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KyPinkRN's Latest Activity

  1. 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 :)
  2. 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!
  3. 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!
  4. This must be why we have been seeing record numbers of patients in our ER.
  5. KyPinkRN

    Hyperkalemia and order of meds

    NEVER give the insulin first... what would you do if you gave the insulin then lost IV access. I always start with D50 then insulin, then ca, then sodium bicarb. I've been told that the order doesn't really matter. I give each thing slowly and always with running fluids even if I have to hang a 250 ml bag just to get the drugs in. Hope that helps. :)
  6. KyPinkRN

    Nurse with a condescending attitude - rant

    You can explain this as many times as you want to, but it won't change the fact that you can't just ask the first person you see with orange on their badge about a patient they very likely know nothing about. If it's not my patient I can't give you an answer without finding the nurse who is actually taking care of them (which sounds an awful lot like what YOU were supposed to be doing in the first place). That takes time away from the 50 things that I have to right at that time. You couldn't get ahold of that patient's nurse or the charge right that minute? Well wait until you can... that visitor isn't going to die if they don't see the patient in the next 5 minutes.
  7. KyPinkRN

    Nurse with a condescending attitude - rant

    Have you ever thought there may be more to the story here? Why does you coworker feel the need to avoid this person? Did this nurse speak directly to you in this manner? If not, then I would say that it's your coworker's responsibility to handle the situation, not yours. Maybe it's not the nurse who has the problem, but that your coworker just doesn't like this particular nurse or has had a disagreement with her. I would think about things like that before I went up the chain of command. Especially if, as you said in your post, she wasn't rude to the patients.
  8. KyPinkRN

    Fluid restrictions vs Patient rights

  9. At my hospital we simply applied the anti-fungal powder and then barrier cream on top of it. The order was usually written BID and PRN (as in whenever the patient was incontinent). We were quite liberal with the anti-fungal powder and usually this would clear things up before the patient was discharged.
  10. KyPinkRN

    When drawing push meds, do you draw the med first?

    If you are concerned about getting the correct dose... here is what I do: For ex. if I am only giving 12.5 mg of Phenergan, I draw up the exact amount of the med in a 3 ml syringe, then take a pre-filled saline flush and pull back a little so there is room to put in the med, then I take my med syringe with a blunt tip needle and inject it into the saline. You can do the same just draw up your saline in a syringe and then whatever your med is in another. I have found this is a way to assure the patient gets the correct amount of medication every time.
  11. KyPinkRN

    No urine output- BUN, Creatinine WNL?

    i wanted to scan him, but being an orientee i got trumped... more important things to focus on i guess. had i still been on the floor i would have done it.
  12. this past weekend i cared for a patient in severe respiratory distress-probable heart failure combined with copd exacerbation. he was placed on the bi-pap and given lasix, solumedrol and pain/nausea meds. after things settled down we inserted a foley... this was after 80 mg of lasix. there was no urine out of the foley so we took the first one out and reinserted... still none, so we irrigated with saline... nothing. pt had no urine output for several hours while he was in our care. what could have been the cause if it wasn't kidney related? could it be that his heart just wasn't pumping out the fluid effectively? i have been racking my brain trying to figure it out.
  13. KyPinkRN

    I feel TERRIBLE!

    as a former first-responder i must agree with the above poster. just passing by an accident scene in your car you are not prepared to assure that the scene is safe for you to attempt a rescue. there could be downed live-wires, leaking fluids from the vehicle... you never know what you are coming up on. besides the danger you put yourself in, you can potentially do more harm to an injured person by pulling them out of a vehicle without first stablizing their cervical spine... that can make the difference between life and death or permanent disability for a person. i'm not saying don't stop but consider what you are doing because everything has consequences, even when you are trying to do the right thing. by all means call 911. if you call from a cell make sure you can give them an accurate location, like a nearby address or prominent landmark. this will be crucial info and saves valuable minutes of the "golden hour". good luck in nursing school!
  14. KyPinkRN

    Patient doesn't know he's terminal

    i used to feel the same way as you do about this. keep in mind that the patient's family knows him better than you do. why not let the patient believe they are fine if knowing that they are going to die will cause them more harm than good. these are very subjective situation we have to deal with as nurses quite often. sometimes it can be hard to keep the family's wishes when a patient asks you how they are doing... i usually ask them "well how do you think you are doing" depending on their answer i would talk about how their vital signs are or focus on progress they have made since admission... not really lying but pointing out some positives. if they ask questions regarding a diagnosis or a test they had where the result wasn't negative i always refer those to the md.
  15. KyPinkRN

    Question about Greater Cincinnati RN Schools

    Good Sam Cincinnati grad here... I had a similar background in fire/ems when I was applying and a considerably lower GPA than you. I was accepted without any issues and started school about six months after first applying. I don't know what the wait is like now but back then (2005) that was pretty good. I knew people who were on a 3 year waiting list at Christ. As far as actual learning and clinical quality I would recommend Good Sam hands down. I work with people who are still (two years out) trying to pass the NCLEX who graduated from Gateway and NKU and recent clinical groups from Beckfield that have been on my unit have left some questions about their program too. Good luck with your search and feel free to PM me if you want to ask any specifics.
  16. KyPinkRN

    Enough is Enough

    As a nurse I have recently been reprimanded for this kind of "customer service" bs. I had a patient who actually needed lots of attention-he was just told he was going to die... all alone in his room, no family was with him, no support for him after the doc had gone. He needed my support and I gave it to him. I sat with him and cried with him and later his family. This took lots of time away from my other 4 patients and I was written up because a patient's "perceived" that I was being short with her. In reality I was so behind because I was trying to be a good nurse to this family who so desperately needed it that I was racing like crazy because you know we get in trouble for clocking out late too. I've had enough too.