Cannula security in the profusely diaphoretic patient

Most of us have had to deal with it. A profusely diaphoretic patient.

These patients are usually unwell, exactly the time you least want to lose their IV access. Yet due to the moistness of the patient’s skin their cannula dressing just lifts away, and scrumples up into a mess, and floats free, and you just can’t seem to do anything to get it to stick.

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You don’t care.

Next month Australians will be sent a voluntary postal ballot to vote on whether or not the law should be changed to allow same-sex couples to marry.
This plebiscite is non-binding. If the majority of Australians vote yes, the government has committed to then allowing a private members bill to go before Parliament to decide the issue.
It is estimated the total cost of this process will be around 122 million dollars.

 

Here is poem that Nurse L wrote about Marriage equality from the perspective of a nurse who happens to be a lesbian…

Continue reading “You don’t care.”

Betty’s Death. 

Some time ago  we had a 98 yo lady (whom I will call Betty), transferred to our emergency department from a local nursing home. Betty was having palliative care at the nursing home and was well aware that she was soon going to die. 
Betty had completed an advance care directive (ACD) stating her wishes not to be resuscitated and that she did not wish to die in a hospital, but in her current environment.

She also stated that she would very much like to be able to listen to some Scottish music and in particular ‘Danny Boy’ at the time of her death.
Betty had awoken at 1am with frequent haemoptysis and severe abdominal pain, and despite her wishes and the ACD, the staff at the nursing home decided to call an ambulance.
I don’t know why this happened. Perhaps there was a mix-up with her directives, perhaps there were new staff on who did not know her plan, perhaps they did not feel confident managing her haemoptysis, perhaps they rang her doctor who told them to transport her.

Perhaps it was a combination of things. I don’t want to be judgmental, but I will say that it is my experience that this sort of thing happens far more than it should.

On arrival in our department Betty remained quite alert, and stated to our nurses that she knew she was about to die.

Following a conversation between Betty and our senior doctor, she was given some sedation and analgesia and our nurses made her as comfortable as they possibly could within the context of a busy, noisy, crazy, crowded, abrasive Friday night in the ED.

Oh….and something else happened that night amidst the crazy.

Something so simple and so wonderful, that it made the hairs stand on the back of my neck.

Two of our nurses had noted Betty’s request in her advance care directive.

One of them pulled out their iPhone, they down-loaded Danny Boy…. and then they played it to her as she died.
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This is it! Don’t get scared now.

The following is a guest post by Vanessa Katsoolis.


 

If I ever come across a nursing student in their final year of their Degree that is willing to be honest about how they feel the first thing they will say is that they feel they don’t know enough, that they are scared that they are going to graduate, get their scrubs, put them on and walk into their first day on the floor and not actually know what to do next.

Continue reading “This is it! Don’t get scared now.”