I have been going through your posts and am greatful for your willingness to share your questions/experiences and expertise. And some things that you all experience-WOW!!!!!
Anyway, I am working in a small rural ER. With the exception of 1 nurse, none of us have ER experience-it is a learn as you go. No preceptor program of coarse. So my concern is-this is somewhat the blind leading the blind on some levels. OF coarse, the other nurses have their experience, and yet, it is from a limited environment. The facililty doesn't send the nurses to other ER's for orientation.
As I was reading through the posts, I was wondering-how will I learn good triage skills, in some ER's it appears, they give a role to the RN's that respond to a code or major trauma. That makes alot of sense to me-we did that during our "code Purples" in a crash C-section and it cut down on alot of the confusion,disorganization.(This was in another facility-not rural). And yet, at this stage-everyone here just shows up-I guess it works, but seems disorganized (I am sure though some of it is my newness to the ER too). But I think, how much do we not know, how many tips, tools,resources are we missing because we are so small and only pass on information from a limited pool of knowledge? Any tips/resources would really be appreciated-not just for myself, but hopefully for all of us in our little facility.
Thank you so much
Nov 11, '05
One thing that will help your Emergency Dept. immensely is to develop a good relationship with the closest teaching hospital. Their trauma coordinator should be able to assist you by explaining in detail how they want patients that are being shipped to them treated (What labs are important, what exrays are important, and what could be skipped). Most will even be willing (depending on job description) to come and do some trauma things with the nurses. They can also help you to organize a response to trauma that makes sense for your facility- so that you don't have all nurses working a trauma and no one taking care of any other patients. Definitely good to have assigned roles during times of high acuity and stress.
When I was at a Level one (I think I've just posted this recently)- our Pediatric specialist did a program where she ran mock Pedi codes all over the state. It really sharpened up the nurses to have someone walk in with resQ annie and state she was 2 years old and cyanotic...and would someone please assist. She then went over different ways to manage a pediatric code/trauma/near drowning (we had had a tons of them for some reason).
They might even allow some of your nurses to come to their education days. And surely they would share protocols with you.
Also, Look at your local Emergency Nurses association organization. They usually have something once a month- a lecture in the evening etc that can help sharpen skills- and of course sponser and teach TNCC and ENPC etc. Also they will help to sponser events in the state- trauma conferences etc.
As far as triage- there are some books and articles out there, but again, maybe someone from another hospital could be convinced to come and do a small class of some sort- it really depends on the triage system used at your facility as well.
Best Wishes- sounds like quite a challenge. I'm sure, and I hope some others have good ideas for you as well!
Nov 11, '05
Oh here's a link also for you. http://www.trauma.org/resus/moulage/moulage.html
There you will find moulages to help prepare for certain trauma situations. I've found these helpful.