robinzkj

Our door to EKG times are not good. They should be 10 mintues or less. I have to do a PI project to help us decrease our times. Right now when a patient arrives to the ED, they stop at registration to give name, dob and complaint. If they state chest pain, the registration person calls the charge nurse (who has a full assignment) and the person is brought straight back and EKG and triage is done at bedside. If no open rooms, the EKG is done in one of the triage rooms. However, we run into situations where registration is not telling us the complaint, the triage nurse may have the patient in the triage room when the patient adds on a complaint of chest pain to their original complaint and now we are past the 10 minutes, and other issues. What is your process to get EKGs done quickly? The only thing I can come up with is doing EKGs in triage and not having the patient stop at registration first. Any ideas would be appreciated.

I am taking it also. It starts Sunday. I don't think it looks too bad. Robin

I love my Alegria shoes! They are very comfortable and stylish. I wear them in the ED for 12 hr shifts and my feet and legs never hurt.

Yes, that is the first thing I did. I went to his website and all they have for sell are the books I purchased.

I went to a one day CEN review class by Jeff Solheim (wish they had the 2nd day but they didn't) and I purchased the set of 6 pocket guide books. I am looking for the CDs or a pod cast with him for the material we missed out on. Does anyone know where I can purchase them? Thanks! Robinzkj- ED RN

You have the right answer on both questions. On the 2nd one, I rounded the weight to 42kg and got 6.3 ml for my answer. When it comes to peds it is always a great idea to have someone double check you math. when in doubt ask... If something just doesn't seem right.. ask... good luck! Robin

Alegria shoes. I got the Alegria Seville about a month ago. I work 4- 12 hr shifts in the ED and my feet feel great. They are very comfy and stylish too.

I am an ER nurse and we once had a patient complain that "the nurses all ignored me, they were ALL in with the patient across the hall". Well, said patient was here for a non emergent complaint and the patient across the hall was a full arrest. So, you bet we were ignoring her because we were all in with the code! (all meaning the 3 nurses and 1 doctor that we have on night shift in the ED) Some people are just too ignorant.

Wow,that's a lot of stuff! I carry 2 pens, trauma scissors, my phone. Maybe a dollar for a diet coke at 1 am. Can't imagine carrying anything more. Cant do CPR with a pocket full of stuff. Everything else I need is in the room, tape,gloves etc.

1) How many RNs do you dedicate to the practice of triage? All ER nurses take turns in triage, must be an ER nurse for 6 mos before they can be in triage 2) Who is the FIRST PERSON that interacts with and takes the complaint of your patients when they come through the waiting room doors? Is it a licensed nurse or patient care assistant/registrar? We always have an RN in triage, the triage window is the first place the pts stop and give their chief complaint. Pts get "quick registered" name, bday, by the ER nurse and triaged according to acuity 3) If your answer to #2 was pt care assistant/registrar, are they supervised 100% of the time by licensed staff? 4) What is your yearly volume? 18000-20000. we are a small community hospital w a 20 bed ED. 1 doc, 4 nurses on nights, 5-6 on days with a medic I dont want to say where because I am at work right now :)

don't be afraid to ask lots of questions, volunteer to do things without being asked, see and do anything you haven't seen or done before because this may be your only chance. Do compressions on a code, start IV's, hang drips....

In our ED we are able to do POC troponin, influenza swabs, rapid streps, ua dips and urine HCG. All are kept in individual logs with pt info, result, lot # and exp date of test and RN initials date and time. We then put the results in the computer with our computerized charting. Troponins have to get faxed to the lab and they place the result in with the labwork for the DR to see.

"I'm sorry ER, but our ICU is often just an extension of your situation. Unstable patients with another one rolling through the doors. (And sometimes two at a time.)" My ER doesn't send unstable patients. However, we do get many unstable patients at one time, via triage and by squad. 1 RN who also 4 or 5 other patients. We don't have the luxury of asking EMS to hold a patient because we are too busy or at lunch. I don't even get lunch in a 12 hr shift. WE find an open room and we take the patient. It's very sad that some of our ER pts wait 6-7 hrs in the ER and most being bed wait times to the floor.

NFL team pens, earrings, socks, stethescope cover, covered cup,---

Where I work you must have 6 mos ER experience before you can go to triage. No rules here for charge but I've been in charge and have 18 mos nursing experience, 9 of which in ED.