When Does the Nursing Start??

I had a busy shift in triage recently. Often there was a line-up and I'd be required to move on through ~ ABCD and focused assessment, two-three minutes per patient, no more ~ but every once in a while there was a lull and I could start some nursing care to make the wait to see the doctor more pleasant and to initiate care to reduce wait times once in the department - things like:

* providing ice to injuries and ordering xrays when appropriate
* providing tylenol and ibuprofen for fever & pain and pedialyte for vomiting
* offering blankets, water and popsicles to the people who had been waiting for hours to be seen
* collecting urine specimens and throat swabs and sending them to the lab
* applying freezing cream to the veins of kids who looked like they would need IVs
* reducing a pulled elbow (on the first attempt and only after a thorough assesment and history)
* removing the imbedded rock from the boy's knee and flushing it with saline before applying freezing gel

I acted completely within the scope of my practice, using standing orders, delegated medical acts and shared competencies to facilitate this or discussing with the physician prior to initiating care that fell outside these (such as the facial xray for the guy who accidentally shot his lip with a nail gun).

None-the-less it appears I did more than usual at this facility as no less than three people made comments to me

*"Why are you doing all that out there for? We won't have anything left to do when they get inside!"

*"Stop keeping them so happy - they'll just keep coming back!"

and, the real insult ....

*"What, you think you're a doctor now?"

Nope. I think I am a nurse and I am providing nursing care. I am amazed to think that I should do any less!