Category Archives: critical care

The Entitlement of Respect

If you want respect just because of a title, go to medical school.

That may sound harsh… but I believe it to be true.  Let me explain a little further.  I have heard time and time again how demeaning and insulting the term “midlevel provider” is when referring to Nurse Practitioners (NPs) and Physician Assistants (PAs).  Arguments such as “nothing I do is midlevel” have been made time and time again by NPs and PAs who are striving to gain the respect and recognition of their peers in the medical community.  The latest term that all sides have mostly agreed upon is “Advanced Practice Provider” or APP, although I feel that this term is still a somewhat vague representation of what our role entails in today’s healthcare system.  Continue reading The Entitlement of Respect

“Old School” vs “Gotta Get Into School”

Nursing genocide has been a long time coming. There, I said it. And here is why.

Ever since I graduated with a 2 year Associate of Science degree in nursing, I was asked the question – “So when are you going back for your Bachelors degree?”

I would quickly reply with a resounding “Never, unless I have to!” which lasted for about 2 years… I then decided that this was not enough, I wanted to take it to the next level. Not just a BS nursing degree (pun intended), Continue reading “Old School” vs “Gotta Get Into School”

The power of the story

I love a great story.

There is truly no substitute for the way a woven web of words can play to your sensibilities. If you think about an incredible movie, the CGI is what makes it come alive in front of your eyes; however, without a great story line, it all falls flat as smoke and mirrors. Medicine is no different. As we come to love and embrace the sexiness that is advanced scan techniques, ultrasound, robotics, it is easy to lose the more human element of the people that stand before us.

“We need a little help down here.”

The emergency department called with a 40 year old male, diagnosed with bilateral pneumonia, who they were having difficulty oxygenating. The report that they received from the flight crew was that he had been sick for approximately two weeks. Had seen his PCP 4 days ago, been prescribed antibiotics, no real improvement. Progressive dyspnea today and his wife called EMS.
On my arrival, his 02sat was 79%. Violent coughing, froth to the OETT, normotensive, tachycardic at 135, significant JVD.
Patient was more heavily sedated, decreased tidal volumes, increased PEEP and achieved a sat of 91. I took a quick look at his CXR while someone retrieved his wife.

“So he’s been sick for about two weeks?”

She immediately gave me that look that my dog gives me when I try to discuss the intricate details of this week’s episode of “The Walking Dead” with her.

Continue reading The power of the story

When I grow up…

There are a few childhood memories that will always stick out in my mind and at the top of that list is this question-

“So, what do you want to be when you grow up?”

I cannot even begin to count the number of times I had to come up with answers for this query.  At age 5, my usual answer was that I wanted to become an orthopaedic surgeon.   Then of course there was the follow-up question of “why?”  I simply explained everything my 5-year-old brain understood about orthopaedics with- “So I can take out the bad bones and put in new ones”  (insert orthopaedics joke of choice here).

As I began to “grow up,” my goals and focus shifted several times, ranging from heavy equipment operator/contractor, to farmer, to airline pilot, and then finally to becoming a nurse.  During my senior year of high school I began making college plans to study nursing.  It seemed like the perfect choice- I could get an Associate degree, take boards and start working/making money in just 2 years of college, and NEVER have to go to school again!  Sign me up!
Continue reading When I grow up…

The patient needs YOU…

As Frank and I embark on this new endeavor, I have contemplated a great deal about my first post.  I want my passion to shine through.  I love vents, ABG’s, lungs, airways, critical care and all that it encompasses.  I’ve deeply contemplated where I want this journey to begin, what I want to share, teach, impart.  My brain has been buzzing.  And then I had a bad night.

I started my usual night trucking down the hall, looking at my list, making plans.  Then I passed one of our critical care nurses who flagged me down.

“We’re bringing a bad one to the unit.”

Okay, ‘bad one’ is kind of my bag.  The nurse gives me some quick details and I tell her that is sounds like the patient is well covered and that I’ll stop by, weigh in, and see if anyone needs anything.

“No, she needs YOU.”

These words have become both a compliment and a curse. I know immediately what it means. It means a complicated social situation, confusion, sickness. It means that she is dying.  Continue reading The patient needs YOU…