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Monthly Archives: December 2011

Nursing Lingo Part 3: Frequent Flyers

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“Frequent Flyers” is a favorite nursing term of mine.  I suppose the definition is rather self-evident.  These are the patients that you take care of repeatedly.  Inpatient medicine floors are chock-full of frequent flyers. This could be a young person with Cystic Fibrosis or Sickle Cell or perhaps an elderly patient with COPD* or ESRD.**  On a surgical floor this could be a patient with non-healing wounds.

I like this term because it’s a pretty benign “label.”  The patients are not “the chronically ill” or “sick.”  They are just normal people that happen to frequent the hospital.

Personally, I like taking care of frequent flyers.  They know the ropes.  They also know that they will be seeing a lot of the nursing staff so it makes sense to treat us respectfully.  You just have to be careful that the familiarity doesn’t destroy the professionalism of the relationship.  I had one nursing friend who “fell in love” with a frequent flyer.  Four months later they broke up but he continued to receive his care on our floor.  Awkward all around.   However, caring, lasting relationships with pleasant frequent flyers can really bring joy to your day, and your career.

The down side to frequent flyers is also that they know the ropes.  While the vast majority of my patients are wonderful people, there are always a few bad eggs. The naughty frequent flyers know how to play the staff against one another so stay on your toes!   As soon as you hear, “But last time the nurse let me …” or “But the docs always give me more pain medicine than…”  you can be pretty sure you have a naughty frequent flyer!  As always, treat them respectfully but draw boundaries and stick to your guns!

I enjoy a challenge so if a particularly difficult frequent flyer shows up, I often offer to take the patient.  With the right mix of warmth and boundaries you can convert a naughty frequent flyer to a satisfied and pleasant frequent flyer.   And the icing on the cake? Now your co-workers owe you one!

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*Chronic Obstructive Pulmonary Disease (emphysema or chronic bronchitis)

** End Stage Renal Disease (kidney failure)

Nursing Lingo Part 2: DFO

Nursing Lingo Part 1: Circling the Drain

 

Nursing Lingo Part 2: DFO

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Thanks to reader Terri for submitting the correct answer for what DFO means!  I’ll have to think of a good prize for you.  Customized medical Spanish-English list? Customized report sheet?  Guest post?

To set the scene of when I first heard DFO: I was doing my last rotation of nursing school so I had already deciphered most of the common medical acronyms.  But in report a veteran nurse  said a patient “DFO’ed.” I could have played it off like I knew what the word meant and then google it later.  But I could not think of ANYTHING that made sense.   DFO…?  Detached Forearm Operation?  No…  I gave up and asked.  Turns out DFO, at least here in the South, means Done Fell Out!  It’s actually a pretty great term that basically means “fainted.”  Usually the patient was standing, passed out, fell, and probably hit the floor.

Believe it or not, if you look in certain medical dictionaries, DFO is explained!

If a patient DFO’ed at home before they came in, that’s a bad thing.  If they DFO’ed at the hospital on your shift, that’s a very, very bad thing.  I say I have two rules for my patients, keep breathing and no falling. If your patients can stick to those two basic rules, your shift will be MUCH smoother for the both of you!

Next post will be on one of my favorite terms, “Frequent Flyers!”

Nursing Lingo Part 1: Circling the Drain

Nursing Lingo Part 3: Frequent Flyers

Nursing Lingo Part 1: Circling the Drain

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Like any profession, nursing comes with its own jargon.  “Keep Vein Open,” “Drips,” “Early Ambulation,” and “Ins & Outs” are some of the phrases you’ll hear emanating from Nurses’ Stations at change of shift.  But nurses, a communicative bunch, have also developed nursing lingo you may be less familiar with, no matter how many seasons of ER you watched.    This week, I’ll share a few of my favorites.

Circling the Drain

After doing your dishes, you flip on the garbage disposal. You watch a floating piece of iceberg lettuce as it starts circling the drain. You know the lettuce is headed to destruction.  It’s not headed straight for the drain.  There is still time to intervene.  But moment by moment it gets closer and closer to an inevitable destination.  This is an apt metaphor for some floor patients.  They aren’t worsening so dramatically that they need to be shipped to the ICU. However, they need closer observation and hopefully a medical intervention that might stop the decline.  Without intervention, they’re headed for trouble.

Veteran nurses can almost sense when this is happening. To those of you newer to nursing, here are some possible signs: You’ve bumped up their oxygen requirements twice in one shift, their heart rate is higher than is usual for them, or they getting increasingly exhausted or confused.  Describing this patient to the physicians, other nurses, or the charge nurse as “circling the drain” will help them understand that this is a patient that needs intervention or a higher level of care and needs it now.

Next post I’ll explain the Southern nursing lingo term, “DFO’ed.”  Any guesses what it means?

Nursing Lingo Part 2: DFO

Nursing Lingo Part 3: Frequent Flyers

 

Run, LuLu, Run!!

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Nicole is a particularly southern NA.  She would honestly say things like “My boyfriend and I work re-po on the weekends,” in as twangy a drawl as you can possibly imagine.  One day she yells to me from the other end of the hall, “LuLu, come!!”  First of all, my name is not LuLu. My nickname is not LuLu.  LuLu is just what Nicole called me because that’s how country she is.

I start down the long hall.

“LuLu!!  Run!!”  I hate running in the hospital.  Nothing freaks out patients (or other staff) quite like seeing a nurse run down the hall.  “LuLu!”

I kick it up a notch and start to jog.

Pamela, in room 17, is no longer in room 17. She’s in Bob’s room across the hall.  Thankfully, Bob is off getting an X-ray.  I look around and put the pieces together.  Pamela had to poo. She got up, wandered into the hall, went in Bob’s room, used the bathroom, and then got in Bob’s bed.  Unfortunately she left a, um, “trail” everywhere she went.  The discovery of the trail was the only reason we discovered quickly that something was amiss.

Now mind you, two hours ago Pamela was a normal, middle-aged lady who knew how to find the toilet and use it.   To you nurses, what would you do next?  Yep, get a blood glucose.  Her “sugar” was really low.  Four juice boxes later, she was back to her old self and had no memory of her exploits.  Too bad I’ll never forget it!

New Look

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Forgive the long hiatus in posting.  I’m back and the site got a makeover to celebrate!  =)  Thanks for your support!