New grad ER nurse here. So after only a couple weeks, they're letting me see the "clinic" type stuff on my own which is all good and I think I'm managing OK so far but I'm having trouble deciding what's going to need a bit of a workup and what's not. For example, I got a young healthy pt with c/o migraine and nausea. 8/10 pain. Vitals were stable, no hx, no meds, bit of a drama queen (sorry but true). Put her on monitors and left the room without starting an iv. Doc ends up ordering head CT, iv meds, fluids, labs.
Because I didn't start the iv and draw labs immediately, it kinda set me back and I felt like I was moving patients like molasses. Honestly, I thought the doc would just order some PO pain meds/anti inflammatory and send her home.
SO my question is should I just preemptively start an IV on all adults? So long as they're not there for something like suture removal of course...
Jul 11, '13
In general for ER's you have some "standard guidelines"
ER (A), Line and lab all urgent patients (ESI 3,2,1)
ER (B), Line and lab, place orders: Chem 7, CBC, Lft's, Meds: I.e Zofran (docs will then co sign)
ER (C), Line and lab if your nursing judgement thinks your patient needs it
ER (D), If you have an old-school doctor that rarely orders much, then wait...
Best thing to do as a new-grad who is unfamiliar with treatment in the ER; as your fellow coworker "Hey, should I line and lab him?"
Last edit by Adenosine6 on Jul 11, '13