paphgrl

Does your agency provide paracentisis when a PleureX catheter is contraindicated? I know it is expensive but it is symptom management. Your thoughts?

She was an adult

A patient presented to triage in severe respiratory distress after aspirating cinnamon while doing the cinnamon challenge. Her O2 sat was in the 50's. She was immediately intubated but prognosis very grim. please pass the word that this fad is dangerous and can be fatal.

20 something female worth co low abdominal pain. Quite obese. 5 minutes baby born. Didn't know she was pregnant.

Get out while you can. I had a very similar experience and your post made me sick to my stomach thinking about what I went through. Ed nurses have a long memory and probably won't let this go..I went to A cardiac unit for about a year and returned to a new Er with skills and confidence. I have been a Ed rn for years now and when I think back to my first job I like to think they blew it when they let me go. Be easy on yourself because those people will not.I wish you the best of luck.

When I have encontered patients with difficult IV access I have placed IVs in shoulders and sometimes in veins of the breast. I have had good success with these sites. I have not seen other nurses do this. Has anyone ever utilized there peripheral veins? Are there any contraindications that prevent RNs from utilizing these sites? Your input is valued, PG

My hospital became Magnet. I had thought it was a good thing until I saw the process. Management put on a big show for the magnet folks that came to assess our hospital. Front line nurses were shielded from the interviewers. Certain nurses were selected to be interviewed by the magnet evaluaters, they were scripted, and given talking points. Within days we were granted magnet status. It was shockingly fast, virtually overnight. There was no change in policy and no shared governance. There has been no change in nursing practice and nursing morale is as low as I have seen it. I am very disapointed. Having seen the process, I have come to believe Magnet status is merely an expensive advertising program. Magnet is a scam.

I started my career in the ER. After nine months, I asked for a transfer to med/surg. I realised my lack of expreience was putting my patients in danger. I will return to the ER in a few months with a solid background in patient care. It was a difficult decision. I loved every minute in the Er. It was a horrible way to start my career. I am only just now getting my confidence back.

I wouldn't work in a non union hospital. Last year, our contract was negotiated to include twice a year salary increases. Within months, the other two non union hospitals in the area had to increase wages to retain nurses. So the nurses who work in our local non union hospitals can thank our union for their wage increase. Because of union oversight, the management in my hospital is less likely to be unfair to workers. Because of this, Individual grievences are rare. While I have not had to file a grievence, I take comfort in the fact that I have an advocate if I need to. do so.

As long as nurses are afraid to discuss their med errors openly, they will keep happening, and patients will suffer. How many med errors have you made in the last year? Did you report it? How were you treated? How does your facility handle med errors?

I started in the ER. 9 months later I decided to transfer to a med/surg floor. Once I get a year of med/surg, I plan to get experience in critical care...THEN return to the ER. Imagine how difficult it was for me to transfer after only 9 months. My confidence is as low as ever. My only consolation is that I made a good, but very difficult decision. When I return to the ER I will have critical care experience. I will be confident with arterial lines and multiple IV drips. I will be able to take charge in a trauma with the confidence that comes from an experienced nurse.

How many Medication errors do you make? Are you afraid to report med errors at your facility? How does your facility handle critical med errors?

Thank you all for the kind words and advice. I look forward to starting with a clean slate. This will make me a better nurse.

I have discussed this with my manager. Many nurses in the dept. are against hiring new grads, and so don't support them. I worked shifts with nurses who watched and waited for me to make mistakes. I had no support. I was hearing criticism through the rumor mill. No one ever gave constructive criticism. Do I sound angry? I am. Now I am in the don't hire new grads club.

I had a twelve week orientation. After orientation I was thrown to the wolves. I had no support. When I had too many patients, I wasn't given to option to say no to additional patients. I was working at the same level as the more experienced nurses. I was expected to take on the same patient load. Now I am going to another department where I can get my confidence back up. This is not how you want to start your career.

I am a new grad in the er. Many of my nurse coworkers feel that the er should not hire new grads. After 9 months of constant critisism from my coworkers, my confidence is gone. I did have the support of most nurses in my department, but a few were were looking for me to fail. After months of being expected to work at the level of a veteran er nurse, and not having the support that a new grad needs, I made the difficult decision to transfer to another unit. I loved being an ER nurse, but I am emotionally trashed. I feel like I am starting from scratch. I am angry that I wasn't given the support that a new grad needs. Be very careful about starting in the ER. Make sure the department and its nurses support the hiring of newgrads. You dont want to end up like me

In our ED we generally have a 4 to 1 ratio (sometimes 5-1) We have few techs or CNA's. How do you handle your four patients when one is has a hgb of 6 and is agitated and trying to get out of bed, one is in SVT, one has a blood sugar of 40 and the mother of the 14 year old pregnant girl is demanding more pain medication because she is nauseated. Seriously, what do you do in this situation?

I am a new grad working in the ER. I love it! I wouldn't want to work anywhere else. That said, I find it very challenging. I want so badly to be good at my job, but that comes with time and experience. Don't beat yourself up if you aren't able to work at the level of your experienced coworkers. Accept that you are a novice and will be a novice for several years. Don't take on more than you can accomplish safely. Good luck

I am a new ER nurse. I need help with my organisational skills. How does one stay on top of things when you have seven people, (docs, patients, familys, phone orders...) who need your attention right now! I know some of this will come with experience, but any advice would be helpful.

Does anyone know of any podcasts related to nursing?

At my union hospital, nurses who don't care to have their dues go to the union can opt to have it go to other radical leftist socialist organisations like the American Cancer society or the Red Cross. And they still get the benefits that the union has negotiated for them...better wages, benefits, and no more mandatory overtime.

Last year my union voted in a new contract with a wage increase. Within two weeks, the other local non union hospital increased their RN wages to retain their nurses. Though they are non union, our negotiations had a direct influence on their wage increase. We can all thank our union, the ONA, for ensuring nurses are fairly compensated.

Injurys to ones genetalia is not funny. I do not "size up" my patients according to their looks or genitals. I found nothing funny about the kid who put a gun to his abdomen yesterday. Maybe there is something wrong with me if I don't see the humor in attempted suicide, but I dont think so. Tell me...what is it about suicide that you find so humorus?

How would a diagnosis of "disturbed energy field" and the interventions associated with the dx, when documented in a patients care, hold up in court in a malpractice case? I wouldn't want to be involved in an attempt to defend it. BTW, thank you all for this great discussion!

Well, I hope I don't offend anyone here, but it is my opinion that there is no scientific basis for human "energy fields". Nor is there a scientific basis for intellegent design. Nursing is a profession grounded in science as is the process of evolution. But please, I hope this doesn't turn into a debate on the merits of ID.