I recently visited Emily at The Waiting blog and after leaving a comment on her excellent post about heart murmurs the narcissist in me was inspired to write about how to be an awesome nurse on my own blog. Being an awesome nurse involves bragging rights and many of these rights are found through these six nursing tasks. Mastering or accomplishing any one of these tasks will provide you with
great fame and fortune awesome bragging rights among your coworkers. Enjoy!
Task #1: heart murmurs
Murmurs are really harmless and boring about 90% of the time and the other 10% they are just mired in uncertainty. There is a long standing joke I just made up involving how many nurses it takes to recognize a heart murmur. The answer is always one nurse to hear it and nine to provide a second ear before a cardiologist with a fancy stethoscope orders an echocardiogram that will actually confirm it. Hundreds of dollars of your patient’s insurance will then finally confirm just how awesome you really are. Ultimately, this will be a giant waste of money used to recognize a harmless heart murmur, but at least you’re awesome.
Task #2: Successful foley catheter insertion in elderly morbidly obese women
Most of the time foley catheter insertion is really boring, but every now and then you stumble across the Where’s Waldo of urethras. These mythological holes are covered with many layers of untrimmed pubic hair, adipose tissue, and wrinkled genitals before victory is finally established through the yellow stream of urine flowing through the catheter and into their urine bag. This will be followed by a round of awkward high fives.
Task #3: Creative IV insertion in habitual drug users
You haven’t lived until you’ve slid an IV site through the last remaining vein located somewhere between the left or right big toe of a frequent flying habitual drug user. I’ve only witnessed sites like these a few times in my life (I suck at IVs) and have never personally felt the satisfaction of placing them myself, but what a joy that must have been.
Thirty seconds later this site will be blown and someone will order a central line. Months later this patient will linger in the hospital as they refuse every form of medical treatment except for pain medications while complaining or yelling about the ‘crappy’ service they have been receiving while watching horrible television as they suck down our free DSHS provided juice. Tens of thousands of dollars later we will all complain about the overwhelming cost of health care as we finally discharge this patient back to their homeless shelter to see them only seconds later in our emergency room. Sometimes, life sucks.
Task #4: Dobhoff tubes
Unlike nasogastric tubes, dobhoff feeding tubes are slid down your nose and into your duodenum. The last leg of this journey is done blindly. Thirty minutes later an abdominal x-ray will let your friends and other nurses know how awesome you are.
Task #5: Recognizing that obscure ECG rhythm
Every nurse knows their dangerous or life-threatening rhythms, but not every nurse knows those obscure often benign rhythms nobody has ever heard of. Sure, Torsades is exciting and you’re ability to recognize low magnesium without consulting their labs will be appreciated, but nothing beats recognizing an idioventricular rhythm or Wolff Parkinson White Syndrome on the ECG.
“What’s Wolff Parkinson White?” a coworker may ask.
“Oh, it’s an obscure non life-threatening rhythm that demonstrates how awesome I am at recognizing obscure non life-threatening rhythms. Geez, what are you an idiot.”
Task #6: Discharging that horrible patient everybody hates
There are always those patients nobody enjoys working with. These patients split staff members and manipulate their care while constantly berating the majority of our staff to get what they want. What they want often keeps them in the hospital longer as they refuse all other manner of treatment.
They curse and spit their way through each day until they get what they want. They will do whatever it takes to stay in your hospital and have often done so much to ensure there is no safe place to discharge them outside our hospital that they stay for months on end until we happily transport them outside our doors. One such patient stayed for over a year until she was escorted out the door with a smile and a very satisfying pizza party.