I just figured it out, ER nurses are hated among other nurses because we constantly send other units "work", we believe in the motto of treat and street or send up! We have doctors on site and can resolve issues with patient right there without calling answering services and so forth...........We treat the complaint and not the entire body system, the biggest complaint of ICU nurses about ED........we are excellent multitaskers.........we can handle a code, a vomiting child, a stemi and a cva all at the same time............what other department can do this, all the while a GSW drives up when everything is happening and we get the job done! We do this everyday and are the most under appreciated bunch...........BUT I LOVE IT. I Wouldnt do anything else........I marvel at how much Ive come in a year.......Ive seen a lot.......I marvel at how quick I think on my feet.........Im amazed at how team work makes the worse case scenario the most fun..I also marvel at how the floor nurses call us to start their IV's, yet they complain about us.............one nurse said why do you all alway put the IV in the AC..............my reply..........it's usually the quickest access............she replied, if I were down there I wouldnt do that, my reply, If you could do it, I wouldnt be here starting this IV for you now...........How funny is that? Wow ER nurse are the best, if you could do it and suceed you can go anywhere, but you'd probably get bored fast?...............my point...........YOU ARE THE BEST AND GOOD JOB ED NURSES!!!!!!!!!!!!!!!!!!!!!!
The ER calls MY department for help and assessment when a stroke comes in, and I don't believe anyone has ever called the ER in my hospital for an IV start.
Anyway, I'm glad when anyone loves their job, and our ER nurses are great. My best friend from nursing school (now working in ER) told me she could never work anywhere outside the ER because she hates watching people cry and mourn, and respects other nurses for the strengths she lacks.
Specializes in Clinical Research, Outpt Women's Health.
What a funny post. We all know ER nurses have their special skills as do every other type of nurse specialty and one is not neccesarily better than any other.
BUTT, the post did make me laugh and should provide some fun!:smokin:
i dont neccesarily start AC IVs because its the quickest access.... I start AC IV's because the vein is usually bigger there in case I need to do a quick resuscitation, or I need to adminsiter blood, or I need a CTA Pulmonary...
I don't do things just because "it's easier." I do things for a reason... and if its easier, its a plus.
I understand the reasons why in the ER, the AC is often the "go-to vein", plus you truly have to go with what you have. However, it is overutilized; it should not be the first place you look. A very important consideration is that when you place an IV, is doing the best you can to make sure that it will last. AC IVs are notorious for going bad due to their being so much movement at that site, if there is a BP cuff on that arm, AND infiltration is harder to catch early at that site.
It's a rare bird that truly needs the Level One in the ER. Also don't be afraid of the IO if access is an issue- at least until you get central line in. The AC access in the ER, unfortunately, is NOT the rare bird. In most people there is a nice fatty vein that runs down near the ulna and it works great for putting a 20 or 18 guage in for CT contrast.
I'm just recommending that you branch out and use better sites when you can, so that you'll be proficient and comfortable using them. That's just my .
LOL
The ER calls MY department for help and assessment when a stroke comes in, and I don't believe anyone has ever called the ER in my hospital for an IV start.
Anyway, I'm glad when anyone loves their job, and our ER nurses are great. My best friend from nursing school (now working in ER) told me she could never work anywhere outside the ER because she hates watching people cry and mourn, and respects other nurses for the strengths she lacks.
Our ER doesn't field calls for help in IV placement either. It is usually our unit (s). And I agree, there is a niche for every nurse. Thank goodness for that!
Our rad techs will not do a PE study CT with anything but an 18g in the AC for the contrast. It's policy, unfortunately, established by the radiologists. When we get r/o PE patients, we have to use the AC, and 18g.
Our rad techs will not do a PE study CT with anything but an 18g in the AC for the contrast. It's policy, unfortunately, established by the radiologists. When we get r/o PE patients, we have to use the AC, and 18g.
You can't argue too much with policy. However, policies do need to be re-examined from time to time in light of current, well-researched evidence.
You can't argue too much with policy. However, policies do need to be re-examined from time to time in light of current, well-researched evidence.
It's been a battle ... unfortunately this was the latest outcome. The most recent back-and-forth was using EJs for PE studies, but that was crossed off the list of possibilities as well.
In most people there is a nice fatty vein that runs down near the ulna and it works great for putting a 20 or 18 guage in for CT contrast.
We constantly get complaints from CT and the OR if we don't have an AC line in. To complain that we go in the AC first when we are required to by other dept's is not fair. I'd be happy to place an IV in any hearty vein and am perfectly comfortable going anywhere or using the bedside ultrasound to find a deep vein when necessary.
OMG GUISE....yOu ARE SOO leeT!...... WHERE Do U work????...i want to BE taken CAre of Only by U.................U can start an IV....ANYWHEere u want to!!! Pleez bilateral EJs and 2 14's in my AC pl0x!!,......
It's been a battle ... unfortunately this was the latest outcome. The most recent back-and-forth was using EJs for PE studies, but that was crossed off the list of possibilities as well.
I wouldn't place an EJ just for the purpose of giving CT contrast, but if that's all you have, are you not allowed to use it for contrast? If so, why not? (In the context that this is a truly emergent case).
We constantly get complaints from CT and the OR if we don't have an AC line in. To complain that we go in the AC first when we are required to by other dept's is not fair. I'd be happy to place an IV in any hearty vein and am perfectly comfortable going anywhere or using the bedside ultrasound to find a deep vein when necessary.
Right, I agree it's not fair to complain about something that's required. Every hospital is different I guess. At my hospital, for IV contrast, they're happy as long as it is a 20 gauge or greater above the wrist or even a PICC with a power port. Our OR has never made any preferences known other than requesting a free flowing line already set up with a 3 way stop cock attached.
In fact, one of my pet peeves it getting a patient back from OR with only one or two (if I'm lucky) shaky field IVs! (In the AC, lol!) (These are our trauma patients that go directly from ED to OR). And that happens a lot!
I wouldn't place an EJ just for the purpose of giving CT contrast, but if that's all you have, are you not allowed to use it for contrast? If so, why not? (In the context that this is a truly emergent case).
Nope, no contrast through EJs. I think they were more concerned about infiltration/extravasation of contrast material in that area.
:smokin:
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Davey Do
10,666 Posts
motivated2nurse:
I had fun with that, thank you very much.
BTW: Weren't you also the one who coined the phrase "Delusions of Grandeur"?
Dave