So, the new show “Nurses” starts tonight. Finally, a show where nurses are not just in the background. Still, it is going to be interesting to see how accurate it actually is. With that in mind, I decided to post of my top medical show per peeves. Enjoy.
1) I just finished watching a house marathon on TV, and I did not see them properly defibrillate a patient ONCE! Believe it or not, there is actually a correct way to use the defibrillator paddles. This is because, to actually work, the electrical charge must actually pass through the heart. The correct placement is below the right collarbone and then the second one goes on the left side (the actual side of the patient) just above the diaphragm. Sometimes we use the sandwich technique, one on the front, one on the back, slightly left of center. Also, we would rarely use the actual paddles. Usually, we use stick on pads now. Much easier. Also (though most nurses don’t even know this), it is not necessary to actually “clear” the patient anymore.
2) One of my all time favorites, air bubbles. The human body can actually take about half a cup of air through an IV before an emboli becomes a risk. That tiny little bubble will not hurt you.
3) Believe it or not, we actually watch when patients are on a monitor. Every cop show has that one episode where the killer comes to the hospital to finish off the victim. We get to see the patient go flatline on the monitor for dramatic affect, before the killer makes his escape. In real life, those machines are there to tell us when something is wrong. They make the most awful racket every time a patient so much as coughs, so what do you think would happen when the patient is actually dying. Before the killer could finish up, 10 people would be running into that room as fast as they can and the killer would be caught red-handed..
4) Speaking of patients who are flatlined (what we call asystole), they can not be shocked back to life. EVER! Yet every medical show that I have ever watched does this every time.
5) Whenever someone gives a medication on TV, they seem to use whatever method works best for the plot. In real life, we pick those routes for a reason. Sometimes, we need to get a medication into someone quickly, so we use an IV. If it’s not that urgent, we might give a shot. If it doesn't matter at all how long it takes, we give a pill. We would never use a pill on someone dying of infection, just so the audience can watch. Also, when we give a shot, it is in the shoulder or the buttocks. No one would ever give a shot holding the needle at 90 degrees, right into the elbow joint.
6) There are blood tests that we do routinely on all patients, yet in TV land, “This patient has been here a week and we don’t know what’s wrong. We better do a CBC.” Say what now?
7) Symptoms rarely appear and disappear from one second to the next. No one “suddenly” has a fever.
8) A heart attack and a cardiac arrest are DIFFERENT THINGS! Just stop, please.
9) If a patient does have a cardiac arrest, it is very rare to get them back after one shock. A lot of the time, even if we do get them back, they will arrest again later. The odds of someone surviving a cardiac arrest are actually small and they never go home all better the next day. Oh, and we often break their ribs.
10) Doctors do not suddenly switch specialties. The doctor who sees the patient in the hospital is probably not going to be the one performing the delicate brain surgery on the patient, just so they can have some heavy conversation for the audience. You will also NEVER see a doctor doing the nurses work. WE get the patients out of bed, we give the medications. Drives me bananas.
11) All that equipment at the side of the bed has a purpose in real life. We actually use that stuff. IV pumps, suction, etc. The next time I see someone on TV hang an IV medication without touching or altering the IV pump, I will scream.
12) I get a little annoyed whenever I see a trauma patient, with blood coming out of every orifice, being successfully resuscitated after one shock with the defibrillator. Trauma patients die because they bleed out, leaving no blood for the heart to pump. The chances of actually shocking a trauma patient back to life like that are so close to zero that most times we would not even try.
13) Little things, like wearing your stethoscope correctly. The ear pieces face FORWARD! that’s because your ear canals face forward.
14) When giving oxygen to a patient, it helps to put the nasal prongs in the right way. Also, placing a non-rebreather mask on a patient (the mask with the bag at the bottom), the bag needs to be inflated. I get that it’s fake, so it’s probably not hooked up to actual oxygen, but you could still pump it full of room ait, just so that it looks correct.
I am sure that I will come up with some more. Feel free to comment on any that bug you.