I like the phrase extremis. One of our docs used it a lot. It says it all in one word instead of droning on and on about the heart rate and rhythm, lack of respiratory effort, cyanosis, etc. or – since you are charting all that on the front of the chart, you could just write, ‘received patient in extremis’. No one expects you to see how oriented that patient is or if they follow commands. That whole ‘continue home meds’ order that wasn’t completed is fully explained by one word. I wish we had something like that in home health.

I look up words all the time. I love the way my iPad Kindle app lets you touch a word to get the definition.

I appreciate how hard you have worked to obtain your wound ostomy credentials. I have absolutely no doubt that you could assess and treat a wound far better than myself. My point is that too many times, the feet are not examined. So, regardless of how much I respect the experts, nobody can do anything about a wound thats never been seen before.

The only people who should be insulted are the ones who do not take off patients shoes and socks and look at feet. And someone wise pointed out, they probably don’t take the time to read this. On the other side are the other nurses who have read documentation or followed behind nurses who have failed to check feet and appreciated the fact that someone else shared their frustration.

One thing I have learned over the years is that people respond differently to different people. We have different styles of learning and widely disparate senses of humor. It’s okay if you don’t share my sense of my humor or if you prefer to learn from more scholarly and academic models. You are perfectly free to interpret anything I write any way you like.

What I write and how I write is ultimately my decision and my responsibility. You may choose to respect my right or not. I appreciate your feedback but beleaguering a point that’s been made, clarified and discussed will not get me to rewrite my blog according to your wishes. Just saying….

‘just Habit’ gets nurses into trouble routinely. We are all guilty but making a conscious effort to be ‘present’ and attend to documentation goes a long way.

By the way, I have two maggot stories but one was a direct admit to CCU. And apparently ants love tube feeding. What can I say? The south is a very hot and humid place. If you get a Patient in extremis, it is okay to get a heart rate and rhythm before checking for pedal edema. Sometimes situations arise that make the nurses sicker than the patients.

Oh, and the one time I sort of understood drunk driving is when I went to insert a catheter on a patient only to learn he did not have a penis. Poor dear. I still don’t approve at all. I loved my brothers very much until they died in a drunk driving accident.