Latest Likes For Emergency RN

Latest Likes For Emergency RN

Emergency RN, BSN, RN, EMT-B 5,123 Views

Joined May 24, '06. Posts: 570 (65% Liked) Likes: 1,888

Sorted By Last Like Received (Max 500)
  • Apr 11

    the problem you're facing here is one of degrees. sure it is bad, but not as bad as hanging blood with d5 alone. will you get cell hemolysis? yes, but not to the degree that you would had there been no saline at all. that said, the amount of actually hemolyzed blood was probably small. here's why; generally, when blood is running, the regular ivf ns that runs with it is shut off. so, the blood likely only came in contact with the hypotonic solution at the very beginning and very end of the infusion. that is, the bulk of the unit was probably not affected by the mistake. also, any clots that may have formed in the line were probably trapped by the in line filter where the blood first came into contact with the wrong solution.

    but make no mistake about it, this was a huge mistake.

    there are times when you need to do what i call "personal time outs" to ensure that what you're doing is correct. just like when you get into a car, the first thing you check is make sure you have your seat belt on, adjust your mirrors, seat, and windows... all before you start the car. at least, that's the way it is with me. after a period, it becomes second nature to the point that you won't even think about it, you just do it. for transfusions, besides checking for the order, consent, and the five rights on the patient, you need to also check the entire iv, from infusion site back up to the bag before you even start to check the blood.

    i'm sure that we don't need to berate you on this, as you're probably already pounding your head into a wall over this already. but, like they say, painful lessons are sometimes the best teachers. just be thankful that the patient didn't suffer any long term harm from it.

    good luck.

  • Apr 9

    the problem you're facing here is one of degrees. sure it is bad, but not as bad as hanging blood with d5 alone. will you get cell hemolysis? yes, but not to the degree that you would had there been no saline at all. that said, the amount of actually hemolyzed blood was probably small. here's why; generally, when blood is running, the regular ivf ns that runs with it is shut off. so, the blood likely only came in contact with the hypotonic solution at the very beginning and very end of the infusion. that is, the bulk of the unit was probably not affected by the mistake. also, any clots that may have formed in the line were probably trapped by the in line filter where the blood first came into contact with the wrong solution.

    but make no mistake about it, this was a huge mistake.

    there are times when you need to do what i call "personal time outs" to ensure that what you're doing is correct. just like when you get into a car, the first thing you check is make sure you have your seat belt on, adjust your mirrors, seat, and windows... all before you start the car. at least, that's the way it is with me. after a period, it becomes second nature to the point that you won't even think about it, you just do it. for transfusions, besides checking for the order, consent, and the five rights on the patient, you need to also check the entire iv, from infusion site back up to the bag before you even start to check the blood.

    i'm sure that we don't need to berate you on this, as you're probably already pounding your head into a wall over this already. but, like they say, painful lessons are sometimes the best teachers. just be thankful that the patient didn't suffer any long term harm from it.

    good luck.

  • Apr 5

    Quote from classicdame
    dextrose is sugar. sugar is what we put in water to make syrup. dextrose can cause fatal reactions when hung with blood.
    really? first time that i've heard this one. can you please elaborate and explain just how...

    ...dextrose can cause fatal reactions when hung with blood?

    i'll have to be really careful then, next time i push that amp of d50...

  • Mar 29

    you know, i could go the blah, blah, blah about the five rights that they drummed into us from nursing day 1, and wag my finger that you should be more careful and let this be a lesson, ad infinitum et nauseam; but i won't. why?

    because frankly, there is nothing wrong with you; the fault is with the system. if drug manufacturers continue to name things that sound so much alike, then even seasoned rns with 14 years experience will continue to make the same mistakes. in the interest of patient safety, the manufacturer should be required by law to change the name.

    btw, the clonidine (catapres - an antihypertensive) vs klonopin (clonazepam - a benzodiazepine used in seizure or panic disorder) mistake is probably one of the most notorious error prone pairs within health care. it's been zinging nurses and doctors for years.

  • Feb 1

    I find it stunningly ironic, that a nurse who makes a living undermining the livelihood efforts of other nurses, is here asking for advice in how to obtain more of such employment. If you want to be a nursing mercenary, that's certainly your choice and right; but I for one would never assist you (or those of your ilk) in such efforts. You're not the only nurse who needs to eat; IMHO, your employment strategy of stabbing your colleagues in the back is akin to cannibalism.

  • Jan 31

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 26

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 24

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 23

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 22

    I find it stunningly ironic, that a nurse who makes a living undermining the livelihood efforts of other nurses, is here asking for advice in how to obtain more of such employment. If you want to be a nursing mercenary, that's certainly your choice and right; but I for one would never assist you (or those of your ilk) in such efforts. You're not the only nurse who needs to eat; IMHO, your employment strategy of stabbing your colleagues in the back is akin to cannibalism.

  • Jan 21

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 21

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 21

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 21

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.

  • Jan 21

    To make a long story short:

    ED = confusion, down and dirty, stabilize and get 'em up alive, move on to the next victim.
    ICU = figure out what's REALLY going on, fine tune, start the road to recovery
    MED-SURG = heal, educate, rehabilitate, release.

    It's a nursing continuum and one needs to remember that. After 30 years of hospital service in both Emergency and Intensive Care arenas, I won't belabor the point. But IMHO, I think that all ICU nurses should have an annual mandatory rotation in the ED and vice versa. The lack of appreciation for the clinical needs and differences of each setting is what drives this perpetual misunderstanding and my personal belief is that management seriously needs to look into providing a solution. However, one final note. If the confusion in the ED rises to the point that patient contacts are so haphazard that it OVERLY impacts patient care, then staffing is generally at issue.


close
close