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Monday, December 16, 2013

Thirty Minutes In The Day Of A Registered Nurse

I was working as the nursing supervisor of the Family Medicine Center on a busy Thursday afternoon. The center saw about two hundred patients a day. The center was a resident training program and also had medical students. It was brimming with people all the time. Because I am a registered nurse I routinely checked in patients for the doctors. Family medicine doctors see patients from infants to the very elderly and deliver babies. It was an exciting place to work where anything could happen. Fourteen nurses staffed the center with two supervisors. The center was divided into two sections and five or six doctors would be seeing patients on each side. That made for ten doctors seeing patients in the morning and ten or twelve in the afternoon. It was barely controlled chaos due to the sheer numbers of patients we saw.

On that Thursday afternoon I went out to the lobby and asked a young man in his twenties back into an exam room for a senior resident.  I saw immediately that he was incredibly ill. I put him in the first room available by the door. He should have gone to the emergency room but it was far too late for that discussion. It was not unusual for our patients to come in while having a heart attack instead of going to the emergency room. I quickly took the young man's blood pressure. It was low. His pulse was rapid. He had a high fever. He had a purple rash all over his arms. He was not fully alert. His neck was stiff. I started a large bore IV and opened the IV fluids to flow freely. Then I quickly went after the resident.

I told the resident about the patient's vital signs, that IV fluids were started, and that I suspected meningitis. I know nurses do not diagnosis patients but after you have seen an acute illness many times it is not difficult to at least presume in the absence of a spinal fluid specimen. The doctor immediately stopped what he was doing and quickly went to exam the young man. He thought it might be meningitis as well. But what kind? Hard to say without doing a spinal fluid tap. He had me start IV antibiotics. He quickly talked to his attending physician. The decision was made to send the patient to the emergency room. We placed the young man on a stretcher and rolled him the short distance to the emergency room. Our center was part of a large university teaching hospital and adjacent to its emergency room. All of this from the time I greeted the young patient to the time we took him to the emergency room took approximately thirty minutes. Maybe less.

 The family medicine staff and I, who had contact with the patient, had to take Cipro, an antibiotic, just in case the young man had a contagious form of meningitis. That was not the first time I had been exposed to a contagious illness nor would it be the last. I had taken Cipro three times while I was a hospital charge nurse for seventeen years. We later found out that the young man fully recovered. I was afraid he was going to die. He was acutely ill and in shock while in our center. He did have meningitis but it was not a contagious form.

My days at the center were, thankfully, not always that eventful but my education and nursing experience prepared me for those thirty minutes.
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  1. Very interesting read. I am glad the man did not die. You were on top of things with all that you have been taught.

    God bless you. Merry Christmas!

  2. I know it has to be a special calling to be a nurse and you sound like you are really a good one. So glad you were swift and that probably saved the young man's life! Hope you're doing well and are ready for Christmas! Thanks for popping in to see me.
    Be a sweetie,
    Shelia ;)

  3. The young man in question was very fortunate to come across a nurse of your ability, experience and expertise. A very interesting read Olive, it could so easily have been a story with an unhappy ending.

  4. I agree with Rosemary. People sometimes criticize the National Health Service we have here, but I have nothing but praise for the doctors and nurses who do such a marvellous job. I would have long been a widow without them.

  5. Stories of your old career are wonderful reading. I often look at my PC and wonder how she gets through the day. Or, as Cathy, one of my favorite assistants said to me, "We don't go home until we are through all the paperwork, every day."

  6. That's scary. Glad he ended up being OK.

  7. Olive, I am thinking the same as Pam..scary ! Glad you helped save this fellow though. I bet you have seen it all too. Take care . Hope you are enjoying this wonderful season. How's CC doing? I think of her being far away. Hugs to all of you. xoxo,susie

  8. Thank goodness that young man was seen by you, Olive. You most likely saved his life with your quick actions. Nursing is an under-appreciated profession, they do so much of the work that the doctor's often get credit for. Your patients were fortunate to have you, Olive. I've met many a good nurse through my years caring for my parents, my daughter and even myself. They are unsung heroes in my eyes. Thanks for sharing that story, I hope it will inspire some new nursing students. Ann

  9. thanks to all those wonderful nurses like you olive! I too was touched by someone like you…
    my son came home from college with flu like symptoms and we took him to a medical center…that nurse recognized the symptoms and he was diagnosed with menigicoccal meningitis. after weeks in the hospital he recovered with only a couple of side affects. he was lucky his dr. gave him the vaccine before heading off to college…infectious disease drs. said that probably saved him. you are all a special breed of people!!

  10. Olive, what a wonderful article about nursing. It is great to hear of the nurse-patient relationship instead of about all the paper work! You were that guy's guardian angel. I am more likely to trust a nurse than a doctor!

  11. Very interesting. I love reading of your experiences. You have "a gift" in the telling . . .

  12. Those 30 minutes, whether he realized it or not, were probably the most important half hour in his life up to that point. And whether he ever realized it or not, the most blessed because of you and your training and dedication to your career.
    P.S. You really are a dedicated nurse to be willing to take Cipro. That stuff is awful!

  13. I think Nurses are one of the unsung Heros! I have several friends, (you included!) that go beyond what is expected of them with little thanks. God Bless you for service!
    Merry Christmas to you and yours! xo

  14. What an amazing story. I am sure your quick decision making helped that young man in his recovery.


I adore your comments. They are like finding unexpected chocolates. olive