Eighth of Nine

For My Co-Workers in the ED

2007-03-29T04:10:00.000-12:00

Guest Editorial
ACEP News
September 2006
By David F. Baehren, M.D.

For a generation or two, we have lamented the loss of role models in society.As parents and individuals, we naturally seek out others we would like to emulate. Sadly, a serious search through the popular culture leaves us empty-handed and empty-hearted. Thanks to a long list of legal and moral shenanigans, many entertainers, politicians, and athletes long since abdicated this momentous position of responsibility.We usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses.And not just any kind of nurse: the emergency nurse. There are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. But it is the emergency nurse who shoulders the weight of patient care. Without these modern-day heroes, individually and collectively we would be in quite a pinch.This unique breed of men and women are the lock stitch in the fabric of our health care safety net. Their job is a physical, emotional, and intellectual challenge.Who helped the paramedics lift the last 300-pound patient who came in?Who took the verbal lashing from the curmudgeon giving admitting orders over the phone?Who came to tell you that the guy you ordered the nitro drip for is taking Viagra?The emergency nurse has the thankless job of sitting in triage while both the long and the short buses unload at once. With limited information, they usually send the patient in the right direction while having to fend off some narcissistic clown with a zit on his butt. They absorb the penetrating stares from weary lobby dwellers and channel all that negative energy to some secret place they only tell you about when you go to triage school.Other kinds of nurses serve key roles in health care and attend to their patients admirably. However, few function under the gun like emergency nurses do.It is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is "ready" to accept the patient. The productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital "can't take report." Many of our patients arrive "unwashed." It is the emergency nurse who delivers them "washed and folded." To prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care--and caring.Few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. These nurses must deal with patients who are in their worst physical and emotional state. We all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into.For the most part, the nurses expect some of this and carry on in good humor. There are times, however, when the patience of a saint is required.In fact, I believe that when emergency nurses go to heaven, they get in the fast lane, flash their hospital ID, and get the thumbs-up at the gate. They earn this privilege after being sworn at, demeaned, spit on, threatened, and sometimes kicked, choked, grabbed, or slugged. After this, they go on to the next patient as if they had just stopped to smell a gardenia for a moment.Great strength of character is required for sustained work in our field. The emergency department is a loud, chaotic, and stressful environment. To hold up under these conditions is no small feat. To care for the deathly ill, comfort suffering children, and give solace to those who grieve their dead takes discipline, stamina, and tenderness. To sit with and console the family of a teenager who just died in an accident takes the strength of 10 men.Every day emergency nurses do what we are all called to do but find so arduous in practice. That is: to love our neighbors as ourselves.They care for those whom society renders invisible. Emergency nurses do what the man who changed the world 2,000 years ago did. They look squarely in the eye and hold the hand of those most couldn't bear to touch. They wash stinky feet, clean excrement, and smell breath that would give most people nightmares.And they do it with grace.So, here's to the emergency nurse. Shake the hand of a hero before your next shift.DR. BAEHREN lives in Ottawa Hills, Ohio, and practices emergency medicine. He is the author of "Roads to Hilton Head Island." He welcomes your feedback at DFBaehren@ameritech.net.

Rick is Growing Up

2006-10-11T14:44:00.000-12:00

Lisa and Bruce get new dog

2006-06-15T14:28:00.000-12:00

A Beautiful Day for a Hike

2006-06-06T14:30:00.000-12:00

Atop McAfee's Knop on the Appalachian Trail.

Ready for Snow

2006-02-11T11:37:00.000-12:00

Destination: Steamboat Springs, Colorado
Purpose: A Valentine's Week of Play
Date: February 11, 2006

But...

Developing Nor'easter Heads Up East Coast

So we are watching it snow in Virginia. Instead of spending the day travelling we are spending a cold, snowy day at home. Bruce assures me we will get to the slopes. Cross your fingers.

MERRY CHRISTMAS

2005-12-17T04:47:00.000-12:00

Hope you all have a very Merry Christmas and Happy 2006! Bruce will be sharing Christmas with his dad in Florida and I will be here working in the ER. To each of you: may all your Christmas wishes come true.

Paddy Knappe's Picture

2005-09-05T07:44:00.000-12:00

New Corgi to Join Household

2005-07-21T15:29:00.000-12:00

Pictures of Paddycake will be forthcoming. Expected time of arrival: Friday noon.

Yippee, Yoohoo

2005-07-05T13:49:00.000-12:00

Elisabeth W. Knappe, RN

What I Have Been Preparing For!

2005-06-29T12:40:00.000-12:00

NCLEX: National Council Licensure Examination. A student must pass the NCLEX in order to become a licensed registered nurse in the US. Most nursing students take the exam within 3 months after finishing nursing school. This correlates to a May-July test "season.

Think of me Friday, July 1, 2005 at 0900 Eastern Time as I sit to take the NCLEX. I will report my results here, July 5, 2005, after a long weekend of waiting.

First Day of Work

2005-06-03T15:50:00.000-12:00

Vacation came to an end on Monday and orientation started Tuesday, but the real work began today. I worked a 12 in triage. It was a very good introduction to the ER! Bruce has been working on his blog report of our vacation from sailing to Maine. Check it out at http://www.theknappes.us/blog. His new job in Wind Turbine Controls is blowing him out of the country and all the way to Germany on Sunday afternoon. Bandit and the cats are doing fine. Hugs all round.

2005-05-01T13:43:00.000-12:00

Today the sun sets on my last day of nursing school. Tomorrow is my final. Think of me from 0900 til 1200. I will report my final grade here. Thank you for all your support during this final semester. I will continue to work hard to make you proud.

School is Over! Now the Work Begins

2005-04-27T03:02:00.000-12:00

Monday marked the final test and lecture of my nursing degree. I don't have the results of the test but I am hoping that it is an improvement from the previous failure. Yes, I flagged a test. Bruce and I had a great time at the Cherry Blossom Festival but it did nothing for my test prep. So... I wait for the results of the final test as I try to prepare for the final exam. I wish I had a bit of that motivation from 10 weeks ago. I will report in a week if I successfully completed the program. Cross your fingers.

2005-04-16T00:32:00.000-12:00

Let the sun shine...

2005-04-10T13:21:00.001-12:00

Lisa and Bruce

2005-04-10T13:21:00.000-12:00

Beautiful

2005-04-10T13:18:00.000-12:00

Our weekend trip to DC to see the Cherry Blossoms. Very fun.

School and Work

2005-04-03T00:03:00.000-12:00

Test grades

Burns/HIV 89.29
Psych 90.91

As school winds down, the work world is looming large. To that end, I interviewed in an ICU on Tuesday and was hired Wednesday during my second interview on the spot! As of June 1, 2005, I will be working in a local hospital's Emergency Department, a level I Trauma Center. The Level I classification means that the center offers the highest level of expert skill and precision available in trauma care. I can't think of a more challenging place to work. Being hired as a new grad into this position is the opportunity of a nursing lifetime. So as difficult as the last two years of nursing school have been, I do believe the hard work is still ahead. Pray for me.

2005-03-25T03:31:00.000-12:00

HAPPY EASTER. Love, Bruce and Lisa

HAPPY SAINT PATRICK'S DAY

2005-03-17T05:04:00.000-12:00

May those who love us love us.

And those that don't love us,

May God turn their hearts.

And if He doesn't turn their hearts,

May he turn their ankles,

So we'll know them by their limping.

2005-03-10T17:51:00.000-12:00

No, this is not a lunchroom lady. This is the official senior portrait of the next nurse in the family.

Who Passed Gas in Roanoke?

2005-03-05T19:27:00.000-12:00

Bruce writes:
The big news in Roanoke today was the gas leak. Shortly after I arrived at work (around 9:00AM) I got a slightly panicky call from Lisa saying "I think they might be evacuating the neighborhood"! It seems that there was a very strong smell of natural gas pervading the neighborhood. I immediately called the gas company (couldn't get through), and the police (did not know the source of the leak but were not calling for evacuation). After discussing the situation with my co-workers, I decided it would be best for Lisa to leave the neighborhood and go to Barb's until the air cleared but, when I called her to suggest this she told me that the gas smell extended all the way to South Roanoke, they were still looking for the source and that "officials" were recommending to avoid the entire area until the source was found. The mystery was solved when the source of the odor was determined to be the ordoring agent in natural gas; it had been accidentally released at a recycling plant halfway between here and Barb's.

"From WDBJ7, Roanoke News

The smell of natural gas hung over parts of Roanoke Saturday morning.
The foul smell was Mercaptan, the odorant that is added to natural gas to give it a smell.
But the gas company reported no drop in pressure, and emergency crews couldn't find a busted line.
Crews tracked down the smell to the Cycle Systems Recycling facility. Officials say a container that held mercaptan was slightly opened at the recycling plant, releasing the odor into the air."

After the initial excitement (panic), I got thinking about how this might have happened. Maybe some environmentally concious gas company employee took it upon himself to recycle the container of mercaptan instead of throwing in a landfill. But I couldn't resist thinking about what would have happened if he had thrown it out. The container would have been buried under a mound of garbage. At some time in the future (maybe 5 or 10 years from now), the container would have corroded completely through and started leaking. Since natural gas is a byproduct of the decomposition of garbage, the mercaptan would have rediscovered it's purpose in life by odorizing the natural gas coming from the landfill! I know this is engineery humor but I hope you got a chuckle out of the irony of the situation. Gotta love the excitement of living in a small town.

2005-03-03T14:34:00.000-12:00

What a cute pair!

2005-03-01T13:57:00.000-12:00

A nice summer day at Foothill Farm in Athens, Tennesee with our dear friends Vanessa and Charlie and their two sons. Check out the corgie, son of Bandit; great pyrenees, pot bellied pigs, connemaras, percheron, and BLM donkeys. Quite a menagerie!

2005-02-25T14:02:00.000-12:00

Jesse and Bandit. Two old dogs, no new tricks.

3 Down 5 To Go

2005-02-24T06:08:00.000-12:00

92.31

I enjoy posting these good test grades. I hope I can continue with this pace for the next 8 weeks.

2005-02-22T08:40:00.000-12:00

A Year Ago at Eight/Ninths!

Test Results are In

2005-02-16T10:00:00.000-12:00

91.16

Two down and six to go.

2005-02-14T13:27:00.000-12:00

Happy Valentine's Day!

2005-02-14T13:21:00.000-12:00

Wow! Who are those two grey hairs?

Wednesday Evening Before Test

2005-02-09T09:32:00.000-12:00

This has been an eventful week in the family. Let's hope I have studied enough for test No. 2. Will let you know next week. L

2005-02-04T13:34:00.000-12:00

Kids are cute. Cats are easy!

2005-02-04T13:31:00.000-12:00

Who is that sweet cat?

2005-02-03T15:08:00.000-12:00

Number Seven in Fishing Heaven!

2005-02-03T15:06:00.000-12:00

More Fishing Fun!

Groundhog's Day

2005-02-01T21:38:00.000-12:00

I am here to see if Mr. Groundhog is waking up yet and I just had a very fond memory of Groundhog's day. When I was in Second Grade, in Ms. Conyers class, Mom came to school drew a groundhog standing outside of his den on the bulletin board right outside our classroom door. He stood about 2 1/2 feet tall and his little hands were held right in front of him, just like groundhogs do. He was a perfect groundhog and I was so proud to have had mom draw him for everyone to enjoy. I can remember her standing there drawing him like it was yesterday. I think that is the best Groundhog's Day I ever had in my entire life. Hope you have a great Groundhog Day.

Welcome to the Blog of Number Eight

2005-01-29T02:18:00.000-12:00

This page is to share with you the highlights of my final semester of nursing school. I will share with you thoughts from along the road as this formal education is completed.