medichall

I had a pt drive 4 hours to our ED, I was stuck in triage, he comes to the window and says " I have a wire stuck in my rectum" WTH? OK sir come on in here and let me get your vitals. While I'm getting his info I ask how it happened. "I was been stupid." (Ya think) In my mind I'm trying not to laugh in his face. The MD comes in and starts to assess him. Pt tells DOC same thing... doc looks at me with WTH look on his face too. Send the pt to admissions and then to X-ray. MD says don't you dare bring that back while I am here (its 30 til shift change) New MD on now, bring some more back I'm ready to see some new pts OK I say how about this one. He says "What the f***" X ray shows its not in the rectum but the member and all the way into the bladder. MD goes in and says "Dude how did you do that?" He didn't tell doc how either. Makes me wonder is he is to stupid to know the difference between rectum and member or was just too embarrassed to tell the truth. Buys hisself a trip to OR for removal. Ahh I have several good tales from triage. LOL

We have a NP or PA in triage that orders meds, labs, x-rays etc from triage, then off to the waiting room for these guys and usually a quick d/c from triage when results are back. Something our hospital is trying is sending "admitted pts" to our out pt surgery holding beds, while waiting for the pt to be d/c'd upstairs and the room cleaned etc, this is freeing up beds in the ED and cutting down on wait times.

This nurse did have an extensive orientation process with the other clinical manager and has taken required classes ACLS, PALS, HEMO monitoring etc. She even did a 240 hour clinical before she was hired into the ED with this other manager for her RN program. On a daily basis I discharge her patients and call report to the floor, I also transport them up there for her. I do try to help her and I have talked to her about time management, setting her priorties but she is still "not getting it." This is a very small VERY busy ED and she is not well liked by her coworkers because she is putting more work on them and not pulling her weight. Now having said that they also help her, they are not mean to her but they are getting very tired of it. Lots of complaints to me about her and her work. She runs our medic to death doing things for her like hanging her antibiotics, giving the pain meds, EKG's. These things are important, time is muscle with these MI pts and she is taking up too much time. We have a great team except for her. And I hope that I'm not being to hard on her because the others are doing " so well" In the ED we don't have the excuse that we are "too busy" to take report. When have to take that MI, CVA, resp distress or whatever comes through there regardless of what else is going on. I'm not trying to get rid of her. I want to see her improve. I'm looking for suggestions on how to do that. About the breaks, she gets her breaks, the whole team does because I take over their pt load while they eat, break or whatever so that is not the problem. Thanks for the help

Help I am the clinical manager in a 13 bed ED that sees about 90 to 100 pts per day. We end up putting stretches around the nurses station and against the wall to expand to 19 beds. CHAOS!!! Here is my problem. I usually don't take a pt assignment, I float and assist the nurses with critical pts or just the PITA pt. I have a new nurse, she has been in the ED for 8 mths, long enough to see if she would be able to pick it up. She holds pts when they already have a bed assignment. Or holds a pt discharge for hours. The rest of the team has to help her constantly with IV's, meds, ng tubes you name it. I have repeatedly talked to her about it. I stay on top of her cases but am busy helping others too so sometimes it slips through the cracks. I don't know how else to help her. Any suggestions? I realize she is new and that it takes time, but I hate to constantly stay on her case. I've told the unit manager and she just smiles and say ***** gives pts that something special, (yeah the whole team!) She does have an excellent bedside manner and is very personable but just not cut out to be in the ED. I think she would make an EXCELLENT ICU nurse where you can have that one on one care. Thanks Michelle

I hope you did well on the NCLEX, I have heard from Friends who have taken the test before that if It cuts off at 75 that you probably passed. :)

Could I get a copy of your study pan too. I graduate in May and will be taking the NCLEX in late June. Thanks! Leslie