hlgarrett77

At my facility we give Tylenol for fever, aspirin for chest pain, and Albuterol nebs for asthma at triage. If someone is vomiting and I have a subtriage bed (as well as a few extra minutes) to start an IV and give Zofran I will. I simply do not have the time or space to medicate someone with narcotics or even Phenergan, I can't monitor them for adverse reactions or safety checks while I am running around triaging other patients, starting stroke protocols, and cleaning rooms. I know that patients come in for severe pain, but triage is a place to assign acuity. We also start care protocols (i.e. labs, EKG's, and Xrays). I have been in severe pain myself and I know that it is awful, but my license is important to me and so is patient safety and I will NOT jeopardize that. On a side note, we obtain an order from a provider to medicate patients once they are in a room and under the care of a primary nurse, so at least patients aren't waiting for the provider to see them and a nurse can monitor them. The idea of giving someone IM morphine or Percocet and then basically setting them free to leave or have a reaction in the waiting room sounds crazy to me.

NICHE- Nurses Improving Care for Health system Elders http://www.nicheprogram.org/ GENE- Geriatric Emergency Nursing Education http://www.ena.org/coursesandeducation/education/GENE/Pages/GENELanding.aspx

A lion's share of our patient's are 65 or older, especially those that get admitted. NICHE is gaining speed on other units and the ENA has launched GENE. My ED is trying to get the ball rolling on improving care for this population and I would love to know what other EDs do or wish they did.

I work in a Level II emergency center that has a fairly brisk pace, but isn't insane all the time. I am trying to institute a more team oriented atmosphere with our nurses and techs. Many simply come in, do their job, and collect a paycheck. I really think that if we could make teamwork a central part of our practice we could make our department safer, improve patient outcomes, increase patient and staff satisfaction, and reduce staff turnover. The problem I'm facing is changing the way most of the staff work together and they are RESISTANT! Any ideas for me?

I am in my first year in a SICU. The thing I noticed the most is the old saying that older nurses "eat their young". I think it's especially true in critical care. No matter how much I know and how many inane little questions I answer correctly, I still get hounded and treated like a baby. Just reading this board makes me realize that nursing could be in a much worse position soon if current nurses don't make a huge effort to treat new and existing nurses with respect and compassion. I guess what we new nurses can offer is the vow to give nursing a real try and not give up without a fight, after all four years was a long time to go to school for something. We also need to remember what we are going through and not put anyone else through the same thing. We may not be able to make the providers treat us well, but we sure can do something about ourselves and fellow RNs. Whew! I think I'll just step off of my soapbox now.