andhow5

Get the CEN review book offered through the ENA website, study your TNCC book, then go for it! It's my understanding that the percentages of the areas of content will be changing - but I could be wrong. When I looked on the ENA website a couple weeks ago, there was a link SOMEWHERE that offered a PDF file that listed the new test outline. I remember that it didn't seem much different than the current outline, so I wasn't too impressed. You can do it!

They have to have a signed release.

I agree with the above posters. You have to *try* to leave it at work; but sometimes that's easier said than done. Sometimes you just have to hug the family a little tighter, play with the animals a little longer, or do something "creative" with your time - write in a journal, draw, pain, design graphics... Good luck!

You bet your bupkiss I will defend my right to defend myself. Just because I became a nurse does not mean I gave up my civil rights. As far as the facilities that say not to inflict pain - I can agree to a point; use just enough force to get away. And if it comes down to it - I'm the one that will be going home that night. If the bleeding hearts and facilities tell you how awful you are for defending yourself, let them get abused in your place, and we'll see how quick that whiny little tune changes. If the facility still was insistent that you let yourself get abused and/or killed, tell them you require that policy in writing for your attorney to review, because they are not providing a safe workplace - they are guaranteeing a hostile work environment. Now, all that being said - if it's a head injury, or little demented old person - I'm gentle as I can be for as long as I can be, but if force is required to get away, so be it. The hospital won't provide for my 3 children if I don't work... As for the people that make the choice to be an ass - then it's on. I don't provoke it by any meas, but they will have a fight on their hands, as I REFUSE to let myself be intimidated. Good luck to you - hope all is healing well, and WAY TO GO for defending yourself!

I completely agree!

Hey all! I'm fine, and doing well. I never got in trouble for anything. I was given an "atta girl" for doing what I had to do to get away from the drunk and prevent myself from being hurt any further. Our facility places a slightly HIGHER value on the safety of our nurses as opposed to the drunks. Of course, they get the medical care they need (despite their drunken stupor, and combativeness) - and then they get shipped right on over to the pokey to have a nice long visit with the poe-poe. Thank you for the well wishes and support from the majority of you. And for those that are telling me I should have no right to defend myself - sorry, but I have not and will not give up that right; you, of course, are welcome to let someone beat you to a pulp while you are waiting for someone to come rescue you. For your sake, I hope and pray that does not happen to you.

Bad, BAD care. He was a trauma patient, and treated like a fast-track patient. Considering his MOI, he needed much more ADVANCED care than he received. I'm glad he's OK, and I hope he heals quickly.

We've had mostly "A", several "B", and a few that were positive for both. We treat symptomatically, and a few scripts for tamiflu if recent onset of symptoms. If I'm triaging, I give them a mask and tell them to cover their mouth AND nose, and if they refuse to wear it, I chart on the front in BIG RED letters, "pt REFUSES mask." I've had a few people that were instructed to stay home from work for 3 days (which made them happy), but they said they had other things to do (attend weddings, etc). I was not a very nice nurse and told them exactly what I thought of their intent to further spread the transmission of the mutated flu virus to others. Pure selfishness!

Wow... We're only allowed to give Phenergan through central lines, rectally, or IM. We are not allowed to give IVP anymore.

I'm also a real "control freak", and it really upsets me when I don't feel like I'm able to keep up with the flow. But you know what? It doesn't matter HOW long you're there - you will have days where it is just plain horrible no matter how hard you try. Everyone has those days at one time or another. I hate accepting help, but when I do get it, I just make sure to jump right in and help everyone else as soon as I'm free! Tag team ED nursing rocks! There's no better sport in the world!

Congrats, and welcome to the jungle!

LOL! After the night I had, this response made it better! ROFLOL! I'm so glad to know I'm not the only one...

Sometimes, when it gets to the point I feel as though I need to either cry or start giggling uncontrollably, I sometimes hum, "She Works Hard for the Money" - the version as performed by Hank Azaria in the movie, The Birdcage.

I must say that I have been using JACKa$$ a lot lately...

Keep them coming guys!

It sounds like you understand what a zoo you could be getting into! There are 2 groups it seems to me: Group 1 - Get experience first, then go to specialty Group 2 - Go right into specialty - they'll train youBoth groups have excellent points. But the best answer you can get is the answer you give yourself after doing a brutally truthful self-assessment. If YOU feel that you perform well under pressure, can think quick, and have faith in yourself that you could recognize a situation that requires immediate attention; I'd say, "go for it", "go with your gut instincts", and "follow your dreams".

I'm glad to hear you're settling in! It sounds like you've gotten into your grove OK. But no matter how hard you try (or try to control/maintain) - some days it makes NO difference. They just keep coming, and coming, and coming... On those days I just grit my teeth and do the best I can, and if I end my shift with no death paperwork, consider it a fabulous day!

The thread about names got me thinking - not about real names (which honestly, we couldn't make up), but about "pet" names or nicknames that you give to your patients. Do any of you have any interesting ones? We've used: Mah-maw, Pah-paw, gomer, smurf, pickle (pickled from one too many), drunk boy (or girl), monkey boy (climbed up on cot, swinging from overhead light), spider monkey chick (thought we were all spider monkies), etc... Of course the usual and most common (jerk, jack @$$, etc..) also apply.

I also agree 100%! *Secretly saying voodoo chants and sacrificing small chickens...* Hey - maybe if we sprinkle holy water on them as they come in???

With the kids I try to remind them that crutches are not weapons (don't assault siblings, et al), look out for throw rugs or scattered toys, and watch out for family pets darting around. Also for the fall (after first hard frost/freeze) and winter, I remind them to watch for slick spots (or "black" ice), loose gravel, piles of wet leaves... Footwear with a rubber sole- NO flip flops or clogs! I emphasize, "Slow and steady wins the day".

... and the only thing we "HAVE" to do is to make sure there is no immediate life-threatening illness or injury. *Edit to add: (and then I'll take care of them or disposition them per protocol.)

We hook tele to our CP, SOB (CHF and Resp Distress), OD, Trauma, bad GI, Stroke sx, anytime something just doesn't "feel" right. We don't have to have an order to put tele on a patient. Our tele is only 3 leads. We do 12-lead ekg's on CP, OD, Stroke sx, Trauma, bad GI, and as ordered by the MD. The only CT's we do without contrast are: Head, cervical, facial bones, and abd for stone. The majority of our other scans are with IV contrast, and at our facility the CT Techs give the IV contrast. It's rare that we have to use oral, but if we do, the CT Techs come over to do the teaching on it, and get them started on it. If we suspect the patient might get a scan with IV contrast then we always get a saline lock size 20g or bigger (of course when we start locks we always go for 20g or bigger anyway - if they're "sick" enough to be there, then they "need" the lock). But I'd estimate that about 95% of our patients get locks regardless... I usually say, "Hey Fred (whatever the name is) - when you're finished with what you're currently doing, would you be able to do me a HUGE favor and do 'X' for me? Thank you." They are very quick to pick up on rudeness or pick out what nurse is being just plain lazy (I know - I went from tech to nurse)! Most of them (but not all), have the basics down and can also anticipate what you might need on your patient so they won't be surprised by the requests. Ours is a teaching hospital so we have students of all kinds at all hours. It gets kind of interesting trying to meld all these different approaches, patient needs, and helping the students (of all disciplines) get in the tasks they need to get done.

I have to jump on the bandwagon and say FILE CHARGES! And take extra special care of your back as that IS our livelihood.

I usually joke, "Sux in a blowdart for everyone!" Seriously. Every shift I work anymore there is some sort of physical scuffle. And the verbal abuse - Whoo! It's now considered the norm to be verbally abused and threatened. In our clientele's minds, it's OK to be rude and treat us like their servants. In our minds however... Things get very ugly very quickly. And when we hear the phrase, "I need help!" being screamed - you all drop and run unless you're bagging or doing chest compressions. And that's including all the assorted law officers! :trout:

I agree, I don't feel sorry for them either. It's a choice they make, and all too frequently it's blamed on "mental illness". It's a choice they made, and they need to deal with the consequences and attempt to grow up.