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NinaC's Latest Activity

  1. NinaC

    Co-pays in the ER

    I live on Oahu, HI, and we are not allowed to refuse care to anyone. In fact, most patients that come to the ER come there because they don't have insurance. When patients come into the ER registration is not even allowed to see them until the nurse has seen them first or placed into a room. Refusing treatment to a patient in the ER is a COBRA violation. How does some hospital get away with it. I'm glad don't live in Tennessee either!!!
  2. NinaC

    nurse:patient ration in the ED

    We have 13 beds: 4 monitored and 9 clinic beds we have 3 nurses (our model is primary nursing) 1 is the charge nurse 1 is the trauma nurse (monitored beds) 1 is the clinic nurse (usually the hardest becuase she cares for the patients that are also placed in the hallways if we have no beds).
  3. NinaC

    need advice desperately!!!

    I've been an nurse since 1993...I felt the same way when I first started. However, as I got older, there were certain things that I felt were important and things that were not. I worked on a tele floor for 3 years; cried going to work, cried at work and cried going home from work; like you, my stomach would hurt just thinking about going to work......the solution that I found was....quit and go find somewhere else to work especially if the manager is not supportive. Managers who are petty over the meager little things need to get a life.... and if she continues to do that then she'll lose a lot more people in her unit and she'll have more problems. I work in ER now..its busy, hectic, a lot of critical patients but for some reason, I like it better. I think that I work in a more supportive enviroment, with nurses that love to teach and a manager who tries to accomodate our schedules and is supportive...at least she tries. But anyway, you need to sit down and re-evaluate what it is you want to do, and how much you can tolerate of the unfairness you are experiencing. Someone told me at one time...."you need to find your niche." Thats exactly what I did and I'm much happier.
  4. NinaC


  5. NinaC

    Men vs. Women

    i agree with your post. you're right about the independence and er nurses in general feel that their opinions are important to the doctors.
  6. NinaC

    Co-pays in the ER

    In our hospital, we are not allowed to discuss insurance....also nurses must triage the patient first and then the admissions clerk goes and registers them. It is an emtala violation if they are asked about their ability to pay much more ask for co-pays
  7. NinaC

    IV conscious sedation

    sorry, rick, i didn't mean to be too vague. perhaps just the test questions that are usually taken after staff inservices is what i was asking for (the staff is up for their annual reviews and we also have new staff coming on who have never done ivcs).
  8. NinaC

    IV conscious sedation

    Dear ER friends, I'm in the process of reviewing our conscious sedation policies and also looking at taking over the IVCS inservices. Can anyone give me a sample of test questions relating to IVCS? or perhaps refer me to links that may help me? Your help would greatly be appreciated. :)
  9. Hi Rick Would it be possible to have a copy of your policy and procedure for faxing reports to the admitting floor? or perhaps the worksheet your dept. will be using for the fax information? I would like to have some idea to bring back to our er to discuss. nina
  10. NinaC

    admission delays

    apprarently this has been discussed as one of the options but it seemed that a lot of managers on the units upstairs were resistent to the idea but no explanations were given as to why they did not want it as an option. infact, the unit wanted us to write down a report and then fax it up but still they wanted us to call them and give report. but really, my issue is that, the patient is sitting in the er waiting for a bed, even if the nurse is not yet ready to take report, why can't the patient just go up to the assigned bed and wait instead of the patient waiting/occupying an er bed while we are extremely packed in the hallways, waiting rooms and we're on divert
  11. NinaC

    admission delays

    I would like to thank you all for the replies I received for "Admission Delays." I just find it so frustrating that I often wonder if any other hospital has this problem. In general, ERs are the money makers of the hospital but yet we have no support by administrators, supervisors. We sometimes have nurses pre-booked to assists with ER holds but as soon as management finds out that its overtime for them they get cancelled. We often go on ambulance divert....but like you all know, all priority 1's, code 500s have to still come in not to mention the patients who are walking in with active MI's, CVA's, etc. and no where to put them because every monitored beds are occupied with critical patients. But we as nurses continue to work in these conditions, and you know what somehow, we get through it (I think only ER nurses can:D ) Despite all of this, I really do love what I'm doing.
  12. NinaC

    admission delays

  13. NinaC

    Prayer for the Stressed

  14. NinaC

    admission delays

    I work in a busy ER and there are times when we are so busy and overloaded that we have no room to put patients in. Most often times than not, our monitored beds are often occupied by patients that are waiting to go upstairs because the nurses upstairs are too busy to take report, or actually refuse to take the patient period because they don't have staff, or someother reasons.....becuase of this we've had to put patients in the hallways on monitors. Have some of you encountered this? If so, what have you done to help alleviate this problem? by the way, supervisors never support the ER (They tell us to hold the patients in the er until the floor are ready to take them), they tend to be more supportive to the floor nurses, floor managers/and floor nurses feel that the ER are chronic complainers and are hostile in general toward the er staff. I know this happens everywhere, I'm just curious on what your opinions/solutions are for this.
  15. NinaC

    why do you come to this site?

    Rick, I come to this site because I sometimes find it amusing...some of the spats that the nurses get into are the same spats I notice happening in my workplace....The best thing I have noticed is that some of the members here have the same exact personality that my co-workers have.........
  16. NinaC

    fluid therapy with DKA?

    Janine, Bolusing the patient with 2 Liters of NS is a common order for DKA basically to dilute the glucose. It is what is ordered commonly in the ER. If the attending had questions about the order and did not want to listen to your explanation, then you should have reffered her to the ER doctor or perhaps you could have asked the attending why the patient should not be bolused with the saline over that period of time.