take crap from anybody.
But perhaps some of the barriers between professions aren't for any of those reasons. Perhaps some doctors come across as being jerks even if they try hard not to. Perhaps sometimes it's just because of simple misunderstandings.
Not because of a superiority complex, not because somebody thinks they're better than someone else, but because they just never took the time to stop and think about how differently we have been trained, and how our professions are designed to look at the same problem from different directions. And that's where the strength, the untapped gold mine of interdisciplinarity, comes from.
Yeah, I'm still fresh and new and idealistic, perhaps, but hopefully I can keep stopping myself whenever I think ignorant thoughts like that, and hopefully I'll continue to challenge myself to treat everyone with the respect they deserve. After all my good intentions of being kind to nurses, and then seeing my initial reaction to Kim's comments, clearly good intentions aren't all that it takes.
Thanks, Kim, for letting me pick on you without so much as asking, and I hope that this hasn't discouraged you from writing out your true feelings in the future, even though it it might make you vulnerable to ignorance people like me. I really do admire your writing.
Ever since Kim was kind enough to post this at Change of Shift (Grand Rounds of the Nursing blogworld, from my interpretation) I've noticed a lot of readers who have come from there. Those who want to read more about the difference between how doctors and nurses approach patients might want to take a look at the evil resident's take on this issue.
Wednesday, July 04, 2007
Why do we need to know all this physiology?
We were told by a physician before an exam review session:
Students sometimes ask me why they need to know all this respiratory physiology.
I simply tell them,
About 14 months from now you will be in third year. With that comes responsibility.
For example, one day, you will get paged, and the nurse will tell you, "Mrs. S.'s oxygen saturation just dropped to 80% (life-threatening). The resident is in surgery, and the attending physician is in the ER resuscitating somebody....
...what do we do?"
That's what third year is like. That's why you need to know all this respiratory physiology.
So, you might want to learn this.
My class has never been that quiet.
Monday, July 02, 2007
I've got blood in the back of my cab
The other day while I was shadowing paramedics, we had just dropped off a patient and were sitting by the emergency department entrance, waiting for one other paramedic to finish up on a phone call before we left the hospital.
A cabbie pulled up and rolled down his window, and shouted at us through a thick accent, “I’ve got blood in the back.”
“Huh?” one of the paramedics replied.
“Blood – I’ve got blood in the back of my cab,” he said again, using his thumb to point at the back seat.
We looked at each other, not sure what to do, until one paramedic turned to the cabbie and said, “Here’s what you do – get some water, and some hydrogen peroxide, and you’ll be able to scrub it out real nice.”
The cabbie mumbled something, and drove off.
We started shaking our heads when he pulled up to the front door of the hospital.
“What’s he doing?? Does he actually want a nurse to come out and clean the back of his cab for him?”
He popped the trunk, got out of his cab, and walked to the back. He reached into the trunk and pulled out a big cardboard box.
“Ohhhhhhh,” we all said, as the lightbulbs went on.
Here we’d been trying to picture the cabbie wanting to clean up after some drunk ride all cut up from a bar fight bled all over in the back seat.
Instead, I had simply witnessed for myself the apparent courier system for the blood bank.
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