[John_RN_EMT-P]

Ask a Nurse. I know you want to. Really, feel free. I want to help, it is in my nature. I am sure others have the same questions. If you know a nurse or other medical provider you trust then ask them. If you don't, then you can ask me. If I know the answer I will tell you. If I don't know the answer I will try to find it. If it not in the scope of my training and experience I will tell you.

A few nights ago on my way home from working 14 hours in the ED, I stopped at the grocery store to pick up some milk and cough drops. I had to work the next day so I was anxious to get home.

After grabbing some milk, I went to the pharmacy section to grab some cough drops and encountered a woman and her child. The woman had three different cough syrups in her hand when she looked up and saw me in my scrubs, with the emboldened "RN" hanging from my emergency department RN name badge.

Stupid me! I should have taken off my name badge when I stop between work and home, however, I have misplaced my name badge twice already and it is a real hassle to get it replaced.

The pharmacy was closed and the woman desperately asked if I could help her. My thought was, 'If I can keep her and her family out of the emergency room then this will be time well spent'.

After spending 10 minutes answering her questions I was able to help her choose the appropriate over the counter medications to treat her family and give her advice on treating the flu.​

My mother was a registered nurse and I started off with her American Red Cross first aid manual. I became a boy scout and learned all about first aid, emergency preparedness, lifesaving and wilderness survival. I went on to become an American Red Cross lifeguard, water safety instructor, first aid instructor, and CPR instructor.

I joined the Coast Guard and became an emergency medical technician.

I left the Coast Guard and became a paramedic and worked on a 911 ambulance in a major city for 19 years. Been there, done that!

I went to nursing school, getting too old to do a young man's job.

I have worked as a Registered Nurse for the past 5 years and a board-certified emergency nurse for a year.

:thumb: So ask me your medical-related questions. I know you want to.

I will try to answer them in a timely manner, just know I sometimes work a four-day stretch 12 hours a day and it might take me a while to get back to you. :taped:

If you are experiencing a medical emergency then you should either visit your local hospital's emergency department or dial 911... that is if TEOTWAWKI has not already occurred.

 

[goat daddy]

The doctors at work always advised against asking a nurse question. Their philosophy was that a nurse takes orders and does not make decisions. they think they know everything but they do not. My experience is that the doctors are correct is most instances.

 

[Goodwrench708]

The doctors at work always advised against asking a nurse question. Their philosophy was that a nurse takes orders and does not make decisions. they think they know everything but they do not. My experience is that the doctors are correct is most instances.

Who spends more time treating patients? A doctor or a nurse?
Nurses do

 

[maintenanceguy]

No doubt that Doctors have more knowledge then nurses. But, 25 years in any trade and you pick up some knowledge.

Find a guy who's worked for a licensed electrician or carpenter for 25 years and he probably knows something about the trade. If I need brain surgery, I'll find a doctor. But for most routine medical issues, I'd trust my local RN.

 

[Goblin X]

Ive got a question, but I would rather PM it to you if possible. thank you.

 

[Hoka-hey]

Not really a medical qt but thank you anyways. I have a team of DR's looking after me from 2 different hospitals and a highly rated third one is consulting on their dime.
I've gotten to know quite a few nurses and they all seam as dedicated as you , many have a calling I've found.
I have a few months ahead of me but things are looking far better than they initially did.

Ok here's to qt. I spent 13 hrs in ER because the hospital that would specialise in my emergency surgery was at capacity.
Still couldn't get a bed so I was admitted at the er hospital for several days as they tried another avenue.
It worked for a couple of weeks but then I had to go back to the ER.
This time I waited again with iv's ect about 7 hours waiting for an opening and that evening I was transported( a 3 hr ambulance ride).
I was very week at this point and the Docs said if they didn't get an opening they were going to declare an emergency and send me to another hospital ( not in my insurance plan) and the insurance would have to pay.
Either one are highly rated teaching hospitals , but my point is what's up with hospitals being at capacity.
If there was any small disaster I'm thinking they would be overwhelmed.

 

[Outpost75]

I am lucky that in the WVU Medicine Family Practice I frequent, most of the PAs and RNs are also military vets, current EMTs and military reservists who have had multiple tours downrange or current local EMS experience. The supervising docs use them to do initial patient assessment and routine primary and followup care and to monitor medications and wellness. My dentist is also part of this group and I am well satisfied with the quality of care.

Time spent in patient contact is superior and the advise helpful.

 

[GrizzlyetteAdams]

Interesting thread, John_RN_EMT-P.

In the event of a prolonged crisis event, and if there is no doctor and if your personal antibiotics-of-choice are depleted...

What would you do if you or yours had cellulitis or sepsis?

Even if reasonable care is taken to maintain cleanliness during disasters, it does not take much for cellulitis to quickly set in, and consequently...sepsis.

 

[John_RN_EMT-P]

i went to the dr to get a physical.

during the blood draw i felt a weird pain in my wrist area.

now i keep getting pain in my wrist area when i do certain things
am i gonna die?

No, but you might go blind. Worst case scenario is that your wrist might fall off.

 

[GrizzlyetteAdams]

You won this one, John. Unbeknown to me, you were responding to that post just a split second before I deleted it for trolling.

But your answer was so good, I think I will let the quoted post stand. :thumb:

 

[John_RN_EMT-P]

The doctors at work always advised against asking a nurse question. Their philosophy was that a nurse takes orders and does not make decisions. they think they know everything but they do not. My experience is that the doctors are correct is most instances.

You must be shaking in your boots whenever a nurse comes near you. I wonder if there is a name for phobia of nurses?

I have never heard of anyone getting doctored back to health. Nursed back to health is another story.

Doctors diagnose and prescribe. There are many skills that nurses do that a doctor doesn't and vice-versa.

Perhaps you have never heard of a Nurse Practitioner. A nurse practitioner is a primary care provider which is becoming more and more common as physicians do not want to practice primary family care or general medicine when they graduate from medical school.

Doctors are not Gods and nurses are not angels, we all make mistakes. The best doctors I know collaborate with nurses. When I was an ICU nurse, the patient's physician would come to me and ask me how the patient was doing. That is because nurses spend the majority of the time with the patient when they are hospitalized. Doctors just review charts and diagnostic tests and lay eyes on the patient once or twice a day.

You can train any monkey to take orders, it takes a skilled nurse with critical thinking skills to be the last line of defense between an overworked physician and the patient. If a physician gave an order that I know will potentially harm a patient, it is my job to question that order. You would not be comfortable knowing how often this happens, especially at teaching hospitals.

Who do you think gives discharge instructions and education to a patient when they leave the hospital? The doctor? No. It is the nurse who is the one who explains those discharge instructions to the patient and family.

"Mr. Smith, the doctor wants you to follow up in three days and in the meantime be on a bland diet. What kind of bland diet? I don't know, you will have to ask the doctor." And I would be looking for a job the next day.

If you don't trust a nurse, then I guess you can just ask Dr. Google and hope you understand what it means.

 

[John_RN_EMT-P]

Who spends more time treating patients? A doctor or a nurse?
Nurses do

The only time a doctor might spend more time with you is when you are at a doctor's appointment. Otherwise, nursing staff spends the majority of the contact time with a patient.

 

[John_RN_EMT-P]

Ive got a question, but I would rather PM it to you if possible. thank you.

feel free to PM me and I will help you if I can.

 

[Eddie_T]

 

[John_RN_EMT-P]

Not really a medical qt but thank you anyways. I have a team of DR's looking after me from 2 different hospitals and a highly rated third one is consulting on their dime.
I've gotten to know quite a few nurses and they all seam as dedicated as you , many have a calling I've found.
I have a few months ahead of me but things are looking far better than they initially did.

Ok here's to qt. I spent 13 hrs in ER because the hospital that would specialise in my emergency surgery was at capacity.
Still couldn't get a bed so I was admitted at the er hospital for several days as they tried another avenue.
It worked for a couple of weeks but then I had to go back to the ER.
This time I waited again with iv's ect about 7 hours waiting for an opening and that evening I was transported( a 3 hr ambulance ride).
I was very week at this point and the Docs said if they didn't get an opening they were going to declare an emergency and send me to another hospital ( not in my insurance plan) and the insurance would have to pay.
Either one are highly rated teaching hospitals , but my point is what's up with hospitals being at capacity.
If there was any small disaster I'm thinking they would be overwhelmed.

Yes, the healthcare system is at capacity. Healthcare is expensive because people expect free healthcare. Those of us who have decent health insurance are paying for those who have crappy health insurance or no insurance at all. I guess it depends on your location but it is getting hard and harder to get timely quality care. I don't know how to fix the system. I just have to make do with the system as it is and hope I can take care of patients.

 

[John_RN_EMT-P]

Interesting thread, John_RN_EMT-P.

In the event of a prolonged crisis event, and if there is no doctor and if your personal antibiotics-of-choice are depleted...

What would you do if you or yours had cellulitis or sepsis?

Even if reasonable care is taken to maintain cleanliness during disasters, it does not take much for cellulitis to quickly set in, and consequently...sepsis.

Here is my take on antibiotics.

There are gram-positive bacteria and there are gram-negative bacteria. Medicine understands that certain bacteria are more susceptible to and sensitive to certain antibiotics.

When a patient comes into the hospital with a suspected infection, we will collect blood cultures or wound cultures which typically take three days to grow and analyze. In the meantime, the patient is placed on broad-spectrum antibiotics to try to slow down the growth of the bacteria making the patient ill to give time to grow the cultures. Sometimes the provider is lucky and the broad-spectrum antibiotic is sufficient and no change is needed. Sometimes the antibiotic needs to be changed to target a specific bacteria.

With the overuse of antibiotics and with patients not completing a full course of antibiotics prescribed, humanity has been facing a crisis for the past 20 years due to antibiotic-resistant bacteria.

There are several go-to antibiotics that providers prescribe for cellulitis in general. The problem is that some people may have a sensitivity or allergy to certain antibiotics.

In a TEOTWAWKI event, many people are going to die from infections. Sepsis causes multi-organ failure and only early detection and treatment with the appropriate antibiotics for sepsis will a person survive. I do not see clinical laboratories up and running to run blood cultures let alone there being sufficient supplies of antibiotics to treat it if TEOTWAWKI.

 

[John_RN_EMT-P]

You would be amazed at how many people come into the emergency department in a panic because of something they read after googling their symptoms ... up to and including death.

 

[GrizzlyetteAdams]

Here is my take on antibiotics.

There are gram-positive bacteria and there are gram-negative bacteria. Medicine understands that certain bacteria are more susceptible to and sensitive to certain antibiotics.

When a patient comes into the hospital with a suspected infection, we will collect blood cultures or wound cultures which typically take three days to grow and analyze. In the meantime, the patient is placed on broad-spectrum antibiotics to try to slow down the growth of the bacteria making the patient ill to give time to grow the cultures. Sometimes the provider is lucky and the broad-spectrum antibiotic is sufficient and no change is needed. Sometimes the antibiotic needs to be changed to target a specific bacteria.

With the overuse of antibiotics and with patients not completing a full course of antibiotics prescribed, humanity has been facing a crisis for the past 20 years due to antibiotic-resistant bacteria.

There are several go-to antibiotics that providers prescribe for cellulitis in general. The problem is that some people may have a sensitivity or allergy to certain antibiotics.

In a TEOTWAWKI event, many people are going to die from infections. Sepsis causes multi-organ failure and only early detection and treatment with the appropriate antibiotics for sepsis will a person survive. I do not see clinical laboratories up and running to run blood cultures let alone there being sufficient supplies of antibiotics to treat it if TEOTWAWKI.

Yes I understand that considering how aggressive sepsis is, it is pretty much a given that if you suffer this condition in an austere situation, you are likely to die. That's why I was curious what someone in your capacity would do for something like cellulitis, which is notoriously difficult to treat without antibiotics, and could develop into sepsis.

Even when reasonable hygeine is practiced to prevent it, cellulitis could deteriorate into a deadly septic condition.

So if you found yourself with a case of cellulitis in the event antibiotics are not available in a prolonged SHTF event, what would you do?

 

[GrizzlyetteAdams]

You would be amazed at how many people come into the emergency department in a panic because of something they read after googling their symptoms ... up to and including death.

Haha! This reminded me of a quote by my favorite curmudgeon, Mark Twain:

"Be careful about reading health books. You may die of a misprint!"

 

[John_RN_EMT-P]

So if you found yourself with a case of cellulitis in the event antibiotics are not available in a prolonged SHTF event, what would you do?

For minor cellulitis, you might try taking turmeric powered orally and applying tea tree oil topically. Unfortunately, if you develop a fever and the cellulitis progresses there is not much that I know of that can be done without oral or IV antibiotics. In a TEOTWAWKI scenario, the prognosis is poor.