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Joined Jun 6, '07. Posts: 2,000 (46% Liked) Likes: 2,918

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  • May 14

    HAHA!!! That has to be the funniest assumption ever. However, after several years of working in ERs of various types and sizes, it's not surprising such assumptions are made of ER nurses.

    ER nurses literally save lives. Patients do not enter the hospital proper in emergent situations without first having had the touch of an ER team. An ER nurse often gets 5 minutes or less notice of a trauma arrival that will upend a large portion of one's shift. At any given moment, you might be hanging life-saving medication while dealing with a repugnant drunk who thinks it's okay to cuss you out over the hospital's choice of plain turkey sandwich as their main ER entrée. One minute you should be silently swearing to yourself over the self-serving complaints about the wait time over their mild cough and sniffle while you're trying not to lose your sh@t because you know part of that wait was due to a police officer getting shot and the whole team trying to rally to save him. ER nurses do their best to walk into a patient's room to offer a refill of ice to a patient who's been hammering the call light while you've been busy performing CPR on a young boy and his brother who were shot in the head by a deranged parent. And despite your best efforts, you now have to somehow gather what remaining willpower and strength you have left for the family who now has two empty seats at the table.


    It's not all doom and gloom, but I don't know of a single other environment that has such various elements (highs and lows) in a shift. You could be at the end of your rope of patience in dealing with people who aren't really sick or who just want a place to crash because they got drunk again... and in the next moment have to refill your compassion bucket to deal with someone who is on death's door.

    Just as inpatient nurses may feel they get endless admissions, ER nurses do not get to tell ambulances to go somewhere else. We just take them because that's what we do. Even when we are at capacity. That's usually when we really need nurses on the inpatient side to understand that delaying that report, or pushing admissions off on the next nurse may seem like its helping you, but in the end it's compromising patient care.

    It takes a team. Assuming all ER nurses do is "set IVs" and such is just about as insulting as someone assuming that non-ER nurses just sit at a nurse's station. We can do much better.


    Thanks,

    Darth Practicus, NP and all-around good guy
    Former ER Nurse, ICU Nurse,

  • Apr 30

    I for one am not surprised that a Nurse can perform in a leadership capacity that is Nationwide. She after all hold a PhD in Nursing. We should be celebrating that our profession is much more than what the general public perceives us to be. I am very proud of the new Surgeon general, no matter how long she will be in place, it is the top place and well deserved.

    Congratulation Admiral Sylvia Trent-Adams Ph.D., R.N., F.A.A.N on all your hard work, on your competence in a world where it seems to be lacking at times and for being a leader who inspires so many people to "make something of your life". May your time in this position be filled with challenges that you over come and that you make the Public Health System in the US better as you assume this important leadership position.

  • Apr 30

    A, she's not technically the first; there was a physician surgeon general who was also an (or had been an) RN, and claimed to have been the first nurse SG.

    B, she's the acting SG and will likely be replaced as soon as Trump can find a physician craven and disreputable enough to meet his standards.

    I agree, though, that it's kinda cool while it lasts ...

  • Mar 18

    Quote from HannahKay
    Would you say it's the military's way of discouraging people from doing it? By making it a complicated process?
    No, it's a matter of maintaining accountability of your troops and ensuring that their readiness for military duty is not compromised by outside work. Military is a 24x7 commitment, and they are just protecting their assets.

  • Mar 7

    Daily medication approved by the flight surgeon is allowed. They just carry out and destribute it out on the field.

  • Feb 21
  • Feb 21

    Think of it as "acting." When you go into your patient's room (or wherever ...) "act" like a calm professional nurse. Play the role - think of yourself as "on stage, in front of an audience."

    Soon, it will become 2nd nature to you -- and you WILL be the calm professional nurse you appear to be.

  • Feb 21

    It is different for military because you are on a huge plane, not a helo or private. You take care of patients that are not critical, there's a separate critical care team (CCAT) who comes on board during the transfer. A military flight nurse ensures the plane is set up to care for all patients. You take care of the non-critical and assist the CCAT team. Th CCAT team are not flyers like FN's because they are solely caring for the patient before during and after transport. I am prior service and have fellow FN friends. Only one year of acute care required and they will send you to training that equals 6 mos sporadically or consecutively, depending on timing. Anyone who works in a plane is considered a flyer, all flyers have to go through survival school where you are trained to be in a capture situation if you were to survive a plane crash. Water survival is included. My spouse went through it. Pretty cool. So yes, the military FN is much different than civilian.

  • Feb 21

    Why not address the HTN with a true HTN med instead? If you hit the max of Propofol, something else should have been used. Sure up to 100/mcg/kg/min short term is probably not harmful with that high a pressure, but there are other meds out there to deal with it. Add Versed and Fentanyl for the agitation and then a little hydralazine or labetolol for the HTN.
    What was used for sedation for RSI?
    Was the reason for the AMS found?

  • Feb 20

    We do not give patient's narcotics unless they have a driver, or are being admitted. Zero. We are strict about this, because the way we look at it, even if they are homeless, if they walk into the street and get hit by a car, they can claim we caused it by giving him meds and not making sure he was with a responsible party.

    Not sure about the P&P, as I have not actually read it, but we are very strict about it. A cab ride isn't sufficient. Most of our frequent flyers know this and bring a ride with them.

  • Feb 14

    It generally takes longer to do CRNA via the military, however it can be done nearly free***(for a service commitment). There is a competitive program where they send you to school full-time for free and you still collect your normal salary: AFIT.

    You would apply for a commission as a critical care nurse. You would have to do 2-4 years at your first base and then apply for the DNP/CRNA program (which entails 6 years of added service commitment I think).

    Search the other threads on Government/military nursing to learn more. It's been rehashed hundreds of times.

  • Feb 11

    There is a program where you can go back to school after at 2 years at your 1st base: AFIT. They offer a DNP/CRNA program. You could be an ICU nurse for 2-4 years, and then go back to school on the AF's dime and still collect your full RN salary. It is very competitive.

    Tuition assistance, which is $4500/yr of basically free money, is something everybody gets. The only MSNs you can really do part time in the military are informatics, leadership/management, or education in my opinion. All the other ones (CNS, NP, CRNA, CNM) require clinical rotations.

  • Feb 3

    As a SANE, you may work regular shifts at your place of employment just like any other floor nurse. For instance, a SANE could work the regular three 12 hour shifts per week in their ER, but then be on call on their time off as a SANE. Some places with multiple SANE certified RNs may rotate call so that one SANE isn't overstressed, but that depends on the location/number of SANEs.

  • Feb 3

    We are expected to chart something at least once per hour. Obviously changes of conditions, medications administration, etc. but what about those soft threes and fours who are just chilling and watching tv, or those patients when you're just waiting for a bed, etc? What do you chart when really nothing notable is happening?

  • Jan 29

    I'm becoming less and less therapeutic over the years myself. I tend to address it head on, as in, "we have rounded on you frequently but have still not managed to reduce your need to utilize your call light often this shift. Are you lonely or worried? Can we call a family member or friend for you to visit with? Is there a favorite television or music channel you prefer to help you pass the time? Please remember that we are here to meet your medical needs and want you to have a successful hospital stay with also feeling well cared for but we are not able to stay at your bedside consistently when you are medically stable."


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