ALISHAJO

In our ER dept, we are staffed with 1 RN at night with alarms on the ambulance entrance doors by our desk and the entrance doors to the front lobby. each entrance has 2 sets of doors and the alarms will ring when they open to admit someone. One night when I was working, the ambulance entrance doors opened and closed repeatly for ~ 5min in a pattern like someone was walking thru the doors going outside and then turning around and walking back inside. No one or thing around to cause it to go off and there was no wind that night to make it accidently go off!!! That was the only time that I experienced that in the ER but the lobby entrance doors do it frequently at night..I guess that our ghosts like the lobby entrance better:D We also had a sighting in our Radiology department. At the time, our main Radiologist's daughter had been murdered and her body was buried in another state. They had just found her body shortly before this and one of the house supervisors was making rounds thru the departments and when she took a shortcut thru Radiology she saw her hoovering in the hallway:eek: This girl was in Med School and would come to visit her father in the department frequently!!! My last story has to do with smelly ghosts!!!! We once had a frequent flyer who was rather large in size and admitted frequently. She had a particular odor to her that could be smelled quite a ways from her (like down the hall, getting worse the closer that you got). Anyway, she died one night, so they called the funeral home and then cleaned the room throughly after they took her body away. The odor was finally gone....or was it???? For 2 weeks after she died, doors would mysteriously open and close, followed by her particular odor that would linger in that area for several minutes...it happened at different times and places through out the hospital:eek: We were glad when she finally went out the lobby doors and didn't return!!!

THANKS FOR ALL THE INFO! I really appreciate the replies. Just curious......Has anyone seen an actual Wernicke-Korsakoff's patient? How did they present? Thanks....Lish

I have a question that maybe someone can answer for me. The situation: 65yo Fe goes down at local camp grounds- brought in by EMS- coding the whole way- had initial few heartbeats at scene then asystole. In ER, pt not responding at all.....Pt is diabetic...did accucheck with BS in 200's. ER DOC orders IV Narcan 1 amp, thiamine 1 amp and D50 1 amp in that order. Narcan given....looking for thiamine in ER...all out from busy weekend...put in call for med to supervisor to get....in meantime D50 given.....no changes whole time...(thiamine shows up 20 min after code stopped) ER DOC informed but not listening until after he calls the code to a stop. Now he is upset that the D50 was given but the thiamine wasn't....explained to him that I donot have the powers to make meds suddenly appear when they are not present in the department....he is telling me that I could have caused great harm to this patient....I ask him what could be worse than death? I understand why we give it in unresponsive patients- looking for possible causes and to reverse it if possible ( narcotics, alcohol problems and hypoglycemia ). But...now for the question....What is so special about the order? That seemed to be what he was so upset about at the time.

"the unit clerks really appreciate being able to find you for a drs call or family looking for you. " .....I guess my question is how does this help the NURSE? If I am busy with a patient, then that patient becomes my priority!!! The phone idea for each of the staff actually sounds like an excellant idea and is one that we have talked about at our facility for sometime....That way when I need Resp stat or for the House Supervisor to get something for me from one of the other departments, there is no delay while we are waiting for the pager to send the message out or to even find out that the pager tower is down (that is always fun!!!!) "Also, if a pt c/o "havent seen any staff for hours" you have proof how often some one did go into the room. " I am impressed!!! You mean that your QA department actually believes you!!!! The comment that I got from ours was.." the patients say that the doctor and nurse can document anything that they want but that is not what he/she (patient) is being told. THEREFORE, THE PATIENT IS ALWAYS RIGHT! Sometimes your proof is not enough....In my first year of working as an RN on a Med/Surg floor on nights, the family of one of my dying patients complained to administration that I had not been in the room all night long to check on her. So I got wrote up for it. My question to them was how could I have been getting those hourly urine outputs then, since you have to go in and empty the urine bag every hour to obtain them. My arms don't reach all the way to the second bed from the hallway and my eyesight is not up there with Superman that I can see thru curtains and the bed and the patient. I did not feel that I needed to wake the family to obtain this. My Supervisor's suggestion: Kick the chair legs under the visitors chairs each time that I went in the room the next night. "It allows me to know ahead of time what my pt wants and to meet their needs quicker. " Can you explain how it does this?

ELECTRONIC MONITORING???? ISN'T THAT WHAT THEY DO FOR CRIMINALS THAT ARE HOME BOUND???? How caring of your institution to want to put you right up there with the prison population!!!! I would be asking if they will also be putting these devises on administration, physicians and board members so that troubled patients and concerned family members can find them quickly to tattle on the staff!!!! looks like to me that administration is not standing behind their nursing staff!!!!! just my view of things;)

Sailnaway: It sounds like you have your work cut out for you. Organization has to start somewhere. Why not a unit meeting and present possible triage rules and agree together on what is the policy? Then post the triage rules in your triage areas. Not everything falls into clearly into these rules....I am a firm believer in intuition and that is why you need someone with experience to do the triage/teach others....I have worked in the ER at a small hospital for 17 of my 18 years. I love ER but hate the improvements that keep happening!!! I'm not talking about medical advancements.....I mean administrations ideas of advancement/cost savings or improvement... we average 20-25 patients per day plus outpatients. We have 1 RN per shift (12 hour shifts) and 1 MD. The Rn is responsible for all the ambulance calls, triaging, answering the phones( which we are the operator also after 11 pm), caring for the patients plus advise phone calls. Most days the phones ring endlessly!!!!! :mad: My family doen not understand why I hate the phone so much when I am at home. On night shift, we are responsible for registering patients and being the operator after 11 pm and security since the only unlocked door is the one that leads to the ER.....When we need help, we have to beep someone like the house supervisor or maintance.....Sorry so long but it is so frustrating!!! I work hard to give my patients the best care possible and when my needed help arrives, I have to end up doing their job too!!!! Even the Doc's can tell because they will by pass the person who is their to assist and give the orders or ask the question of the ER RN......You need to take a stand about getting things organized there or things will not improve...Why work harder when you can work smarted for everyone!!!! Good Luck!!:)

In Illinois they are called Field RNs and have to pass tests just like the EMT-P and you basicly work on the same level as the Paramedic- You are limited by your regions accepted policies and protocols which include what meds that you can give. The EMT-P have to keep up to date with CEUs/year which the Hospital RNs are not currently required to do with the state. We do not have any Field RNs in our area currently. Any Field RNs out there to give us your point of view?????