Tuesday, February 11, 2014

NIHSS

So I'm doing my yearly renewal of the NIHSS certification, and I have to say - for practical, ER usage...it's kind of bullshit. I do my best to score patients appropriately, but when I'm watching the educational videos it's impressive how far off the test situations are from the reality of the ER.

For example: on the item where we're supposed to show patients a card and ask them to name certain objects. According to the video, "for the intubated patients, have them write down their answers on a notecard and then score them appropriately."

Riiiiiiiight. I can't even get patients to do the simplest of tasks correctly. Like put a thermometer under their tongue. Or take their shirt off before putting a gown on. Or not try and rip off all their cardiac leads because "they're itchy." Or even provide me a list of what surgeries they've had, because why should someone know what internal organ has been ripped from their insides? So with that in mind, do you realllly think I'm gonna have my newly stroked out intubated patient brought out from sedation long enough to try and draw me a pretty picture on a notecard? I think not.

It's more likely they'd bypass my NIHSS attempt, rip the ETT out with their one good arm, and then arrest a minute later because they're too gorked to maintain an airway. I guess they score a 3 on the aphasia part if they're dead?

2 comments:

Aesop said...

Shit like that is why I no longer go to nursing practice conferences.

Listening to dipshit Ph.D. speaker gush on and on about their clever useless busywork stupidity invention usually gets me short-listed by security as "the guy to watch" by Day Two of general sessions.

It's way more fun to just comply with the stupid shit at work, and brighten the day of some random QA chart-checker weeks later.

Q. 5 - Identify items:
patient responses (intubated)
"Blarg"
"Phnork"
"Flownk"

For the musically inclined, charting the noises on a 5-staff musical notation may be more clinically precise.

Shrtstormtrooper said...

I keep coming back to this comment and laughing, because for some reason I am outrageously amused by the thought of charting sheet music as a verbal response.