# Math Quiz for the Emergency Department Staff

1. You are assisting a primary nurse with charcoal administration down an orogastric tube. The room measures eight feet by twelve feet. The patient starts to retch before the tube is pulled. Knowing that charcoal can spew out of a tube in a five foot radius (even with a thumb over the opening) and the stretcher is two feet wide, how many feet per second do you have to back up to get less charcoal on you than the primary nurse?
2. Doctor A picks up a chart out of the rack. S/he finds that it is a repeat patient with abdominal pain. Doctor A puts the chart back. Doctor B picks up the chart five minutes later and also returns it to the rack. Doctor A leaves the nurses’ station heading south at three miles per hour. Doctor B leaves the nurses station for the doctors’ lounge at five miles per hour. How long before the patient is at equal distance from Doctor A and Doctor B?
3. You were assigned two large treatment rooms and the gynecologic room. By the end of the day you have cared for ten patients. Four patients were female over the age of 80, all complaining of weakness. Two patients were male, ages 72 and 50. The last four were female, between the ages of 24 and 40, all complaining of abdominal pain. It is 3:00 p.m. and time to restock the rooms. How many bedpans will you need?
4. You are the primary nurse for an elderly patient with congestive heart failure. The IV stick was exceptionally difficult, but you are able to start an 18 gauge catheter on the second attempt. You leave the room to check on another patient. A relative thinks that the IV has stopped dripping and opens the clamp. How much IV fluid will infuse before you return?
5. You are sent for your morning coffee break. You need to use the restroom but can’t find one unoccupied and have to walk down to the lobby. The coffee pot is dry and you have to make more. When you get to the cafeteria, the line extends ten feet into the hallway. You can’t remember exactly when your break began. How much time do you have left?
6. You are the primary nurse taking care of a particularly shy female in the gynecology room. Her private physician arrives to see her, but you can see that he is not in a particularly good mood. After much coaxing, the patient agrees to a pelvic exam. How many people will open the door during the exam?
7. An elderly man arrives in the Emergency Department by rescue squad. Twenty minutes later his wife arrives and registers him. She is shown the entrance to the department and slowly shuffles in. How many rooms will she walk into before she finds him?
8. You are assigned to the EENT room. You have a patient to be checked for a peritonsillar abscess. The ENT physician has been paged and expects to arrive in 45 minutes. Three hours later, he arrives and is at the patient’s side, asking for a flashlight. Lightly jogging at 22 miles per hour, how many rooms will you have to search before you find one?
9. You have been asked to cover a coworker’s rooms during her break. One of her patients is an elderly, confused male with an enlarged prostate. A catheter has been inserted and his physician is coming to see him. Somehow he manages to get off the stretcher. The drainage bag is firmly hooked to the side rail. Knowing that the catheter is 16 inches long and the drainage tubing is three feet long, will he be able to reach the door before pulling out the catheter?

# Hospital Memo

To: All Hospital Staff

Subject: New Cost Cutting Measures

Effective immediately, this hospital will no longer provide security. Each charge nurse will be issued a .38 caliber revolver and 12 rounds of ammunition. An additional 12 rounds will be stored in pharmacy.

In addition to routine nursing duties, charge nurses will rotate the patrolling of the hospital grounds. A bicycle and helmet will be provided for patrolling the parking areas. In light of the similarity of monitoring equipment, ICU will now take over the security surveillance duties. The ward clerk will be responsible for watching cardiac monitors and security monitors as well as regular duties.

Food service will be discontinued. Patients wishing to be fed will need to let their families know to bring something or may make arrangements with Subway or Pizza Hut to deliver. Coin operated telephones will be available in patient rooms for this purpose as well as for other calls the patient may wish to make.

Housekeeping and Physical Therapy will be combined. Mops will be issued to those patients who are ambulatory, thus providing range of motion exercises as well as a clean environment. Families and ambulatory patients may also sign up to clean the rooms of non-ambulatory patients for special discounts on their final bill. Time cards will be provided.

As you can see on the “from” line above, hospital administration is assuming the grounds keeping duties. If an administrator cannot be reached by calling his/her office, it is suggested that you walk outside and listen for the sound of a lawnmower, weed-whacker, etc.

Maintenance is being eliminated. The hospital has subscribed to the Time-Life “How to…” series of maintenance books. These can be checked out from administration, and a toolbox will be standard equipment on all nursing units. We will be receiving the series at a rate of one volume every other month. We already have the volume on “Basic Wiring”, but if a non-electrical problem occurs, please try to handle it as best you can until the appropriate volume arrives.

Cutbacks in phlebotomy staff will be accommodated by only performing blood-related tests on patients who are already bleeding.

Physicians will be informed that they may order no more than two X-rays per patient stay. This is due to the turn-around time required by Photomat. Two prints will be provided for the price of one, and physicians are being advised to clip coupons from the Sunday paper if they want extra sets.

Photomat will also honor competitors coupons for one-hour processing in emergency situations so if you come across any extra coupons please clip out and send these to ER.

In view of the hot summer temperatures, the Utilities Dept. has been asked to install individual meters in each patient room, office, etc., so that electrical consumption can be monitored and appropriately billed. Fans will be available for sale or lease in the hospital gift shop.

In addition to the current recycling programs, a bin for collection of unused fruit and bread will soon be provided on each floor. Families, patients, and the few remaining employees are asked to contribute discarded produce. Pharmacy will utilize this for antibiotic production. These will be available for purchase and, coincidentally, will soon be the only antibiotics on our HMO’s formulary.

# Things You Don’t Want to Hear During Surgery

• FIRE! FIRE! Everyone get out now!!
• And now we remove the subject’s brain and place it in the body of the ape.
• Don’t worry. I think it is sharp enough.
• Uh-oh.
• I don’t know where that came from! Just put it over there.
• Better crank up that anesthesia.
• I don’t think that was supposed to come off.
• Gonna have to stop here, his insurance won’t pay for the rest.
• Well, it’s five o’clock! We’ll just put this off till tomorrow.
• Hey….maybe the janitor knows what this is.
• Cool! These colors are giving me flashbacks.