Latest Comments by AZEMS

AZEMS 946 Views

Joined Aug 24, '01. Posts: 15 (0% Liked)

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    I think we need to look at staff wellbeing along side patient safety.

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    As an adjunct in Phoenix I'm paid $35 per hour assuming a cummulative of working on clinical site 12 hour shift twice a week for 8 weeks. My check comes to an equal amount at this preset rate. With a BSN we mentor, supervise and oversee clinical performance and grade care plans. Its hands-on and a wonderful job. Only drawback is no benefits.

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    I'm interested in starting a nursing association. Does anyone have tips or wisdom on how to start one from the ground up.

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    You charted well. Its easy to look back and tear your chart apart. You charted the facts and notified your findings approriately. The fact is something horrible happened that could be prevented again. Not because you did wrong but, because things took place that indicate a problem starting.

    Phenergan is a nasty drug. It works well and causes many side effects. I myself now chart and change and teach a new way of giving it. I mix phenegan in 50cc solution as a drip over 5 mins. I notice no burning complaints or EPS-tremor reactions since.

    You could say in your sceniro that the first indication of burning should of caused you to pull the IV notify the doctor and establish close monitoring. A panel of expert nurses would agree. However, several nurses would agree that you had a running order and was prudent in your care as any other nurse would. Others would argue that keeping her as an admit caused some potential harm. Either way learn two things.

    Always dilute Phenergan documented in research needs to be 20cc I use 50cc
    Always take consideration to D/C an IV after one issue of burning--repetitive events cause greater potential for harm.

    Take pride of what you did giving the circumstances before knowing the outcome and learn from your experiences

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    Nursing is rough and in the ER it can be RAW. But a ER nurse is the one that enjoys the pace the interaction and the environment day after day. I don't hesitiate coming back to work. The patients and cases are new each time a bed is turned over. The only problem comes with those and what you have to work with. Even a vetern ER nurse can adapt to that

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    Your experience unfortunately is repeated daily

    You should complain to the hospital adminstration. I see this care too often at work and its healthcare provider oriented. A nurses job is to advocate and communicate. Many times we hold meds for tests or because it effects assessment but science is great there's plenty of meds and treatments to TREAT people while preserving caution. When people complain the heat comes down if you complain to the top dog. You should of had a nurse say i'll ask the doctor to tell you why you can't give a med or what there impression is. I even give my name and ER# is if a difficult discharge needs help I can answer basic info even when policy says no. I look at it as extended d/c follow-up. I can pull a chart 3 hrs after d/c and note vomiting continues advise use of meds, fluids or return to ed. its called giving care. Your right to feel upset I would and no excuse is acceptible

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    diane

    i work in phoenix and feel your anguish. I like you give everyone a equal chance to tell their story and get treated as if family. But out here its horrible. People abuse and use ER's like I've never seen. Its time nurses take the upper arm and make patients establish TRUST. If they expect the same then we should from them. Good job I think many times we feel like cops. With the need to investigate the WHY they are here and the objective facts for their needs

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    Amen

    Glad to be in ER. Was a medic running calls left and right with limited ability to educate or change a patients life. But, I enjoy the interactions of patients most tend to feel the same AMEN.
    They don't want to be there in line, waiting only being told to follow-up with their doctor. They appreciate the care and education we give....when we trul give it. The problem is finding time and abililty in the hassle to take 5 mins to show it.

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    ER-ED "everyone requesting every drug"

    I'm from phoenix also and its horrible out her. I see mom-daughter combination seekers in the ER every three days.
    my only response document and destroy. Sign Rx with phone #'s instead of DEA #'s verify the pts. RX history with pharamacy. Refer to pain mgt. with only 2-3 day supply of pain meds.
    Inform pts with pcp's thet will be called about there "problem" event. Tell frequent non-urgent flyers without obvious disfunction
    long wait related to frequent problem and poor follow-up place them in lower priorty levels and inform your chrg nurse. get them there w/c to help get them out of a car then place them in a seat and tell me you need it for the next pt to be assisted its the only w/c for transport.
    only through our critical thinking and appropriate actions and documentation could we defend, diminsh, and destroy seeking behaviors

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    don't worry about burn out. your role will change drastically!

    you will find that you will feel uneasy and underqulified, but you have an advantage....environment you'll know who to go to, where it is, and how to obtain it, and where to call. these are things all nurse new to a department feel lost about. your experience on the unit will change daily as you fall into your new role. find your mentor on the unit and they will guide you to where you need to go and burn out will be only appear as your RN tasks become old hat.

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    WAS A PARAMEDIC FOR 5+ YRS. BEFORE BEING NEW GRAD IN ER.
    i RECEIVED NO ORIENTATION AND JUMPED RIGHT IN. IT WAS NOT ROUGH AND NOT RECOMMENDED BUT MY EMS EXPERIENCED CARRIED ME THREW MOST OF THE WILD ER ROUTINE.

    NOW I'M THE LONGEST EMPLOYED MEMBER ON MY SHIFT AND PRECEPTOR SAD TO SAY ITS ONLY BEEN 2 YRS SINCE THAT FIRST DAY. ALOT HAS HAPPEN IN THAT TIME BUT THE ONE THING FOR SURE IS I AM VALUED AS A RESPECTED STAFF MEMBER BY MY COLLEGES AND THE GO TO MAN FOR ADVICE, HELP, OR EXPERTISE. I'M CONFIDENT IN MY ROLE AND HAPPY I HAD MY EMS TO FALL BACK ON.

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    TEX

    AS AN ER PRECEPTOR, LOOK FOR A MENTOR FIND THE PERSON WHO HANDLES CHAOS WITH EASE AND SEEMS TO HAVE THE STAFF'S CONFIDENCE. THIS IS SOMEONE YOU SHOULD WATCH AND GET TO KNOW. QUESTION WHAT YOU DON'T KNOW AND WHAT YOU WOULD LIKE TO KNOW. PLAN A GOAL EACH DAY THAT IS REALISTIC LIKE STARING A DIFFICULT IV START. OR WORKING ON A PEDS CASE THAT YOU NORMALLY WOULD AVOID. YOUR PRECEPTOR SHOULD GUIDE YOU AND ASK YOU WHAT THINGS YOU LIKE TO DO MOST AND THEN THEY SHOULD AS LOOK FOR THE THINGS YOU FEAR MOST AND GUIDE YOU THROUGH THEM.

    A MENTOR HOWEVER WILL NOT APPROACH YOU BUT AWAITS FOR YOU TO SEEK THEM. THEY WILL GUIDE YOU THROUGH THE MOMENTS YOU NEED HELP MOST AND WILL HELP YOU ESTABLISH THE SKILL AND METALITY YOU SEEK MOST.

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    DIANE I HEAR YOU!!!!

    PHOENIX ER NURSING IS ALMOST THE SAME EVERYWHERE.
    THE THINGS I'VE SEEN AS BRAIN STORMS OR STREAMLINING ARE JUST RIDCULOUS WAYS OF AVOIDING THE NEVER ENDING REALITY.

    HIRE MORE NURSES AND ASK THERE INPUT...AND LISTEN!!!
    TO WHAT THEY THINK IS A GOOD SOLUTION TO THE PROBLEM.

    WHEN I FIRST STARTED I WAS ACTIVE IN COMITTEES AND THE CHANGE PROCESS. BUT TO NO DISBELIEF THE WAS NO RESOLUTION OR ACTION TO OUR IDEAS.

    I LEARNED TO ADAPT AND RIDE OUT THE STORM WILL MICRO MANGING THE BATTLES.... ONE AT A TIME .

    AFTER A WHILE MOST THINGS LATER SEEM TO SETTLE DOWN AND RETURN TO ITS UNORGANIZE CHAOS BUT WITH RESOLUTION OF ONE OR TWO PROBLEMS THAT ONCE EXISTED. VOICE CONCERNS BUT DON'T TAKE THE WIEGHT OF BATTLES AND FIN THE ENVIRONMENT THAT LETS YOU DISCUSS CHANGE AND GIVES YOU FEEDBACK.

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    tHE THINGS THAT OCCUR IN THIS ENVIRONMENT CAUSE US TO QUESTION WHY...AND TRUTHFULLY THERE ARE USUALLY NO GO ANSWERS ONLY MORE QUESTIONS.... HUMOR IS A WAY OF EXPRESSION TO THE QUESTIONS THAT CONTINUE TO ASK US WHY.

    IN HUMOR WE FIND A PLACE THAT GIVES US STRENGTH AND ABILITY TO WORK WITHOUT ALWAYS LOOKING FOR ANSWERS BUT INSTEAD COMING TO TERMS WITH WHAT WILL HAPPEN NEXT!

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    HI i WORK OUT IN PHOENIX AND MOST HOSPTIALS OUTHERE ARE NOT A PLEASURABLE ENVIRONMENT.

    A CO-WORKER OF MINE HAS WORKED AT CHANDLER AND STATES

    IT SU!#S. NO SUPPORT FROM MANAGEMENT, SHORT STAFFING, AND OVERCROWDED.

    ARIZONIA IS NOT A GREAT PLACE TO DO NURSING AND THERE IS NO ENJOYABLE WORK ENVIRONMENT. HOWEVER, TRAVELERS ARE NEEDED AND ALMOST OUT STAFF CORE STAFF.

    GOOD LUCK

    WISH I HAD BETTER HONEST ADVICE BUT ITS THE TRUTH.



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