Archive for June, 2007

Crippen you love us…

Posted on June 28, 2007. Filed under: Elsewhere in the blogisphere |

That Moaning old git has been at it again – nurse practitioner bashing. It was Mental Nurse who got him started again.

On June 25th he started NP bashing again….boring.  Just this once I am going to lower myself – because I feel passionately?

No, thought it might be fun.

I know Dr Crippens hides a secret passion for Nurse Practitioners, he just get confused between love and hate.

I am one such Nurse Practitioner…I sit in a GP surgery, behind a desk, with my tie on, call my patients and then:
Assess, (Diagnose), Plan, Implement and Evaluate their care (this is called the Nursing Process – cool hey?).  I even – heaven forbid – prescribe.

Am I bound by Protocol? Hell no! I am (he’d love this bit) – an autonomous practitioner…. Crippins are you there? No? I can relax, I don’t want to be responsible for his blood pressure going up.

Do I work for the NHS? NO!  I work for a partnership of GP’s.  Yes – those mad fools employ me!! 

WHY would they employ a NP?  I hear you ask,  Well the truth is 2 fold:
1: I’m good at my job,
2: I am cheaper to employ than another Dr. ( oh I feel so degraded and cheap – sob sob)

They can save money and buy sports cars instead of employing a Dr!!- WOW!

Hang on then – so the NHS don’t employ me – the Doctors themselves do….

Max ‘n’ Crip’s
Yes I am Frankensteins Nurse Practitioner. Doctors created my job…. Queue demonic laughter HA HA HA HAAAAAA – If it wasn’t for Doctors wanting me I’d be a “normal” nurse in an A&E (ER).  

I know my scope of practice and I have no concerns about asking my colleagues (sorry I obviously meant superior doctors) about things I don’t know….and…are you ready for this…..sometimes they even ask ME for advice… Oh, I hope Crippen isn’t reading I don’t want to be responsible for his chest pain?

I should stop, but I am enjoying myself….

 The movie “based” on the true story..

Historically Dr Crippens have been murderous creatures, is Dr John Crippen in fact related to Dr Hawley Harvey Crippen?  Perhaps Dr HH Crippen’s wife wanted to move back to the USA to be an NP, and thus he murdered her. Perhaps this deep seated hatred of NP’s has been in the Crippen family for years.

Dr John Crippens seem to enjoy being rude about NP’s – is it that he enjoys our attention really?  In the way a son might about a mother perhaps!! Sigmund where are you????

He is perhaps a sad man who just needs to have a big hug. Go on John give us a big manly hug. Make it your mission to embrace a Nurse Practitioner. You never know you might just grow to like us…

And yes, I know, if that big blogging monster Crippens reads my little blog he will slate me, and make rude comments. But actually I don’t give a monkeys.  Why haven’t more NP’s commented? – I know the answer, they’re busy seeing his patients while he spends all his time blogging. (and yes – I am a blogger too – so I am skiving as much!!)

Dr. John Crippens I send you big manly hugs, and as much sarcasm as you like. 

Meanwhile the fantastic new Nursinglink.com is hosting Change of Shift….plenty of reading so grab a coffee and a bourbon, if the urge takes you!

Read Full Post | Make a Comment ( 10 so far )

At what point would you like me to start banging my head on the desk…

Posted on June 21, 2007. Filed under: Journal from behind the desk... |

Some people in jobs like mine say “I thought I’d heard it all…”  I will never say this. I am aware that every single person is diverse, and as such there is an infinite amount of “stuff” they will do, say or have happen to them.

Infinite Diversity

The elderly are great, and determind to stay young, not just using medications to stay alive and healthy for ever, but active to prove themselves (and too right to).

 I have told in the past about the elderly lady with and her under garments.

This week I had a patient attend with a history of falling off a skateboard and hitting his shin on a concrete bollard.  Fair enough these things happen you might say and indeed good on him, at 83 years old some people struggle to walk, and this dude is trying his hand at skateboarding!!!

He told me last time he skate-boarded was 20 years ago, and people said then he should know better at his age.

These people don’t make me want to bang my head on the desk.  I felt proud at the old boy – keep it up. (Hope you leg doesn’t ulcerate)

It’s the ones who do stupid things, but not with any sense of excitement or balls about it. Take my last patient for example, I confess I was perhaps a little short with her.

Pt: I’ve started having fits again.

Max: Have you been taking you Epilim?

Pt: No! My boyfriend said I should stop it.

Max: And he’s a neurologist?

Pt: No!

Pt again: I stopped taking them a week ago and I’ve had 7 fits.

Max: After the first 2 or 3 fits, did you not think perhaps it might be sensible to start taking the tablets again?

Pt: Yeah, suppose so!

Diversity is diverse. Stupidity is just stupid!

Read Full Post | Make a Comment ( 1 so far )

How to start a consultation (part one)…

Posted on June 14, 2007. Filed under: Journal from behind the desk... |

Part one….looks at the quiet patient… 

 Quiet TimeBig bird gives Max the creeps…

Wise practitioners will tell you, that after introducing yourself to your patient you should sit and allow your patient to talk….without interuption, until they have devulged their burning issues, at which point the practitioner can proceed with open questions and lead into the more specific closed questions.

Sometimes this doesn’t work….

Max: So what’s the trouble?

Patient: M’knee.

Big Pause…

(Big Paws….)

Max: OK? (expectant pause – nothing recieved)…and what exactly is wrong with it???

Pt: If I knew that I wouldn’t be here…

So sometime you have to guide your patient through, how long has it been a problem, the following responses are not helpful…

“Ages!” (at this point I get ratty and short “days, weeks, months or years? and how many?”  Sometimes to the point of questionnaires answers : “1-3 months, 4-6 months, 6-8 months or 9-12 months???? Well????”

“Since I went on holiday” (You failed to send me a post card, how the frogs legs should I know when you went on holiday?)

So the morale of the story is that the practitioner can be taught how to start a counsultation, but someone should teach the patients.  You’ve been sat in the wait room ready 10 year old copies of “Good Housekeeping” magazine, why did you not take the opportunity to consider what you were going to say when you got called in???

In part 2 we look at the patient with a blinding opening statement…

Meanwhile..

Find of the week: I was trawling around, and popped in to Doctors Gadgets to find this fantastic walking “wheel”-chair!  To me it appears that this walking wheel chair has two major flaws:

Hubo FX-1 Chair Bot-firstly it elevated the user to new heights – literally, I have vision of multiple attendences in clinics due to disabled people with head injuries from walking straight into door frames. The UK has only just managed to ensure most door ways have wheelchair access, before you know it all houses will need to be knocked down and rebuilt to make sure their is enough headroom for these robots!!!!

 -secondly: you would need a bloody long extension lead!!  Perhaps this is a marketing ploy, the more people with walking wheelchairs the more wires for people to trip over, therefore leading to more people needing wheelchairs.  Quick someone call my stockbroker…. Buy, Buy, Buy

Bye, Bye, Bye….

PS: Change of Shift is up.  1 year old, so a big well done to Kim. (I was a bit slack this time and didn’t send in.  I am studying presently – it’s a lame excuse I know)… 

Read Full Post | Make a Comment ( None so far )

Name games.

Posted on June 8, 2007. Filed under: Benign, Did I say that? |

In staff-nursitis I looked at tricks to play on arrogant or bored staff within the A&E. Well it occurred to me I forgot something significant, and we used to do this to newbies, but also try to catch each other out.

The name game. The basic idea is that you give your co-worker a piece of paper with a patients name on it and ask them to call them from the waiting room. This sort of thing happened regularly, so the occasional trick name would not be recognised until it was too late.  My favorite example is Hugh Janus.

“Hugh Janus please! – Is there a Hugh Janus in the waiting room?”

Other favourite patients included Melina Stools, Mike Litterus, Donna Keighbab and the one I never used:  Mike Hunt.

On a similar tone, we used to challenge each other to say words of a given theme into a conversation with a patient.

For example: you choose a theme before going into a patients cubicle with you colleague – say colours (for beginners) and then compete to see who can mention the most colours during you time with the patient…. This is worth playing in whatever job you do….

“Hello, Mrs Jones – you look a little red faced” (1 point).

“So your chest pain is quite severe, well don’t be blue, we’ll get you some Ivy pain colours” (debatable 3 points – is Ivy a colour?)

“Well with all this attention your friends will be Green with envy” (1 point)

For the more experienced players choice a more difficult theme. “Song titles” is a classic.

Hello Mrs, Mrs Jones , oh Sorry your not Mrs Jones”.

Gets you 3 points before you’ve even got in the cubicle!

 Say “ahhh, ahhh – ah ah, close to you”

Moving on… I ‘ve just received a newsflash via email….reporting that Apple Computers announced today that it has developed a computer chip that can store and play music in women’s breast implants.
The iBreast will cost between $499 and $599.
This is considered to be a major breakthrough because women are always complaining about men staring at their breasts and not listening to them.

Hey you! Stop looking at my Ipod!

Read Full Post | Make a Comment ( None so far )

Liked it here?
Why not try sites on the blogroll...

Follow

Get every new post delivered to your Inbox.

Join 125 other followers