Rounding out the trifecta of wonderful nurse guests this month on Maybe Medical is Flight Nurse Colleen R.! We covered how she feels you need to be able to fly by the seat of your pants to perform in her role, as well as have an emergency and critical care background. We talked about work and home partnerships and how to balance it all while supporting each other. She was extremely inspirational and I can not express my gratitude enough for her taking the time to sit down with us. Thank you Colleen!

Registered Nurses*

Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members.

2017 Median Pay: $70,000 per year ($33/hour)

Educational Degree: Initially Associate's Degree or Bachelor's Degree

Number of US jobs in 2016: 2,955,200

10 Year Job Outlook: 15% growth, much faster then avg.

*Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Registered Nurses,
on the Internet at https://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited November 16, 2018).

Terms Covered in Episode

American Nurses Association

Trauma Surgery - Surgical field dealing with acute traumatic injuries such as falls, motor vehicle crashes, gunshots, blunt and penetrating injuries, etc.

Pulmonology - A medical specialty that deals with diseases involving the respiratory tract.

Consult - When asked to weigh in officially with your medical opinion from your specialty on a patient managed by another team.

Perforated Bowel - Opening in the intestines due to trauma (knife, bullet, etc) or disease (infection, cancer, etc).  Is a surgical emergency.  Yuck.

Sepsis - A potentially life-threatening condition caused by the body's response to an infection.

Ventilator - To move breathable air into and out of the lungs, to provide breathing for a patient who is physically unable to breathe, or breathing insufficiently.

"Coding" - What we casually use to describe a cardiopulmonary arrest in which there is a sudden loss of function of the heart or loss of respiratory function that requires immediate intervention in a life or death situation.

IR (Interventional Radiology) -  A subspecialty of radiology that uses minimally invasive, image-guided procedures to diagnose and treat diseases in nearly every system or organ of the body.

CVA (Cerebral Vascular Assault, Stroke) – Possible permanent damage to the brain from a loss of blood flow from either rupture of a blood vessel or obstruction from a tumor, clot, plaque, etc.

MI (Miocardial Infarction) - "Heart Attack" refers to a blocked coronary artery that has caused, or is moments away from causing, irreversible cardiac (heart) tissue damage.

ET (Endotracheal) Tube - A tube of varied sizes that is inserted into the trachea for establishing and maintaining a patient's airway.

Choose Your Own Adventure Books

ER (Emergency Room, Emergency Department, Emergency Ward, Accident & Emergency Dept) - Department that must provide initial treatment for a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention that arrive unplanned by walk-in, private vehicle, or ambulance.

ICU (Intensive Care Unit, Critical Care Unit, or Intensive Therapy/Treatment Unit) - Part of the hospital with the sickest patients requiring the most intervention from both staff and equipment.  May consist of intubated, sedated, and ventilated patients.

Bachelor's Degree - On average four to five year University Program to pursue a degree in a specific field.

Sacred Heart University College of Nursing

Bridge Program - A postgraduate program that is usually shorter then traditional programs that take into account previous experience.

Physical Therapist - An important medical provider and part of the rehabilitation team to help assist with treatment, recovery, and overall well being of patients with chronic conditions, illnesses, or injuries.

Prerequisites - Classes you may need to take before further applying to a program.  Usually a focus on science/math for the medical field.

PA (Physician Assistant) - Providers who practice medicine on teams with physicians and other healthcare workers. They examine, diagnose, and treat patients autonomously and as part of a team in all various specialties of medicine. On average a Master's level degree of education.

NP (Nurse Practitioner) - A nurse practitioner is trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and formulate treatment plans.  They may work in a solo practice independently or they may work within part of a hospital system.  They graduate from a Master's or Doctorate level medical program.

ASN/ADN - Associate’s Degree in Nursing.  Usually around two years.

EMT/Paramedic - Emergency medical technicians and paramedics care for the sick or injured in emergency medical settings by responding to emergency calls, performing medical services and transporting patients to medical facilities as needed.

ER Techs - Staff who in all aspects of patient care under the supervision of the Practitioners and Nursing staff.  Many have a paramedic/firefighting background.

Travel RN - Nurse who travels for limited contracts working in all variety of places and roles.  On average 8 to 13 week contracts.

Smart Pumps

Compact Nursing States

NCLEX (National Council Licensure Examination) - A standardized exam that each state board of nursing uses to determine whether or not a candidate is prepared for practice.

Wake Forest School of Medicine PA Program

Harborview Medical Center

King County Medic One

"Board & Collared" - Refers to the practice of placing a patient on scene on a very hard and rigid backboard to immobilize them and place a neck collar on them to prevent any head movement in the event of a spine injury while they are transported to the hospital.  They are incredibly uncomfortable.

Intubated - When an ET Tube, or similar artificial airway, is placed, either in an emergency, where there is loss of respiratory function or planned such as in surgeries.

First Responder - Generally refers to the first on scene in an event.  May be police officers, firefighters, or paramedics for example.

"Packaged" - Patient is ready to be transported.  IVs are in, airway is secure if one is present, patient is strapped in, paperwork is read.  Let's roll!

EZ-IO - Used to gain access for medications or fluids when unable to get a line in a blood vessel.  Using a drill a hollow bore is inserted into the broad side of a bone.  Yeah, you drill into bone.

"Push Line" - An IV that gives you access for medications that need to be administered over a short amount of time.  Pain meds, sedatives, cardiac meds, etc.

Vasopressors - Class of Antihypotensive medications that are used to raise blood pressure by contracting blood vessels.

EJ - An IV placed into the external jugular of the neck.

Central Line - Larger then an traditional IV placed into veins in the neck, chest, groin, or through veins in the arms.

EMS (Emergency Medical Services) - Services that treat illnesses and injuries that requiring an urgent medical response, providing out-of-hospital treatment and transport to definitive care.  Paramedics, Police, Firefighters, etc.

Level One Trauma Center - A Level I Trauma Center is capable of providing total care for every aspect of injury – from prevention through rehabilitation and includes teaching residents and medical students in all fields.

Med/Surg/Floor Nursing - Refers to what you would think of "general hospital patients." Those with pneumonia, new cardiac issues, skin infections, etc that do not require focal subspecialty involvement (cardiac, neuro, ortho, etc) or critical care support.

Nocturnist - Hospital-based practitioner who only works overnight.

Admit - To be brought in to the hospital for specific medical care.  Entails obtaining a medical history, making a medical diagnosis, writing orders for treatment and other diagnostic procedures, diet, activity, etc.

Post-Op/Recovery Room - The period right after surgery.

GI (Gastroenterology) - The branch of medicine focused on the digestive system.

Orthopedics - Branch of surgery concerned with conditions involving the musculoskeletal system.

Neurology - The area of medicine focused on the nervous system.  This includes the nerves, brain, and spine.

Potassium - A naturally occurring mineral and electrolyte consumed in our diet.  Involved in metabolism, hormone secretion, blood pressure control, fluid and electrolyte balance, and more.  Normal standard range is around 3.5-5mEq/L.

Critical Values - Any values considered to be too high or low and requires immediate medical attention to prevent further issues.

"Bagging" - The act of using a manual balloon like bag that is squeezed for each breath to a patient.

"Titrate a Drip" - To adjust the flow rate or dose delivered of medication in a IV or central line.

Peggy Sue - Badass Patient Advocate

"Shake and Bake" - Hyperthermic Intraperitoneal Chemotherapy is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery.

Multi System Organ Failure - A cascading domino like effect where multiple organ systems start to shut down due to injury/illness.

Krista Haugen and Survivors’s Network

Post Resuscitation - The fragile period after performing CPR or similar resuscitation of a patient.

M&M (Morbidity and Mortality Meeting) - Where we dissect individual challenging cases to identify what other choices could have been made for possible alternate outcomes.

Off-Label - Using a medication that may not necessarily be the indication that it was originally intended for.  For example Demerol that is a pain medication is excellent for post-operative rigors (shakes).  A small dose works like magic...fun!

IV Fluids - Intravenous fluids are given through an IV, central line, or IO and usually consist of normal saline or lactated ringer's solution.

Levophed (norepinephrine bitartrate) - Medications used to raise blood pressure in critical patients. Used to be referred to as "Leave 'em dead" as any patient sick enough to require norepinephrine to manage their shock, then they were most likely going to die.  Very commonly used nowadays.

Society of Critical Care Medicine

PFCCS - Pediatric Fundamental Critical Care Support

ACLS - Advanced Life Support

PALS - Pediatric Advanced Life Support Certification

NRP - Neonatal Resuscitation Program

ATLS - Advanced Trauma Life Support Certification

CCRN - Critical Care Registered Nurse

CEN - Board Certification of Emergency Nurses

Each and every episode of Maybe Medical is for educational purposes only, not to be taken as medical advice.  The opinions of those involved are of their own and not representative of their employer.