1. A&E (Accidents and Emergency) not ER/ED
2. Medication administration: no Pyxis or pharmacy. You prepare all your own medication after searching for it in the cupboard. This includes high alert medications such as insulin or norepinephrine infusions
3. Triage is the only time computer documentation is done. Everything else is paper charting. However, there are plans in the works to convert to a computer charting program in April. This could be epic!
4. A patient will get admitted while being worked up. No admitting diagnosis needed, query appendicitis is enough. The ultrasound or CT will be done on the floor/ward. In addition, a patient will transition to the floor/ward typically in less than 4 hours. For example yesterday we had a stroke patient admitted after their head CT but prior to receiving the results.
5. Every patient gets a venous blood gas as part of their immediate work up
6. As a nurse, you can wear a stethoscope, but expect to be mistaken for a doctor if you do.
7. You wear a plastic disposable apron and you change it with every patient. I got a look of disgust when I mentioned we don’t use them in the U.S.A. . . “What do you do if you have to change a soiled patient?”
8. Vocabulary EKG-ECG, MVC-RTC, Blood glucose/dexi-BM, BM-open bowel, urinal-bottle, sick-poorly, vital signs-observations
SAME report both in English, one in American English the other in British English
9. Other than an initial ABCDE (Airway, Breathing, Circulation, Disability, and Exposure) assessment, no other assessment or reassessment is done by a nurse.
10. Lastly nurses are trained specifically, not globally. An nurse trained in adults does not do pediatrics and visa-versa. And only a midwife would check for fetal heart tones.
How ’bout your overall view of things? Is care better? Are nurses more or less empathetc?Patients more demanding? Nicer? Funnier? etc
Overall view…challenge accepted! But to your specific inquiries…nurse are equally empathic maybe slightly more, patients more grateful and patient for the care provided, care overall is different…more to come.
Heart tones = USA
Heart SOUNDS = UK