Hi! I'm Nurse Bubbles. I have been a Nurse in Coronary Care for many years and am here to share my expertise with any less experienced or student nurses in this area.

Dear Nurse Bubbles.
If a patient develops AF post AMI should DC cardioversion be considered if the ventricular rate is >120 bpm or should it be controlled with flecainide?
Nurse Libby Wartcrusher (Macclesfield).

Dear Libby
I am a firm believer in DC cardioversion in the treatment of AF. A quick shock is a lot less fiddly that piddling around with all those drugs and the treatment has the additional benefit of rendering the patient unconscious for several hours and unable to press the buzzer. PS Was your father Dr Henry Wartcrusher? If so I think I once "knew" him.

Dear Nurse Bubbles
During the DC cardioversion of a patient having a VF arrest do you recommend a protocol of 100J, 200J, 360J or do do subscribe to 200J x2, 360J.
Nurse Sally Hotbanger (Cardiff)

Dear Sally
There really is no point messing about with 100J or 200J shocks - go straight for a good whack of 360J from the outset. If I could I'd just plug them into the mains, but being AC this would probably do some damage and, if by some miracle they survived, would mean a lot more work. At a nursing conference a few years ago I "met" a Jim Hotbanger from Wales. Boy did he live up to his name! - any relation?

Dear Nurse Bubbles
Would you recommend metoxlopramide as the anti-emetic of choice when considering the analgesic management of AMI?
Nurse Billy Strawclapper (Torquay)

Billy baby!
Well how are you? I imagine you still remember our "teaching session" at the Thrombolysis seminar in Bristol, (have the scars healed?) As for your question regarding the treatment of pain following AMI, patients should realise that there is bound to be some pain following a heart attack and they really shouldn't whinge all the time. They have to remember that nurses have a lot to do without being pestered by patients all the time, especially during new medical intake when there are a lot of new, young doctors that they have to get to "know". The best way to manage a patient's pain is to insist that they grin and bear it. If this does not work threaten to break their finger if they press the buzzer again, (but do not actually break their finger as this will just mean more work for you). If this does not stop them whingeing or if the pain is genuinely unbearable I suggest an immediate DC shock of 360J. This will render them unconscious and painfree. We must get together again some time for a "chat".

 

Dear Nurse Bubbles
We have been given instructions that we have to improve our customer relations at the Unit where I work. One of the things we have to do is make tea for visitors of newly arrived patients. Do you think we should have to do this when we have other things to do like chat on the phone and look through the Avon catalogue?
Nurse Trixie Ballwalker (Nottingham)

Dear Trixie
You have taken the words right out of my mouth. We have to do this at the Unit where I work. I generally lace the tea with Frusemide, put a sign on the visitors toilet saying "Out Of Order" and tell them the nearest toilets are at the main entrance to the hospital. This at least makes them suffer and stops them asking silly questions like why aren't we dealing with their so-called loved one's pain. It also keeps them fit so it is good for them. By the way are you the Trixie who I met at the Heart Failure course in Birmingham and had a "team-building exercise" session with the three Jamaican men? If so do you still have the photos?

Dear Nurse Bubbles
I am an avid reader of your work, but I notice that in your photographs your appearance changes so radically. I understand that lighting and make-up can affect one's appearance but how do you account for the different hair colours?
Mr C.J. Stollenburger (Halifax)

Dear C.J.
Can't a girl go to the hairdressers now and then? Are you by any chance Colin Stollenburger who gave me a lift to Rochdale last summer? If so has it grown?