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widi96

widi96

Emergency Dept
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widi96 has 10 years experience and specializes in Emergency Dept.

widi96's Latest Activity

  1. widi96

    CEN EXAM - HELP!

    I second Solheim's class if you have the opportunity. He has high pass rates for those who attend. I took his course for my TCRN along with two others from our facility and all three passed. For my CEN I used the ENA's CEN Review. It offers videos to watch which I didn't find overly helpful but it did have printouts on each category that I studied and was able to make note cards from and was successful with that. I liked the printouts much better than the videos. It all depends on what your learning style is. Good Luck on your test!
  2. widi96

    Esophageal Intubation

    Good Morning! I am working on an educational presentation regarding medical errors and am looking for real life situations in which they occurred. Specifically looking for esophageal intubations and the aftermath - Does anyone know of any articles or names I can search for this information (looking for websites, articles, etc)? I have found a couple of outside the hospital examples (Drew Hughes and Megan Gilbreath) but was hoping to find some inside the hospital examples also. Any information you can provide would be appreciated. THANKS
  3. Hi All! I don't know if anyone is interested but the Kansas Emergency Nurses Association is sponsoring a TCRN Review class on Nov 11 and 12 at Stormont Vail in Topeka, KS. It will be taught by Jeff Solheim (President of Solheim Enterprises and the past president of National ENA). Class is $150 for ENA members, $250 for non-members. Everyone who has taken his courses seem to love them and say they are very valuable. Registration is available on Eventbrite (search TCRN); or if you prefer to print and mail in registration the form is available on the website at https://connect.ena.org/ks/home - you just have to click on the 'upcoming events' to find the actual registration form.
  4. widi96

    Pain Management in Long Bone Fractures

    We currently only have one protocol that includes pain medication and that is flank pain for possible kidney stone and we can give IV Toradol after a negative preg test. I don't believe it is our physicians that are causing this problem - this is much more of a ED size issue. We've added more rooms and still have 4+ hour wait times frequently for our level 3s. We're trying to get things started in triage prior to seeing a physician. The pt who complains about a twisted ankle that is doing ok may have to wait awhile then find out they have a non-displaced fracture vs the patient with obvious deformity who would go right back. We're trying to improve the situation until they can get to see the provider.
  5. For those who have protocols for pain medication in (actual and potential) long bone fractures - what do they look like? What medications are you using? What contraindications are listed in the protocol for administering the medication? We are looking to add pain medication to our protocol and want to see what others are doing. Wanting to see if there are better options or something we aren't thinking of.
  6. widi96

    Did I do the right thing?

    You did the exact right thing. The patient had a complaint that was concerning - you did what you could in your facility with no improvement and notified the physician who made the decision to send them to the ED. I'm an ED nurse and can tell you that about 95% of the time we can't find a cause for a patient's chest pain - it happens all the time. But I'd rather work up all of those patients than miss it when they are having an acute cardiac event. The only thing that you might've been able to try (if the physician was agreeable) would be if they would order something for anxiety and see if that improved her pain/HR. But again, your actions were appropriate.
  7. widi96

    Decreasing Falls in the ED

    Hello all. I am wondering if anyone has had success in decreasing falls within the ED, and if so, how did you go about doing it? Is is a difference in the fall score, equipment, etc? Our Practice Council will be working on attempting to decrease falls within the ED and unfortunately there is not an overabundance of research specific to the ED - and what works on the floor does not necessarily work in the ED. Would greatly appreciate anyones input.
  8. widi96

    ENA2015 in Orlando

    For anyone who has been to the conference before - do you know what the 'general assembly' is? Not sure what to expect from this portion.
  9. widi96

    Practice Council

    Hi all, I am just wondering if anyone on here is involved in their ED Practice Council. I have been in the ED for a year now and our PC has been pretty much non-existent since I started. We do have additional committees of Emergency Preparedness, Trauma and Triage. I am just wondering what are some of the goals and projects other practice councils have taken on. Thinking of attempting to revitalize the committee, but need a direction to go in. Any ideas would be great. (This is for a Level 1 Trauma Center at an Academic Institution)
  10. widi96

    Counsel me Nurses!!!

    Everything I think of would require additional education - but have you thought about becoming a nurse educator? If you don't want to go the route of teaching nursing students - do you have large hospitals in your area? The hospital I work at has an education department, plus every unit has their own educator. You could keep up with critical care without the stress of the 1:1 interaction.
  11. widi96

    In a dilemma and need advice

    Here are my thoughts - when I was looking for a new job but nervous to give up my comfort zone I applied for a PRN job at another hospital. Didn't have to give up my seniority or anything at the previous job and instead of picking up OT there, worked extra at the PRN job. Lasted 6 months before I quit the previous job and went full time at the PRN job. Doing the PRN thing let me know if I was going to like it there without having to risk my comfort at the old job.
  12. widi96

    ENA2015 in Orlando

    I will be there. Unfortunately, so far I have been very disappointed with their organization and communication. There were very few details published when they wanted my money for the conference - the interactive part being the main thing - then adding the dinner at Epcot. Now, after I paid for the conference in January, we find out that none of what is already organized and advertised is included in what I have paid for. While I will be there this year, I doubt I will ever go again.
  13. widi96

    ER Wishlist Items!

    Our iStats are wonderful - we have 6 and need more. Use them all the time. We recently also got a machine similar to the iStat that will do POC INR.
  14. widi96

    ESI Triage Question

    I do have the book and have actually already read it from cover to cover. Since the blood sugar was an example our educator had given in class in regards to someone who had walked in the front door - then experiencing the patient via EMS who had already been treated - wasn't something I had previously thought about - EMS treatment changing the triage level.
  15. widi96

    ESI Triage Question

    Hi all. I am working on our ED's testing and training for performing the role as a triage nurse. Since I am in the process of the education/testing, it has made me think a little more about some of the patients I see and triage. (Completing the triage testing, etc means we can work IN triage for those who walk in the front door - all ED nurses help check in ambulances and therefor triage those patients.) My question is . . . our educator is emphasizing that anything that requires immediate intervention is ESI 1 - which would include things like mental status changes secondary to low blood sugar. The immediate intervention being the administration of D50. So my question is . . . if this is a patient who was transported by EMS and they treated the hypoglycemia per their protocols - is the patient triaged based on report from EMS or the patient's presentation upon arrival to the ED? Had the patient been brought in the front door and ED staff were the first to see them - it would be a 1, however if the patient's glucose was improved and they were more with it upon arrival to the ED - is it based on what we first see? Despite already receiving the intervention?
  16. widi96

    Stethoscope Bling?

    I have charms on my stethoscope - I do like the cutesy stuff and it helps me differentiate my stethoscope from others. Mine is actually a floating charm bracelet that I tied around the intersection of the tubing. I have not once had a problem with hearing excess noise from the charms. And I have never had another nurse, administrator or patient say a negative thing about them - however, several patients have commented on liking it and several asked where I got it. Bottom line - if you like it and your nursing school will allow it - go for it. And if the nursing school won't - hold onto them - nursing schools seem to be much stricter than many places of employment.
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