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CEN35

CEN35

ER, PACU, OR
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CEN35 specializes in ER, PACU, OR.

RN

CEN35's Latest Activity

  1. CEN35

    Should a new grad try ED or not?

    I started in ER out of school. The first 3-4 months seemed overwhelming. After that the learning curve dropped a little bit at a time over the next two years. After 2 years I was completely comfortable. I stayed there 7 years, then went to PACU. However, I also work ER at a different hospital still. It's up to you. Not every unit or floor is for every person, only you know that.
  2. CEN35

    Too much pain medication

    Most ridiculous ever.............. Dilauded 4 mg IVP Fentanyl 100mcg IVP Demerol 50mg/Phenergan25mg Im Demerol 50mg IVP Morphine 14 MG IVP ALL in 1 hr and 10 minutes. 28 yrs old wide awake complaining we are not helping his pain and denies drug use........... hmmmmmmmmmmmm................
  3. CEN35

    Too much pain medication

    I work 2 jobs right now. ER and PACU - In the ER most docs I have met are always hesitant to give much more than 50-100 of Demerol much less anything else. I can tell you that, one patient will passout after 4mg of MSO4 IV, and the next may take 8MG of IV dilauded, or even (seen it) 235mg of IV MSO4 over 1 1/2 hours. Everybody is different. However, I would give much more than 75 mg demerol, 1mg Dilauded, 8 mg MSO4 (roughly) without a monitor. Ecspecially when it is right there to be used. :)
  4. None - went in right out of school, stayed 7 years and went to pacu.
  5. CEN35

    How should I handle this situation?

    Also you are entitled to request a different nurse. As far as signs? more later
  6. CEN35

    Percent of men in class?

    3% in 1996'
  7. CEN35

    Documentation standards

    Our ER has a q1hr standard, for ER patients. q15 min for critical care pt's, and q 2 hours for thru care. When charting now days, you need to think like a lawyer. What would they grille you about? Personally, my biggest thing was the way they chart. Pt to CT; pt back from ct; pt to x ray; labs sent; lab results back; pt at ultra sound; pt to be admitted to the hospital. Ok let's ee now that someone was charting how the field trip went? How is the pt? All we know from the prior sentances, is that they went and had their tests done, and some results came back. Since they are being admitted, we also assume they are alive at that point. So back to the original thing, chart like a lawyer thinks. If something happens anybody should be able to look at the chart, and visulaize the patient, and what kind of shape they are in, and what was done about it. That's my 2 cents...........
  8. CEN35

    Drug seekers "Drug of Choice"

    demerol in the ER hands down, percocet or vicoden at discharge. I don't think a doc in the ER would ever write for oxycontin. They would say that's for your primary to make a decision on. If it's that bad you need to be admitted.
  9. CEN35

    How should I handle this situation?

    If you have went back since, see if you see that nurse. Say Hi, see how she/he responds. If they are fine, probably a bad day. If they are totally rude again....... Write a letter to the CEO, COO or Chief Nurse of the hospital with the nurses name and floor in the letter. If that were me, the answer would be: "Um no, he could be dizzy from the bleed becoming worse, a tumor, high blood pressure, low blood pressure, hypoglycemia, vertigo, sinusitis and/or any of the medications he may be taking/getting in the hospital. All you did is r/o hypertension. Now how about chilling out, he did nothing to you. Actually he and all the other patients are responsible for your paycheck. Have a nice day!!!!" That would be my response........ Later! :) me
  10. CEN35

    ER violence

    drunks, psych patients, those mad because they had to wait to be seen, and those that don't want their family in to see them: Nice ladie, under the covers (unkowingly to me in wrist restraints), "Sir can you come here for a minute I have a question"? "Yes mam" BOOOMM Kicked in the nads for no reason. A fenale nurse went to stick an IV in a total gentelman, and soon as she poked him he went nuts. I was ridng his back, and it took 9 people to restrain him, and he broke the soft restraints. PCP, cocaine people, any of that. AAA - being tubed, IVF's, CPR, 5 people in the room, one guy limps in and wants to know why there are so many people in the room with the AAA pt, while his ankle is hurting and starts yelling at everybody. 24 yo Female as patient. Does not want the family in back to see her. The father says, "I'm her father I have a right, your lucky I don't come back later and blow your head off". It has been getting worse over the years, and the floors have started to see it the last year or so also. People look at us as a McDonalds drive thru, get in, fix it and get out, or they are mad. Also the pt's families think they have all the rights, and like to tell you how to do your job. When in reality the patients are the ones with the rights. Who knows??????????????
  11. CEN35

    Question about trama levels

    There are 4 levels. I don't remember what they all are, but here's a brief. Level I - Is a facility with 24 hr a day in house cardiothoracic surgeon available. Any other specialty surgeon available within 30 minutes. All types of radiology equipment, and techs available. They require TNCC by the nurses, and ATLS to the medical staff involved. ***They are required to do X-number of research articles and publications per year, therefor they are usually a teaching facility with residents. Level II - All of the above, except the research, so many are non-teaching (i.e. non-resident hospitals). Which is what ours is, and is actually better for learning, because you get involved. Instead of pushed out of the way for residents to do stuff. level III - Must have most of these things available, but are not capable of everything that's needed. level IV - Urgent care???????? At one point Ohio decided they were going to make a law, requiring all traums to be transfered to a "Trauma Center". So many places were in the proccess of getting level 3 or 4 certification. Which defeats the purpose, so Ohio dumped the potential bill.
  12. CEN35

    PACU Nursing?

    The programs in our area at one time only accepted ICU, as a pre-req for CRNA school. However, a shortage in CRNA's has changed their pre-req to 1 yr of PACU, ICU or ER experience. We don't have new grads in our PACU either. However, I came out of school and went to the ER as a new grad, stayed 7 years then came to PACU.
  13. CEN35

    Liability insurance

    the Pro's are: You know your covered. It will help you when the hospital, decides they would be better off hanging you out to dry on your own. The Con's: Allegedly once a plaintiff finds out you have insurance, it makes you a target because they know they can get a decent amount of cash from your company. It tends to make the general public, or plaintiffs think........"they have it because they have screwed up before, and are covering themselves for their known negligence." I have it, always have.......... what the hell? For $80 a year. If it comes down to the facility or you, it won't be the facility, that's a guarentee.
  14. CEN35

    Techs Triaging

    They won't even let medics do it here at our hospital, unless an RN co-signs it. With the shortage, they even went as far as hiring PA-C's, which was not totally thought out. Apparently the PA cannot take direction from nursing, which is what they were hired under. They must take direction from a physician in Ohio. However, the ER physicians are a contracted out group and won't take responsibility. The PA was not an employee of the group. Techs, Never, LPN's NEVER...........
  15. CEN35

    IV starts and drawing blood

    We start the cap, take the blood, then start the IV. If it requires blood cultures, we do the same thing, but the second set of cultures gets drawn 20 minutes later, prefferebly from the opposite arm.
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