Need help with a hospital scene

JackieB

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Hello. Anyone here has any experience working in a hospital? I need to write a scene where a new, inexperienced nurse (or an aide) 'saves the day' by proposing a solution to a sudden crisis with some patient. The doctor/another nurse is unavailable, so she makes a decision, and her actions save the patient. Could anyone perhaps share a story or a specific example of such a problem and solution? (I have zero experience in this field...) Thanks!
 

Bolero

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I'm not a medical professional, but I am unconvinced by the scenario.
First question - you say "nurse" - do you mean a trainee on day 1, or a fully qualified nurse on day 1? If the latter, they might be in a new job, but they would have had plenty of hands on experience already.
Who is she proposing the solution to? If there is no other doctor or nurse around, who is she telling to do stuff?

Alternative suggestion - a total beginner who knows CPR, sees a patient on a trolley who is waiting for scans/to be seen, in a waiting room, just got off the bus to walk over to outpatients, no other medical person in immediate vicinity. The patient has some sort of health failure that can be solved, or staved off, by properly applied CPR. Can still save the day and doesn't involve anything that will take a lot of explaining.
Over to a medical pro to provide the health problem. :)

Electrocution is one, it just occurred to me - and step one is turn off the power before touching the casualty.
 
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Tsu Dho Nimh

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What does this have to do for your plot? What are you trying to set up or show in the character?

Give us that and we can help you out better with the right kind of incident.

***********
I can think of one that did NOT happen.

Right after my first CPR training, I was walking out of the hospital coffee shop when a man went into classic cardiac arrest right in front of me. Alas for my potential heroics, he collapsed in front of the table with the Chief of ER, a cardiologist and a cardiac surgeon. :rant:
 

EllyJackson

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Hello. Anyone here has any experience working in a hospital? I need to write a scene where a new, inexperienced nurse (or an aide) 'saves the day' by proposing a solution to a sudden crisis with some patient. The doctor/another nurse is unavailable, so she makes a decision, and her actions save the patient. Could anyone perhaps share a story or a specific example of such a problem and solution? (I have zero experience in this field...) Thanks!

If you're talking about something major that would require tests or procedures, an order would need to be obtained from a physician. There are standing orders for some things, but the RN would do that anyway. I think a nice, simple, but nonetheless, life-saving thing a newbie could do would be to find a patient who is in distress, oxygen levels are dropping (O2 sats) and nobody can figure out why. Newbie finds that the oxygen is disconnected. It could be at the source (although the nurse *should check that first) or it could be when the oxygen tubing is extra long and several tubes are connected together. Sometimes those connectors come apart. The tubing gets stuck in the wheels of the bed, patient tugs it because they have to go to the bathroom, they come back to bed already out of breath from the exertion, and the tubing is in their nose, the flow meter is on, and the tubing connected to it. A nurse might not necessarily think to check if all of the connections are secure. Newbie finds it, connects them, and voila, patient is now getting the oxygen again.
 

MDSchafer

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Something simple is noticing an IV catheter that's been kinked and the patient isn't getting their dose of an antiarrhythmic, which could send a patient into atrial flutter or SVT.

It's within his scope of practice for a new grad, or even a nursing student in some facilities, to start a new IV switch over the line and save the day.
 

WeaselFire

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I need to write a scene where a new, inexperienced nurse (or an aide) 'saves the day' by proposing a solution to a sudden crisis with some patient.

The only way I see this is non-medical crisis. A patient is hallucinating and the new person plays into paranoia and calms them. A suicidal patient getting talked out of a gun or a knife. Or simply talked out of stabbing themselves with a needle full of narcotics meant for a different patient. Maybe an ex soldier who calms a patient with PTSD who is resisting life saving medical treatment.

It's a rare first-day person who would be left alone, has requisite knowledge and has the courage to take charge. Maybe even non-existent.

Jeff
 

Tsu Dho Nimh

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I think a nice, simple, but nonetheless, life-saving thing a newbie could do would be to find a patient who is in distress, oxygen levels are dropping (O2 sats) and nobody can figure out why. Newbie finds that the oxygen is disconnected. It could be at the source (although the nurse *should check that first) or it could be when the oxygen tubing is extra long and several tubes are connected together. Sometimes those connectors come apart. The tubing gets stuck in the wheels of the bed, patient tugs it because they have to go to the bathroom, they come back to bed already out of breath from the exertion, and the tubing is in their nose, the flow meter is on, and the tubing connected to it. A nurse might not necessarily think to check if all of the connections are secure. Newbie finds it, connects them, and voila, patient is now getting the oxygen again.

^^^^ THIS. When someone is all wired up, it's easy for something to get kinked, stepped on and screwed up.
 

JackieB

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Thank you all for your advice! Looks like CPR fits the bill..
First question - you say "nurse" - do you mean a trainee on day 1, or a fully qualified nurse on day 1?
Alternative suggestion - a total beginner who knows CPR, sees a patient on a trolley who is waiting for scans/to be seen, in a waiting room, just got off the bus to walk over to outpatients, no other medical person in immediate vicinity. The patient has some sort of health failure that can be solved, or staved off, by properly applied CPR. Can still save the day and doesn't involve anything that will take a lot of explaining.
Over to a medical pro to provide the health problem. :)
What I had in mind is a kind of an advanced nursing student who is supposed to follow and help - "shadow" - a nurse, but is not supposed to do things without being told to.
CPR does look like a nice solution. The patient goes into cardiac arrest, and she does CPR for a minute before the doctor and another nurse arrive.

What does this have to do for your plot? What are you trying to set up or show in the character?
I can think of one that did NOT happen.
Right after my first CPR training, I was walking out of the hospital coffee shop when a man went into classic cardiac arrest right in front of me. Alas for my potential heroics, he collapsed in front of the table with the Chief of ER, a cardiologist and a cardiac surgeon. :rant:
Nice story :)
What I'm trying to show in the character is that she can make decisions under stress and may act against rules to help someone..
Newbie finds that the oxygen is disconnected. It could be at the source (although the nurse *should check that first) or it could be when the oxygen tubing is extra long and several tubes are connected together. Sometimes those connectors come apart. The tubing gets stuck in the wheels of the bed, patient tugs it because they have to go to the bathroom, they come back to bed already out of breath from the exertion, and the tubing is in their nose, the flow meter is on, and the tubing connected to it. A nurse might not necessarily think to check if all of the connections are secure. Newbie finds it, connects them, and voila, patient is now getting the oxygen again.
Good idea, thanks! In this scene I will probably go for CPR but could use this later, too.
to start a new IV switch over the line
I'm not even sure what this means... could you explain?
 
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Bacchus

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My father fainted on the way home from work one day and went into what looked for all the world like a diabetic coma for which he would have need an immediate injection of insulin to save his life.

He always maintained that it was a medical student who pointed out that a hyperglycemic coma and a hypoglycemic coma (which is what he actually had due to an enlarged pancreas) can look pretty similar. Insulin would have killed him stone dead, what he needed was cake.
 

Tsu Dho Nimh

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What I'm trying to show in the character is that she can make decisions under stress and may act against rules to help someone..

Good idea, thanks! In this scene I will probably go for CPR but could use this later, too.


The FIRST RULE for CPR is ... don't wait for permission. Follow the steps from your training and jusy do it.

You could also get decision drama out of a plate glass window or something severing arteries. They can be spectacularly bloody and if you stop the bleeding quickly, not too lethal.
 

maryland

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When I worked as a hospital cleaner we cleaners went in at 6am as the night-shift nurses came off duty (They did a pill-round with a trolley of medicines.) Then at 7am the nursing auxiliaries started work (washing, feeding patients etc) At 7.30 am the actual nurses appeared on the wards after a daily strategy meeting. Doctors were not really visible until 8am.Thank goodness nothing serious happened at 6.45 or 7.15!
 

Tanydwr

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My father fainted on the way home from work one day and went into what looked for all the world like a diabetic coma for which he would have need an immediate injection of insulin to save his life.

He always maintained that it was a medical student who pointed out that a hyperglycemic coma and a hypoglycemic coma (which is what he actually had due to an enlarged pancreas) can look pretty similar. Insulin would have killed him stone dead, what he needed was cake.

My mum's diabetic so one of the major things I took from my first aid course a few years ago was that if you can't tell if they're hypo or hyper, always assume hypo. You're far less likely to kill them, and hyperglycaemia is easier to fix!