R—Really? August 26, 2009
Posted by keepbreathing in Uncategorized.trackback
Angry rant coming:
Nurses, enlighten me: how does one make it all the way through nursing school without knowing what a tracheostomy is? I mean, REALLY? When a nurse–a registered nurse–asks me “what is that white thing sticking out of Mr. Jones’ neck?” there is a SERIOUS DEFICIENCY in nursing education. I mean, what do you even say to that? I just walked away and shook my head and died a little more on the inside. If I ever get sick, I’ll stay home and die before I subject myself to the half-baked whims of Albuteholic physicians and undereducated nurses. Who is she sleeping with to get a job taking care of patients, because there is no WAY somebody THAT STUPID could possibly get a job in any legitimate way. Unless the government has made it “discrimination” to not hire dumbasses…
I mean, I always feel sort of bad for my patients, but I spent some extra time that day checking on that nurses patients. That genuinely frightened me, that an RN would actually not know what a tracheostomy was. At least she asked, I guess; I could see her hooking the tube feeding up to the trache and the trache collar up to the PEG tube or something.
I have been told that the “professionalizing” of nursing has resulted in nursing students spending far less time at the the side of patients and more learning management, how to evaluate statistics, and so on. Nurses now learn less about actually caring for and treating patients than did certificate nurses of 25 years ago. At least that’s what the nurses I know tell me.
Wow! That is fff frightening. unbelievable actually. I will admit: fresh out of nursing school I did not have many skills: but at least I knew what a trach was.
Y’know, when the going gets tough, I always console myself with the fact that there will always be stupider nurses than me that graduate. Holy schneikes- that one takes the cake. Maybe she ordered her diploma from Sears and Roebuck?
That is bad! I have nurses at my hospital who refuse to do any sort of trach care, or checking the inner cannula every 2-4 hours, when it’s in their policy and procedures. There is nothing worse then having your patient plug off at 3am all because the nurse can’t do a 10 second task, even after you showed them how to
now this is why I’m seriously considering becoming an RRT instead of an RN.
‘just walked away and shook my head and died a little more on the inside.’
And didn’t tell her, so she still doesn’t know.
‘I could see her hooking the tube feeding up to the trache and the trache collar up to the PEG tube or something’
yep. But you could have told her different.
Wonder what she thinks of you?
Just to throw a comment out on the nurses side… maybe she was unfamiliar with that particular type of trach? was it one of those times when they come back with an ettube as a trach, or perhaps it was in a different position than midline? I once asked an ER doc to “tell me what’s going on with this” on a blood gas. What my end of the day addled brain MEANT to say was “what combination of drugs and illness could be causing this particular patient’s mixed alkalosis?”
Yeah, I’m an RT and I find the same kind of nurses all the time. sigh…
All I can say is, if you think you are mad at nurses like this, try to imagine how mad we nurses are at this kind of incompetence in our ranks! I am proud of my profession, and of most of the fine nurses with whom I have worked, but nurses like this make me feel ashamed. I am embarrassed to know that the person you described puts the same initials arfter her name that I do.
Are you sure that’s not my co-worker that I have been mentoring for two years (I was only suppose to hold her hand for 6 weeks, but she hasn’t turned loose to learn to walk yet). I had to run and suction her patient’s trach last week because “that’s icky, and I don’t know how to do that stuff”, but your patient can’t breath, “I’ll call respiratory”…dudette…it will take too long, just suction her and give them a holler to check on her…………Yup I did the “icky” stuff for her.
[...] a brief moment, but she seems anxious. Maybe I she just needs a little more lorazepam…" Maybe some might though. But the vast majority of us do have the common sense not to do something as boneheaded as that, we [...]
that is very scary, it scares me when CNA’s ask that question. If an RN ever asked I think I would be so scared to even work with her. (And I would start looking in on her patients once in a while too.)
KB:
I have had a trach since 1994, and, believe it or not, I’ve run into “what’s that?” multiple times. This year I met a nursing SUPERVISOR who mistook a feeding pump for the ventilator, and a DOCTOR who couldn’t turn oxygen off and on. She was helpless and had respiratory paged. Then I yelled at her.
Last year I “coded” and blacked out for 15min after I threw a mucous plug and an RN didn’t know what to do aside from suction. When I turned blue and lost consciousness, she called code blue. The on-call doctor at 3am (an infectious disease specialist who looks younger than me) assumed it was an MI or stroke. No, just a simple mucous plug, and as soon as the respiratory therapists ran in and began bagging me, I got the airway clear and regained consciousness and was fine.
Why are respiratory BASICS so foreign to so many nurses and doctors???
Now c’mon ladies and gentlemen. Are we really going down the horrible road of ‘over-generalization’. Yep even in the department of Respiratory Therapy there are those that graduated at the bottom of the barrell. There are RT’s, MD’s, RN’s, CNA’s, etc that we have all crossed paths with that scare us half to death at what they do not know, or how ill-prepared they seem to be.
Let’s keep it clean folks.
I’m sorry to say I’ve had to teach several nursing students how to do trach care myself, because they didn’t learn it in nursing school. And I’ve had to explain to a doctor that the trach tube was in my trachea, not my esophagus. Oh, and then there was the time I was having some minor surgery and the surgeon had to bring my mom into the OR because they couldn’t figure out why the vent was alarming. (The patient pressure tube had come off.)
I don’t think respiratory basics are foreign, so to speak, but with the expansive of the respiratory profession, nursing has taken a back seat with respect to respiratory care.
I’ve been an ER nurse for 5 years. I’ve worked in a variety of hospitals, and the truth is, in most of those hospitals, the RTs did not want me interfering with airways. They do respiratory assessments (after I finish my own, of course), manage airways and vents, and bagging the patient during codes. As they should. I’ve got the rest of the body to worry about. I don’t ask them to put in a catheter, manage ICP pressures or identify causes of septicemia. That is within the realm of MY profession.
So, if you take away a person’s responsibility, assign it to someone else, and identify it as THEIR profession, then you can’t expect them to remain an expert in that part of body care.
All that being said, there is NO EXCUSE for at least not knowing what a trach was.
The Doctor that finishes 1st in his class is looked & admired and called Doctor the one that finished last in his class is snickered at but still called Doctor. An Rn that finishes 1st in her class the same thing, and the same goes for respiratory. But in Respiratory in each place we work we must prove ourselves. to the Doctors that we work with, the Nurses that we work with and our Co-workers. As for the one that needed the extensive hand holding. I would be for getting her the hell out of my hospital. Why do you still cover for her??? At least the smell of sputum does not linger down the hallway for a long time. Thanks but I will stick to respiratory. I have been asked what type of trach is that, but never what is that. Since in our hospital all nurses are required to go with Respiratory for at least 4 hours to learn airway management and 02 delivery devices.
I have to add albuteholic physician to my RT Lexicon!! Thanks for the new term.