Posts Tagged ‘Emergency department’

h1

Blind Spot – At the Intersection of Mother and Nurse

October 6, 2011

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Being a nurse has changed my reactions to situations at home. For one thing, I don’t get overexcited about non-life-threatening medical problems. I can hardly stand the thought of going to an emergency room (Steri-Strips and ice are my usual “go-to” treatment plans). I’d like to blame this on working in a trauma center—it makes sense that seeing catastrophic injuries every day tends to make less severe injuries look insignificant—but I’m not sure that completely excuses my recent diagnostic error.

My son, who’s 12, came home from school last week complaining that his hand was sore. He’d hit a wall in gym, he said, but it was a padded wall, and he hadn’t hit it very hard. Still, he was absolutely certain that, at the very least, he’d dislocated something, and that, most likely, he’d broken his hand.

To my defense, he has a history of overdramatizing situations, and I took his self-assessment with a grain of salt. Although the side of his hand was slightly swollen, nothing was bruised, and everything seemed to be moving all right.

We iced it, of course, and although hand pain didn’t seem to interfere with his usual activities, he proceeded to tell anyone who would listen that he’d broken his hand.

“Stop saying that!” I told him. “You did not break your hand!”

And so it went, for an entire week. Until his volleyball coach mentioned, kindly, that my son had been complaining quite a bit, and asked if I thought I should have his hand looked at.

So I took him for an X-ray, certain we’d be sent on our way with education about soft tissue injuries. I certainly didn’t expect to find out my son had a “boxer’s fracture” (see image above), or to find myself sitting in the office of an orthopedist I regularly see at work, explaining why it took a nurse a week to believe that her son could have a fracture in his hand.

No harm done (physically, I should say). My son graciously forgives my dismissive diagnosis, but I’m left considering the intersection of mother and nurse, and wondering which part of me I should blame for my error.

Bookmark and Share

h1

Caring for Suicidal Children in the ED

September 1, 2011

By Sylvia Foley, AJN senior editor

Emergency lights #5, by DrStarbuck via Flickr

Suicidal children and adolescents are often first seen in EDs. At Children’s Hospital Boston (CHB) recently, a boy we’ll call J.J. was one of them. Still in elementary school, he had just started a new school year. J.J. has Asperger’s syndrome (a disorder on the autism spectrum), and new situations are difficult for him. His classmates were teasing him, and it was escalating: one boy reportedly threatened to kill J.J. for being “weird.” Despite efforts by J.J.’s parents and the school to address the situation, J.J. became increasingly depressed and fearful. As September CE authors Alexis Schmid and colleagues explain,

On the morning of the ED visit, as the family members were starting their day, J.J. had gone into the kitchen, found a butcher knife, and held it to his throat. His mother walked in and saw him. Although J.J. willingly surrendered the knife to her, she said she was “rattled to the core.”

Schmid was the ED nurse on J.J.’s case that day (all three authors work at CHB). In “Care of the Suicidal Pediatric Patient in the ED: A Case Study,” the authors describe the course of J.J.’s care and what they did to keep J.J., his family, and the hospital staff safe as the day progressed. Read the rest of this entry ?

h1

Year-End Reindeer Dreams

December 29, 2010

By Peggy McDaniel, BSN, RN, infusion practice manager

As a long-time pediatric nurse who’s spent many a Christmas at the hospital, I have special memories, many of which still make me smile years later. Some of these are bittersweet, as suffering and pain do not stop for such days. One of my favorite shifts involved a little boy and some reindeer antlers. 

I was working a 12-hour night shift as a traveler in a small community hospital. We got a call from the ED to admit a four-year-old boy who was extremely anemic due to unknown causes. When this child arrived, I realized he was very ill and probably would only spend Christmas Eve night with us. He needed to be stabilized, then would move on to a regional children’s hospital for further diagnosis and treatment. Read the rest of this entry ?

Follow

Get every new post delivered to your Inbox.

Join 296 other followers