Why I Love My Job

Everyone can always tell you the negative aspects of their employer.  No matter how much money you make, you have something negative to say about your job.  Well today I am here to say something positive about mine and why I love what I do.  I work as a Registered Nurse  in the Medical Intensive Care Unit of a teaching hospital.  Most of our nurses take pride in their job.  One of the best qualities I find in  our physicians and nurse is we go above and beyond the call of duty for our patients.  A person could have no chance at all for survival and we will do everything under the sun to try and keep them alive if it is the wishes of the family.  When there is no hope, we provide a glimmer with our duty to save lives.  We get cursed out, scrutinized and sometimes even threatened in our line of duty.  We high five each other when our teamwork pays off and we enable someone to go home to their loved ones.  We also cry and empathize with those losses we have to share with families when no matter what we tried, it seemed to fail.

When all is said and done, I am a proud member of this team and I take my hat off to every doctor and nurse who helps to provide the quality of care we give.  

Have a job you are proud of?  I would love to hear your comments.

A parent's nightmare

One of the worst feelings a parent can ever have is not being able to make their child feel better.  This time of the year is the worst time for respiratory infections in most people but especially babies.

Respiratory syncytial virus (RSV) is a very common virus that leads to mild, cold-like symptoms in adults and older healthy children. It can be more serious in young babies, especially to those in certain high-risk groups.RSV is the most common germ that causes lung and airway infections in infants and young children.. The virus spreads through tiny droplets that go into the air when a sick person blows their nose, coughs, or sneezes. Children in daycare environments will generally spread the virus to other babies around them. Mainly because you can catch RSV if a person with RSV sneezes, coughs, or blows their nose near you. You touch, kiss, or shake hands with someone who is infected by the virus. You touch your nose, eyes, or mouth after you have touched something contamined by the virus, such as a toy or doorknob.  This is also why hand washing is so important.  It one of the best protective barriers you have for infections.

In general, RSV symptoms include: 

Bluish skin color due to a lack of oxygen (cyanosis)

Breathing difficulty or labored breathing

Cough

Croupy cough (often described as a "seal bark" cough)

Fever

Nasal flaring

Rapid breathing (tachypnea)

Shortness of breath

Stuffy nose

Wheezing

Many hospitals and clinics can rapidly test for RSV using a sample of fluid taken from the nose with a cotton swab.  Antibiotics do not treat RSV. Mild infections go away without treatment. Infants and children with a severe RSV infection may be admitted to the hospital . Treatment will include Oxygen, Moist (humidified) air, Fluids through a vein (by IV).

A breathing machine (ventilator) may be needed. 

A simple way to help prevent RSV infection is to wash your hands often, especially before touching your baby. It is important to make certain that other people, especially caregivers, take steps to avoid giving RSV to your baby.

The following simple steps can help protect your baby from getting sick:

Insist that others wash their hands with warm water and soap before touching your baby.

Have others avoid contact with the baby if they have a cold or fever. If necessary, have them wear a mask.

Be aware that kissing the baby can spread RSV infection.

Try to keep young children away from your baby. RSV is very common among young children and easily spreads from child to child.

Do not smoke inside your house, car, or anywhere near your baby. Exposure to tobacco smoke increases the risk of RSV illness. 

The drug Synagis (palivizumab) is approved for the prevention of RSV disease in children younger than 24 months who are at high risk for serious RSV disease. Ask your doctor if your child should receive this medicine.

Lets keep our babies happy and healthy.  

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Demanding Patients and Families

Sometimes patients and their families make you want to pull your hair out!  It really bothers me when you are doing everything you can for a patient and it never seems to be enough.  Mostly it is the family whom you can't seem to please.  Can you move mother's head? Can you fluff her pillow?  Father needs to be moved again. I think dad is in pain.  Can you get some ice water?  All of these questions come after you have just left the room is what makes it even worse.

 I could see if your family member wasn't being cared for but when the nurse is going over and beyond to make them comfortable you should back off a bit.  The continuous nagging and nit picking can seriously reduce the going over and beyond because apparently no matter how well you care for the patient it won't be enough. 

Then you have the patients who forget how to do anything for themselves when they come to the hospital.  If your legs and arms still work you can wipe your own butt!  The hospital isn't a place for you to be waited on, it is a place for you to get better and go home.

I'm sure you have a story to tell so let us hear it.  Maybe you were a demanding patient, if so tell us why.  Feel free to post your comments.

Home Remedies

Growing up I remember my parents and grandparents had remedies for everything.  My mother always made tea out of orange peels for us to drink when we had a cold.  Grandmother made her own cough syrup which consisted of honey, lemon and peppermint.  I think the adults added whiskey to theirs.  My uncle always coated his chest with Vick's vapor rub, turned on the heat and got under a blanket to sweat it out.  Tried that once and thought I would die.  My latest discovery was a hot toddy and I believed it worked.  My kids grandmother said she would rub garlic under the bottom of their feet to keep them from getting sick.  She said it worked. There are also lots of herbal remedies out that also work.  Some people believe they have to have prescribed medications like antibiotics and prescription cough syrup to get better. 

Experts tell us colds take time.  Antibiotics are not necessary unless there is an infection.  The steam from your hot drinks will help open your nasal passages.  This includes hot milk despite the old wives tell of it increasing mucus formation.  Also be sure to include those essential vitamins like Vitamin C and Zinc to boost your immune system. Dressing properly will help too.

Have any home remedies or tips you would like to share?  Drop a line or two and share.

Doctor-Nurse Relationship

The relationship between the doctor and nurse can have a difference in the care of  a patient.  Nurses are generally the ones who see what is going on with a patient. They are at the bedside giving the care, noticing changes and communicating these findings to the doctor.  Hopefully the doctor utilizes the expertise of the nurse to treat their patients.  However, in my many years of nursing I have found some doctors really don't respect nurses at all which puts a strain on the respect a nurse has for the doctor and jeopardizes the care a patient gets.  Nurses are advocates for their patients and when they feel a plan of treatment is not right for the patient, doctors should at least listen to why they feel this way.  Doctors and nurses will not always agree but we must show enough respect to each other and discuss it professionally for the best outcome for the patient.

I work in a teaching hospital and one of the best advice an attending can give a medical student is to listen to and befriend the nurses.  We love doctors who will at least listen whether they agree with us or not.  Then you have the doctors who know it all and think nurses only do anything they can to get out of working.  These are the doctors who will jeopardize patient care because the nurse can't assist someone who knows it all already. 

It is important to note that the doctor-nurse relationship is sacrosanct and building a professional relationship is essential. Patient care should not be a tug-of-war between nurses and doctors, but instead it should be about professionals working together for the good of the patients. The medical team of doctors, nurses and other medical professionals that engage and respect each other will create a positive working environment and perform at an elevated level which can produce quality patient care with exceptional patient outcomes. This is the ultimate goal. 

What do you think? Share your thoughts and concerns. 

It's So Hard to Say Goodbye

Many times families struggle with letting their loved ones go.  It is easy to say what we want to happen to our family member and not examine what he or she would want for themselves. Working in the ICU, I see this on a regular basis.  A patient merely exists because their family selfishly keeps them alive when all odds are against their survival.  They say God will give us a miracle!  I too believe in God and his miracles but he also gave us common sense to know when it is time to let go.  If it is his will for he or she to survive, they will.  I don't know many people who would want to live their life and not be able to enjoy it.  We must look at "quality" of life and not "quantity".  When your family is lying in that bed, put yourself in their shoes.  Ask yourself is this how I would want to live the rest of my life?  Love them enough to let go and enjoy the happy times you had with them.  I would hope my family loved me enough to not let me suffer that way if all hope for a life of quality was  nonexistent.

What would your wishes be?  What would you do? Share your thoughts, comments or experiences.

Has the use of Milk of Amnesia (Propofol) been tarnished?

Ever since Propofol has been introduced to the public by the death of Michael Jackson, people are afraid of having it used on their loved one in the intensive care setting. Propofol has been safely used in this setting for years. What people need to realize is that when used properly in the correct setting it is as safe a drug as Tylenol. Propofol is used to sedate individuals who are receiving mechanical ventilation. In critically ill patients it has been found to be superior to lorazepam (Ativan) both in effectiveness as well as overall cost; as a result, the use of Propofol for this indication is now encouraged whereas the use of Lorazepam for this indication is discouraged. Propofol is also used for sedation, for example, prior to endoscopic procedures, and has been found to have less prolonged sedation and a faster recovery time compared to midazolam (Versed). When used for sedation on mechanical ventilation patients, they wake up faster because the drug's duration of clinical effect is much shorter. This is mainly because Propofol is rapidly distributed into peripheral tissues. Since patients and their families use the internet to try and dictate their care, why not use the resource to educate yourselves on the use of Propofol and how safe it really is!