All posts of Elizabeth Midwinter

Winter is over? Time for a new challenge in ED

Think back to the start of March 2020… Team ED was still dealing with what seemed like the longest winter in the history of the world, Twitter was a-buzz with stories of how “crowding kills”. Corridor care was still a national problem, Staff were tired, and it didn’t look like we were getting any let […]
3 years ago

It’s Ok not to be Ok… but its Ok to be Ok too…

Recently I had a conversation with one of our relatively new-to-ED nurses. We’d had a pretty awful shift with a tragic outcome and that night she text me saying ‘Is it normal to feel upset even when I know I’ve done everything right? It feels like I should be fine but I’m not. I keep […]
4 years ago

Behind the Guidelines

As ED staff we all know that in an emergency we have our trusty guidelines to turn to. This helps with cognitive off-load in stressful situations, but are these guidelines always up to date with the evidence? This post aims to look at some of the most current research, and make you question the guidelines […]
5 years ago

Neuro obs: A right headache?

Situation How often do you take handover of a patient and get told “they’re on neuro obs?” Or get asked by the assessing clinician “can we start this lady on neuro obs please?”. Yet I recently had a conversation with one of our healthcare assistants who said she wasn’t trained to do neuro obs, only […]
5 years ago

Raising the (S)BAR on Handovers…

t’s widely recognised that those of us who choose to spend our working hours in an Emergency Department are easily distracted. We thrive on the adrenaline, the chaos, and the fast change of pace. But if you’re anything like me, those traits make stringing a coherent handover together a bit tricky. I regularly find myself […]
6 years ago

A right pain in the… chest!

Situation Chest pain is one of the most common ED presentations, accounting for between 5 and 8% of ED attendances in the US every year[1]. Chest pain can have numerous causes and it’s important for us to distinguish between the life threatening and the not-so-much. As an ED nurse your assessment of the patient may […]
6 years ago

Horses and Zebras and Flesh-eating Bacteria…oh my!!

Situation It’s a well-known observation that some staff, more commonly new doctors, jump to a farfetched diagnosis when often the simplest is the most likely. Hence the phrase “hear hooves: think horses not zebras”. Think back to the patient with a rattly cough who has a differential of something obscure like lymphangioleiomyomatosis when actually they […]
6 years ago