ReWritten, BSN, RN 2,957 Views
Joined: Jun 21, '08;
Posts: 70 (27% Liked)
; Likes: 49
Unfortunately I don't have any advice for you, but I wish you luck in the interview! I'm curious to know how it goes for you. I'd like to work for MSF one day.
I've only been in the ER for 2 months, but curious to other's reply to this. In my ER, we're required to do preg tests on all females (unless they've had a hyst) before giving Toradol. Does anyone else do this?
Last week I had a pt come in with alot of pain, and my doc ordered Toradol for her. I decided to go ahead and draw it up, but my coworkers argued with me stating I absolutely couldn't give it until we ran a preg test, my doctor overheard the argument and stated to go ahead and give it and that he's never heard of this rule.
According to nearly every weekend in the Dallas Morning Newspaper, Parkland is under alot of fire recently between Medicare funding possibly being denied and questionable overseeing of UT-SW practicing med students. In an article maybe a month ago was talking about how Parkland hired many agency nurses to staff their ER until December (I don't quite remember, I'm going off of memory) because there was a mass exodus of ER nurses -- that right there sounds quite fishy to me. What was going on to make so many nurses leave, maybe not all at once but over a short period of time?
I work in a rural hospital and I actually know a coworker of mine who did take Parkland's offer to temporarily work there. I don't know her that well to know how it's going for her. But the hospital is looking to hire new ER nurses.
I don't know if I'd want to work there given all the negative publicity the hospital has been receiving the last few months, but then again articles could be biased and I've never worked there to have personal experience to say otherwise.
I work in a hospital in rural Texas, just a preface to my replies. 15 bed ER, 3 bed fast track. We probably see around 200 patients a day.
1) What is your standard nurse to patient ratio? 1:4
2)How receptive is management to staff going back to school? Some of my coworkers are working on their MSNs. I think the hospital is reimbursing them if they go part time. But honestly, I'm not sure.
3)What shifts do you guys work? This has been kind of an ongoing battle in my ER recently. Everyone works 12's. The manager wants 7a, 10a, 3p, 7p... but finding people to work the 10's and 3's is pretty difficult so he rotates people through them (only dayshift nurses will do 10's, and only nightshift nurses will do 3's).
4) What are the requirements to work ur traumas? We're not a trauma center, but we do have 2 trauma rooms. Everyone takes turns rotating through these room assignments.
5) What certs are required and how soon? ACLS, PALS or ENPC (you can have 1 or the other, or both, but required to have at least 1 of the 2), and TNCC. I believe all of them have to be obtained within 6mo of hire.
6) Do you have midlevels (NPs and PAs ) in your ED? Yes, but they only work midday shifts. The latest they'll possibly stay is 1am. (they typically only work 11a-11p, 10a-8p, 3p-1a)
7) What do you wish someone told you about ur ED before you started working there?? I worked on the floor and lived with some ER nurses. They're the ones that convinced me to transfer, so I know what I was getting into beforehand.
8) I know no one like to talk about $$, but what is ur base pay rate.... $20-23/hr, $24-27/hr, $27-30/hr../ >$30/hr??? I'm in the $20-$23 range. Most of my ER coworkers started out as travel nurses to my hospital and received very nice sign-on bonuses. Also, they have many years of experience compared to me so their pay scale is much higher than mine.
9) How long have you been an RN?? 1 year and a few month's worth. I worked Med-Surg for 9 months before transferring to my ER in June. I'm very thankful for my amazing coworkers who all of them have years of experience compared to me and have taught me ALOT since coming. Also, my manager didn't want new nurses in the ER, but they argued for me to come stating it'll be easy to train me brand new than someone "stuck in their ways".
Been in the ER only a couple months now, but we don't. We might test to give us an idea of they're actually on something or to help us determine how to treat them, but other than that, we could care less. If their alcohol level is too high, they're stuck with us until it goes down before discharge unless they have a ride.
two pens, paper and plastic tape, pen light, alcohol pads, 1 or 2 NS flushes, scissors, hemostats
I have just transferred to the ER, and on one of my first nights, we had a pt come in with an OD. EMS was called by his wife due to his decreased response and hard to wake up. When we asked where the wife was at this time, they replied "She said she was too tired to come and stayed at the hotel". Guess it was a good thing the pt didn't die!
My roommate, an ER nurse, showed me a sign-in sheet he had saved. The time written was around 5am. On the Reason for Visit line, a woman wrote she needed a wrist band to show her husband to avoid a fight for being out so late with her boyfriend. Needless to say, she didn't get a bracelet.
A doctor who wanted to make his patient a DNR, and had asked me if I had talked to him about it or if the patient had said anything about it. I reminded him that was his job if he really wanted to do that, and when I asked for parameters for a rapid response so I didn't have to keep calling him (the pt was asymptomatic), he replied, "Well, I guess if he stops breathing you'd have to code him..." talk about insensitive! This patient is A&Ox3, and yes, he's quite sick, but he wasn't anywhere near death.
Everyone at work knows our pharmacy is absolutely horrible. Even my manager stated quite seriously in a meeting, "Don't trust pharmacy to have things correct...". My coworker had a patient on Zosyn and pharmacy seriously timed the medicines q30 minutes on their MAR. Needless to say, we had a good laugh with that one. But at least our medicine inventory was well stocked for all that zosyn!
My coworkers and I have this theory that when people are admitted to the hospital, they suddenly become invalids.
There's been plenty of times we've lectured our patients, "Who does this for you when you're home?" And that often will motivate them to do it on their own. I think the best story I have of this, I actually had a patient call me in his room to scratch his butt, where he's well capable of doing it himself! (He asked me AND my coworker to do this!).
I've also had my fair share of pts requesting to be turned in their beds, when they were just up and walking around in the hallway.
Really, I don't know what gets in people's heads when they come to the hospital. I understand you're sick and feel awful, but if you're well capable of doing things on your own, DO IT!
I feel very fortunate that I passed my NCLEX the very first time I took it, and obtained a job 2 months after graduating last year. (Not in the specialty/hospital/location that I wanted, but I was just thrilled to get a job so quickly).
I feel very fortunate that I have amazing coworkers that didn't mind training a new grad (me). They encouraged me to ask questions no matter how dumb they may have seemed, because they rather have me ask and be sure than to risk harming my patients.
I feel very fortunate that despite the hospital's many faults (poor admin, often times poor staffing) my coworkers know what team work is, and will help out without questions asked.
I have almost 8 months of experience. My very first code ever was my own patient, and I know exactly how you felt! When you're not ACLS certified, the only thing you'd be asked to do is compressions or being the recorder. What prepared me/gave me more confidence in the situation was getting ACLS certified. (It's a requirement on my floor). If you're in that situation again, it is best to just observe and learn. Maybe obtain the patient's chart for the nurse in case questions are asked.
Med-Surg/Tele and 10 patients? I'd turn it down. I work nights on a Med-Surg/Tele floor, and we get 5-7. One really horrible night I had 8 and almost tore my hair out. But we also only have 1 or 0 CNAs on my floor.
I'd be worried you'd be risking your license.
Don't become too focused on what others say. I don't know anywhere where there isn't day shift vs. night shift. I work nights on Med-Surg and I don't know when there is a shift where we don't make a negative comment about days. But for what it's worth, they're so crazy busy I can't imagine keeping up with all the admits/discharges and keeping up with orders. (When I visited my ER, there was also day vs. night, which I found kind of hilarious)
That being said, time management and critical thinking kind of come with time. I'm almost at a year of experience, and there isn't a night that goes by where I haven't learned something (which is the biggest reason why I love nursing). I typically have time management under control, but when I'm given an admission it throws off my "schedule" I've set for myself. You just have to adapt to what's given to you. There's only 1 of you and about 5-7 patients that you're responsible for.
My advice is, even though you may feel like you're a burden to your coworkers, they rather have you ask questions then to just do something that may potentially be wrong/harm your patient. You're never going to learn unless you ask. Even the most experienced nurses on my floor ask each other for advice/opinions.
Unfortunately my facility doesn't have anything for us to spray... so I typically mouth breathe, like others have said. Vomit and diarrhea are nothing... GI bleed and draining pus is what gets me.
I'm worried after spending time in Med Surg no one would be willing to hire me in the ER
That's a load of crap, and nothing to be worried about! I work in a community hospital where they pretty much won't hire any new grads into anything except Med-Surg. This summer I'm transferring to the ER and I know I've already been approved. If you get hired into Med-Surg first, you still learn alot (I sure have!) and make connections... I wouldn't have had as many opportunities as I've had if it weren't for all the various departments/employees I've met and got to know.
if I hadn't failed a class that put me behind a year, I'd been 21. BSN @ 22, passed boards just a few days after my 23rd birthday.
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