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About Me

I am an ER nurse, new to nursing, and new to the ER. I am terrified, exhilarated, and I LOVE my job. I have created this space to share and archive the lessons that I am learning, to blog about my day to day experiences, and to provoke discussions and dialogue with other ER nurses and healthcare professionals, and the general public on all things related to nursing, health and healthcare.

The Usual Suspects - What Can We Do?

Submitted by ernurse on Mon, 06/09/2008 - 13:02.

One of the things that I've observed so far working in the ER is that there are very few truly unique stories. Sometimes it feels like we're dealing with the same old suspects again and again in varying shapes and forms. If this is indeed true, then it seems to me that there should be a way to reduce the number of ED and hospital visits and improve general health by using preventative measures or by some form of public health initiative.

Let's start with the GYN corner - the usual suspects are STDs, because someone (not necessarily the patient) was careless, and vaginal bleeds, usually because someone is miscarrying. The miscarriages, more often than not, are in patients who have not had prenatal care, and are using or abusing one substance or another. This is not ALWAYS the case, but more often than not it is. So what can we do here - lots of public health education on how to prevent STDs, how to take care of yourself when you're pregnant, and what clinics are for.

The peds corner is full of fevers, ear infections, tummy aches, strep throat, and the like. Most of the time it's mothers who don't want to wait for an appointment at the peds clinic or with their pediatrician and decide to come in. Kids get sick, a lot. And there are usually plenty of home remedies and things you can do. Again, I am not denying that there are definitely those true emergencies that MUST be seen immediately, but most of the time the right dose of tylenol will take care of that fever.
NOTE: If your child is really sick, please don't hesitate to go to the ER.

Then we go to the Crisis/Psych corner. Besides the people who are really in Crisis, and are suicidal or homicidal because of life events or because they've not been taking their medications, we have the other usual suspects - overdoses, drunks, and people who are "acting out". Is there a way to make sure that patients have and take their medications on time? That's what day programs are for, but is it enough? From the repeat visits that we see, often from the same people, I am guessing it's not enough. For the drunks and drug users that we have to cater to every night, I really don't know what to say. It's a lifestyle choice that's costing our health care system.

And finally, the adult medical cases - heart attacks, strokes, renal failure, sepsis, UTI, dehydration, cellulitis, abdominal pain, headaches, etc. There is no overarching theme to all of these that I can point out, but there are a few things, which again are a matter of public health education and individual choices, that can make a difference.

- If you don't watch your diet and increase your activity, you will end up in the ER. It will be hard to effectively treat you because obesity leads eventually to some level of debilitation, to heart attacks, and increases your risk for almost every terminal disease under the sun. If you watch your diet and that of your children, and increase your physical activity, and that of your children, you are on your way to a healthy life.

- If you keep smoking you are increasing your chances of having a stroke and other cardiovascular issues, not to mention cancer, COPD and other respiratory problems. Smoking is one of the top killers in America. You may think you look cool lighting up that cig, but tomorrow you may be that guy walking around with an oxygen tank who can't catch a breath.

- If you don't drastically cut down your alcohol consumption you may have to learn the meaning of hepatic encephalopathy, and that's not a good thing. Your liver is precious, and it does a lot in your body, you really don't want to lose it. Moreover, excessive alcohol consumption also cripples your brain and many other vital organs, and you are opening the door to a deluge of other diseases. To make matters worse, you may end up in the crisis corner at some point, in restraints.

There are so many things I could add, but I wonder does it make a difference? The bottom line is this, you get one body, one shot. Educate yourself about your health and get on the path to making the right choices. You'll be surprised the difference it will make 50 years down the line.

Aging brings it's own set of physical vulnerabilities and troubles, don't add to them.

  • ernurse's blog

Hey ernurse, My response to

Submitted by Jen (not verified) on Wed, 07/09/2008 - 15:27.

Hey ernurse,

My response to this post turned into a bit of a hijack so it turned it into the blog post it was longing to be. It can be found here:

http://protectinsite.blogspot.com/2008/07/food-for-thought.html

Cheers, Jen

  • reply

Very insightful

Submitted by ernurse on Wed, 07/09/2008 - 21:12.

Jen,
Thank you for your very interesting and insightful reply. I encourage everyone to read the post:

http://protectinsite.blogspot.com/2008/07/food-for-thought.html

I have left you a reply and will be following that up with a more detailed post here in the near future.

Thanks again!

ernurse

  • reply

My mother in law works in an

Submitted by Jenny Stevens (not verified) on Sun, 01/11/2009 - 20:16.

My mother in law works in an ER as well and she deals with the usual cast of characters often. Though she cannot really say much she does let me know that she wishes the individuals would get the proper help they really need and not the quick attention of the ER.

  • reply

Staying out of the ER

Submitted by Billiard Lighting (not verified) on Wed, 02/25/2009 - 15:00.

Lots of great information here on how to avoid going to the emergency room. This is a place nobody wants to be.

  • reply

Health

Submitted by Ulcer (not verified) on Tue, 07/21/2009 - 09:58.

If you don't watch your diet and increase your activity, you will end up in the ER.... I definitely agree with this sentence.... I have had the same issues... Now I am happy that i have gained some interesting points from your article.... Great work...

  • reply

ER

Submitted by Guest (not verified) on Tue, 07/21/2009 - 11:05.

Loads of information on your blog..... Thank you... Keep up with your good work...

  • reply

You do only have one life to live.

Submitted by Brain Training (not verified) on Wed, 08/26/2009 - 04:15.

I think the reason people don't necessarily take care of themselves is they don't see the value in it. You mentioned the importance of good health, but people also recognize the value in vices. Whether it be overeating, smoking, or something more extreme, they recognize that they do only get to live once and want to enjoy it. Sure we could all eat the right foods and exercise and don't drink alcohol, but we would miss those other things. I think moderation is a much more reasonable goal and also the replacement of some worse vices with more constructive ones. For example, we now overeat as a society, but we don't smoke as much due to emphasis on the problems with smoking. We are making progress even if it does not seem that way.

  • reply

Love your blog

Submitted by HelenRN (not verified) on Tue, 06/01/2010 - 10:43.

Great Blog Ernurse! Keep up the great work. I worked as a staff RN in a Children's Hospital ER for quite a few years before leaving to become a telenurse. I eventually became burned out in the ER with the endless stream of kids with simple fevers, earaches, rashes and tummy aches. The ER was used as a drop-in clinic by so many parents. I remember a family who had 7 children and the mom was there almost every week with at least one of them. We kept trying to encourage her to get a family doctor, but why would she? Anytime her kids had any problem she could drop in- no appointment necessary and we couldn't turn anyone away. It's amazing how long someone will wait in a waiting room to be told their kid has a viral rash and needs no treatment and to go home. *sigh* (but not before infecting every child they have come in contact with in the meantime)
Ahh, wonderful ER...

  • reply

It's amazing how ignorant

Submitted by Utah Nursing School (not verified) on Wed, 05/18/2011 - 16:13.

It's amazing how ignorant people are of their own health. I hope that the public health education you're giving out is having an impact on those who don't understand.

  • reply

I've never really identified

Submitted by Brittany (not verified) on Tue, 08/23/2011 - 17:16.

I've never really identified it as a lifestyle choice that was affecting our health care system so much. How disconcerting!

  • reply

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The cases and persons that are described in these pages are composites, none representing any one particular patient, person, or case. While the medical facts are all true and accurate, I have edited and doctored and composited enough that none of the personal descriptions, family settings, or any other distinguishing features are representative of any real actual person. In other words, I am not violating any HIPAA laws and regulations on this website, and the privacy of all my patients is completely protected. Any resemblance to any living person is completely accidental and unintentional.

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