Watch ER Nurse Breaks Down Nursing Scenes From Movies & TV | The Breakdown

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You know, Greg’s in medicine too, Larry.

Oh, really?

What field?

Nursing.

[everyone laughing]

That’s good.

I’ve certainly been teased as like,

Hey, Fokker

or Murse, you’re a murse.

I think that came up in Meet the Parents at some point.

There are certainly gender stereotypes

related to different professions.

Hi GQ.

My name is Peter Glennon.

I’m an ER nurse in New York City.

And this is The Breakdown.

[upbeat music]

ER.

[Greene] Let’s go.

[dramatic music]

[heart rate monitor beeping]

[Nurse] Call respiratory, we may need to intubate.

Do you know what she took?

I don’t know.

She just went into the medicine cabinet,

we’ve got a lot of stuff around.

We have no idea what she has taken.

Julianna Margulies’ character has come in.

She’s one of the ED nurses

and she is being treated for a drug overdose.

Certainly in real life,

her privacy would be the utmost importance.

Just because you work someplace doesn’t mean

any of your rights are diminished.

We take patient privacy pretty seriously.

I want a drug screen right away.

Two milligrams of Narcan and an amp of D50.

You want to pump her?

[Greene] Yep.

The way he actually manages the patient is appropriate.

He’s gonna give Narcan,

which is a reversal agent for opioids.

That would certainly be ordered quickly.

They get their tox screen.

They would order that too,

because they’d want to understand what a patient took

could possibly overdose.

Because it will certainly map out

what the treatment plan would be for that patient.

The Narcan’s given right away,

just in case it’s an opioid to try to reverse it,

as you can have some respiratory depression

as a result of opioid overdoses.

So, excellent care by Anthony Edwards.

[Greene] Is that a mistake?

Repeated twice.

[dramatic music]

Dr. Edwards orders U-Tox,

and they’re looking to see what,

if any, drugs are within her system.

So they see how they’re able to treat,

what the right treatment would be for her.

It came back very, very quickly.

30 seconds later, it seemed like to me.

It would take a bit longer were

certainly the lab I worked with,

one of the fastest ones in the city,

but it would have probably have been about 10 minutes

before that lab came back.

They may have used a point of care

where they’re able to do it in the ER,

the one I work in doesn’t.

But, funny that it came back so quick.

And in no way would nine to 10 people

surround the case like that.

It would just be the care team treating that patient.

Julianna Margulies’ friend is there.

And she’s offering some information

about what’s happening with the patient.

And it’s interesting that she’s in there

while Julianna Margulies is getting treated,

but it’s important information.

It can really direct the plan of care for that patient.

So, that’s accurate,

if it meant getting the information needed,

she would be in the room with the docs and the nurses

while they’re treating the patient.

Because the information she provides

can actually save Juliana’s life.

So it’s important to get as much information as possible

in an emergency situation like that.

Meet the Parents.

You know, Greg’s in medicine too, Larry.

Oh, really?

What field?

Nursing.

[everyone laughing]

That’s good.

No, really.

What field?

Nursing.

I’ve certainly been teased as like,

Hey, Fokker.

Or Murse, you’re a murse.

I think that came up in Meet the Parents.

There are certainly gender stereotypes

related to different professions.

Nursing, certainly, I think people at one time

thought of only women in that role.

I think that’s completely changed

in the last number of years.

There’s a lot more male nurses out there

than there were 10 years ago.

Certainly the profession is majority women,

but more and more men are turning to nurses as a career.

And I think that’s super exciting.

The more diverse, the better.

I mean, in all things.

I wanted to keep my options open,

but in the end, nursing was just a better fit for me.

It gives you the freedom

to work in several different areas of medicine.

Plus, I can focus a hundred percent on patient care

as opposed to being a doctor

where you have to deal with the bureaucracy of–

Uh-oh.

I can relate.

Often the question you get asked as a nurse is,

Well, why didn’t you become a doctor?

And my answer typically is,

Because I didn’t want to.

Greg’s talking about his passion for patient care.

And I think that certainly is a common thread

through all nurses,

whether they’re in the emergency department

or in the ICU or on the medical surgical floor.

It’s a different connection to the patient

than a provider has.

It’s a, certainly a special one.

It is certainly a calling.

You really have to have that empathy

and desire to aid in the healing process to be a nurse.

It’s something that always spoke to me.

I was actually a paramedic.

I would drop patients off at one of the emergency rooms

in my area that I worked.

And there was a guy who was the triage nurse

and he was super cool guy.

And he would, he had his white jeans on every day.

And this, his cool shirt, like Hawaiian almost shirts.

They had no dress code at this hospital, I guess.

But the way he interacted with patients

was just so warm and he was so smart

and he knew, always knew what to do

and knew what they needed that it inspired me

to become a nurse, actually.

I saw some representation there that I could identify with

and I wanted to be like him.

The Upside.

Done.

Young Merlin’s got the sword.

So that would make my penis the stone then?

Can you stop saying that word?

Just using your analogy.

Stop saying the word.

I’m asking you. Okay.

It’s not helping me.

Okay.

All right, so I’ll take this out.

And then I…

I gotta pinch the head, put it in.

All right?

We see patients present occasionally

with urinary retention.

And this is a very painful condition.

And if left untreated,

can really cause damage to the bladder,

bacterial infections, and in late stages of it,

kidney failure.

So us having the ability to place a catheter

is super important.

It one, provides relief for the patient

and also can avoid those complications

once that catheter is placed.

Clearly, Kevin Hart is not a registered nurse,

based on his performance here.

Placing a urinary catheter is a very serious procedure

that can, if not done appropriately, cause infection.

So, there’s a lot of preparation done

to ensure that it’s a sterile procedure.

Also, a registered nurse or a doctor

or anyone in the healthcare field would respect

this patient’s anatomy more appropriately

and make them comfortable

and not have this kind of banter.

He’s removing the catheter.

And then is, it seems like he’s about to put it in,

back in, but he’s not utilizing,

he’s not creating a sterile field.

His hands are everywhere.

We would create a sterile field, wear sterile gloves.

It’s a very thorough process to apply them

as to maintain that sterility.

And that is, takes some time.

And we actually do it with another nurse

to ensure that they can verify

that we actually did maintain sterility

before putting a catheter in.

Nurse Jackie.

I know you.

I just had to sit there

and look that kid’s mother in the eye

and tell her that we did everything we could,

you dumb shit.

That was my patient.

I told you he was slipping.

And he was.

I tell you to order a scan, you order a goddam scan.

Because if you don’t do it,

I’ll just go to the next doctor,

and the next doctor after that.

And in the meantime, that kid died.

It’s just so out of the realm of reality,

that would happen in a hospital.

There’s so many things wrong with that scene.

If she had a concern about care,

that would have been addressed in real time,

and she would have escalated and gotten resources

to assist her.

A conversation like that they were having,

I would immediately want an HR person to come.

Yeah, that man wouldn’t work in a hospital.

No.

House.

Thank you for joining me for tonight’s dress rehearsal.

Playing the part of Andy is Morty Randolph.

For his donation to science, we give our thanks.

Once Andy is cool, he goes off bypass

and we have 60 seconds to get two liters of blood

out of her body, back into her,

with pictures to find the clot in her head.

In the ED, we’re certainly not doing it on a cadaver,

but we do practice a lot.

And, as you know, new nurses,

we spend a lot of time in a sim lab

where we use pretty,

some advanced robotics that mimic different situations,

whether it’s a patient, the way to manage them,

lowering their blood,

their blood pressure’s really low or,

they’re having difficulty breathing.

Most recently, we set up some sim where I work

to handle an imminent delivery of a baby,

which happens in the ED occasionally.

So it’s such an incredible way to learn.

You certainly need to read the book

on how to treat a patient,

but actually going through the muscle memory of it,

and the physicality of it is pretty incredible

and such a great resource

for both the person who works in a hospital

or a nurse, a registered nurse, or a doctor,

but also what that means for the patient,

that great skill set that someone can develop

using simulation like that.

Certainly a surgeon or a doctor,

or a mid-level provider potentially,

would do skills on a cadaver.

That definitely happens.

[alarm going off]

[Unseen Doctor] Sorry, my hand slipped.

How hard can this be?

It’s a little busy down here.

Again.

[alarm goes off]

[Nurse] If we didn’t have to lavage or gastro–

Again.

[alarm goes off]

Again.

[alarm going off]

You should be able to hear a pin drop in that room.

It’s usually really quiet.

Usually, the provider that’s leading

needs to be able to direct different folks

to do different things,

whether it’s give meds or provide respiratory support.

So it’s really important that

only the right people are there

and that there’s a state of calm in that environment.

So we can hear each other

and that nothing is critically missed.

It’s really something amazing to behold,

it’s almost like a symphony the way people work together

in an environment like that.

It’s a really impressive thing.

Grey’s Anatomy.

Okay, Cassidy,

the doctor said the labs and imaging

showed an eight week pregnancy.

So, you’re all clear.

So that’s it, it’s just the pill?

Two pills actually.

You’ll take one medication now to block the hormones

to keep the pregnancy viable,

then a second pill in 24 hours to help contract the uterus.

You’ll feel nauseated and crampy,

probably emotional because, hormones.

She’s giving a great summary of what the medication does.

And so, great job by the nurse in that scene.

I haven’t watched Grey’s in a bit, but you know,

it’s on season 47 at this point.

In the first few seasons, you would,

they really under utilized or underrepresented

the scope of practice of a registered nurse.

I mean, you see a lot of

them doing sort of like cleaning tasks,

which are certainly important in a hospital setting,

but they don’t really demonstrate really what a nurse does

in terms of the knowledge base they have,

the monitoring, the clinical skills

in terms of like assessment and showing

what the status of a patient is

and how important their role is in identifying problems

that may arise with a patient and in a hospital setting.

They are sort of these, like,

I don’t know, ancillary characters on,

in these shows sometimes.

It really just doesn’t show like

their true nature in the hospital setting.

MASH.

This one’s in shock and he’s hemorrhaging.

A unit of whole blood, STAT.

Come on, take him.

Okay, it’s his leg, do a sterile prep.

Move it, hurry.

Pump his chest, he’s in pain.

MS, one quarter, he’ll be next in OR.

Come on, move it, move it!

We’ve got more coming!

So we see Major Houlihan triaging patients,

which was completely appropriate.

She’s doing what they call a gestalt assessment,

which is just really trying to rapidly understand

what’s going on with the patient

and what kind of care they’re gonna need.

Certainly, I’ve never seen a triage nurse

in a wedding dress at work.

But, you know, the process is important.

It’s what, you have to understand and make a quick judgment

about what’s going on with a patient

and get them the care they need.

What is her accuracy rate?

I couldn’t tell ya,

but I think her judgment in the setting that it is,

she’s probably getting those folks the best care possible.

In the emergency department,

we do a lot of planning around multi-casualty incidents.

We call them MCIs and there’s a lot of algorithms

on how to manage a high volume of patients

that would appear suddenly.

It’s all about resource utilization

and how do we use our resources to best treat

the largest amount of people.

So we certainly would classify the extent of an injury

or, whatever’s happening with that patient

and try to timely,

get the people who need the care the fastest

to get that care.

And if there are folks that potentially could wait a bit,

we’re certainly gonna prioritize the severity of the injury.

Pearl Harbor.

[dramatic music]

Wait here.

Don’t touch me, you Jap!

Get your hands off me!

He’s critical, get him into critical.

Keep him off me.

Critical, front board.

How… bad am I?

You’re gonna be just fine, sweetheart.

I don’t wanna die.

You’re not gonna die, sweetheart,

I’ve got your hand.

Give him enough morphine to make him comfortable,

he’s not gonna make it.

It’s very important that we not mix patients up

when so many of them come at the same time.

You know, where I work,

we actually have built an algorithm

called MCI, the First Hour

to ensure that when faced with something like that,

you have the necessary tools

and you prioritize your resources to get the victims

of a situation like that the best possible help

we can possibly give them.

We see Kate Beckinsale, she’s running around.

She’s trying to triage as many patients as possible.

She’s using her lipstick and you see,

she writes the C on one patient, they’re critical.

They need to get care right away.

They’re gonna go right in and see the doc.

And then sadly, she writes an F on another patient.

She has made the assessment that they are too far gone

for care, and that they unfortunately

will expire in the near future.

And that they would be a drain on resources.

In real life, now, in 2021,

most MCIs where there’s a big, there’s a lot of casualties,

they use a star triage system.

And that is a way for prehospital folks

who care for patients in the field

to tag different patients with different categories.

And, you know, they’re looking at

what’s the mental status of the patient?

What’s their respiratory status?

How is their circulation?

Are they bleeding?

Do they have any significant injuries?

And they will tag, we’ll actually tie a tag

to folks in an MCI in those different categories.

Some, sadly, if they’re deceased or if they have minor care,

sometimes just a minor cut or bruise needs to get assessed.

They’ll check that out.

So they’ll have a green tag.

And there’s also a yellow one, that means delayed.

They are not in an urgent need to get care right away,

but they may have an injury

or something happening with them.

And then you get to critical or red tag.

And that means that that patient really requires

rapid intervention.

Kate Beckinsale grabs her stocking,

and I think she’s using it as a tourniquet.

Fortunately, we don’t need to do things like that.

One, it’s a huge infection control problem.

And two, in the hospital setting,

we don’t need to MacGyver things.

We have what we need.

We understand the tools,

we train on those specific types of tools.

I have never really seen too much MacGyvering.

‘Cause you want to use equipment in a way

that’s really safe for a patient.

So it’s important to utilize the appropriate tools

at the appropriate time, in the appropriate way.

John Q.

[tense music]

Done.

[Unseen Nurse] – Pressure up.

[Unseen Doctor] – Pressure up.

Now, one, two, three.

[dramatic music]

When you’re in a hospital setting,

the use of a defibrillator would be so accessible,

there would be no reason for him to do that

tap on the heart.

Certainly, we don’t recommend

people punching people in the chest.

The current recommendation is

you would always go for a defibrillator.

So that wouldn’t happen in today’s world.

Staff, certainly their safety is paramount.

So, if there was a hostage situations,

many hospitals have different codes

with a color coordinated.

For a hostage, we would have a specific color

that the staff would be educated on.

And there would be an announcement through the building

if God forbid, there was a hostage situation.

Dr. Death.

This isn’t right.

No, it isn’t.

We gotta run STAT H&H.

You need to say something.

[eerie music]

Oh, shit.

[blood dripping]

Should we start the [indistinct], Doctor?

Focus on your job.

As a nurse, your job is to advocate for your patient,

whether they’re awake or undergoing surgery.

So, there wouldn’t be this shyness

when the situation isn’t safe, that’s our duty.

The culture I work in really encourages someone,

a team member to speak up and,

despite hierarchy or what your role is.

And that really, that kind of culture serves the patient.

There’s a lot of bleeding doctor.

We should get an A-line kit, 14 gauge IV, blood warmer.

Need to give ICU a heads up?

And we have an algorithm we would follow.

So if we feel like something isn’t going well,

we want to first voice our concern.

Be like, Hey guys, I’m really concerned about this.

And then if there’s no response to that concern,

then we’re going to yell, you know,

I’m uncomfortable with this.

And then lastly, This feels unsafe.

And so, we all say that to each other, as a team,

always, that’s certainly where I work,

that first, I’m concerned,

we would all just stop what we were doing

to have a conversation if we feel like

the whatever’s happening, isn’t the right course of action.

We’re the patient advocate.

So we want to make sure that the patient’s getting

the best possible care.

We gotta get this under control, Doctor.

We?

You mean me.

I need to get this under control.

Yes, you, Doctor, need to get this under control.

Perhaps we bring in vascular.

What’s vascular gonna do

when you can’t get the blood pressure under control?!

It’s not an issue with the blood pressure.

Well, why don’t we start there?

Shall we?

See the disc.

What is blood doing for us?

It’s providing oxygenation to the body.

So, if you know,

it’s leaking out all over the floor,

it’s certainly concerning.

We can exist with some blood loss,

but at a certain point,

we wouldn’t be able to maintain life.

So, he’s worried.

He feels like that’s too much blood loss.

And the surgeon in this scene doesn’t seem to be concerned

or is willing to play with how much he can actually lose

without causing harm.

Certainly, you know, the docs I work with,

this would never happen.

Just, you know,

this is definitely one for a movie or a TV show.

The Knick.

[cranking]

Christ, the bullets lodged in the tunica.

It’s the only reason he hasn’t already bled to death.

You really think we’ll be able to save this leg?

I’m not even sure we can save the man.

If someone has a leg injury like that,

we in the ER, are gonna stabilize that leg.

And depending if you’re, you know,

there’s different types of ER,

some are trauma centers, some aren’t.

Different kinds of ERs can handle

different types of emergencies.

That guy definitely would have needed a trauma center

for a gunshot to the leg,

because it requires special kinds of surgery.

So we would stabilize that patient

and we would get them to a trauma center.

Within the trauma center,

they would be stabilized in the ED,

and be sent right up to the OR for treatment.

You need to take the leg off now.

It’s already showing signs of necrosis.

[Thackery] Can’t get the broken bones to set.

[Edwards] His pulse is eccentric.

We need to amputate now.

Amputation, definitely not an ER procedure.

Certain types of cancers today in trauma

could require some amputation.

That’s a thorough, thorough process.

And a lot of specialists would have to weigh in on

to make a decision like that for a patient,

with the patient.

The gentleman is trying to irrigate the wound for him,

using a giant syringe, I guess,

with, which is like salt water.

It’s the same osmolarity of blood.

And he’s trying to clean the wound.

Today, we would certainly use sterile water or saline.

[bullet clanging in pan]

That patient probably,

with all the fingers and such going into his leg,

probably would get a nasty infection.

That poor man and his leg.

I certainly sympathize for him.

Thanks so much for watching these clips with me.

I hope you learned something.

Until next time.



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