86toronado 13,329 Views
Joined: May 6, '07;
Posts: 525 (41% Liked)
; Likes: 657
5 year(s) of experience
neurology, cardiology, ED
This is why I love ER nursing. Report consists of something along these lines:
"Okay in room 1 you have a 65y/o male no cardiac history, chest pain for 3 days. Line, labs, EKG done, doc hasn't seen him yet. Room 2 is a 48y/o female abdominal pain, vomiting for 3 hours. Line, labs done, meds given. Waiting for CT and still need urine. In room 3 you have a 2 y/o with a fever and cough. Tylenol given, and the temp is down, he's up for re-eval. Room 4 is empty. Any questions? No, okay. Have a good day."
This is a perfectly acceptable ER report. You're used to knowing nothing about patients when they roll in the door, and having to do some digging, and they turn over so quickly, you really don't need to know much more than what's been done, and what's pending. I went back to work the floor briefly after having worked in the ER for two years, and remember being one of the quickest report takers, because I would rather just look things like labs and new orders up for myself.
I don't know. If it were me, I'd want the healthcare provider taking care of me to know all about my medical history. For example, I've had pneumonia 3 or 4 times in my life. I've had at least three concussions. None in the last 15 years, but still pretty important, I think. These are all things that I don't take medicine for every day, but they are something a provider would probably want to know if, for instance they were ruling out pneumonia, or a head injury.
As an ED nurse who works triage a lot, I find it incredibly frustrating that when I ask most patients if they have had any medical problems in the past they give me a blank stare, and sometimes ask "What do you mean?" Most then proceed to give me their surgical history.
Sometimes after I get the blank stare, and then the surgical history I ask if they have any problems that they take medication for every day, but that doesn't cover everything, like they could have had an MI in the past, but not necessarily be on any meds related to it.
Is there some other way to ask people that would make it more clear what I'm looking for? I work in a busy ED, and see probably 50 patients a day come through triage, so I guess that's why it's bothering me so much lately.
I wear mine, but it's just a plain silver band, no crevices or anything to get stuff caught in. And when I wash/sanitize, I routinely push the soap/sanitizer onto/around/under it. Most of my married co-workers wear their big diamond solitaires to work, though.
I've worked in float pool, and was expected to float anywhere except ICU, ED, and OB. That said, since I had PALS, I suspect I could have been asked to float to OB if it had been necessary. And I did regularly float to ICU, and took "step-down" paints, even though I knew they weren't really... Not that safe, but I never complained.
It's all about perspective... Does a doctor, or a lawyer, or an engineer think that my $60k a year is big bucks? No, of course not. But the people who say that to me are not doctors, lawyers, or engineers. They're waiters, retail workers and of course, our patient care techs who work with us. It sure looks like big bucks when you make $9/hr - trust me, I know this from experience.
As far as whether I feel like I make good money, in short, yes. I drive a new car, I own a home in a nice neighborhood, and go on vacation several times a year.* I am able to do all of this by working 3 or 4 days a week. There is no other job I can think of where that would be possible. Oh, wait. I could be a firefighter... Nah. I'll stay a nurse.
*disclaimer: I don't have kids, and my husband is an RN as well
I have been threatened by patients when working in the ER, so I could see it from that perspective. I don't know why the med-surg nurses would need to watch their backs though...
... One thing here. I was used to same day benefits when hired (as soon as you signed up for them). Here it's 2 full months from the END of the month of your date of hire. So if your first day of orientation was today you would not have insurance until Sept 1st. The longest I had ever encountered was 30 days at previous jobs.
Um... to be blunt, it wouldn't even be a question for me. If I were in a position where I needed to borrow money for rent, I would take any job I could get to put food on the table for me and my family, even if it was waiting tables, or mopping floors. (Both of which I have done by the way, which is probably why I have never been in the situation to need to borrow money to pay the rent)
Wow! 35% on nights??? That would be amazing! I hear Orlando pay is a little higher than the rest of the state, though... I have a couple of friends who have transplanted there in the last few years. But my husband is intent on living hear the ocean... so any thoughts on the Gulf coast anyone??
I love this topic!!! I just had to meet with not one, but two managers of a unit I floated to after working a 12 hour shift, to answer about a patient complaint regarding my nursing the night before!!
The patient, who waved me away when I attempted an assessment, said that I failed to assess her and her roommate. Said roommate, whom I got no report on, was very unstable, and I actually spent the entire night following up on her lab values, vitals, blood sugars, etc. The other patient (ie: the complainer) was the most stable of my 7-patient assignment, so excuse me if I didn't get in to assess her until 2145. So, unfortunately, the patient I "wowed" that night was unable to speak for herself, so instead I had to answer to the management regarding the alert, oriented and independent complainer.
My husband and I (both RN's) are planning a move to Florida, specifically the Sarasota area in the next 6 months or so.
I hear all the time about how FL nurses don't make that much money, but according to their online job postings, Sarasota Memorial Hospital's pay rates are very similar to what we are getting paid here in upstate NY. Considering the slightly lower cost of living, and no state taxes, we may actually come out ahead. Unless the shift differentials less? Is that what everyone is complaining about? Here we get about 10% on eves, 15% on nights, and an additional 10% for weekends, it varies only slightly by facility. We both plan on working nights.
I've done a couple of web searches, and haven't really found any definitive information on shift differentials in Florida. So I would like to hear from people who are actually working there, not necessarily in Sarasota, but a general idea would be nice. Thanks ahead of time for your help!
Like some of you above, I am naturally "programmed" for nights as well. Prior to starting nights, I was never a "good sleeper" I would take hours to fall asleep at night, and then never feel rested when my alarm went off. Now I've worked night shift for almost 5 years and have the opposite problem from most. I feel like a zombie when I have to be up in the daytime for something. But my husband is a natural morning person who works nights, and here are some things that have helped him out:
-We keep the bedroom cool, about 65 degrees
-We have curtains on all the windows (it used to be blackout ones, but now that he's more acclimated to nights, it's just regular curtains.)
-There is always a fan on in our room, even in the winter.
-A sound machine, or some other kind of white noise is essential
As far as supplements/medications for sleep go, I've never tried anything prescription, but have used the following (usually when I need to go to sleep at a "normal" time for a class or something in the AM)
-Benadryl made me more zombie-like than if I hadn't taken anything at all. I took it when I had to be at an ACLS class all day, and had to go take a nap in my car at lunchtime just to get through the day.
-Melatonin I've found to be very beneficial in helping me fall asleep, which is sometimes an issue for me. But I still sometimes wake up after a couple of hours
-Valerian root, on the other hand doesn't help with the falling asleep, but is fantastic for the staying asleep aspect. Gives me weird dreams though, so I only use it once in awhile.
It's probably already been said, but I had to place my vote for a hot bath... just thinking about it now makes me want to have one when I get home from this shift, not that it's been a difficult one at all!
Yes. Go for it. Even if some hospitals don't have RN's drawing labs, some do, and all that I know of consider IV starts a nursing responsibility. If you are competent at drawing blood, starting an IV will be that much easier for you, and that could make you more employable, especially into a position where you do that more, ie: ER, pre-op, urgent care, etc.
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