guy_nurse

So true...."Shelia, has your patient been in V-tach all night?" LOL If the patient is a altz or dem pt, see if the attending doc will give restraint orders, trendelenburg with head up (to keep them from scooting off the end of the bed), maybe some strategic use of carefully placed bed sheets---I'm just saying.

Do you find yourself having a hard time remembering what the date or time is when you are charting? Do you find yourself asking the attending doc which doc you were taking admission orders on the phone from just NOW? Do you find yourself walking the wrong way to go to the bathroom? Do you get mind boggled trying to find CT because someone convinced you to take "the other elevator"? Welcome to the ED, or just "new-nurse" growing pains. It will get better, I promise, just hang in there. If you were screwing up MAJOR your preceptor would let you know, they ALL have been there.

I went to the ER straight from graduation. I had no prior medical experience, one of the toughest "trial by fire" experiences I've ever had. You can do it, as said earlier just don't go in like you know it all. Every ER has its own "rhythm", you've got to dance to it until you get your feet wet. Good luck, ER nurses are...lets just say "unique" to the healthcare industry. No way I can see myself as a floor nurse.

The first thing I do is cut their clothes off, period, it just makes it easier. Drunk=large bore IV-at least 18g, rally pack, foley catheter (you've got to get a urine sample, right), some restraints (because they ARE going to try and remove the foley-trust me, don't ask), and ask the attending if you can have some drugs if they are still too roudy. OD=call to posion control, large bore IV, usually charcoal-I give the option to drink it, or we can put a tube down and get it in that way--oh yes we can! If they choose to not drink it-restraints, NG or gastric lavage (now that is fun-NOT), foley, and petition the doc for some drugs. May sound harsh, but I work with a nurse that PRNs at a military base and they say that it is not uncommon for docs to intubate drunk solders until they sober up.

Wow, sir it looks like your potassium is a little high--rectal tube and kayexalate infusion, please turn to your side! Fellow members that find this offending --well I don't know what to say. This thread had me feeling better about myself, it let me know that others in my field feel the same way sometimes--and I am NOT an insensitive, cold nurse for not being over concerned with grandma's terrible pain, brought to my attention by family at bedside while grandma snores!

When I get to that point in my life I'm gonna have "ATTN: I'm a DNR" tattooed on my chest.

I LOVE the original thread starter, that sums up most of my days. I have read several times that a complaint is pts having to pee; well here is my rule on that, if I am going to give you lasix, you are getting a foley-period. Chances are, you are too big to ambulate to the bathroom safely by yourself or too big to use a bedpan / urinal (can't see your winky to aim it--after the first time a "fluffy" fellow urinated all over the place--I said NEVER again). I need to monitor how much fluid I pull off anyway--I've got at least 3 other patients to worry about--let's just save some time and drop a foley. I had a floor nurse call me the other night (there is one floor that I take patients to that WILL call back 10 minutes after I deliver the patient EVERY time). This nurse informed me that the pt was c/o pain, and wanted to know what I had given them and at what time. I asked her "I don't remember, what does my nursing note say I did?" "Where is your nursing note, what does it look like, we don't have time to shuffle through those." So then I politely asked if she had EVER read an ER triage sheet--she said NO-we don't have time to. I replied that until you find the time to read MY note, I don't have time to talk to you--and I hung up--I guess she found the time to look at the triage sheet. I took another patient, I got a call about 45 minutes later--"that pt you just brought me had a FSBS of 50!" I said "Wow, well what did you do about it?" The nurse quipped "I gave her some OJ, and now it is 90". I commended her for her quick thinking and hung up. The pt was not admitted with anything blood sugar related--admitting md orders were fsbs at ac&hs, this was at like 3 in the morning that I took her up. We have this thing at our facility--home med list; we have to fill them out on each admit. I had a patient the other night that denied taking home medications, so I didn't see the need to fill one out as the admitting doc covered in his admission order what medications he wanted the patient to be taking. Well, I got a phone call from the floor saying that they needed me to fill out a home med list on this pt. I ran through the story with the nurse, and she told me that I still need too fill one out and write on it "PATIENT DENIES HOME MEDS"!

I had a pt just the other night that was admitted with afib with RVR-HR was in the 140s, BP was 100-110/60-75. I had done the 15 mg Lopressor IV thing, and now I was titrating a cardizem drip; he was asymptomatic, family at BS. All the family (and the pt) could complain of is he hasn't eaten today, no not a diabetic. After hearing this complaint 3 or 4 times in an hour, I finally said that "being hungry isin't gonna hurt him, but not slowing his heart down while at the same time not tanking his BP, just might." They left shortly after that, and the pt went to sleep, cardizem at 5mg/hr, hr 105, bp 105/65. Gotta LOVE the family!

Yep, I think you handled it very well--much nicer than I would have. Besides if your administration won't stand behind you in situations like this you've gotta ask yourself if you really want to be at this facility. It is not like we have to look for jobs anyway. I had an older white female pt one night accompanied by her middle aged daughter and her husband, this was just a few days after the presidential elections, she had fell and hurt her arm while fixing dinner. I came into the room after the doc had filled out his order sheet-of course there was an x-ray on there, CBC, SMA7, CT of head, cardiac enzymes, EKG, etc. I was explaining to the pt what we were gonna do and the husband cuts me off and says "why are ya'll doing all of that, hell we've been waiting for 5 hours, it is her arm that is hurt. I'm gonna call Obama about this-he'll fix all of our problems!" I politely told him that "we were going to do an x-ray and if the arm is broken we will surely treat it, but it is this hospitals policy to try and find out why she fell, did she lose consciousness, did she have a CVA, did she have an cardia event, or did she just simply fall? We could just treat her hurt arm, put a cute cast on it like a "doc in a box" would do and send her home to die in her sleep from the stroke or MI that she may have had, now sir would you allow me to continue doing my job?" He left the room, never to be seen again--his daughter appologized many times for his behavior.

Luminox-glows in the dark (self light powered). Adopted by the U.S. Navy seals (super tough), I never take mine off even when using power tools (not in the ER). Rotating bezel (helps keep track of drips, or shot times).

1. How many questions did you take on NCLEX? 75-I knew it was going to cut off at 75, I actually thought "put me out of my misery already". Little did I know that the misery was just starting as I have been refreshing the Georgia BON page all day! 2. What study materials did you use? Did you take a test review course? I studied everything that I could get my hands on-HESI, NCLEX 3500, saunders-all of them were of NO help at all. 3. Did your SON offer any testing (ERI, ATI, HESI)? HESI, we had to make 900 to graduate (it was our "exit exam")-made 950" 4. How long did you wait for results of the test, or are you still waiting? Took mine yesterday and I'm still waiting, about to loose my mind! 5. What were your thoughts coming out of the test (total disbelief, certainty you had failed, confident you had passed)? not too good, wondering where those med questions (meds that I've never even heard of) came from and all of those "check all that apply". 6. Was this your first attempt at NCLEX? yes

I did my practicum in the ED in a hospital, they showed intrest in me--so I will graduate on May 8 th and go to work there as a multi-care tech level 3, that is until I pass my boards. On a side note, a fellow student of mine was set against working in the ED, she was a tech on a med-surg floor and wanted to be there as a RN; well her preceptor had to go on medical leave before precepting started so the student was re-assigned to the ED. Now she has been bitten by the adrenalin bug and says that there is no way that she can go back to a med-surg floor.

It has been a few semesters since I applied (I am a seinor now), but I think that I had like 190 points. You can take the A&P at SUSCC and Auburn will accept the credit, I had several classmates that did just that. If you do take the A&P at SU get Grace Lewis as the instructor--many do not like her, but when you leave her class you know your A&P. You are doing the right thing by talking to an advisor, they should be able to put you on track. As a side note, I have had many clinical instructors scoup me up on clinical rotations over Troy, Auburn, LaGrange College, etc. they (the nurses) say that Southern Union students are more proficient in the clinical setting than most of the other students, they can do more procedures--dressing changes, blood glucose checks, suctioning, etc.

Good point - you do have to look at the benefits, if someone reports making $35/hr, the next question on my mind is: Do you have insurance, retirement, paid days off, are you full time etc. I guess when you get older, you start thinking about the benefits. My plan (I am a student) is to have a position at a hospital, and do some type of part time job at other facilities without the benefits for the extra money.

What is it that you do now? In my experience I have found that the accredited facility curriculums are set by the state and the accreditations board. You saying that you have excellent test skills and can test out of many core classes if only given the opportunity is EXACTLY why that opportunity is NOT given. If you truly want to do this, just go back and take the classes, if you know the material, good for you, you will have an advantage; you never know you just may be surprised to find that you don’t know everything. I am a male 36 year old steel fabricator, and I have lots to learn; I have classmates that have associate degrees, bachelor degrees, and some who have worked in the medical field as techs, LPNs, administrative, accounting, etc. and they have to devote more to this than anything they have ever done. It is not easy, and you are correct to assume that this is some sort of conspiracy—it really is; if you are not willing to put forth the effort—the school nor the health care facility—want you. Good luck!