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  1. KyPinkRN

    What would you do?

    Thanks. And yes I realize that the hospital has put us in a no-win situation when they closed our L&D. I would have even gone so far as to start some labs... I drew the blood but wasn't allowed to order any tests. A CBC would have been the very least I would have done and the results would probably had been available by the time she got to the L&D. I know this is going to come up again because we frequently get people who need to be in the birthing center for monitoring. I'm uncomfortable with the attitude that we can just schlep this girl in the car and send her on her way.
  2. KyPinkRN

    What would you do?

    I work in a small ED that is part of a larger system. About a year and a half ago the powers that be decided that one of our sister hospitals needed to be a level 1 NICU. In doing that they closed the birthing center in our hospital. The sister hospital is but 10 mins away from us. I had a pt who signed in yesterday 32 weeks c/o heavy vag bleeding x 20 min. We triaged this girl, established IV access and started fluids and rushed her to the 10 min away L&D... we didn't waste any time but the process still took about 45 min because we had to call the squad and wait for them. Our ED doc said after the fact that we should have sent this girl straight to the L&D from our waiting room in their POV. At this point the inner nurse/former EMT in me is serioulsy conflicted because that just about goes against everything I've ever been taught. Would this not be sort of like abandonment? I know that the pt needs to be in the OR sooner than later and that adverse outcomes can happen if they're not but I also know that if I turn a pt away at the door of our ED and provide no care and something happens on the way to the other hospital something equally as bad can happen. I should say that I have the utmost respect for this doc that I work with and have never questioned his practice before, he is a well seasoned and respected member of our organization. I want to do what is best for the patient, but I'm still conflicted about what that is. Thanks for any input you have.
  3. KyPinkRN

    What's in your pocket - ER Style

    This is almost exactly what I have in my pockets... except I always have a few alcohol swabs. I have found that they are quite adequate for jotting down a set of vitals. Plus I'm not wasting paper cause as soon as I chart said vitals I can use the alcohol swab :)
  4. You could volunteer, that won't get you the skill set you need to survive. Here's what I did: I worked med/surg for about 2 years and learned a lot about assessing pts, and time management. Both things will get you far once you do land a job in the ER. In the meantime get your ACLS PALS and an EKG class if you haven't had one. These are all things you MUST do once you are in the ER and if I was going to hire someone it'd be a real plus if you were already trained in these areas. Good luck and the effort is absolutely worth it. I :redbeathe the ER!
  5. KyPinkRN

    After my 12, I just want to go home! RANT

    I once floated to a unit in our hospital who recorded report for the oncoming shift. The off-going nurses would just take turns when they had the time at the end of their shift and the ones getting report would do the same. It seemed to work very smoothly. Also remember that you don't need to tell the patient's life history when you are giving report. Just the pertinent things that happened on your shift and any changes in condition. Keep it simple!
  6. This must be why we have been seeing record numbers of patients in our ER.
  7. KyPinkRN

    Do FNP's really make 80k to 90k a year?

    No kidding... and what good is making all that money if you're too tired to spend it.
  8. KyPinkRN

    MRSA precautions in the ER?

    wash your hands, wash your hands, wash your hands... and when your done with that wash them again! Also as others have posted be sure to wiped down stretchers and equipment between patients. Remember, if you are healthy you are not likely to have problems with this sort of infection... it's our patients that are at greatest risk when cross contamination happens.
  9. KyPinkRN

    What HAVE you said to patients???

    Sometimes that's what it takes to get them to realize why we have to do things. I bet he got a "deer in the headlights" look on his face and did exactly what you asked after that.
  10. KyPinkRN

    Planning to have a baby.. new nurse

    I would wait until about 6 months after you find a job. That way your new employer can see what kind of nurse the non-pregnant you will be. Your first year as a nurse is hard enough adding a pregnancy on to that may not be to your advantage. I understand about waiting though. I graduated in Dec of 07 and got preggers in May of 08. It was tough on me and I can honestly say that while preggers I didn't do the same quality of work
  11. KyPinkRN

    Sterile gloves during procedures

    sterile gloves for doing procedures such as removing sutures and such is a waste of time. the wound itself is dirty (aka germy) i used to work on a "wound care" med/surg unit... multiple dressing changes on many patients a day. we didn't use sterile gloves for that. think about the condition of the wound, most of the time a patient with staples or sutures by the time you are ready to remove them they are open to air. the air itself is not sterile, nor is the bed sheets or anything else that wound is touching. i would however recommend using strict sterile procedure for things like central/picc dressing changes, inserting a foley etc. these are instances when contamination can mean major complications. for regular iv starts, accessing saline lock, and dressing changes regular clean gloves are sufficient.
  12. KyPinkRN

    Sigh. Is this really how we are graded?

    When I have pts refusing meds like that I usually politely suggest that they would be more comfortable recovering at home (sign out AMA)... I've not once had anyone actually do it, but it gives the patient perspective about why they are admitted to the hospital and the importance of following the plan of care.
  13. KyPinkRN

    Sigh. Is this really how we are graded?

    After receiving a complaint by a pt once... I was told to never tell a patient that I have other patients. Makes it sound like I'm too busy for them. Instead I'm supposed to say (in my best Stepford voice) "What do you need? I have the time." The joke is that I really don't have the time, and that management on that floor just kept adding more non-nursing type things to our responsibilities until we barely had time to do an assessment or pass meds. This is why I transferred to the ED... which compared to the med/surg floor I was on is much less hectic even on a bad day.
  14. KyPinkRN

    How I miss my beloved text-paging

    If you are using this information for direct patient care... it's not a HIPAA violation. Perhaps that Cardiologist needs some more education on the finer points of that legislation. Or maybe you should start routing all night time calls through his personal phone... just sayin.
  15. i agree with most of what the other posters have said. i want to add that after a while being that emotional at your full time job is going to wear you out... actually burn you out. nursing is a hard job with lots to think about and even more to do. being emotional all the time while you are doing it is going to take it's toll on you. that being said, i do think that occasionally you have that patient that just touches your heart and you can't help it. just be careful and take care of yourself too. good luck with school and i hope your shadowing goes well.