My biggest challenge in the ED is prioritizing. I always use the ABC as a rule of thumb, however I still feel overwhelmed with the other tasks such as discharging, admitting, and receiving patients.
For an example: When I have a patient to discharge and a new patient to see which one comes first?
Should I finish my discharge,then see the new stable patient? Or should I assess the new patient then discharge?
I guess it'll take time.... sigh.
Quote from JessiekRN
Learning to balance is one of the toughest things to figure out. My apologies to the charge nurses lol- but look at it this way- if you discharge your patient first, then go see your new one- you will have two new patients before you know it. And that "stable" patient might not be as stable as they appear- sometimes it's not that clear cut. I think better to see the new one first. (Unless the discharged patient suddenly decides they need to leave NOW and they're standing in the hallway making threats. Just give them their papers. It happens)
I completely agree with seeing the new patient first. Sticking your head in the room and just taking a quick look without gathering more information from the patient, and at least taking vital signs/doing a brief assessment, is a good way to miss some unstable patients. They may have an airway, may be breathing, and may not have fallen on the floor, but don't assume that they are not very unstable. People can be deteriorating right before your eyes and still say they're ok when you stick your head in the door. Some emergencies have a narrow time window for treatment i.e. sepsis. You wouldn't want to leave a patient waiting who needed urgent fluid resuscitation and IV antibiotics, would you?
Last edit by Susie2310 on Feb 1, '13