kmoonshine

kmoonshine RN

Emergency

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About kmoonshine

kmoonshine is a RN and specializes in Emergency.


Latest Activity

  1. takotsubo

    Try reading through this case presentation (I found it interesting): http://www.flightweb.com/forums/index.php?showtopic=618&hl=takotsubo&st=0
  2. Quick question about IV starts.

    There is a topical cream with lidocaine that works wonders, but as other have said, it takes quite a long time to work (I put the cream on thick over the potential IV site and cover the cream with a transparent dressing; I then put a warm compress ov...
  3. IM injections -should we massage or not?

    I've never heard or seen this practice. I would think that it would cause more discomfort by increasing leakage into subcutaneous tissue (but that's just my opinion). I use an infant heel warmer to increase absorption of some meds, such as morphine ...
  4. Help explaining thyroid panel results

    Try relating it to something that the patient understands. Perhaps say something like "TSH levels go up because the pituitary gland is sending out more horomone to get the thyroid gland to respond. Kinda like trying to call someone by phone but they ...
  5. Policy on ED violence

    I can't say much for policies...but, you need to beef up the security to protect staff and other patients. Discuss the use of panic buttons in all rooms, having a locked unit, and implementing a 2-visitor/patient rule (visitors must check in at triag...
  6. How fast do you push metopropolol

    I give metoprolol 5mg IV push over 5 minutes and I wait around 2 minutes before administering another dose.
  7. Long shifts---how long is too long?

    We have 4, 8, 10, and 12 hr shifts in our ED. I've seen people pull 16+ hrs before. Personally, I think 12-hr shifts would be safe if staff were given a decent lunch break (at least 30 minutes) and at least two 15-min breaks to step away from pt care...
  8. drawing blood from picc line

    Here's some info: http://doctors.shorehealth.org/nursing/iv/DECLOT%20ACCESS%20DEVICE-3-WAY.pdf Obviously, follow the P&P at the facility you work at.
  9. VENT: You mean I still have to work when I'm on the clock?

    From the moment you punch in to the moment you punch out - you are working (hence, getting paid). Ms. Ramona needs to punch out when she is done doing her share of work (if she wants to sit in the break room at 2310 until the end of her shift at 2330...
  10. drawing blood from picc line

    Before I access a PICC, I ask the pt why they have a PICC in the first place. If they can tell me why they have it and what is capped in the line, then I will access it (however, I am hesitant to access PICC lines if it's used for chemo, since it is ...
  11. Than who's fault is it?

    The cost of emergency services is high due to the need to staff 24/7 (lab, nurses, docs, radiology, etc). UA and preg, with CBC/BMP, RH, serum Hcg; abd. ultrasound to rule out ectopic - all finished in 3 hrs isn't too bad. I've delegeted things befor...
  12. Health Provisions Slipped into Stimulus Package

    Just a thought: would these new "rules and regulations" be applied to our president, senators, congressmen/congresswomen etc? I doubt it. We (the American people) should receive the same quality of health care as our elected officials. Afterall, we p...
  13. Back Rubs

    I don't give back rubs in the ED - sorry! When I was nursing student on a med-surg floor, I had a 28 yo post-op hyst pt in severe pain. She looked very uncomfortable, was on Dilaudid PCA (which should have been increased by the primary RN per MD orde...
  14. :smiley_abNope, no fight-picking here! I totally see where you are coming from, as it seems silly for me to be upset because I want to go home but the floor nurse won't take report, since she is going home too. However, I went out of my way to do a...
  15. Central venous catheter placement in the ED

    BTW: In the past 6 months I havent had a pt in the ED go for PICC placement. The other pt I spoke of (vomiting, needing antiemetics and IV fluids) was being taken care of by another nurse and is the only pt that I've seen go for PICC placement in the...