Heather56

Were I work, Victoria bc, we have well written P & P for use of subcu butterflies. A differrent one is used for each med and they are primed with the particular med so no flushing. as the med is sitting in the subcutaneous tissue and slowly being absorbed by the body I would imagine use of more than one substance at the site would cause irritation. Also flushing with saline would actually be adding saline to the medication in the tissues and could change the effectiveness of the medication.

Vancouver Island Health Authority has 164 registered nurse and psych nurse positions posted this week on it's public postings, that's not counting internal postings. VIHA covers vancouver island and some areas on the mainland.

I'm sorry Fiona59 has had such bad experiences with ESNs. We have had them in the er I work in and, although there can be exceptions, generally they are very helpful. I would certainly recommend going for your RN and forgetting the LPN route. Good Luck and maybe our paths will cross at some point!

I've been almost relieved to see a familiar face when waking in PAR or on the floor. I have also looked after co-workers and others I know. I've looked after family members of friends and they seem to be happy to see someone they know. I think it would depend alot on what they are there for and the kind of care needed.

This is a hard issue to answer as we don't know the circunstances. I know, though, that in the job qualifications for nursing jobs at my place of work is that the applicant have the "physical ability to perform the duties of the position"

In BC canada the only one who can give instruction to the paramedic is the er doctor at the receiving hospital. Certainly no other health professional including drs have any say at the scene. I have to say that having been the one stuck in the car after hitting a tree on a dark stretch of highway I appreciated everyone who stopped to help.

best of luck to you minmi, just don't get ahead of yourself, I'm sure you know all the sayings!

I know we've all had the pt who's allergic to most pain meds. I am one of those who is actually allergic to all nsaids, I have severe asthmatic reactions to them. It's fairly common with people who have asthma and nasal polyps. I certainly have gotten the "look" from nurses and docs when I tell them though. It does make me get a bit more history when pts tell me they are allergic.

First I would just like to say I am not under any circumstances advocating alcohol or drug abuse. However, that said, we see alot of young people in the ER who are experimenting. There are some times of year where it's particularly bad such as the first week of University/College. The ambulance arrives transporting a drunk, puking young lady and her almost as drunk but, thankfully, not puking boyfriend/date. He didn't know what to do with her. Or it's transporting a very drunk fellow and is closly followed by a group of friends who, again, are almost as drunk. He was having trouble walking so they called and ambulance. The other classic vists are the "I just smoked some marijuana and now I feel weird, I just did some cocaine/crystal meth and my heart's racing, I just did some heroin/sedation and I feel like passing out." My response "and what did you expect to happen?"

Managing my time was the most difficult thing for me. No amount of school training can prepare you for all the things that crop up during a shift. One thing I took from my training was med checks. With frequent news artlicles about med errors it's taking the time to go threw the checks that make the difference between an error and an almost error.

I'm bad with remembering names so use "Dear" alot with patients. Being 51 I can get away with it with both young and old. I have never had a negative reaction to using dear however numerous times I have been corrected when I've used Mrs with an elderly woman who is a Miss!

Last night had a patient come in with a rash. brought him in out of the wr to a chair right away as I was concerned about scabies. Pt proceeded to make rude comments to me everytime I walked by him. After he had been in the dept for 20 min heard a loud voice in the wr and turned in time to see my pt, pants down and rash covered bottom displayed saying we were all idiots as he toddled out the door. hmmm The issue of pt behavoiur and duty to treat was addressed by our nursing association recently in their magazine. They said that, although we did have a duty to provide treatment/care, we also had to consider the safety of others in the wr and of staff. In our er if a pt becomes loud and verbally aggressive or bothers other pts we call security. They will read the pt the riot act and if the pt refuses to behave he/she will be escorted off the property. This is actually quite rare as these pts do have enough sense to realize that they won't get anything if they don't behave. It's after they've been seen and d/c (after getting some ibuprofen) that they really start to scream at us but security just arrange for them to get a personal ride with the local police.

See this frequently here. I believe, though, that once retired they lose all their seniority so are at the bottom of the casual list. Mind you with the shortage of nurses that still means they can work lots if they want.

I have a hard time with calling 911 to avoid an er wait. If I had been triaging this patient I would have looked at all the factors, no sob, easy resps etc and triaged her accordingly regardless of how she arrived. It's a common misconception in our et dept that pts in ambulances get seen first. Heather

-Family Doctor or specialist calls in saying, "sending so & so to emerg for x reason". Patient arrives and is upset that they aren't immediately rushed to front of line, their Dr made an appointment! -Pt calls ambulance from pay phone downtown with c/o pain somewhere (I have a good suggestion!) is triaged, downloaded into the waiting room or on a stretcher then disappears. Check of pt information finds pt lives 2 blocks from ER. Of course they don't pay for the ambulance as they are on assistance or are destitute. Some even make sure they get as much food as they can get out of us before they disappear. -Pt who keeps asking when he'll be seen (every 5 minutes), when finally gets a stretcher (after having to be called numerous times as outside for smoke, gone for coffee, etc.) again asks when Dr is coming. Asks to use phone then 1 minute after he hangs up Grandma calls and reams out nurse for Grandson not being seen immediately and that he is in soooo much pain. (He has a tooth abscess, never went to a dentist, and didn't take own morphine before coming in as figured he'd just get it from us.) -Pts who closely watch for your reactions when they give details at triage, my pain is a 6/10, no an 8/10, no a 10/10! I have pain in my stomach, well no across my whole front, well no in my chest, well no chest and down arms! -And, finally, how often the horrible symptoms the patient has had for days, vomiting, diarrhoea, bloody stools, etc, disappear as soon as they arrive in the ER and never are seen again even though they are there for 8 hours. It's amazing the cure one gets just walking (or being carried) through those ER doors.