level1_traumaRN

I just want those of you to know that it's reported :)

Trust me, I know how to appropriately ask medical questions to patients :) and it's not in front of a room full of people :)

Thank you everyone! I know now everything is going to be fine. You know..as nurses..we work in a risky environment But our patients count on us and we are there because God put us there ya know. I think with my pregnancy I'm clumbsy with my fingers, hands so I have to focus more on that! Anyway, thanks for all concerns :) It's always scary when something like this happens. I, fortunately, although unfortunate to have a needlestick, was stuck by a very sweet lady who bless her soul has so many medical problems...but has been a regular patient at our hospital for many years and is followed closely for her medical problems. I told my mom I should be praying for her and her problems than thinking about myself ) Thanks everyone! I'll be tested just to ease my mind but now I know all is well and I am protected more than I know by our great Heavenly Father above :) He's watching over me and my baby :)

So...I'm driving myself crazy :*) 1 Week ago tomorrow I walked into my patient room and started a 20 gauge PIV, somehow I managed to stick myself (superficial) in the high side/ at the main tip of my index finger. I immediately bled it, clensed with alcohol, soap, and water. I asked my patient if she had ever been exposed/diagnosed with HIV/Hepatitis C---she said "Well no but I have had Shingles"--I thought that was cute. Anyway, she is 57 years old--had church family in her room as well as her own family, kids, and grandchildren. Her history includes lymphoma , HTN, Osteoperosis, Degenerative Disc Disease. She possibly was in the ER for a pulmonary embolism and she has kidney stones. She has been a patient at our hospital for a long time, she visits her doctor regularly and always has a CBC/BMP drawn for her lymphoma. She has been seen three times this year at our hospital and comes back in a week for kidney stone surgery. She has also had a hip replacement. So...I am 5 months pregnant. I asked other nurses they didn't think it was anything to worry about. I should have reported it but guess I felt crazy b/c it was a stupid mistake. I realize the only stupid thing was not reporting it. I know God watches over me while I'm at work and he is protecting me. But...I am an advid worrier aboout everything!!! What do you all think? Do you think I'm in the clear that everything is okay? I just need to hear from people I don't know rather than people I do know b/c of course everyone I have told at work were all like "it's fine, there is nothing to worry about!" But...I am driving myself crazy!

With ABG's you don't apply a tourniquet. When applying a tourniquet you are occluding that vein, it's the total opposite for an ABG :-) You should be able to palpate the radial or brachial artery and go on in :-) Our Protocol for a STEMI is 2 large bore IV's, Nitro gtt, Heparin gtt, we have been automatically giving 600 of Plavix--they are currently reviewing this. We must get them to the cath lab in under 50 mintues from the onset of symptoms if possible. Our ABG's and lacate is all that goes on ice.

question...does this include private student loans..because that's what i need to consolidate.

Hey everyone! I'll first tell you a little about my situation! I have 50K in student loans (private) loans:madface:. I can't afford my payment hardly we just bought a new house and my interest rate on the loans is 10%! It keeps going up. I am making my payment of 560.00/month on interest only! My hospital does not offer any kind of payback program. I just really didn't know what else to do besides to ask you all if you know of ANYTHING that can help me. I literally work 5 12 hour shifts per week and one more 8 hour shift per week. I am overworked, I am going to school full time as well to get my bachelors degree and other classes for my masters degree. Please help...I'M STUCK!!!

In my ER we have 42 beds, it's a level 1 trauma center and there are only 2 in the state. Our problem is that the hospital is always full and it has 450-500 beds. However, we work as hard as we can, whenever there is a bed ready we will call up to the floor (we don't care if it's 6:52pm), we have took care of them ALLLLL day or ALLLL night (or they have been in the ED for 1-2days and finally have a bed ready). The floor nurses are always getting angry at us but they don't understand that this patient needs to get upstairs because there is always someone else waiting to be put on their stretcher.

Thanks. I'm not trying to use the excuse "we see so much crap everyday". I am nice to all my patients, some people are like "why are you so nice???" haha but you know I treat everyone the same. I never want to get out of ER nursing...it just seems like that is everyone's excuse you know "we see the same thing everyday" and it's the truth but I guess it's not a great excuse.

Hey...guess what I graduated in May...started at a level 1 trauma center june 12th with NO prior experience!! I feel I had a great orientation/preceptor...I have been on my own since November and I feel like I've done good. I couldn't imagine ANYTHING else...floor nursing isn't for me...it's all about the Adrenaline rush for me and ER nursing :-) it's a work of art...go for it!! Never second guess yourself, I'm glad I didn't!!

I work at my level 1 trauma center and I am a happy/friendly person, or so I've been told. However I feel the ER has turned me into a not so nice person. I can't hardly explain it to you but everyone I work with is that way. I must say I love most everyone I work with but where we are so busy, and SOO much is expected of us as well as people constantly asking "when will i get a room" or "what is goin on with me" or "when will i get out of this hallway" things like this over and over every day just get to you. Then you have the traumas that come in like pediatrics, that can ruin your whole day or week for that matter. It just depends about what is goin on around you :-) i love being an emergency nurse though and i wouldn't change this experience for the world :-)

I work at a level 1 trauma center and all of the following are required: BLS ACLS PALS/ENPC TNCC I do think TNCC and ACLS are totally different classes and both are great to have. ACLS focuses on the life threating part of (codes for example) while TNCC focuses more on what to do in a trauma :-)

I am planning on attending the University of Kentucky to become a NP. My question is this: where can a Acute Care NP work, I understand in the hospital...but outside of hospitals? Which types of clinics? doc's offices? can you work in? Which is more valuable to get an Acute Care NP degree or FNP and go from there? what is the difference?

I am really into a dilemma with my own life. I can't decide what I want to do? I am working in a level 1 ER which is very stressful, I am applying to NP program within the next year. I have always had dreams of being an Acute Care NP in a BIG ER. Now I have doubts! I don't know....I am planning to move back home in Eastern, KY after my husband finishes Medical School. There are no trauma centers in Eastern, KY...therefore I don't believe there would be a job for a ACNP. I am interested in Family Practice as well...I don't know. Please give me advice on the benefits of both specialties as well as what you enjoy with being a NP?

Guys I just need someone to talk to. I don't know what I would do if I didn't have the hope and encouragment from reading all the treads here. I get off orientation in 1 week after jumping into the "joy" of ER Nursing right after I graduated in May. I love my job, I just feel SO overwhelmed! There is SO much to learn, it's like I can't think quick enough. Some nurses are able to pick up on things I hadn't even began to think about. I wonder when I'll be like that or when I can impress someone with my smarts? I feel horrible, I had been severely depressed but this past week I moved to night shift since it's what I'll be working and I LOVE IT. Yea it's busy but it's much more laid back. I really like night shift and didn't think I would. Point is, I know that I'll have people to ask questions if I need it, but I'm torn up not feeling competent enough!~

If you come in for "Chest Pain 10/10" please do not tell me you are going to go smoke, i will only tell you no...and then if i see you go outside I am telling the doctor, and he can send you home! Please dont keep asking me over and over if you are going to be getting a private room like "you requested" after you leave the ER... you and everyone else has requested the same thing..so unless you have some infectious disease, alot of money, or transplant...you aren't getting one! If your child has been really sick and in pain, I give pain meds...they finally fall asleep after screaming for 2 hours...please do not wait till they start snoring and wake them up again...it only makes everything worse. If I give you an IV, you go outside and "shoot up"...i can tell if you did when you come back in...by looking right into your vein! we will send you home! (yes this really happened) If you threaten me at all, your butt is going to the house! If you ask me over and over again when you are going upstairs to get a room...i am only going to tell you the same thing. You and 23 other boarders are waiting for1, but I PROMISE as soon as you get 1 after me you'll be the first one to know!!! Please don't tell me you've never done METH or drank alcohol...and when you are telling me this i smell ETOH and you have hamburger meat for what is supposed to be the inside of your nose!

1. If you come to the ER, think your waiting too long...go back home and call the ambulance to bring you in, we WILL make you wait in the waiting room with everyone else and put your name on the bottom of the list. 2. If you are in pain and refuse to take anything PO because "it don't work fast enough", don't think that the doctor will even give you something IV. 3. If you look at me and pull me aside to say "hey he was seen first", don't expect me to be extremely nice to you at all or give you and explanation of why another patient was seen first. 4. If you are out in the waiting area and continue to come to the window at triage and ask "when is it my turn" i'm going to keep telling you the same thing I told you 10 questions ago.

In the ER I have noticed that we have many patients that constantly want pain medicine and refuse to take the PO kind because it "dont work as fast". I am not talking about the patients who are really ill, but the ones who come to the ER and just want "pain meds". I find myself torn because I see the Hospice patients that hardly ask for anything as well as the elderly. I don't understand it. How doyou all feel about this and how can you treat the patient without being "aggravated" in your mind?

Yes Suzanne I know it is illegal-- I was asking for examples, not the test questions. I didn't know if it was like TNCC questions or PALS...anyway I just need guidance!

I had the ENPC course today, the test will be next week. For those of you who have had ENPC, is the test like TNCC or totally different?

In the ER I have noticed that we have many patients that constantly want pain medicine and refuse to take the PO kind because it "dont work as fast". I am not talking about the patients who are really ill, but the ones who come to the ER and just want "pain meds". I find myself torn because I see the Hospice patients that hardly ask for anything as well as the elderly. I don't understand it. How doyou all feel about this and how can you treat the patient without being "aggravated" in your mind?

I do have a preceptor, she is a great teacher. I am still in my orientation, which has been 4 months thus far and I have 3 weeks to go. I am just so scared! Some nurses have told me it takes them a while to feel comfortable...I just hate that I can't get it right off the bat you know. I am scared I am going to hurt someone or something...I don't know I'm just so stressed. I do need to step back, take a deep breath, and look at this situation... I appreciate you guys.

So here I am at this Level 1 Trauma Center...and yes...it's overwhelming. I wonder if I am supposed to think as critically as other nurses do? I feel dumb at times....I can tell you all about how to take care of CP's, abd blunt trauma, car wrecks, trauma victims...but if someone comes in breathing fast, but has no apparent respiratory problems...how can I tell straight off w/out labs that this patient could possibly be acidotic? I seriously wonder how I can put everything into prospective...I can't dx things right off and I feel that is what I am supposed to be doing. I don't know if I am thinking as critical as I should. How long is it taking you all to get the hang of everything, not feel overwhelmed, and to put everything n2 prospective? I just feel like crying because I feel like I don't know enough! I don't want to end up killing someone...HELP!

Don't forget about sticking people with needles like a million times a day, constantly monitoring the ICP, CVP, PWP...oh and did I forget to leave out the overdose patients, trauma victims who need ALL your attention...hmm the list could go on....yea and we don't do nothing..haha that's a joke! I feel like I work as hard as I can and still it is not enough!

Wow...you shouldn't even be posting on this site!!! You were once a nursing student or a "nurse wanna be" as you say!!! I can't believe you would even start a thread like this. I was a NURSE WANNA BE just 6 months ago, now I am one! Wow...people these days.