Sassy5d

Cleveland clinic

Im sure there's a link on google somewhere for the official triage system of number ranking. Many times that makes people's triage esi number higher, as in the cheeto eating c/o 10/10 pain would be a 2.. Technically, i would make hypoglycemia that needed d50 a 2.. High risk situation?? How long is d50 going to keep them alert?

We have a gastric lavage kit. Use liter bags of ns. Instill ns, the bottom bag is clamped. Unclamp and repeat until about 3-4 liters were used. I hate it. There are some older providers that still think its best practice.

You need a nursing base to work in metro ER and a BSN.

Sure, refuse. Then find another job. Your job does not depend on these tests. The test see's where your understanding is and then shows you where you need improvement. It's to HELP you. There is no 'out of your scope'. Sheesh

We have a 10 minute policy. 10 minutes from bed assignment to report. The ER doesn't close. We don't get to turn away patients. We can't tell EMS that the bed is dirty and they have to wait. We can't say we're hungry or we need to pee so the pt needs to wait. There is no waiting, the patients keep coming. If it's 1 minute to shift change, guess what, I have to deal with the patient. Patients keep getting admitted. I have a near brick wall when I try to call report. Stalling and more stalling. I get it, I'm the bad guy because I know you're stressed to the max and here I am giving you more to do.. It's not me, it's the nature of the beast. These patients need to get out of my ER.

Besides the fact that many times, there is a critical patient being worked on while a non-critical patient is waiting to be dispo'd, the biggest barrier I find to admit to removal from ER is the floor. If I had a shot of vodka for every time I was lectured about door to floor time (we're not dumb, we know what it truly boils down to), I'd be intoxicated every shift I work. The bed is dirty, although I think it's funny that I can wipe an entire ER room down with sani/bleach wipes in 5 minutes.. The nurse has not been assigned, the nurse is on lunch. The nurse is off the floor, the nurse is in report, the nurse is busy with a patient (again, I know floor nurses are busy), This patient is not appropriate for the floor and we are calling the supervisor, ect. What have we done about it? There's really nothing to be done about it. This is just how it goes. We've gone up the ladder and nothing changes. I guess when reimbursement plummets, maybe we'll see a change

It's amazing, isn't it? I would imagine it's whatever your hospital policy is. To be honest, I'm not exactly sure what my policy is. But I feel your vent. Many times, I pop my head in the room and say ok, here's a phone, we're working on getting you discharged. It is very rare that I find a patient who is completely unable to find a ride home but I don't put up a fight with my elders.

Always dilute. But unless they are in heart failure, I always have IV fluids running.

Your child was prescribed glucagon and instructions provided by their doctor. It would be out of your scope to give glucagon to another person. I know this sounds silly, but way down deep in the legality of it, if you give medications without md order, you are acting as a physician and if you dispense, you're acting as a pharmacist.

That's a tough one. You would essentially be giving someone a prescribed medication at the wrong dose, to someone without a prescription. (Out of your scope) You can't advise a lay person to give a prescription med to another person without a prescription. (Out of your scope) Ems has been notified and are en route? I wouldn't give the Epi.

This circular argument is really dreadful. If you can't make your point without using negatives words, your argument is invalid. Screaming that people don't vaccinate out of fear and then following your sentence with fear of unvaccinated children. Why are fully vaccinated humans contracting 'preventable' diseases? Preach your protection and science, when science shows you that vaccines decrease the likelihood of infection or severity of symptoms. Science does not show you that you are 100% immune to diseases or that you are fully protected. Children that are not immunized are just dirty, filthy, disease infested monsters? Vaccines are great. Vaccines work. Why are so many people scared of non-vaxed people?

Sometimes I just want to ask patients soooo bad how they would handle someone coming into their job and acting the way they act and how it makes them feel. Then I remember that most of them are unemployed.

There's always time to go back to school and become a doc or PA so you don't get any more ice scrapers!

Yes we stay in for 12 hours. My Place does not tend to utilize triage protocol orders like labs. Sometimes I order streps and urines

Just venting. How the universe can be thrown out of tilt simply by the staff member you are taking over for... And it takes you sometimes hours to dig yourself out of the trenches..

I hope I never have to be placed in that position again. But I looked it up, intoxication is not an exclusion or reason not to give TPA.. I was uncomfy.

How about TPA for a person with Alcohol level over 400? That was my oddest. I wouldn't have thought acute stroke

Tonight it was we were the best hosp ever cuz we didnt have 6 hour wait times.. ?

^^^^this!!!!!

Lactic doesn't always indicate infection. First draw is your baseline. 2nd draw indicates if your interventions are helping. If you wait to draw lactic, and say it's 4. That info is more helpful if it's higher or lower than your first draw. No idea why it's iced. Along with ammonia.

Any time/any part of nursing, if you drop staffing.. They are going to freak. Safety concerns much? Sheesh, I bet those dumb nurses really complain when you lecture on core measures and patient satisfaction.. Oh, btw, that doesn't do much for your job security when your department tanks on all levels.. Treat your staff poorly, they perform poorly. Who gets fired?

I'll take all the fluffy cc.. Just eliminate the dramatic pts who come to the window and act like they are dying so I get them back quick. I have yet to master the 'art' of really sick vs dramatic

Isn't it ironic though, that it seems to work this way... Pt x comes in with vague complaints. They don't get a work up. Give em some po meds and watch em. They feel better and go home. 3 days later, they return, get a full work up and bam, they are being transferred for a sub dural bleed.

Every cyclic vomiter i've ever taken care of smoked large quantities of weed. I've yet to take care of one who wasn't demanding of pain meds. It is what it is and working in ER keeps me humble. Thank goodness I'm not the one on the gurney