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Emergency RN, BSN, RN, EMT-B 6,692 Views

Joined May 24, '06. Posts: 570 (65% Liked) Likes: 1,896

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  • Jan 31

    Doing it by only working 3 x 12 hour shifts per week, with 6 weeks annual vacation (BSN, 26 years exp, nights); but unfortunately live in bleed through the nose (tax and expenses) New York. If I moved to Texas, I would make ~ 43K but actually have a (calculated) 16% increase in my standard of living.

    So it really isn't all just dollars and cents.

  • Jan 25

    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.

  • Oct 18 '16

    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.

  • Oct 3 '16

    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.

  • Sep 10 '16

    My question is, can a PICC line catheter tip being in the right atrium cause ECG changes?

    Maybe, but generally, it would be limited to rhythm abnormalities secondary to tissue irritation rather than ischemia (ST segment) infarction (troponin) events. If having a line in the RA or RV were that clinically dangerous, then it would negate the use of Pulmonary Artery (Swan-Ganz) catheters. PICC lines can also be used as a poor man's CVP line. That said, there is nominally a danger of perforation (tamponade) events but those are generally historically statistically small in view of the numerous central venous lines that have been inserted. Further, pacing wire tips routinely are placed directly into either the RA or RV, and if untoward events related to line presence were a big risk, that process would not be even possible.

    My two cents? It was good that the nurses were astute enough to have caught the missed pull back, but in the final analysis, it was probably clinically insignificant.

  • Jun 28 '16

    Several years ago, I remember once wandering to the web page of New York State's Education Department License Division (they're the ones who grants and disciplines all NYS professional licenses) and looking up the revocation and suspensions of nurses; the results were eye opening. The majority, and I mean like 99 out of 100, of cause for license action was related to improper activity with controlled substances (theft, diversion, substitution, etc). Very, very rarely, did I see anything related to improper clinical care. Further, I was not able to find a single example of action taken for abandonment.

  • Jun 15 '16

    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.

  • Jun 13 '16

    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.



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