Happy Thanksgiving: What I Am Thankful For.... An ER Nurses Version #nurse #ernurse

Nurses are thankful for many things, but they seem to have a strange way of showing there gratitude sometimes. Only another ER nurse that has been in the trenches day after day (or night after night) understands the gratitude shown by another ER nurse. We are an odd breed of nursing creature, we are.
Humor helps us cope with the stress, chaos, drama, unrelenting flood of patients, death and dying, and our own misfortunes too. We have a dark side of humor that most laypeople just don't understand. Believe me, most of the time we are laughing with you and would never wish to hurt your feelings by laughing at your pain or loss. Laughter is a coping mechanism for healthcare providers.
When you hear laughing and joy in the Emergency Department, don't get upset and think the staff is just goofing off, not doing their jobs and have forgotten about you or your loved one.
Laughter is a good thing, it means the nursing staff is able to destress a minute,cope with the situation at hand, and they might be distressing together as a team.
You want your nurse to be happy.

This Thanksgiving I am so very thankful to be a nurse, for listening to my mother when she talked some sense into me at age 16. I wanted to be a veterinarian, but I don't do well taking care of sick animals (makes me cry) lol. So she suggested nursing instead since I was already working as a junior volunteer at a local hospital. Since 1979, I have loved being in the healthcare field, very thankful for such great nurses that took the time to show me their tips and actually believe in me.

Here is a list of other things that ER nurses can be thankful for:

• Great co-workers, nurses, nurses assistants and ancillary staff all included- we all work together for the common goal. 
• When you actually have a great manager that listens to you, believes in you, and is fair all around, not unwilling to roll up his/her sleeves and work along side their staff to get the job done.
• Educators that educate, consistently making sure staff is up to date on certifications, new policies, new procedures etc. Not just making pretty bulletin boards (pet peeve), also willing to work in staffing when needed.
• Equipment that works
• EKG machines that print clear readings on the first try
• A well stocked supply room (yes I am reaching here)
• Benefit plan that fits your family needs -- they are not all perfect, but at least we have them
• No Psych pts on your shift...lol
• Sober patients are always nice
• Nice big juicy veins- and the ability to hit your iv on the first stick all day
• QBT---quality butt time....lol when we have an unusual night
• Laughter with great friends

I can think of so many more things to wish for, but that might be another blog post.....

Tell me what your most thankful things are about being a nurse, I would love to hear them. 

Croupy cough- Barking noises, nighttime surprises

Croup seems to be on the rise early this season. I have seen many children brought into the Emergency Department with this scary ailment. Most commonly seems to awaken kids at night with this horrible sounding seal like barking noise. If you have ever heard a croupy cough or stridor coming out of a small child's mouth you will remember it well.
If your child wakes up barking loudly do you need to bring them to the Emergency Room? Well, that's a very good question. Not all children need to be rushed to the ER for a croupy cough. You can try a couple of things at home first.
Ask yourself these things first 

• Does my child have a high fever? ( check it rectally if they can not hold the thermometer in their mouth well, of course you are the parent and you know when your child has a temp. Go ahead and medicate them for fever, it will help with discomfort also. 
• Does my child have any breathing trouble, like retractions (look at them with no shirt on, does it seem like they are sucking in hard to breath?
• Does my child have stridor-- a high pitched noise when they breath, not just the barky cough?
• Are you freaking out and just don't know what to do (its ok if you are, better to bring them in to be checked out than not)

OK-- If your child is limp, lethargic and turning blue around the lips, call 911!! 

IF your child is happy, playful, and looks normal, but still has that terrible sounding cough- take a deep breath and calm down, its gonna be just fine.

Try these methods at home if your child seems ok at home first:

• Turn on the shower water to hot--get the bathroom nice and steamy (of course don't put your child in the hot water) take your child in the bathroom and stay with them, help them to breath in the nice steamy air in the bathroom for around 5-10 min or so.
• Take them immediately outside into the cool nighttime air (its ok, you are not gonna make them sicker doing this--no matter what your grandma told you) 
• The alternating of the steam and the cool air will most of the time help stop the bronchospasm-like coughing  and help them calm down and settle back to sleep.
• Don't medicate your child with any sedating cough syrups, alcohols or home remedies. Cool mist vaporizers or humidifiers in their room is fine. I use the old Vicks vapor rub on their chest and feet remedy myself (unless they are infants)
• Call your peds doctor or advice line if you want more advice before traveling to the ER, they are a wealth of good information.

So What is Croup?? 

Croup is a condition that causes an inflammation of the upper airways — the voice box (larynx) and windpipe (trachea). It often leads to a barking cough or hoarseness, especially when a child cries.

Most cases of croup are caused by viruses, usually parainfluenza virus and sometimes adenovirus or respiratory syncytial virus (RSV).Viral croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids too. Some children are more prone to developing croup when they get a viral upper respiratory infection.

Most cases of viral croup are mild and can be treated at home. Rarely, croup can be severe and even life threatening.

The term spasmodic croup refers to a type of croup that develops quickly and may happen in a child with a mild cold. The barking cough usually begins at night and is not accompanied by fever. Spasmodic croup has a tendency to come back again (recur).

Treatment of symptoms is the same for either form of croup.

Signs and Symptoms

At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airway (the lining of the windpipe and the voice box) becomes more inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup, often sounds like the barking of a seal.

If the upper airway continues to swell, it becomes even more difficult for a child to breathe, and you may hear a high-pitched or squeaking noise during inhalation (called stridor). A child also might breathe very fast or have retractions (when the skin between the ribs pulls in during breathing). In the most serious cases, a child may appear pale or have a bluish color around the mouth due to a lack of oxygen.

Symptoms of croup are often worse at night and when children are upset or crying. Besides the effects on the upper airway, the viruses that cause croup can cause inflammation farther down the airway and affect the bronchi (large breathing tubes that connect to the windpipe).

Hope this helps you understand Croup a little better, have questions? Feel free to post in the comments.