- Have you heard or seen anything
even remotely like that happen?
- No no no. (buzzer ringing)
Like that could never happen.
- I have been notified that
there is a new medical drama called Nurses.
I needed a nurse to help me understand
what's going on in the show.
Welcome back Bianca Antisera to the channel.
- Thank you so much for having me.
I am an ER travel nurse.
I specialize in trauma.
I believe this show kind of highlights ER nurses,
so I feel like I'll have like a really good insight
onto what we're about to see here.
(upbeat music)
- Can you take my photo?
(laughing)
- That is so you.
I feel like you would take a selfie.
You would ask a patient with an IV pole
to take a selfie.
- I could tell she was near too
because like when she's walking in,
she's like, "Oh my God."
Like here's the hospital and it's just this.
- Listen up I'm your charge nurse Damien,
but you can call me Sir
Or Sir Damien or Damien sir.
- For those who don't know,
can you tell us what a charge nurse's duties are?
- Yes so a charge nurse is basically
kind of like what you would assume a manager is
in most roles that are outside of medicine.
The charge nurse is basically going to say who goes where
into what unit and who's assigned to what things.
If you have an issue your first line of defense
is going to be your charge nurse
to try to rectify the issue.
Or if you happen to need backup on a situation,
you're gonna wanna to talk to your charge nurse.
So not only do they handle like the managerial side of it,
but they also assist you clinically as well.
- I want you to know who you are and what you are.
Because when you're elbow-deep in a 75-year-old man
who's cursed with anal boils or checking the lady business
of a half-dilated laboring woman who's bellowing
like a gorilla you won't be a rockstar.
You'll be the one thing between that old guy
and the death of his dignity.
- I love that she said that actually right there,
because one of the things
that you're gonna realize very early on,
especially being a nursing student
or like a fresh new graduate nurse,
is you have to maintain dignity.
And there's dignity in things that most people
would look kind of down upon.
But you have to remember that everybody
that you're dealing with is a human being
with a whole history and a whole life
and emotions and everything.
And if you put yourself into those situations,
especially medically speaking,
you never want somebody to be scared to talk to you
about an issue because they're embarrassed
or they just don't want to be seen in that light.
- Someone who's vulnerable is opening up to you,
allowing you to see them in this vulnerable light.
That should be something that's appreciated
and I feel like nurses at least the ones I've worked with,
have been the ones that get so much positivity
from those moments.
Someone might say, "Oh I don't want to help someone.
"I'm tired," like this.
But a nurse will say, "I'll go help,"
and then reap the mental health benefit
from helping that person.
- All right listen up.
As you've no doubt seen a van's just driven
into a courtyard of people down at the art college,
so not the kind of day that anyone expected.
Rise up lives depend on it.
Whatever comes through that door is yours.
- John Doe we're patching up the neck wound,
plugging it down in the abdomen the FAST is positive.
- Internal bleeding no kidding.
- And now I'm having problems in ventilating.
- Okay let's prepare to intubate.
- Blast lung.
- What?
- Nothing is just
- It's a team sport I wanna hear from you.
- EMS reported that there was a propane barbecue
that the vehicle went into causing a mini explosion.
- I love the fact that the doctor
asked the nurse to speak up
because she was obviously being nervous and hesitant.
It is a team sport.
And I think hospital systems that encourage
that type of speaking up actually give better patient care.
Have you ever felt a doctor perhaps
not allowing you to do that.
- All the time actually (laughs)
especially like when we get like a new set of residents,
they all kind of come with a different mentality,
but they kind of want to show that
they know what they're talking about.
So they're gonna give you all different types of
differentials and stuff like that,
of what could be happening
and what could be affecting this patient.
However the nurse is the one typically
who has the experience to say
yes like I understand what you're talking about,
but from a nurses mindset set,
especially in a trauma situation,
a lot of us have what's called like a TNCC certification,
which is a trauma certification.
We have a very specific algorithm that we're going through
and so in our heads we're like time is of the essence.
- All right we need the 18 gauge needles in both arms.
We need to undress the patient do a full body scan.
And no one is allowing you to do your job
because they're trying to get like electrolytes
on the patient or something that can be done later.
And they're doing it out of order.
- Excuse me doctor
- Uh nurse.
- Oh sorry I just assumed.
- It's all good.
- So I was near the Sororon Art Institute.
I saw the whole thing happen.
I fainted right on the sidewalk
- Were you dehydrated?
- I don't think so.
- Have you had a cough recently?
- No.
- Any cardiovascular condition?
- Why is he out of nowhere like passing by in the hallway
and then questioning the patient I'm confused.
- This is funny too.
Cause as soon as she said she fainted,
I was like they may think they're okay
especially when I started out on the ambulance,
you have people who are kind of like in shock
and they're walking around and they feel fine
cause they have that adrenaline pumping through
their bodies but in reality whenever you know,
you're taking their vitals and stuff like that,
they could have very high heart rate,
very low blood pressure.
So they're showing signs of internal bleeding,
but they may not be aware of it when she said she fainted.
I would have questioned her a little bit more as well,
especially once I saw that she's pregnant.
- Yeah absolutely.
I think whenever adrenaline's going,
you might not feel certain symptoms.
My issue with sort of how this happens you know,
it's very structured when you walk into an emergency room,
at least where I've been,
where they have a nurse assigned
to a specific group of patients
so that if someone's just passing in the hallway
and someone says, "Hey by the way I passed out."
The answer would not be, "Okay what's going on?"
Even though that's the correct line of questioning,
it would be okay let me get your nurse
or let me get your doctor
and we can have that conversation established.
Because if everyone just kind of strolled the hallways
and started questioning patients,
patients would end up getting frustrated
because they continuously have to repeat the story.
And when they do that they feel less inclined
to give the same amount of details each time.
- Blast lung's gonna make the anesthetist's job real tricky.
- Yeah if he makes it to the OR.
There's no type O negative I mean,
we could push hydroxyethyl starch but.
- Why do they not have old blood?
- And they seem like they're in a very large city as well.
So they should have this.
- It's a level one trauma center like.
- What are you doing?
- I'm O negative universal donor
we can buy him some time.
Hook me up to him.
- What are you serious?
- People do whole blood transfusion.
They do it on the battlefield
that's pretty much what we're looking at here.
- Okay chances are he'll react negatively.
- Chances are he's gonna die.
- I have never seen that happen
nor do I think that's ethical
nor do I think that should ever be happening.
I mean like have you heard or seen anything
even remotely like that happen?
- No.
Like that could never happen.
God forbid what if he had something that
this patient could contract from him?
He may not even be aware of it,
you know what I mean?
Like you could possibly do more harm than good.
- Is there something wrong?
- Could you shift just a little to your left please?
- Please tell me what's wrong.
- I can't find a heartbeat.
- What?
- I need some help here.
- While it's important to figure out
what's going on on the ultrasound,
it's more important to make sure that the patient
is comfortable and understanding
the process that's going on.
- I believe that he's quite new.
So for him to be using this ultrasound as well,
especially not with anybody watching him,
of course this is a crisis situation.
So I have to give them the benefit of the doubt.
However with his hand shaking and what he's doing,
and he's saying that, "I can't find the heartbeat."
He doesn't seem like he's very well equipped
to be handling this ultrasound,
nor is he like possibly checked off or certified
to use this ultrasound.
- I just bumped my head please go take care of my students.
- Acute head trauma is a priority.
We have to rule out parenthesia autoria and rhinorrhea.
- She has to rule out Rhinorrhea and Otorrhea?
- I feel - Like nasal discharge?
Is she just rattling off medical vocabulary?
- Please just go take care of my students,
- I will right after I give you a full neuro workup.
But in order to do that,
I'm gonna need a pen light be right back.
- Nurse if you see my (mumbles).
- We need help over here.
- What's his name?
- Nathan Richie
- Nathan look at me can you hear me?
Nathan his pupils are blown must be brain bleed.
- I would have liked to see the doctor
instead of rush to use the pen light,
to actually check a pulse and see
if the patient is not going into cardiac arrest.
- He should have been triaged.
We should have had a set of vitals.
His pupils should have been checked.
All these things should have been checked.
- Having a different sized pupils also known as Anisocoria
is a sign that there is
some sort of neurological defect happening.
The steps they are taking it are valid,
It's just the order of the steps seems off.
- You're welcome to assist in the OR.
- No they need me on the floor thanks.
- I'll page you when he's in recovery.
- Take care of him.
- We'll do our best.
- Are they really in the O.R without face masks?.
- Yeah so I was like they are.
- Who are you?
- I am Nazneen Khan I'm new.
- Nice scrubs.
Do they come in your size?
Mr Richie he's just out of surgery,
where should I leave him?
- You shouldn't I'm down two nurses
to a Shawn Mendez concert and now this.
- We have a video where you talk about
'nurses eating their young.'
Is that what you feel is happening here?
- First off I'm not sure if she was a nurse
or if she was like the unit secretary,
but I can definitely tell that this girl Naz this nurse,
she has what I feel is a romanticized version
of what her first day is gonna be
and how it is gonna be in a nurse
that I'm gonna come in here and I'm gonna take charge.
She's got to learn really quick that like,
you're not gonna walk in here and find your patient,
like on page five of your textbook.
- You should know Nathan suffered a subarachnoid hemorrhage.
There's still significant swelling.
We are hoping that that subsides.
- And what if it doesn't?
- The damage will be irreparable but there's still hope.
- That's a tough situation,
especially in trauma where you have mass casualties.
And I understand that they're kind of
like in a crisis situation.
However I do not think that was her place
to explain that at that moment,
she should have had the care team.
She should have had a discussion with the doctor
and the doctor should have explained that
to the family member and the doctor would have been there
to answer any questions that she would have had.
- Also you know they mentioned the subarachnoid hemorrhage.
Usually that presents with a really bad
like worst in your life headache.
He did not have a headache
so that was really unusual from a medical perspective
I will say that there are many times where
another part of the healthcare team
will start explaining things to a patient prematurely
and sometimes inaccurately where I have to go in
and then debrief the patient on what
they've already been told and what they already know.
And then sort of put the things back
into their correct place.
It's a tough scenario where you want everyone
to speak up and educate,
but at the same time you want to just make sure
that it's done accurately.
- Our John Doe was the driver who did this.
- They saw him trying to save people.
- Yeah well they got it wrong.
I was just sitting there holding his hand comforting him
when he told me it was him.
- Linda call security.
- He's alive because of us.
- Grace we didn't know.
- Okay if you did know,
would that have changed your management?
Our job is not to play judge or jury,
our job is to focus on one thing
and one thing only that's helping patients
irrespective of their criminal status,
race their ethnicity,
whether they're nice they're mean or anything like that.
- At the end of the day,
your job is to save lives in the best way possible.
Regardless of her feelings towards the situation,
she doesn't need to notify the police
and she does need to get security involved.
That way this patient does not end up harming other people,
but yeah it should not have changed
the way that she rendered care at all.
- And Bianca how common is it
for folks who have traumatic brain injury
to say wacky things that are not true.
- Extremely common.
- Lydia I'm Dr. Banks
and we're gonna be delivering your baby today.
- Wow that sounds so surreal.
- Hi I'm,
- The noob who couldn't find the heartbeat.
- Yeah you're already a bit of a legend around here.
- One of my biggest gripes in medicine is
that conversation could have happened away from the patient
that should not have been said - Yes
- In front of the patient
because one it undermines the nurse and it affects the trust
that the patient has in that nurse.
And it also affects the way that the patient
sees the doctor.
That should have been something that was discussed
behind closed doors.
- The only time I will give the benefit of the doubt
in a situation is if it's in the midst of an emergency
or trauma and you have to make a correction in that moment,
this is not one of those instances.
- (patient coughing) Nice try Mr.Tippit.
Code blue we have a chronic bleed in 68
- Why is she calling a code blue?
In my hospital code blue is a person who has pulseless.
- We don't call code blues cause I am essentially
a part of the code blue team
So I would have been there and we would have had the staff
to have handled the situation anyways.
- Everything's a code blue - Correct.
in the ER
- This one's from seven years ago.
- No.
- What?
- No one ever changes their emergency contact.
- Ooh no no.
(phone ringing)
- [Voice On Phone] This is Sarah talk at the beep.
- Sarah hi I'm calling from St. Mary's.
Lydia is in the hospital.
- HIPAA alert - Yes
HIPAA breakage alerts.
- That is a thing specially with nurses being
at the bedside so often
they get attached and you have to be very careful.
You have to be careful with the personal information
that you give but you also have to understand
his patient was coherent.
Okay at this point if that patient wanted to call Lydia,
whoever the emergency contact was,
she had every right to do so.
- Patient information is a protected asset rightly so.
Everyone's entitled to their own
confidential healthcare record.
And the fact that he just thought
it's the right thing to do,
even if it works out it's the wrong thing to do.
And it's potentially a reason why someone could get fired.
- My name is Wolfe.
I'm a nurse here and I've actually
been looking for you all day.
- Don't tell me you have my fingers.
- Actually.
- Oh wow I was just joking.
- But due to the length of time that they've been separated
from your hand they're toast.
- That wouldn't be his call to make
because there could be viable tissue there,
there could be tissue that can be cut off,
and the rest of the finger can be reattached.
There's a lot of options here
that I wouldn't even feel comfortable making as a doctor,
as a family medicine doctor I would only be comfortable
if a hand dedicated hand plastic surgeon would say that.
- Mrs. Richie we've been closely monitoring Nathan
as his ventilator support was removed
while we conducted an apnea test.
Unfortunately his test results are positive.
- What does that mean?
- A positive result is defined by the total absence
of respiratory efforts.
It means Nathan has no brain activity.
- That call would never be made
within 24 hours of the accident.
You would wait for inflammation to subside
for the patient's blood levels to return to normal,
electrolytes returned to normal.
And only after a designated period of time
of doing these tests repeatedly
could you even come close to making
a recommendation like this.
I mean I think you got out of surgery a couple of hours ago.
Like how do you possibly know? - Yeah
that his seizure could be wearing off.(laughs)
- Seriously no I'm 100% there with you too.
Like this is literally like the same day
that this is happening.
In no way can you call something this quickly,
especially with the inflammation and everything
like you're talking about.
- Yeah and the neurological system
is notorious for recovering slowly.
(soft music)
- For anybody who's wondering why they're lined
outside of the OR they're honoring the patient
for his organs so that he will go on to save more lives.
- Any thoughts on the show?
Bianca what do you think accuracy one to 10
I'm low I'm sitting at a four.
- I wanna say more of like a five out of a 10.
Yeah I feel like this is one of the shows that I've seen
that goes kind of above and beyond to show nurses
in their capacity.
However I feel like it's always like,
they'll show you nurses,
but then they show too little of doctors.
Like it's very hard to find a show that shows
the proper dynamics between them.
- Well I hope you enjoyed Bianca and I
watching the first episode of Nurses,
we actually also played a game of would you rather.
Check it out here,
click on it as always stay happy and healthy.
(upbeat music)