What a writer needs to know about the medical field

Because we’re nurses and love our jobs, Beloved and I watch fictional medical TV shows like House M.D. and (sometimes) Nurse Jackie (not Beloved’s favorite for some reason).

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And, because we are nurses and work in a hospital, there are things we see in every single episode that is either wrong or unrealistic. I’m not saying we know everything, because we don’t. I’m not talking about the diagnoses. I’m talking about the little things that don’t seemingly matter, but in real life would be a big problem.

In House, we constantly see that the IV is almost always in the hand and almost always facing the wrong way (only once have I seen it done correctly on House).

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If you look close enough, you’ll see the IV line is going towards his fingers. This is a huge, huge, huge mistake. The IV catheter should always face towards the core, so if the IV is in the hand, it should face up towards the shoulder. If in the foot (happens sometimes, though you need someone else besides a nurse to do this), you face the IV upwards towards the core. Always.

Also, they never reinforce the IV. Sometimes it’s just hanging there like, “Hey, I’m ready to get pulled out at any given moment, especially considering the likelihood that this fellow will go into cardiac arrest ’cause that happens on every episode of this show.”

Which brings me to my next point.

Everyone always has a heart attack.

What’s with this? I’ve only seen one cardiac arrest patient and they ended up passing away. Not everyone has heart attacks. Not every day is a “let’s shock them back” day.

The heart attack.

Which brings me to my next point.

They shock them back without syncing to their heart.

Did you know you could kill them if you shock them when the heart is beating at the wrong moment? I can’t explain in detail about it. Just know these few things: they don’t use paddles and rub them together anymore. We have stickers that we put on the chest and attach to a defibrillator. The defibrillator then calculates when the best moment is to shock a patient according to their heart rhythm. Also, they hardly ever shock a patient’s heart back into normal rhythm without giving them a sedative… Because it hurts. Duh.

(Disclaimer: I’m sure that there are exceptions, and I’m sure some places use the regular ole paddles. I’m just saying what I’ve seen and experienced myself when someone crashes.)

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WHICH BRINGS ME TO MY NEXT POINT.

Someone crashes, only three people (only doctors apparently) are there to help.

In TV shows, you see someone crash, they yell, “Get a crash cart in here,” or for some reason it’s already right there even though a second ago the patient was 100% okay and they were planning discharge.

Here’s the reality of a code blue: You have someone from respiratory, you have maybe one doctor, if there’s a doctor around on the floor at the moment, probably 3 nurses from that floor and then a team that is trained to respond to a code blue (which is reported over intercom and where it’s at) rushes to the scene and fills the entire room. Literally, the whole bed is surrounded and everyone has a job. They push meds, they defibrillate, they do a bunch of stuff.

My point? It’s never a couple of people. It’s a whole team.

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There are many other things that I could point out, but maybe I’ll save them for another time.

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4 Comments

  1. Haha! With a former Marine Corps captain for a father, watching action movies through my childhood always included a running commentary of “in real life, they…” It did teach me the importance of research, though. (And anyone who knows anything knows the nurses are the ones who run the show. I’ve learned that much from stays in the hospital and my aunt. Even doctors admit this.)

    Really, anything I’ve come to be educated on, I’ve found Hollywood has managed to bungle. Horses? Check. Hunting? You betcha. Basic seismic geology? Oh, yeah. High school science? Totally mucked. Kindergarten level religious studies? You wouldn’t recognize it. The list goes on.

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