nurse2033 16,181 Views
Joined Jun 6, '07.
Posts: 1,883 (46% Liked)
I think prompt attention to their psych help is needed. They should not have to wait until 8am - chances are they can't sleep anyway. So yes, getting them help ASAP is indeed good. I can't see why we should wait?
I would be outraged to hear that voluntary patients had to wait to be seen and to speak to someone. This is something I would try and reduce!
Personally, I think a large part of the appeal of ED visits comes from the fact that going to the ED involves no planning or commitment on the patient's part. They don't have to be there at any certain time, they don't have to make any pesky phone calls to schedule appointments...just show up when you feel like it. I know that a lot of PCPs have walk in hours, but those hours usually seem to be pretty limited. I wonder if people were allowed to just walk in to their PCP at any time would cut down on unnecessary ED visits.
There is also most definitely a cultural aspect. Your mom took you to the ED for a fever when you were little, so that's what you do with your own children. It's hard to break a habit.
Let's think for a minute about what HIPAA is. Health Information Portability and Accountability Act. While what it actually is, and who and what it covers is a very detailed topic, the short version is that a HIPAA violation involves releasing or sharing protected health information without the consent of the involved party.
So now you can answer your own question. If the parent was not a patient of this provider, nor a patient at the hospital, they are not protected by HIPAA. Arrests/criminal actions are a matter of public record and not at all related to HIPAA. Inquiring about one's neighbor who was arrested, regardless of where they were arrested, is in no way related to HIPAA.
This story sounds like the "Lemonjello and Orangello" twins. Everyone says they have heard of patients by those names, yet no one can provide proof that they exist.
I am both a paramedic and an ER nurse. I have been working in the ER for about a year now and I have about 7 years experience as a paramedic. I would have to say that probably the hardest thing about making the transition from paramedic to ED RN is learning to prioritize tasks between your patients. And you will always be reprioritizing what you do and when you do it. Another thing that you will have to get used to as an ED RN is that you will probably not have quite the extensive protocols that you are used to having as a paramedic, at least as far as patient care is concerned. There are lots of policies that you will have to get used to and there will be some protocols that you will be allowed to follow but the majority of what you do will depend upon the medical practitioner that you work with.
As it pertains to patient care, in my ER we have a grid of things that we can do without consulting ER physician. This grid basically follows 12 conditions that may present to the ED and what they want us to do during the triage process, including ordering x-rays, lab work, medications, fluids, etc. On top of that, some physicians are just different, mostly in that they would rather you do the basic triage stuff and then they'll come in and assess the patient and determine what labs and studies need to be done.
One good thing about the ED is that all of your orders and the like are typically "stat" and must be done basically right then or very nearly so. In a typical MedSurg environment a lot of your medications and tasks are set to be done at certain times of the day and I really load you up with stuff to do. In a typical day I will usually see somewhere between 13 and 22 patients, depending upon the shift that I work. Generally speaking, that means that I do all the work of assessing, charting, passing medications, doing various tasks, communicating with multiple people and getting my patient to the floor, transport, or discharge home that many times a day. It also means that I am typically seeing 3 to 4 patients at a time all day long. I then get to turn my rooms over and make them ready for new patients between 4 and 6 times per room, on average. I will have some patience under my care for hours and some I will have under my care for maybe an hour. This past week I had several patients that were under my care for less than half an hour. I have also had patients that were under my care for the better part of 8 hours and were turned over to the next shift.
There are also times that we have had absolutely no patients in the waiting room or in the ER so we had absolutely nothing to do for quite a while. When that happens, typically I start looking to do things like restocking the rooms and making sure things are clean and checking inventories and only if there's nothing else that I need to do, I might then sit down at the computer and surf the Internet for a little while.
I have been at this for a little over a year now. I'm certainly getting more competent in what I do but I still have a ways to go before I consider myself very capable of handling anything that comes through the doors. Do understand that I am not in a nurse that is incapable of handling stuff, rather I'm still somewhat new and I'm still learning things. One of my biggest tasks over the next year is for me to become even faster at things that I do. One of the things that I do not do "fast" is deal with medications. That is the only area that I will not be fast simply because if I make a mistake with the medications, that can have profound implications for the patient if something is not correct. And I have caught problems with medications simply because I have taken the time to check. Everything else that I do is typically done very quickly.
The biggest thing you will probably spend more time doing is learning to manage your time effectively. You will also probably have less autonomy than you are used to but your scope of practice will be much wider than it was in some ways.
You have indicated that your orientation period will be 12 weeks. I highly suggest that you really take to heart the "lessons" in the book "Fast Facts for the ER Nurse" as you are currently reading it, continue studying it. Probably your first day or two actually in the ER as a nurse will be spent shadowing. I would then expect that you will get one patient at a time for about a week, maybe 2, and then you will probably add another patient to your load every week or 2 until you are at a full load. After that you will probably spend a lot of time working on time management and prioritization. With any luck, you will not get a nurse that does not like new grads in the ER, especially those that were paramedics before. I had one of those. Fortunately for me, she at least did her job and once I switched over to a different preceptor, I was able to do very well.
I wish you the best of luck! The ER is a wonderfully crazy weird place to work and I would not want to work anywhere else.
so heres my input on your situation
youre a medic, your colleagues will know youre not an idiot and familiar with the emergency setting.
here are the differences between being a medic and being a er rn
1- you will now have x patients at the same time instead of your usual 1 at a time
2- you will now be with the patient for hours instead of your usual 15 minutes
3- you will now get dumped on instead of being the dumper (haha)
4- you will now be serving turkey sandwiches to your patients and figuring out how they will be going home
hopefully, you get a good preceptor. somebody who most importantly can train you in a fun way. I would rather have an ok but fun preceptor than a very smart/educated but strict one. you can practice safely and still have fun doing it
5th amendment rights
If the person refuses to answer and the person is not displaying any signs or symptoms of going cray cray, not much you can do.
I had the sweetest lady the other day. 92. Worked 40 hours per week as an RN. Until she was 84. I made her repeat it while I picked my jaw up off of the floor.
As a former Sailor, all I can say is run, sit ups, push ups, repeat
Lowest was room temp whatever that was. He was dead. Never took the temp but that was probably the lowest.
A lot of nurses (myself included) think the NURSE part of nurse practitioner is pretty important.
What one learns from practicing as a nurse for a substantial amount of time is often what makes a nurse practitioner so valuable.
Also, about the RNs making so much $$$ - not always the case. We are severely underpaid in many parts of the country.
And we don't often get the opportunity to "comfort" the way we would like to.
I don't think jealousy is the determining factor here. More like selfishness on their part. Instead of them congratulating you, they're concerned with what's going to happen to them after you're gone. Whatever you do, don't let them guilt you into staying any longer than your notice. Had the company been laying off, they would've given two craps about it being Christmas.
Wait...so you gave a 2 weeks notice and they're trying to make you think that it is within their power to accept or reject your resignation? Funny stuff.
Omg their response would be downright hilarious if it weren't so selfish. What a bunch of pigs LOL.
I have had some interesting experiences as an atheist nurse, if not downright puzzling. What follows is but a few of the many interactions that I have encountered.
When pressed for an answer to the question "What church do you belong to?" and I divulge my lack of religious belief, I am always utterly amazed that the next question is invariably "You worship the Devil?" Ummm, no. No I don't. It is my understanding that to believe in one (God) is to believe that the other exists as well (Satan) and since I don't believe in God it wouldn't make sense to believe in the Devil alone.
"Aren't you afraid for your soul?" Again, no. See above.
"How can you have morals if you don't believe in God?" Ethics. I believe in doing what is right simply because it's the right thing to do and not because I fear for my soul or that "someone" is watching and judging my every thought and action. I get an uncomfortable feeling in my gut if I don't address something that should be addressed or if I'm thinking of doing something that I shouldn't do. On the flip side, I get a nice, cozy "atta girl" feeling when I've done the right thing. In other words, my conscience guides me.
"You can't be a good nurse unless you believe in God." Yes I can. See above.
"You just haven't been to the "right" church." Wrong. I've read quite extensively on many different sects of Christianity as well as other religions and have attended many different denominational services and remain unwavering in my position on the subject of religion.
"I'll pray for you." If it'll make you feel better, be my guest.
What gets me riled and provokes "Rabid Atheist Mode" is when I'm told that I "must" be an amoral, Devil-worshipping nurse and sorry excuse for a human being because I don't believe in God. That's when the gloves come off. Personal attacks are unwelcome and will be dealt with accordingly.
This is just a small sample of some of the most common questions/statements that I've heard over the years. There have been many, many more I can assure you.
Let it also be known that I truly don't care what or who anyone worships, to each his own. If you choose to worship a badger that's fine by me, whatever gets you through the day. I ask that you please refrain from trying to get me to worship with you and I'll refrain from trying to get you to abandon your beliefs. I respect your beliefs, you respect mine. I think we can agree on that.
I'm male. I'm relatively new, but I can't say I've noticed any difference in how physicians interact with male or female nurses. As concerns being yelled at, etc. the nurses I work with talk about it as if it's a regular thing. I can assure you it won't happen to me. I won't allow myself to be treated that way. If a doctor decides to try that with me, I will definitely tell him he has no right to speak like that to me. Second, I will go to human resources and file the necessary complaint. Out hospital is Cerrified by Joint Commission. JC requires their hospitals have a program in place for doctors mistreating staff. I believe it's called behavior detrimental to patient safety.
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