I'M Back!, return to ER

Trauma Columnist · Jun 4, 2007

Hi Don and welcome back! I have to ask you about TNS...are you in IL? TNS is specific to IL (or so I thought). Can you tell me about TNS if you didn't take it in IL? It has been on hold here in IL because of loss of test integrity and we are just now starting it up again. Thanks for any info.

dnnc52 · Jun 4, 2007

Yeah: The TNS was a course many years ago taught in part by the UNC Chapel Hill dept of nursing. I think there was only 3-4 classes and then it fizzled out. But was a worth of knowledge and rather intensed.

Dixielee, BSN, RN · Jun 4, 2007

Welcome back to the ER! I did the same thing....went to home health for 5 years after many years of ICU/ER. It was a welcome break and I enjoyed it throughly, but I went back to the ER for a number of reasons 9 years ago.

I don't think you will find much different, except maybe the computerized charting if your hospital is doing that. It will take you a little time to get your rhythm back, but the skills will still be there. It will take you a little while to get your cynicism back......but don't worry, it will be back soon!

You will find that more and more people are using the ER as primary care, and there are more non English speakers. Hope your ER has interpreters, it is a pain using the Language line, doable, but still better to have a real person with you.

I have seen a rise in violence in the ER over the past few years. Our hospital now has armed off duty police in the ER from 7p-7a.

Most of the equipment is about the same, with a few updates, but easily adapted from previous knowledge.

Good luck, and happy trails!

dnnc52 · Jun 4, 2007

Thanks folks for the support.

teeituptom, BSN, RN · Jun 8, 2007

Our ER doesnt havent armed off duty officers, they have me. Im tougher than any officer. Howevere there are rumours about getting an Immigration Officer in the ER. Triage, Immigration.

dnnc52 · Jun 8, 2007

Tom: Wow man talk about the immirgration situation.

allnurses Guide · Jun 18, 2007

But what in your opinion will be the most changes that I will notice.

Lot heavier patient loads. More non-emergent clinic patients. Lot more people all night long, doesn't empty out as early as it used to. Much higher censuses. Run out of inpatient beds before 9PM.

Still lots of drunks, not so many places to send them to. Full time security officer in the department. Officers bringing in people with no medical problems just because they don't have anywhere else to take them (drunk, not incapacitated) because the jail won't do PCs tonight. No social worker at night, have to call in crisis counselors or wait till morning.

Massive amounts of paperwork to use simple restraints. Pt in the locked seclusion room has to have one to one face to face supervision for the first hour. (Yeah, right. LIke ERs have enough staff for that).

More intricate procedures in the ER. More central lines, art lines, invasive monitoring. Cardiac surgeon sewed up a heart after cracking the chest in the ER last month, then went to OR.

Ah that adrenaline rush!:monkeydance:

JRapha'sRN · Jun 18, 2007

It will take you a little while to get your cynicism back......but don't worry, it will be back soon!

:lol2:

One change I've heard some talk about is that there has been a direct correlation between the rise in popularity of the cell phone and the calls for "found down" (our homeless drunks who state, "yeah, they always find me" when they wake up...

Also with the increasing use of the internet you will find a lot more people who know exactly what's wrong with them and what tests you "need" to do. :trout:

Welcome back! I'm sure you will find that a lot of it is just the same, after all, human nature doesn't change!