ED practicum

[nursing.mypassion]

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.

[nursing.mypassion]

wow, thx so much for all the helpful and thoughtful advice. I'm so thankful. :)

[EmergencyNrse]

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

[Calixan]

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! :)

[hiddencatRN, BSN, RN]

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.

[traumaRUs, MSN, APRN]

Combined both threads.

[ImThatGuy, BSN, RN]

Mesa threw up a pretty good list.

[herowneulogy, BSN, RN]

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!)

LOVE YOU LONG TIME

[Hacker]

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