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Lurksalot BSN, RN

Emergency Nursing
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Lurksalot is a BSN, RN and specializes in Emergency Nursing.

Lurksalot's Latest Activity

  1. Lurksalot

    Pet Peeve: Poor Grammar by Nurses

    Same one where "I was vomiking so I took a bambulance to the ER" is a primary complaint.
  2. Lurksalot

    My best orientation mistakes

    Keep laughing and you will be fine. I started in ER, and had a 6 month orientation. First ICU patient I had all by myself, I was so excited, thought I did a great job, had all my tubes and lines nice and neat and orderly, all my meds given, patient was packed for ICU. I was nervous to take the patient to the unit since they never seem as darn pretty in the ER as they do when ICU nurses have 'em squared away--and I was sure the ICU RN would be impressed with the pretty package I was bringing up. He was on bipap and we had successfully kept him from being intubated, and was improving. Unfortunately, the patient was >400 lbs, and he had rocked back and forth for me so I could change the sheets under him and sneak a look at his backside skin, which is something us ER nurses sometimes are not great at. So I got him up there, gave bedside report, nurses were like "wow, you even have your lines labeled," and "wow, you have 2 x 16g IVs in him," and "all his meds are given," haha so I was very proud. I go back to the ED and a few minutes later get a call. "Hey, by the way, did his sacrum skin look okay?" asked the nurse. "Oh, yeah, sure, he rolled over for me & it looked great." "Oh, okay, just asking, cause I just pulled his wallet and glasses out of his buttcrack." Uhhhmm.....yeah. So now my patients don't get of the ER without a clear visual of their butt cracks.
  3. Lurksalot

    Facebook or Blackboard

    well, I cruise facebook while I'm supposed to be on blackboard. But if the instructor really wants me, it all goes through school email.
  4. Lurksalot

    What do you pack in your lunch box?

    couple bottle of 5 hour power drink.
  5. Lurksalot

    What do your hands say about you?

    haha, its not my hands that would talk, it's my aching wrists from computer charting and writing papers for school. Ouch!
  6. Lurksalot

    how to cope with humiliation

    I am very sorry to hear you are going through something like this. I know it is probably the hardest thing in the world to keep your head up & face scrunity straight on, especially when you know you didn't do anything wrong. Stay strong, lean on your friends, and stick to the facts to pull through. Good luck to you.
  7. Lurksalot

    nursing heartbreak :/

    The only thing that should have happened is that your instructor takes the opportunity to show you how to correctly mark a documentation error. The correct way to strike out a written error is to put a single line through the entry, initial and date it. Technically, one should not throw out any part of the patient record. It is also not acceptable to use white out, scribble an entry out, or mark over in in black marker. A simple single line through the entry with initials and date is the correct way. Everyone makes mistakes. There is no harm to anyone, you caught the error, and corrected it. There was no issue with patient care or safety. There is absolutely no reason for an incident report. I am sorry that it was blown way out of proportion, when there was no reason for all that drama.
  8. Lurksalot

    How much pain medication is "too much pain medication"?

  9. Lurksalot

    Please dont hate me for saying this...

    Thank you, I am so glad to be able to communicate this. I hope the OP can see how we can change emotionally, and how we may need to keep changing inside to do what we do every day. And now I go back to Lurking....and I must admit, a glass of my favorite wine. :wink2:
  10. Lurksalot

    Please dont hate me for saying this...

    You ask a very timely question that has caused me to post after a very long absence here. I very vividly recall how I felt as a brand new nurse. I was eager to join the team in the ER, learn as much as I could, and truly do some good by making a difference for the patient population I chose to care for. I jumped out of bed every morning because I could hardly wait to get to work. I tried to gain the respect of my coworkers and become a trusted member of the team, and a tough bunch of type A personalities it was! I tried to help the brand new residents, because I sure know how they felt--new and lost! I would gladly skip my lunch because everyone was too busy to cover for me. Hardly a shift went by that I did not cry in my car on the way home, thinking about the patients I cared for that day--those that made it, and those that did not. I thought to myself, "I will always remember every patient we coded that died..." My nights were spent trying to find a way to fall asleep because I was so ready to get up and do it all again. Then things began to change. I was exhausted but happy to get up and go to work. I was beginning to feel like part of the team, but still painfully aware that my glaring lack of experience was a barrier to gaining the respect of my coworkers. I still tried to help the residents, but I was quite busy watching my own backside because I'd been burned by the residents too many times. The nights that I drove home crying were getting less, and I spent more time at the bedside holding a family member's hand and feeling like I had finally achieved composure enough to comfort people most effectively. (Since I had been told multiple times I was way too caring for the ER.) My nights suddenly became battles to get to sleep---all day I had kept a stoic demeanor, but when I laid my head on that pillow at night the images just would not stop. I wondered if I triaged that patient correctly, or if I had just done something different the outcome would have been better. It haunted me that I could not recall the number of codes I'd been in, or the faces of people I had watched die. And things still change more even now. Just today on my way home, I thought back on the day, and I wonder what on earth is wrong with me. Am I sick in my head? Have I become some kind of monster? I did not sit and hold the hand of a heroin addict who came in for a broken needle, instead I gave him teaching on drug abuse and informed him he should be more worried about the heroin he just injected than the needle broke in his arm. I make sure I get to eat, even if it is sitting at the nurses station looking like I am being lazy. I don't trust the residents for a second, but I still manage to be nice to them. My coworkers have become like a second family, and a closer group of people I could not imagine. I've gained trust and respect, and am part of the team. No longer do I dream at night, but when it's been really bad at work I might have a glass of wine so I can drift off to sleep as quickly as possible. I wonder how I arrived here, because sometimes it hits me that I no longer cry on the way home from work, and I think something must be wrong with me. The other day I realized that I had lost track of how many failed pediatric codes I'd been in on, and I could not recall all of their faces anymore or what happened to them. But I still do what I need to do. I am efficient, I prioritize, and I give excellent patient care. Have I taken vital signs on a person and then not gone back for a long time--yes, I have, if the person came in for papercut or a runny nose. Yet it is probably because I am at the bedside of a patient we are about to send to the cath lab or intubate, and because this is what I do for a living I am certain the runny nose will be okay without me at the bedside. Do I want to be at the bedside, holding the hands of patients and family members, fetching pillow and socks, or getting snacks for them? Yes, I do, when someone is sick and/or sad. Do I have time to fetch a pillow for the third visitor of the runny nose? No, and it makes me aggravated to be asked something like that as I am running down the hall with my arms filled with fluids and supplies. Have I ever referred to someone as "the bloody GI bleeder"? Yes, I have--because thinking of him as the 'sweet little old man who is probably going to die as his wife sits crying at his bedside' keeps me from functioning to do what I need to do. Daily I remind myself that I have not changed inside as a person--I still am the same, brand new nurse, who wanted to help people and make a positive difference in the community. I still care. But I have to care for myself, too. I prioritize my care for the patients I see in the ER, and I prioritize care for my own sanity. I have to grow and change, and I can see that the way I cope is by adapting along the way. I love my job, and love nursing. I miss the "old" me, but I know the change has happened to allow me to keep doing what I love. So this was a lot of rambling, but I hope you can see how things can change. I wish you luck in your future career.
  11. Lurksalot

    When the going gets tough, so does your skin...

    My personality/temperament has changed tremendously since I became an ER nurse. Curt, quick, direct communication no longer bothers me, in fact that is the way I expect everyone to communicate with me now! (A trait I must try to subdue when speaking with my own family and loved ones). Drama and emergent situations...they seem somehow mechanical instead of panicky, I'm not sure if I am explaining that correctly...and example is how I felt the first time an MI rolled in an needed to get to the cath lab--I felt chaotic. Now I feel confident and controlled, and am calm to reassure the patient and family and go about what needs to be done in an efficient manner. Nothing in life seems too hectic anymore....because all I do at work is control the chaos. It doesn't bother me anymore when people "bark" at me....I speak to them matter of factly back and move on. Patients being rude---well, I don't take it personally anymore either---and if they don't want my help, there are always several more patients waiting who do want it! Yes, your skin will toughen up. You may not see it happening, but one day you will look back and think--wow, I can't believe some of the things I use to get upset about!
  12. Lurksalot

    What do you like about your ER?

    I like my ER. We have an amazing team of nurses, we always have each other's backs, our attendings are good (the residents are mostly...good), and we have good resources available. What I like the best is the way we self-assign patients.
  13. Lurksalot

    Stupidest reason to go to ER

    "I have disfavor" "I need a mammogram" and of course, "I need a pregnancy test"
  14. Lurksalot

    Gloucester County College Students Sound Off!

    Good Luck GCC students. Study hard and dedicate yourself, it will be worth it in the end. Being organized and finding a system that works for you is the best advice I could offer for getting started. --A very proud '06 GCC grad.
  15. Lurksalot

    IV drugs RN's can give?

    Our head of anesthesiology designed a facility protocol for conscious sedation use in the ED/CC areas for specific licensed staff, both RNs and docs. To be initially approved to administer, we have to take a class and be monitored through 3 procedures, and then re-cert is a yearly exam. In our facility the docs must push the first dose, and then the RN can do the subsequent doses. We use propofol, ketamine, versed, etomidate, fetanyl, pretty much according to what the doc prefers and what is appropriate for the patient.
  16. Lurksalot

    Happier thread.. Your best moment in the ER

    Best moment in the ER so far? A few I will never forget... ...my first hug from a patient ...the time a patient took my hand and said "thank you so much for caring about me today. No one ever believes that I am in pain, it has been going on so long." ...the time I tried to comfort a crying mom who leaned on me and said "you must be a mom, too."