I have found it interesting, throughout my career in medicine, that I always seem to fill a niche. Now it does vary from time to time, and sometimes from person to person, even during a single shift... Yet, I seem to be "the go to person" for a few select things, more often than not.
Although, there are several of my peers, that I consider my "go to person" for few things as well...
Last night, a new Nurse (recent-grad) was being precepted by an experienced Nurse. The new Nurse, came up to me and asked if I was "Ray?" Then stated that another nurse, the preceptor, was asking for me to help with something. It ended up being a difficult IV start. Three Nurses, six attempts already. I am one of a few Nurses that can and will use Ultrasound to start IV's... this is what they were thinking, as they said as much when I entered the room.
One of the ice-breakers I use with patient's, especially after they have had a few attempts and tell me that they are not going to watch is, "You can close your eyes... I'm going to!" Which, by the time it registers, and they react, I am done. IV started and blood being drawn. I also like when a patient tells me to warn them, so I say, "OK, on the count of three. One (needle already in), two (flash of blood), three (needle out, IV started)." It is when I say three, that about 90% tense, preparing... only to realize, that I am already done... and actually, quite a few begin to laugh.
I also seem to be called upon for "difficult" patients. Asking for a male to be present is not being stereotypical, nor is it out of the norm. There are some situations, cultural considerations, etc., that a male standing in the doorway observing, will de-escalate certain situations. Likewise, when a patient does start to get out of line, and there are four guys suddenly present... it's like a splash of ice-cold water! Most 'bravado' will quickly shrink!
I guess it connects to my no-BS approach. It's not illegal to be crazy. It is also not, always, illegal to be intoxicated. As a RN, I will protect myself and co-workers first, then the patient. Respect for each other, abide by the rules, cooperate in the process. It makes a big difference in how a visit unfolds! I am more than willing to report a felony assault on a healthcare worker, and send someone to jail, just as fast I am I requesting that restraints (hand-cuffs/leg-irons) be removed. I am also willing to physically and chemically restrain a patient if they are a clear danger to themselves or others! A "B52" will give just about everyone a blissful eight hours of sleep. The occasional "Big 10-4" is indicated.
And, if you claim to be a biker, and become difficult, threatening, or God forbid violent... all of my peers (both Nurses and Doctors) know, if you are not under the influence of something, and I am working and available; one of two things will occur if I become involved. Both will result in an immediate attitude adjustment.
And my secret weapon, for both kids and adults...
Popsicles!
I can get any kid to take ibuprofen or tylenol, with the promise and delivery of a popsicle! Even adults, who do not want to try a PO fluid challenge (fluids by mouth), will take a popsicle! Although, I held a Cherry Popsicle in my hand, and as it was melting, encouraged a 10 year old to take some liquid ibuprofen the other night. The pained look on their face... yet, it still took them over 5 minutes to drink 20ml, a mere four teaspoons! They got their popsicle... at least 95% of it!
The best, and by far my most favorite:
Is when someone asks for a second look at something; an independent review of the facts, results, physician orders, etc. Myself included! This is true collaboration. Whether it be trouble-shooting an Arterial-line, a ventilator, reviewing lab results, or just assessing a patient to confirm a concern.
And when mid-level providers (PA's and NP's) as well as some of the Doctors ask for my opinion/input... No-BS.
I do not go to the Doctor for every little thing. Most I work with know, that when they see me standing there, time to take pause and listen to my concern/question. I was actually talking to a friend last night in the hallway, the doctor walked out of a patient's room, and stopped in front of me (because I was standing there), to ask me if I needed anything. This same individual has learned, through experience, that I can think critically, respond to immediate situations, and only seek their input for 'critical' and 'narcotic' decisions.
I should go back to school.
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