ED practicum - page 2

by nursing.mypassion 4,905 Views | 19 Comments

I'm going to have my practicum at an ED both peds and adults. I would appreciate it if anyone would please let me know things that I have to be knowledgeable about to be a good standing student.... Read More


  1. 1
    A good preceptor will not expect too much from you...first shift should really be about observing how the ED works. So my personal advice would be to stay out of the way the first day and ask questions only when it's appropriate (do not interrupt pt care). Most important thing you can bring the first day is comfortable shoes :-)
    nursing.mypassion likes this.
  2. 6
    This is what I send out to our senior students before their ER rotation:

    Items to Review

    Skills
    Whether you have done a lot of IV starts or none at all, don't worry!! Learning is what the rotation is for! I just want you to be familiar with the procedures so you know how to measure the NG tube before we place it. Don't be nervous about skills, there will be ample opportunities to practice in a safe environment. Review these skills:

    IV starts
    Venipucture
    NG tube placement
    OG tube placement (with a ventilated patient)
    EKG lead placement
    3 lead (red, white, black)
    12 lead placement
    Foley catheter placement
    Straight catheter placement
    ABG collection

    Medications:
    Remember, just a few important points about each. Why would it be used it in the ER?:



    Morphine
    Ativan (lorazepam)
    Epinephrine
    Haldol (haloperidol)
    Benadryl (diphenhydramine)
    Solumedral
    Metoprolol (Lopressor)
    Nitroglycerine
    Versed (midazolam)
    Albuterol
    Magnesium (what type of dysrhythmia is it used to treat?)
    Zofran (ondonstrone)
    Phenergan (promethazine)
    Cardizem (diltizem)
    Dilaudid (hydromorphone)
    Compazine
    Protonix
    Xanax (alprazolam)
    Valium (diazepam)
    Pepcid
    Lidocaine
    Amiadorone
    Adenosine
    Atropine
    Dopamine
    Propofal (diprivan)
    Normal Saline
    Dexamethasone (decadron)
    Heparin
    Lovenox
    Vicodin
    Percocet
    Tordal (ketoralac)
    Ancef
    Rocephin (ceftriaxone)
    Activate Charcoal


    What drug do you use to reverse opioid overdose?
    What drugs on this list are narcs?
    What drug do you use to reverse benzodiazepine overdose?
    What drugs on this list are benzos?

    Systems Review
    Keep pathos short, I mean 10 words or less!!! Think about assessment!! You will be doing a lot of focused system assessments while in the ER.
    Cardiac:
    Common signs of an MI
    Remember MONA??
    What is Troponin? What does it mean if it’s elevated?

    Be familiar with the following rhythms:
    Atrial fibrillation
    What does supraventricular tachycardia (SVT) mean?
    Normal Sinus Rhythm
    Ventricular Tachycardia
    Ventricular Fibrillation
    Sinus Tachycardia

    Cardiovascular:
    What is shock?
    What are the four (major) types of shock?
    What is anaphylaxis?

    Renal:
    How do the kidneys regulate BP? (no long patho, just the big picture in 10 words or less)
    Common signs of a kidney stone

    Hepatic:
    How does the liver effect clotting (in 10 words or less!)

    GI/ Abdomen:
    Common signs of appendicitis
    Common signs of cholecystitis

    Endocrine:
    What is DKA? What are the common sign and symptoms?

    Neuro:
    Common signs of a stroke
    Differences in treatment of hematic stroke vs ischemic stroke
    Common signs of herniation
    What is involved in a nuero assessment?
    What is a Glasgow Coma Score?

    Respiratory:
    Common signs of pneumonia
    Common signs upper respiratory tract infection
    Croup, RSV, bronchitis, pharyngitis (we see a LOT of these!)
  3. 0
    wow, thx so much for all the helpful and thoughtful advice. I'm so thankful.
  4. 1
    Quote from nursing.mypassion

    I'm a little worried however in terms of what to prepare for the 1st day of ED practicum. Do you here have any ideas
    You only really need the gray matter between your ears.
    But...


    Get up early. Eat a good breakfast. Coffee optional. Pack a lunch
    (you don't want to waste time getting it from the cafeteria should you actually GET a lunch)

    Pack finger foods: Sandwich, SunChips, Chewy Granola bars, other snacky-things
    that you can eat on the go. A water bottle or two in your bag.

    Show up a little early.

    Clear your mind of as much anxiety as possible so you can observe and learn.
    Ask lots of questions. Thank the people that help out.

    A thank you goes a long way in getting invited back.
    Send a card when you're done. Again "Thank You"

    Lastly- Have fun
    nursing.mypassion likes this.
  5. 1
    I think MesaRN gave an excellent list. One more thing I would add for you is just be a go getter. In my few months experience in the ER I fine the nursing students to be a little hesitant at doing things. They tend to not want to get their hands dirty so much and sit at the nurses station. The EMS students are the ones on top of everything to say the least and asking every one if they need any help. Just don't be afraid to get your hands dirty and be ready to learn a lot. Don't sit at the nurses station the whole time. You'll do great! You already have a good start by asking what you should expect/do. Have fun!
    nursing.mypassion likes this.
  6. 1
    Yes, I've started just bringing our disposable thermometers in to give to parents when they bring an afebrile kid in with a fever.

    Also, had a patient recently who threw up. Once. That morning. And parents rushed her to the ED because "they take no chances."

    The patient whose vision is blurry when they don't wear their glasses is still my favorite "OH NO THEY DIDN'T" story.

    Strep throat is going around now, RSV is still strong in my ED.
    Hacker likes this.
  7. 1
    Combined both threads.
    nursing.mypassion likes this.
  8. 1
    Mesa threw up a pretty good list.
    nursing.mypassion likes this.
  9. 1
    Quote from MesaRN
    This is what I send out to our senior students before their ER rotation:

    Items to Review

    Skills
    Whether you have done a lot of IV starts or none at all, don't worry!! Learning is what the rotation is for! I just want you to be familiar with the procedures so you know how to measure the NG tube before we place it. Don't be nervous about skills, there will be ample opportunities to practice in a safe environment. Review these skills:

    IV starts
    Venipucture
    NG tube placement
    OG tube placement (with a ventilated patient)
    EKG lead placement
    3 lead (red, white, black)
    12 lead placement
    Foley catheter placement
    Straight catheter placement
    ABG collection

    Medications:
    Remember, just a few important points about each. Why would it be used it in the ER?:



    Morphine
    Ativan (lorazepam)
    Epinephrine
    Haldol (haloperidol)
    Benadryl (diphenhydramine)
    Solumedral
    Metoprolol (Lopressor)
    Nitroglycerine
    Versed (midazolam)
    Albuterol
    Magnesium (what type of dysrhythmia is it used to treat?)
    Zofran (ondonstrone)
    Phenergan (promethazine)
    Cardizem (diltizem)
    Dilaudid (hydromorphone)
    Compazine
    Protonix
    Xanax (alprazolam)
    Valium (diazepam)
    Pepcid
    Lidocaine
    Amiadorone
    Adenosine
    Atropine
    Dopamine
    Propofal (diprivan)
    Normal Saline
    Dexamethasone (decadron)
    Heparin
    Lovenox
    Vicodin
    Percocet
    Tordal (ketoralac)
    Ancef
    Rocephin (ceftriaxone)
    Activate Charcoal


    What drug do you use to reverse opioid overdose?
    What drugs on this list are narcs?
    What drug do you use to reverse benzodiazepine overdose?
    What drugs on this list are benzos?

    Systems Review
    Keep pathos short, I mean 10 words or less!!! Think about assessment!! You will be doing a lot of focused system assessments while in the ER.
    Cardiac:
    Common signs of an MI
    Remember MONA??
    What is Troponin? What does it mean if itís elevated?

    Be familiar with the following rhythms:
    Atrial fibrillation
    What does supraventricular tachycardia (SVT) mean?
    Normal Sinus Rhythm
    Ventricular Tachycardia
    Ventricular Fibrillation
    Sinus Tachycardia

    Cardiovascular:
    What is shock?
    What are the four (major) types of shock?
    What is anaphylaxis?

    Renal:
    How do the kidneys regulate BP? (no long patho, just the big picture in 10 words or less)
    Common signs of a kidney stone

    Hepatic:
    How does the liver effect clotting (in 10 words or less!)

    GI/ Abdomen:
    Common signs of appendicitis
    Common signs of cholecystitis

    Endocrine:
    What is DKA? What are the common sign and symptoms?

    Neuro:
    Common signs of a stroke
    Differences in treatment of hematic stroke vs ischemic stroke
    Common signs of herniation
    What is involved in a nuero assessment?
    What is a Glasgow Coma Score?

    Respiratory:
    Common signs of pneumonia
    Common signs upper respiratory tract infection
    Croup, RSV, bronchitis, pharyngitis (we see a LOT of these!)


    LOVE YOU LONG TIME
    popeyepalmer likes this.
  10. 0
    Another one for kids: CIAMPEDS

    C: EC + duration of illness
    I: Immunizations
    A: Allergies
    M: Meds
    P: PM Hx, Parents' perception of illness, Prenatal/birth hx
    E: Events around illness, sequence
    D: Diet, Diapers
    S: Symptoms associated with illness / progression of symptoms


Top