Hospital Employees

I'm just a lowly unit clerk on a maternity ward, but in my experience, if you're looking for an RN character, they should be the "charge nurse".

That is, the nurse that sort of looks after everything on the shift. They're responsible for all the other nurses, so in a way, they're responsible for all the patients in the ward. Think chain of command. They're at the top of the chain.

Doctors do a lot; but the nurses are the ones behind the scenes doing everything.

All supplies can be accessed. The charge nurse generally has the key to the narcotics safe, so she would be able to get medicines. Although a nurse can't officially give narcotics without a doctor's order, she would have easy access to them.

Since I work on the maternity ward, I can't really answer the dying patients question. It depends what they're dying of? Something sudden, as in an emergency? Or are they dying from cancer? Nurses do a whole heck of a lot, so yeah they would be providing care to dying patients.

Hope that helps!

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In the hospital where I work, the nurses have access to pretty much everything, but really tightly controlled drugs like percocet are locked up in this cabinet which is controlled by computer - you have to swipe your fingerprint and get another nurse to swipe also, witnessing what you took and which patient it was for. Also, the nurses generally administer medication, but the orders are on the computers as well as in the chart, so it would be hard to just take drugs. Something like tylenol or anything else low abuse potential could be easily taken, but drugs that are more readily abused are very tightly controlled. Certainly, a nurse would be responsible for the day-to-day care of a dying patient (as well as all of the other patients; nurses in our hospital typically have a load of anywhere from five to seven patients), but if anything changed in the patient's status or condition, the team (intern, resident, or attending, in that order of severity) would be paged and would probably come examine the patient, maybe change the orders. Basically, nurses can do most things (they start IVs, give medications, change dressings) but doctors tend to coordinate the care, put in orders for treatments, and do more complicated bedside procedures (for example, we had a lot of ENT patients on our floor and when one needed their wound unpacked, we would page the ENT team to come do it). Definitely LOTS of access to non-drug medical supplies, though. There was everything on our floor; catheters, needles, you name it.

2005: Stoneless - COMPLETE
2006: Magebond - COMPLETE
2007: ??

Thanks both for your help. I just have one further question in regards to the matter.

How do things work with emergency patients - that is to say, victims of gunshot wounds or people who need prompt live-saving procedures the second they come in the door? Nurses obviously have some part in that as well... I just want to know what the experience is like, and how things 'go down' so to speak.

Thank you again for the help, I definitely got filled in on what I needed to know.

Well, I can't speak to that so directly, having mainly worked in the inpatient and clinic portions of the hospital, but I have been in the ED, so I can give you a general idea: someone really sick would, obviously, be brought in the back way, probably straight to the treatment area where there would be both doctors and nurses. I imagine the nurses would have a similar role there as on the wards - evaluating the patient, giving drugs, starting IVs - but I'm not so certain.

2005: Stoneless - COMPLETE
2006: Magebond - COMPLETE
2007: ??

My mom and brother are nurses (not to mention numerous cousins). My brother used to work in ER. Like doctors, ER, ICU and Radiology nurses (amongst others) wear pages and are scheduled to be on-call during specific periods.

In ER, I believe the nurse helps to stabilize the patient, inserts IVs, administers medicine. I can ask my bro for my details if you'd like.

My mom was a Radiology nurse and in emergency cases a big part of her job was to help operate some of the radiology equipment.

In terms of access to drugs, some nurses have access to all of it. My bro is studying to be a nurse anaesthesologist (sp?) and he has access to everything - and in some states, I believe they can prescribe drugs. That part is not confirmed...just going by memory. Hope this helps!

I worked as a RN in a ER for about 10 years. Most ER's have a doctor right in the area.The patient would normally be met by one or more of the nurses that would triage or sort out the wounds. If brought in by ambulance, the medics would have called in the injury report and the nursing staff would work from there. If the patient is known to be critical, it is very common for the ER doc to also meet the patient as they are wheeled into a trauma room.

Clothing is removed to allow full inspection of the body for additional wounds. The nursing team would begin to apply the machines that would take and record the heart rate, blood pressure, and various other vitals such as the oxygen levels in the blood (sometimes called a 'pulse-ox'). Some one would begin at least one or more IV sites to begin ordered IV fluids and medications. This is done ASAP before the blood pressure falls, making it very difficult to start the IV's.

Obvious severe bleeding is slowed or stopped. The rule of thumb is save the life, save the limb, and then save the use of the limb (or affected body part.) It does no good to save an arm when the patient bleeds out from a gut shot. ie: save the life before the limb) The ER doc will quickly determine if a surgery team is needed and if so, will order them called in. X-rays are taken to determine locations of bullets or other items, status of the lungs and various other info that can be gleaned from said X-rays. Lab work is drawn to determine blood types and other info. If the patient is having a problem breathing, the pulmonary team is called in to attend to that problem.

Once stabilized, the patient is either taken to surgery or to the proper hospital care for recovery.

hmm well I guess I know now where to come when I edit the section of story I'm on :p
Are the people behind the counter when you go into the ER nurses too? I've been using the term Nurse Pratctitioner and trying to remember to type out ER so I have more words. One of my MC's has gone to the ER because of a bite to her finger that looks infected. They'd have to draw blood and all that?

Ziggy

Five exclamation marks, the sure sign of an insane mind.

-- (Terry Pratchett, Reaper Man)
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Hmm...nurse practitioners and nurses aren't the same thing, though. And in my hospital, the people behind the desk are Business Associates, though the triage people, the people you see next, are nurses

2005: Stoneless - COMPLETE
2006: Magebond - COMPLETE
2007: ??

I am not actually involved in patient care at the hospital I work at, as I do all the computer stuff for inpatients (pretty much anything concerned with registration as well as the endpoint for orders: doctors issue them, they are sent to me from the various services and I make the changes in the computer). One thing I would say, however, is that at my hospital there are special "teams." Since you asked about dying patients (which is lovingly described as "expiring"), the likelihood of a nurse being present at the expiration of patients would be increased if they are a member of the COR team (that's what they call it where I work, although I have also heard of it being called a Cardiac Arrest Team (CAT)). This special team is paged overhead to the room and area the instant cardiac arrest occurs. The alarm can be set off via manual controls (small levers in the room) and also automatically by the monitoring equipment. These alarms are occasionally false alarms set off by family members that are either wrongly triggering the COR team or by accidentally leaning against them. Such events are obviously stressful for the staff as the team is "scrambled" from their normal duties around the hospital as soon as the alert is sent out. Also, there is obviously a higher mortality rate in areas that receive more critical patients, IE Surgical Intensive Care (SICU) or Cardiac Intensive Care (CICU), and the likelihood of critical trauma patients arriving is largely dictated by the Trauma Level ascribed to the facility, which is certified by the American College of Surgeons.

I think that might depend on where you're located. At my hospital the people behind the desks are receptionists/clerks. We definitely don't have enough nurses to do registration/check people in/make appointments and look after patients. But I'm in Australia, so maybe you don't have any nursing shortages where you are :)

The Mythology of Planet X

I should really know the answer to this question, but I just have no idea.

In a psychiatric facility, the people who are always with the patients, the ones who tell them to get up, take them to meals, tell them when to go to bed (I'm talking juvenile ward, here), basically watch them. Sometimes they do groups. Where I was they did two of the three groups we had a day. What are they? I'm not thinking of the doctors or the counselors, they only see the patients for like, 30 minutes a day. I'm not sure if they're nurses or not. I really just have no idea what they are, what kind of qualifications you need for this job, anything. Some help?

Sometimes I wonder if my life isn't really just one really really extended metaphor.

I've got the exact same question about nursing homes. The people have who are involved in the day-to-day care of the patients -- helping them get around, bathe, dress, etc. What position would that be and what qualifications would they have? I'm assuming they probably wouldn't be RNs.

not sure if this is allowed, but just giving this thread a bump so I can get an answer to my question

Sometimes I wonder if my life isn't really just one really really extended metaphor.

ummm... nudge

Sometimes I wonder if my life isn't really just one really really extended metaphor.