shoegalRN 12,128 Views
Joined Dec 5, '06.
Posts: 1,379 (42% Liked)
Working a busy ER:
Bed 4 came in via EMS with chief complaint "he's cold and **** his pants", ambulatory, wants thermal boots, waiting on social worker.
Bed 5 is from a nursing home. Per nursing home he is "more cranky than usual" and attempted to hit a nurse. He has a sitter at the bedside. He is bat **** cray.
Bed 6 found down in the aisle at the local grocery store with a can of tuna and a tomato in his jacket. Has nasal airway inserted, reeks of ETOH. GCS of 13. The most we can get out of him is "f you".
Have a good morning!
I am a SANE nurse, but I'm not certified.
For my program, you must have a year of ER, ICU, OB, or Labor and Delivery experience.
I took a 40 hour training course that included evidence collecting, evidence documentation, attending trial, forensic photography, and learning the legal aspects of forensic nursing for my state. That includes the age of consent. That training also included how to perform a forensic sexual assault exam from head to toe, including performing a pelvic exam.
I am also a member for the IAFN which stands for International Association of Forensic Nurses. I would join this organization if you are interested in SANE nursing.
I have had two depositions regarding three of my SANE cases. My kits mostly get good hits on DNA. Although I've had depositions, I have yet to testify in court, due to lack of victim participation.
To date, I've done close to 30 cases and precept other SANE nurses.
I am an ER nurse and take call 2 days a month. This is not a full time job to take unless you are a director of a SANE program. Most SANE jobs are based on call.
I hope this helps.
Ok, here goes. I am a new grad, just graduated on May 16th. I wish someone would have told me how to prepare for the long hours spent studying, the critical thinking skills required, and how to time manage.
I strongly suggest getting a planner and planning out your days, right down to the "naps" you may need to take betweeen clinicals and class. When feeling overwhelmed, go talk to a counselor.
Take one day at a time.
Take time out to relax, read a good novel (non-nursing related) and spend time with family and friends.
Take time out for yourself, join a gym if you havent already.
Oh, and another thing, DO NOT CRAM! There is entirely too much info you have to KNOW (not memorize).
Good luck! The next two years will fly, I swear!
I got 4 similar repeat questions and I know for SURE I got them all right.
I did NOT change my answers. For example, I got one that asked about a certain classification of drugs. Then 4 questions later, I got the same exact question, instead of giving classification of drugs, it gave a drug name (that was from the classification of drugs) and the question included the EXACT same answers, in the EXACT same order. I selected the answer I selected the first time and kept going.
I think NCLEX do that to see if you will question yourself and change your answer to something that may harm the patient.
Do NOT change your answers!
I love working Stepdown/Tele! I am an ER nurse but usually get floated to Stepdown or sometimes may pick up an extra shift to help out when short staffed.
Here's what I suggest:
-Know your rhythms like the back of your hand. Especially the deadly ones like Vtach/Vfib.
-Know how to read a 12 lead EKG
-Know where the EKG machine is kept and know how to take a STAT EKG because you will be doing plenty of those
-Know your cardiac drugs, like metropolol, Cardizem, Hydralazine, amiodarone, -prils.
-Know your diuretics and what to look for, example Lasix, look at K+ level
Last but not least, know where your crash cart is and what is in it!
Take an EKG class ASAP! Become ACLS certified ASAP!
Tele pts can CRASH on you really fast! You need to know how to react in case that happens.
Good luck! You will learn so much on Tele!
I had a pt come into ER as a trauma, young 25 year old girl. Was attempting to play "spiderman" and swing down to the balcony under her because "my friends dared me". ETOH on board. Hit railing of balcony and ended up with a broken pelvis.
About 2 months later, had another girl attempting to swing down to another balcony under her. Was up 4 stories, and instead hit every railing on her way down to the ground, several broken teeth found at scene. ETOH on board as well as other drugs (cocaine, weed). Came in to ER as a trauma. Ended up with a small pnuemothorax, broken leg, and broken jaw. Taken to ICU, left ER talking. Went to oral surgery two days later to fix broken jaw. Was intubated, never extubated upon completion of surgery. Taken back to same ICU. Went into PEA a few hours later. Blot clot found logged into ET tube. Ended up being an organ donor.
I'm an ER nurse and couldnt see myself working anywhere else.
Some of my favorites:
-guy comes in via EMS, backboard and c-collar. States he was "attempting" to rob somebody for drugs, police showed up with guns drawn, he swallowed the crack because he didn't want to go to jail. Now, he feels a little "high" and wants to be checked out. How he ended up on backboard and c-collar? "These two dudes" caught a hold of him as he was running from the police, after he swallowed the crack, and they tried to beat the crack out of him. According to him, he was robbing the drug dealers to try to get "drugs off the street" because he had found God who told him this was his calling. The true story? He was a drug addict who tried to rip off a drug dealer who beat the crap out of him for not paying. Just got released from rehab the same day. Needed a story to tell to his parents who were worried sick.
-guy comes in via EMS, on backboard, bleeding everywhere, obvious open wounds. Guy can not tell EMS or ER what happened. Denies doing any drugs/ETOH. Hooked up to monitor, HR in the 170's, no P waves, slammed Adenosine 6/12/6. Still no change. Pt cardioverted synchonized X 3 after getting some sedation. Pt still denying drug use. Also can't tell us how his legs were sliced or how his fingers are damn near amputated. Police happens to walk by and goes "this is the guy who we are looking for. He's been running for us, jumped out of a 3 story window after we caught him smoking crack".
If that student is allowed to continue on in the program and the nursing director AND school is fully aware about how he feels about gays/lesbians, women, and all other ethic groups, and if they allow him to graduate and he gets into the field and really HURT someone, or worst KILL someone because he disagree with thier lifestyle or skin color, this is just a LAWSUIT waiting to happen. I would send an letter to the State board, along with a copy of the student handbook, as well as a restraining order against this student. If the school won't do anything to protect your safety, maybe he won't be allowed to sit for boards once he does graduate. I don't know if that will happen, but it's worth a try.
I'm sorry you are going through this. Good luck to you!
My advice is to wait until AFTER nursing school to find a boyfriend. I'm dating a guy right now and I'm in my first semester of nursing school and I'm seriously thinking about ending this relationship before we get to clinicals. I simply don't have the time and he's not very understanding of that. So, to avoid going through a break up while in nursing school, I'm just gonna not put him as the priority. I can't worry about that now. I left a very stable and well paying job of 14 years to go to nursing school full time and I have a son depending on me to succeed. I can't be worried if I didn't call him back when I just pulled an all nighter and I'm dead tired and have to be up at 6am the next day for class.
So my advice is to focus on your studies. It's nice if you want someone to go out with here and there, but relationships take WORK and so does nursing school, so you have to decide which one is more important.
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