Latest Comments by Lev <3

Lev <3, BSN, RN 52,466 Views

Joined: Jun 3, '11; Posts: 2,884 (53% Liked) ; Likes: 5,345
ED Registered Nurse; from US
Specialty: 5 year(s) of experience in Emergency - CEN

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  • 0

    What happens when in your ER?

    We have a two step process where one nurse assigns an ESI and the other nurse finishes up the triage process and can upgrade the ESI depending on the situation. Currently, the registration desk is closer to the ER entrance than the triage desk but here is a sign for the patient to see the nurse first, so they first walk to the nurse and then turn around and go back to registration, then they go back to triage. My ER is doing construction and we are hoping to have some of this fixed. Does your ER have registration simultaneous done with the initial triage? Do you have "quick reg"?

    What is your process?

  • 6

    These people shouldnt be in the ER to begin with. I have little pity for people who don't use their primary physicians or go to the drugstore.

  • 1
    TAKOO01 likes this.

    Quote from ChicagoRN3
    Hi all,

    I'm a new grad and currently have 2 offers on the table for my first job. My ultimate goal is to get into the ED after 1-2 years of experience elsewhere, and I'm wondering what everyone thinks would be the best route to go about that.

    Offer 1- ICU in a small community teaching hospital. 14 beds, 1-2 patients on nights. The unit is attached to an IMCU and together they're the only intensive care units for the hospital.

    Offer 2- oncology/medical telemetry unit in a very large health system teaching hospital. 36 beds. I would have 5-6 patients on nights. They've offered me higher pay than offer 1, and the benefits are also better. My current doctors are all a part of this hospital as well

    I'm leaning towards offer 2 because one of my favorite parts of nursing is the direct patient care and conversation (and on this unit, I would be taking care of more patients than the ICU). However, my ultimate goal is to get into emergency nursing after a year or 2 of experience, so if the ICU job would help me out more than the onc position, I could pay my dues for a year or so. I know the ICU would provide me with valuable skills related to drips and vents, and the onc position would be a lot of IVs, chemo, and tele experience.

    Thank you!
    I would go for the ICU job. You will have oncology patients in the ICU and all ICU patients are on telemetry.

    I think offer two sounds good, but those ratios are high for a tele/onc floor. Oncology patients are often sick and can turn bad quickly.

    If your aim is ED, ICU experience is invaluable even if the experience is from a small community ICU.

  • 4
    3ringnursing, OldDude, Davey Do, and 1 other like this.

    Just something funny my siblings and I used to do. When the "gas man" came to the door growing up he would knock and say "gaass maaan" in a singsong. My siblings and I would then make loud fart noises and he would laugh and laugh. He didn't get tired of it LOL.

  • 0

    I got an email from a recruiter about 45 minutes ago (around 445pm) from an out of state hospital I applied to. She wants to have a 5-10 minute conversation with me to get some additional information about my experience and my interest. She said I should let her know when I'm available during the time slots provided. She then gave me one time slot for tomorrow between 130-230 pm. I am working 11a-11p tomorrow and I work in the ER so there's no guaranteeing I am available. Is some way to weed out people? Or does she want to see how I respond? She also said that she will not reply back but she will see my response.

    How should I approach this?

  • 0

    If you had an option between ICU and OR as a new grad and your goal is ED, take the ICU job. Much easier to go from ICU to the ED than from other specialties.

  • 2

    You have to be very careful with benzos in the elderly population.

    Quote from iwannabeanursee
    She's so disoriented and drowsy and falls out her chair and bed more.
    This concerns me. This could be the meds...or something else.

    Is she breathing effectively? What's her pulse ox once the meds kick in?

    She may need a dose decrease...or a different med...or no med at all. Some of these meds have the opposite affect and can actually keep your patient up.

    Its pretty typical for elderly patients to not sleep at night. Particularly in the dementia population.

    Find out if there is anything else keeping her from sleeping? Is she cold? Does she need another blanket. Is her back hurting her? Maybe a PRN tylenol at bedtime? Some patient's swear by tylenol to help them sleep.

  • 1
    ICUman likes this.

    I would say...start off in ICU/Stepdown, preferably surgical (because you will get medical cases too and if the surgical ICU takes cardiac surgery cases too, even better) and then work in the ER.

  • 2
    caliotter3 and mxm80 like this.

    I'm glad you have figured out a solution. Just make sure you actually get back to school this summer. Don't let your anxiety prevent you from going back to school!

  • 2
    ICUman and KelRN215 like this.

    If you love Women's health, go for L&D. Do what you love. Its better to be stressed out working in a specialty you are passionate about than be another tele nurse who doesn't like working tele, but is just there "because it opens doors."

  • 1
    Joe V likes this.

    She was asking for her service dog. Don't worry he's sterile.

  • 0

    Quote from NurseNinja1990
    I go out of my way to give as little information as possible while staying polite. I have a coworker who has to go to court every 6 months to re-file her restraining order against a former patient who began to stalk her. We just got a new DON, and it was pretty clear to me that she has never worked in psych before when she got in a big huff over the staff covering their last names on their badges.
    In all the hospitals I have worked at (4 total), ER and psych only have first names on their badges.

  • 3

    There really isn't such thing as high SpO2. There is only abnormal which is below 90-95%.

  • 0

    I would think the opposite. If a patient is bleeding excessively and has a low hemoglobin because of that you can see hypotension.

  • 0

    It's very long because there is a separate policy on each coming presenting issue and what should be done/ordered.