Wednesday, February 24, 2010

Nurses on Drugs - What You Can Do


A number of years ago I was involved in a serious automobile accident resulting in broken bones and surgery. The standard pain treatment at the time was Demerol--and not too much of that. Now it's common protocol to control severe pain with morphine; a few weeks of sedation will lead to improved healing--not drug addiction as was once feared.

Even though I was fairly young, I remember one nurse who visited me daily at the beginning of her afternoon shift, asking if I needed more pain meds. At the time I thought she was being kind, but I also wondered why she was the only nurse to inquire about my need for narcotic pain killers.

My curiosity concerning her kindness was answered a few months after I left the hospital. It seems this angel of mercy was pilfering from the medicine cabinet, often stealing half of the patients' meds. Was this nurse a rare exception in the sisterhood of Nightingales? Hardly. A few years later a medicine nurse at ECM was killed over a cocaine deal gone bad. I doubt this nurse started her drug habit with cocaine; I also doubt the hospital's medicine stash had never been the object of her quest for narcotics.

Does a drug habit make a bad nurse? Well...I certainly don't think it makes a better nurse. She or he is often impaired while giving patient care and, as in the the two cases we mentioned, often stealing from the hospital or patient. Obviously there have been enough incidents over the years that the general public is aware of this problem, so why am I addressing it now?

Three weeks ago a candidate for the University of North Alabama's BSN program was arrested for felony drug possession. We understand the charges may either be upgraded...or downgraded to that of a juvenile offender. The question is: Do you want this young man to be your nurse? He may become the best nurse in the history of the profession, but do you want to risk that?

We feel for this young man in many ways, but there is also another reason that we have chosen to make a political and perhaps controversial statement considering this would-be nursing student. A friend of ours died at ECM hospital on Monday. I sincerely hope that Bill's nurses were all caring and competent. Let's make sure that we can say that about all of them.

If you have questions or qualms about any nursing or proposed nursing student at UNA, please use the above numbers to make your feelings known. Nurses aren't perfect, but they should at least be drug-free.

Nurse Nan

Friday, February 5, 2010

Kudos to Discovery Middle School Nurse in Madison, Alabama

School nurses deserve a special place in our prayers. Certainly the nurse at Discovery Middle School on Hughes Road in Madison deserves to be called a hero. When she signed on for the job, I doubt she even considered the possibility of attending to a gunshot victim. Yet, by the accounts we have at this point, this is what she did and did well.

I don't know how much training this nurse had in emergency medicine, but unless she had worked previously as an EMT, probably not much. When she reached the scene of the shooting victim this afternoon, she had to make some decisions and make them quickly.

Emergency medicine uses the "ABC" rule. As she approached the wounded student, he would have probably been lying on his back. No matter the direction of a gunshot, a head wound will usually cause the victim to fall backward. Next she would have seen the blood surrounding his head. Using the "ABC" rule, she would have first ensured a patent airway. His chest would have been rising and falling, even with shallow breaths, so she would have known his airway was patent. Breathing, or respiration, is the second part--she would have ascertained this at the same time she checked the rise and fall of his chest.

The third part of the assessment is circulation. The flowing blood indicated that he needed pressure applied to the wound immediately, but that would have meant turning him over. Did he have a second wound she couldn't see? Had he damaged his spine in the fall? She had to consider these things, but still stop the blood flow. The Discovery Middle School nurse did all these things, from what little we have been told, and she obviously did them in a short period of time with throngs of traumatized students looking on.

If you know who your school nurse is, send her a note of appreciation next week. When the name of the Discovery Middle School nurse is published, I hope everyone realizes what a hero she was in a situation no one should have to face.