NuGuyNurse2b 7,691 Views
Joined: Nov 23, '13;
Posts: 868 (60% Liked)
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We use Micromedex for compatibility checks. If drugs are compatible, we use one syringe for an IM, for example, to save the patient from multiple sticks. If it's unavoidable, we stick them twice or thrice. Like i've given Haldol and Ativan in the same syringe to patients who were just off their proverbial rockers. Those are the ones where you have to have security restrain them and get it in one shot.
Unfortunately with the way hospitals are being bought up like restaurant chains, if you don't want to ruin your chances of going to one of their other locations later, you have to maintain good standing at this one. I say tough it out until you can make your move.
I love ER nursing. There's good days and bad days but overall, but it's been my favorite area as opposed to the other areas I've dipped in. I've always wanted to do ER but as a new grad I couldn't break into it, so I did psych and then med surg for a year. Our area is saturated so getting what you want right out of the gate is not a given. I didn't care for psych, med surg I learned my basics in nursing but the whole system with bedside requirements and customer surveys...it was aggravating me. So ER it's a different story, you treat and either release or admit to inpatient and get them out asap.
Maybe it's pancreatic ca?
ER is very hard to break in as a new nurse, and once you're there, try to stick it out for at least a year. If you can do ER nursing, you can do anything. I just started ER half a year ago and I'm still learning, and this is with 1.5 years in med surg. With that said, you shouldn't constantly feel like you're catching up. A good ER is one where the charge evaluates your patient load, rather than your patient ratio, and decides whether or not you're getting that code MI that's coming in from the street. If it's not that case, get your experience and get out because it's not a safe environment.
^ Alrighty, and with that comment, yup, gonna be another one of those threads.
The only time I've taken a pic is using the patient's own camera because they were curious what it looked like, or they wanted to document their progress. It is in their belonging, they can do whatever they want with it. I would never use my own camera.
Most places pan out the bonus that they advertise. Ie, if you stay for 6 months, in good standing, near perfect attendance, you get a portion of the pay (like 25%) and then they pay out the rest in installments or another portion in a set period of time.
It depends on your hospital. At my place, you're not even eligible for tuition reimbursement until 6 months of service.
In our ER we would get the drunks that the cops pick up on the streets. We're often prepared with the EMS team telling us who's a security risk and who's not. But sometimes they're docile in the ambulance and turn on you when they're sitting in the ER. I've had people spit at me, grab at me, etc, just plain battery. So I always assess the situation and make sure that if something does happen, I'm in full view of everyone else so help can arrive.
I think your friend nurse is being stingy on purpose. She wants those sickle patients to request anyone but her. It's old hat. We have one on our floor who's notorious for that. The sickle cells require PRN Dilaudid or whatever drug of choice Q2-3 hrs and that becomes a heavy assignment cause they also request their Benadryl and heaven forbid that IV line clots, you're looking at a very hard stick. One of our regular sicklers - their IV line literally goes bad within seconds when you're changing IV bags. We finally got them to agree to a PICC line and it's been so much better. So your nurse friend is making it obvious she's not a good fit for this patient, hence don't assign her this patience, since the sickle cell patients are often recurring patients and I don't know about your facility but at mine, they typically hang in the unit for 3+ weeks.
On days? 3. Night's up to 5.
At my facility if you're getting something like Dilaudid Q2 you might as well get a PCA pump; ain't nobody got time for that. Regardless, either of those orders would come with prn Narcan for obvious reasons, as well. It's an actual "bundle" in the order entry system when the md selects it.
This is where the lines of communication should be opened and often they're not. If a patient asks me for Ambien and it's 10p when I know at 11p vitals will be taken, I tell them they will be waken up anyway and usually they just say forget it or wait until after the vitals are done. And if there are any scheduled meds, I warn them also. Patients are usually better about being awoken if you warn them ahead of time that you will be disturbing their sleep.
do you bring up your psych history in interviews?
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