Party safely

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I read so many post on here and I do not get on this site very often and I usually create a new username every time I get on here. I am in a tpapn program with Texas.
however I have different views then some others for sure and I’m ok with that. I have different views on Things like dieing, the board time frame for dealing with licenses, my views on how nurses should be treated when applying at jobs, and also including how the general appearance of a nurse should be ( considered hygiene is maintained however I do not expect a miss or mr galaxy including health) I learned all that can change in an instance. I am still learning things about myself personally and I just want to get back to nursing so I can continue a wonderful career and also pursue education in other fields.

I only like to check on here periodically with anything that I would like to share about or talk with however I have just got my life back going with nursing after a decade. And it was well worth it. I hope others are able to find their way and continue on in this life’s journey. I am just an average normal person. Best holiday wishes and party safely

Specializes in Psych, Addictions, SOL (Student of Life).

This is exactly the thing that gets ER and EMS staff furious with nurses in LTC. Sure you always want to act in the patient's best interest but if something can be clearly handled without sending out it should be. Unnecessary trips to the ER just cause longer waits for those that actually need to be there. The house physician at the LTC should be making those decisions, unless they are emergent!

Hppy

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Specializes in Psych, Addictions, SOL (Student of Life).

Hey Spanked glad to see you back on the board - Did you finish your DNP? Are you teaching? I sometimes feel that those of us who survived this nonsense need to stick together!

Hppy

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Yeah as a long time er nurse I agree. You cannot simply routinely send patients to the ER because you don’t know what to do with them and the onstaff docs don’t wanna deal with them. We routinely reported those dumps to the state through our social workers because they usually are understaffed and the patients receive substandard care

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Hey happy!!!

i did finish my DNP and im in a job in an inpatient specialty service. Tough first gig for a brand new np and the transition is rough but I’m hanging in. Still got a few more months of monitoring but honestly I’m used to it. I still hate it and think it’s largely bs but I keep doing it because I see no other choice

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i Am just very interested in seeing my ability in knowing when someone needs emergent care. While having a doctor on call is ideal many times the patient does need the emergency room. If they do not like handling the situation they should find a new career because that is what is an er is for. Not what they want it to be for

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Specializes in Psych, Addictions, SOL (Student of Life).
36 minutes ago, Fun4two said:

i Am just very interested in seeing my ability in knowing when someone needs emergent care. While having a doctor on call is ideal many times the patient does need the emergency room. If they do not like handling the situation they should find a new career because that is what is an er is for. Not what they want it to be for

Wrong the ER is for medically emergent situations that can not be stabilized outside a hospital setting. Trips to the ER can actually be detrimental to some patients. You definitely need to hone up on assessment skills - Start with the ABC's first - Airway, breathing, circulation then move on to neurological (Faces assessment) . If these are not compromised it may be better to stabilize within. Many fragile immuno- compromised patients might develop secondary complications from a trip to the ER such as exposure to MRSA and VRE. Hospice patient's don't generally go to the ER as the focus is comfort care. NO I would not send a patient to the ER for a stubbed toe, broken finger nails or paper cuts. I did read where you stated you wanted to be a nurse practitioner some day. Do yourself a favor and take a patient assessment class where you can do hands on -assessments of real people.

Early in my nursing career I was dressed down by a doctor for knowing the facilities protocol for sending patients to the ER.

Hppy

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Yeah if you wanna get a somewhat sickly elderly patient really sick then send them to an inpatient setting. Many of these folks are immune compromised and many Er docs will admit just to cover their butts. So what can go wrong. The hospital is full of bacteria and viruses because it’s loaded with sick people. These elderly patients pick up these bugs and now they are really sick. Sending a patient to the ER with minor complaints because one works in a place with no support system is a bad idea. Cut fingers and stubbed toes can become pneumonia which (if I remember right) is the most popular choice for cause of death on death certificates. Not to mention the inherent risk of transport (sending someone to the ER in a Blizzard instead of admin Tylenol) and the miserable experience most of the elderly face in the ER outside of their accustomed environment. It’s just a poor excuse for poor care

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While that is all true. However in my personal opinions hospice patients that are full code should be treated with being able to be sent to the er.

i had backup when on most my decisions by the registered nurse don. I was just joking about sending the patient to the hospital with those ailments however when someone suffered a cardiac arrest that is the protocol. There could be other unforeseen problems that have to be ruled out with in-depth testing that a simple head to toe assessment does not address

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Hospice patients are not full code by definition where I work. To get hospice services you need to be dnr

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Specializes in Psych, Addictions, SOL (Student of Life).
7 minutes ago, Fun4two said:

While that is all true. However in my personal opinions hospice patients that are full code should be treated with being able to be sent to the er.

i had backup when on most my decisions by the registered nurse don. I was just joking about sending the patient to the hospital with those ailments however when someone suffered a cardiac arrest that is the protocol. There could be other unforeseen problems that have to be ruled out with in-depth testing that a simple head to toe assessment does not address

In 20 years of nursing in acute, psych, and LTC I have never had a hospice patient who was a full code - The whole purpose is to not add further insult to injury in a dying patient. In fact in California where I work a patient cannot be on hospice and be a full code, but it could be different in some states. In the case you cite a person on hospice who has a cardiac arrest would not receive invasive intrusive care. They would be allowed to pass on their own, without chest compressions or trips to ER. It's kind of the whole point of Hospice!

I am going to quit arguing this point with you as you are going to continue to believe what you want and actually a good head to toe assessment if you know what you are doing can help you make a decision to send out.

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I’m sure it a head to toe assessment can.... however in Texas you can be a hospice patient with a full code. They even taught us that in school. I agree I want to learn more however I think it is difficult in a long term setting without being in a hospital setting that it is difficult to perform all the functions necessary to fulfill an maxim level of practice. I need help in knowing how to do this and no I do not want to offend you or hurt feelings. This is all still new to me and I hope to be able to ask alota questions in the near future on how to exactly handle protocol and based off personal knowledge and assessments. I would just be happy to work at a nursing home with someone who can. Prescribe or change orders and not require an act of Congress to do so. I really do not want to upset you and I appreciate you informing me to take more education in classes. Yes a thorough apical pulse reading can tell you a lot however I would rather someone read me an ekg machine readout.

in Texas we had all different kinds of deaths at the nursing home And we had paramedics there nearly every night... I had never got to be part of anything like that and I’ve never had more fun (except for patient condition) to do. It just all starts with what needs to be called for an emergency and dialing 911... sorry your upset

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And no I never got to learn how to read an EKG. I’m not the smartest nurse however they only gave us one test question on the entire chapter about it. I have no idea about one of those and isn’t that sad... I’ve also never started an IV. Or anything with a chest tube drainage. Or inserted a ng tube. All I know is I was trained in it

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