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Lev <3, BSN, RN 48,552 Views

Joined Jun 3, '11 - from 'Another planet'. Lev <3 is a ED Registered Nurse. She has '4' year(s) of experience and specializes in 'Emergency - CEN, upstairs, troll bashing'. Posts: 2,861 (53% Liked) Likes: 5,288

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  • Sep 1

    Quote from ~Mi Vida Loca~RN
    So question for my fellow ER nurses, how would you guys feel about an integrated ER. They are starting to pop up more and more. One of my best friends was doing his residency in EM/IM and then fellowed in Critical Care. At the time that was the only pathway they really had up and coming and now some places are starting to offer EM/CC.

    Anyway I have learned a ton from him and it completely changed my way of thinking in my patient care even in the ER. As a lot of you know in the ER even when we have a critical patient come in, it often doesn't change our Ratios. The problem with this is when in the ICU the nurses typically have a ratio of 1-2 with these same patients, well a little more stable than when we get them regardless of what some might want to say.

    So in the new integrated ER concepts the ER nurses would be cross trained in ICU and EM. There would be doctors staffed as well that specialize in both. If the nurse works the zone with these patient types their ratios would be reflected for that. The idea is not to hold patients longer in the ER. But more to provide safe and good care for those patients that will have to board in the ER while waiting for an ICU bed. Once a bed is available the intensivest and ICU RN would take over care. My friend was asked to come be a part of one of these ED's when he finished his fellowship and he was trying to convince me to do it as well.


    For me personally, as long as the ratios reflected the higher acuity, I would be all for it. Not only is it safer and things aren't getting missed in the holdover, I have always wanted to cross train in the ICU for the knowledge aspect of it, however had no desire to leave the ER. Would still rather have my ICU patients for a handful of hours and move along to the next. Obviously the ICU nurses would not need to cross train in the ER unless they wanted to switch roles.

    Anyway I was curious what others thought about this.
    I see more cross training of ICU nurses to work in the ER, but not the other way around. I would welcome the challenge to cross train to the ICU.

  • Aug 28

    I started at around $25 as a new grad with a bachelors. Not sure where you live but that sounds like good pay for nursing home work in my area for a person with 1-2 years experience.

  • Aug 25

    I started at around $25 as a new grad with a bachelors. Not sure where you live but that sounds like good pay for nursing home work in my area for a person with 1-2 years experience.

  • Aug 18

    I think you did the right thing. People like that usually don't change.

  • Aug 18

    I would start applying around January - February 2018.

  • Aug 18

    I would start applying around January - February 2018.

  • Aug 12

    I've used Meditech (hate it with a passion), PowerChart, FirstNet, and Epic. I like some things about PowerChart (such as how labs are displayed) better than Epic, but I like Epic too. Right now, I'm using FirstNet and Epic.

  • Jul 20

    Our DV screening questions are part of a set of secondary triage questions which are asked by the primary nurse once a patient gets back to the room. There is an option to click "visitors in room" or "cognitively impaired" as an option for the direct screening questions.

  • Jul 20

    Our DV screening questions are part of a set of secondary triage questions which are asked by the primary nurse once a patient gets back to the room. There is an option to click "visitors in room" or "cognitively impaired" as an option for the direct screening questions.

  • Jul 16

    Quote from hawaiicarl
    If you like focused cases with autonomy, then ICU. If you like task based nursing with rapid turnover, ER.

    Cheers
    It's always the ICU nurses who say that ER nursing is task based and that is the difference. ICU = brains, ER = speed. That is not ICU vs ER in a nutshell. Both are complex, overlap, and are different.

    How much of ICU is bathing, suctioning, turning, mouth care, and dressing wounds?

  • Jul 12

    Mark Boswell?

  • Jul 7

    Short answer, 5 weeks on the the floor is not enough orientation.

  • Jun 30

    Short answer, 5 weeks on the the floor is not enough orientation.

  • Jun 30

    Short answer, 5 weeks on the the floor is not enough orientation.

  • Jun 29

    I'll just leave this lab slip with you, give you this antibiotic to hang, and give you the resident's pager number. Crash cart's down the hall. I'll be in the cafeteria if you need me.


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