TinyRNgrl

My test came back negative. And yes, our hospital does do random drug screens. Quite frequently. Thanks to everyone for the support. And to those I apparently irritated by posting a post that was posted "a gazillion times" forgive my Lord for I have sinned. I did do a search. But mostly the results I got were, "I smoke THC, should I get a second chance" or "I took my mom's cousin's brother's dog's percocet. Am I screwed". I did not come across anything where it was a rx from a year or so ago. I am a good nurse. I will continue to be a good nurse. And I will probably never post again for fear of being scorned because a previous post exists. Sheesh.

I am scared! I have NEVER in my life been in this kind of situation. Was called for a random drug screen this AM. I had one before years ago and of course, came back negative. I don't take anything on a daily basis that would ever cause a positive. I have legit prescription for percocet (rarely take) for a torn meniscus. I seldon resort to narcs because ibuprofen generally handles the pain without the yucky side effects of narcs. My issue is that about a day ago I took a vicodin. I again, have a legit rx from my doctor. My only problem is that it is from a year and a half ago! I took the vicodin on my day off (would never take at work, Nor could I FUNCTION on it at work) and later ended up taking a percocet. Both rx are from a year ago, almost two years ago. Not a doubt my results are going to come back positive for not only the hydrocodone, but also the oxycodone. I am totally petrified. I rarely take narcotics. The fact that I have two full bottles of narcs from almost two years ago prooves that I seldom take it. I am concerned of what is going to happen. They did not ask me to list any medications I was taking. I am sure that someone will call me when the results are back but am I screwed because these are old rx? Please don't judge me. I already feel horrible and I didn't do anything wrong. Other than take medications I legally had that probably should of been tossed since they were almost two years old. I am terrified I am going to lose my job or worse yet, be turned into the BON.

It can be done. Not easy, but I worked a full time AND a part time job while going through nursing school. My full time job was EMS so luckily I had some down time between calls to study and do homework. I would mainly work 40 straight hours from Friday -Sunday. Then school during the week and my part time Nurse externship position. I lived on coffee and barely slept. It is not healthy by any means but I made it and graduated top of my class and passed NCLEX on my first try. Best of luck to ya.

I am sure you are doing just fine. You have only been there a couple weeks. As long as you are prioritizing and making sure the critical tasks are getting done first, then rest assured the toothache pt can wait a few minutes for their meds. I totally get what you are saying about the tech who is anticipating what is going to be needed and on the ball. A tech can make or break ya sometimes. And I always make sure I help them when I can and never abuse them or over delegate. I do as much as I can. The techs I work with know if I am delegating that I just don't have time. Give yourself some time. ER is a tough place to be but is a very rewarding place. And you will feel more comfortable with your pace through time. It took me a good 6 months before I even started to feel confident in myself. As far as your codes go. Again, I think through time you will feel not so "froze". Study up on your ACLS drugs. Review your algorhythms. But again, just like in ACLS, it is different when your in action. If time permits, sit down with a coworker afterwards and review stuff. Understanding WHY we are doing and pushing the things we did helps to put it all together and understand it better. Maybe your boss or preceptor can help answer the things your not sure about. A lot of our docs love to teach and never mind explaining things. Last night we had a trauma arrest come in. We ended up getting spontaneous pulses back and coded this pt for 45 minutes. Came in PEA. 1 EPI, got pulses back for about 13 minutes, went into v-fib, shocked x2, NSR with peak T waves, pushed calcium, pt went into Torsades and was in torsades for several minutes, pushed magnesium. Pt ended up going back into PEA eventually and we had exhauseted pretty much everything and called it. Total this pt had been given, Epi x2, atropine x2, amp of bicarb, calcium, magnesium, amiodarone, had a dopamine drip running, 1 unit of PRBC all while a chest tube was being placed and also establishing an IO in the proximal humerus because the lower extremities were completly mangled. Codes are very hectic......but you will get more comfortable and not so "deer in the headlight" with experience. Give yourself time. And enjoy being an ER nurse. We are a rare breed.

I agree with brainkandy, I have the same problems of periods of low BS even though I am non diabetic. I too keep glucose tablets in my work bag. (super cheap at wal-mart, like 98 cents for a little roll of them) Keep snacky foods that can be "eaten on the run". Trail mix, peanuts, apple slices, ......you get the point. I also keep a jar of peanut butter in my locker when I really need something for in my gut to eat with graham crackers. ER is crazy at times. But even in the craziest of nights I always find time to run into the breakroom for a few minutes and "snack". Otherwise, I would be useless as a nurse in a bed myself getting a amp of d50 through my IV.

ooops. Yea. I am a ER nurse. Thanks for clarifying.

On a positive note....My little niece Emma was born at 24 weeks gestation weighing right around a pound. She is now 9 months old and still thriving...and growing. She was delivered already at a hospital with a level 1 NICU. Thank God. They were ready for her when she came out. Spent the next 4 months there. She was flown a couple times to another big medical center to have heart surgery to close her little valve. She did develop NEC. But recovered with no complications. Thank God she never developed an intracranial bleed or any brain issues. They repeatedly checked her after birth to watch for it. After she came home she was not doing so well. She was having swallowing difficulties and put in a little feeding tube. She has been home since Christmas and is doing great. Has a nurse come in every day to help with everything. She thrived from birth and really fought to stay in this world. Prayers to your friend's little one.

Esme and the others said it all. You were where you were meant to be that day. I would be honored to have you as my nurse. :hug:Hugs to you.

Hey GitanoRN..................and it is in full swing in our ER this Full Moon weekend. Ugh. I think the full moon is tomorrow but we been getting it all weekend. Some people NEVER cease to amaze me with their antics. I used to tell myself these pt's are job security. But unfortunatly, these jack @sses cost nurses their jobs. Sad.

I never reveal I am a nurse. I think it is funny when I get a pt in the ER and I am explaining what I am going to do..(I am going to start an iv and draw some blood) right away I get, "I know, I am a nurse". wow. Good for you. When I ask, "Oh, are you a RN"? I often get, "No, I am a CNA". I could care less if you are a nurse, the pope, a police officer or, Hell, Miss Florence herself. I will treat you with the same respect as all my other pt's. Funny one.......the other day I had a little ole guy. Was staying in the ER until we drew a repeat troponin and then release if troponin negative. Anyhow, visitor was a "nurse". "Nurse" came to the nurse's station to ask if the little ole guy could have a cup of coffee or would that elevate and alter the blood test. I explained we were going to draw a troponin and that is a cardiac enzyme and ............she cuts me off right away with "I know. I am a nurse". It wasn't that fact that she was a "nurse". It was the attitude and demeanor in which she said it and presented herself. I asked if she was a RN. And her reply was "no, I am a LPN student". So my smart ass reply was, "well, when you are a nurse, you will know a cup of coffee will not increase his troponin level". Gave her a polite smile and handed her a cup of coffee.

It is hard not to take things pt's say personal....but you really can't take it personal. I am sorry he said that to you. Hugs to you.... :hug:

"It drives me crazy the EMTs would have the same attitude when we called 911 for a full code. WE DON'T GET TO DECIDE!!!! It makes us CRAZY to call you so please don't look at us like we're stupid. We don't have any control in what the family decides to do. Yes, I said this once to an EMT who started basically throwing a temper tantrum about how 'stupid' nursing home nurses were for calling them." For the first pt I was talking about, it wasn't the family's decision to send her to the ER. They were quit upset that she was sent to us. In this instance, and I know because I talked to the nurse who sent her out, it was HER decision. The nurse. I am not going to get into a Pi$$ing match over the rights and wrongs of sending out LTC pt's and who decides and all that stuff. I have never, nor will I ever, work in LTC. I don't know the process you gals go through in sending people out. But what I will tell you is it REALLY MAKES ME MAD in situations like I described in my original post, that these poor people are being sent to the ER to die! I am sure there are facilities out there that are awesome, and don't send out pt's who are actively passing. AND THIS IS NOT a "stupid LTC nurse sent her out" kinda a post. It is about not respecting out elder's wishes to pass with peace. Not allowing another human being to stay in the comforts of their bed and surrondings. Maybe because when I see a elderly pt like that I see a grandma, a pappy, a mom or a dad and it gets a little personal and I think what if this was my family member. And with anyone who passes in the ER that I took care of, I grieve a little for the family. I even shed a few tears too.

"As for the doctor who didn't want to give the morphine, that should have been handled by the hospice doctor and or nurse. Someone is always on call." Dixie, it was the hospice nurse who called report to me and sent her in because the hospice doctor didn't want to increase the morphine without a medical evaluation and said to send her to the ER. The poor hospice nurse was doing everything she could, trying to keep her home and comfortable.

Twice this past week we received two hospice pt's, two days apart, who were actively dying. Mind you these hospice pt's were DNR/DNI/DO NOT TOUCH ME I WANT TO DIE IN PEACE! One pt wasn't even in the ER 20 minutes and she passed. Thankfully the family made it to the hospital and was at the bedside. And it was a horrible night in the ED. We were getting our butts kicked bad. Every bed filled, flying out a critical, and several other critical pt's to care for. I was so angry that this poor pt was uprooted from her bed, taken from her normal surrondings, shoved in an ambulance and brought to us. The bright lights, hard beds, unfamiliar faces, weird sounds and sometimes horrible smells. What happened to dying with dignity in your own surrondings. But the nursing home didn't want to do the paperwork so they sent her to us. The pt's nurse was tied up with the critical pt being flown and I couldn't stand the family in there by themselves. Her sats were in the 60's, HR in the 20's and she was only giving an occasional gasp. I went in and stood by the bed quietly. I explained that her heart was slowly stopping and that her breathing would soon stop. After a few minutes I watched her heart go into v-fib then a few seconds later asystole. I stayed a few more minutes with the family until the other nurse could take over. The next night again, another hospice pt, actively dying. This time because the dr. didn't want to give the hospice nurse V.O. to increase the morphine to make her comfortable without being medically cleared! Granted she was getting a pretty hefty dose of morphine Q1 hour, but her lungs were diminished in the bases and full of fluid you could hear her breathing from across the room. So, we had to do as the family and dr wished. Put her on bipap, put in an iv, push lasix yadda, yadda yadda. I believe these were comfort measures because it did help her breathing but the poor lady just wanted to be free from her pain. She did pass later that night. Is this common where you guys work?

Wow kayak. Where did this come from? Nobody was personally attaking anyone (well until your post). In which post did Dixieredhead say pt's shouldn't be educated? I must of missed it. She said pt's don't have the right to dictate their tx. As they don't when they come to the ER like the OP did when she visited the ER. The OP basically tied the ED staff's hands when she refused narcs, important tests etc. But pt's do have the right to refuse tx and tests. And KUDOS to all the ER nurse's. From the OP's post (aside from the hallway comment IF it was about the OP) they didn't do anything wrong. You will never know what it is like until you work there. And although we are just "screenames" I feel I have come to know alot of you. And respect the opinions given by my fellow nurse's. If given the chance I would pack up and move if given the chance to work along side some of these nurse's. Dixieredheaded included! Just sayin..

Hi Mom35.......... I moved an hour and half away from my family right after graduation to take a job in the ER. I refused to take a job in med/surg like so many had suggested when my heart has always been prehospital and ER. I applied, interviewed and got the job. Found a beautiful, brand new place to live and everything fell into place. I always felt like it was meant to be. I am meant to be here, even if for a little while. I like it here, coworkers are great and learning so much. So, my advice to you is go for it. If it feels right to you, you really want this job, pack up and GO! The homesickness sucks sometimes but you make new friends and the new adventure is kind of exciting. Good luck to you and many blessings on your new journey.

We have a gentelman who comes into our ED about once a month for his "intractable n/v". We all know when he is there because you can hear him wretching all through the ER and even in triage through closed doors. He always gets admitted because nothing we do seems to work. Interesting though, he never asks for narcs. He gets about 2 liters of NS, labs checked and all the anti-emetics we stock. What is really interesting, and I discovered this during his last visit, when you take away his barf bucket and observe him, he doesn't so much as dry heave. When he is really in an "episode" he is in the fetal position and myself and other nurses and techs have observed him with his fingers down his throat. I believe it is all psychological with this man because he always begs to be admitted and if the doc mentions sending him home he really puts on a show. However, on another note. I have seen a few pt's who have been admitted for intractable n/v and they are miserable. I pray I never have to experience something like that because vomiting is one of the worst feelings in the world.

4'11 baby! AND a redhead

I am with Lunah on this one.

If you have ever played baseball with a chest tube and rolled up tourniquets. Or if you ever went bowling with lined up urinals. Have taken a body bag and went sled riding down the hill outside the ER. Have ever put tootsie rolls in a specimen cup and sent it to the lab on Halloween. (True story. It was an usual and rare occasion that the ER was dead the other night).

That is Hillarious!!!!!!!!!!!

This town isn't exactly "small" but not a large city either. We have a pretty good relationship with pd. This case was actually a rare occasion. This pt is a FF and often a trouble maker and is well known to us and PD. It wasn't only the case where he was looking for a fix (and unfortunatly got it) but then snuck out and drove on a suspended license. The officer was more than happy to go find this guy. Just so happens (I found out later) they didn't "camp out waiting for him" they busted him pulling into a local bar. Go figure.

1. If you are on a zillion medications, write them all down on a piece of paper and give the triage nurse the list instead of sitting there trying to remember what all you take. And no, "this little white pill" does not help, or "it is a medicine for hight blood pressure". 2. Know what your allergic too. Telling me "some antibiotic" is not a good answer. 3. Telling me you are allergic to tylenol, ibuprofen, ultram, toradol, all NSAIDS, and telling me only dilaudid works for your hangnail pain will not fly with me. Or the doctor. 4. If you think your cough you had for three weeks is now an emergency at 2am, PLEASE leave your 5 kids at home so they are not ripping and tearing through all the cupboards and playing in the garbage cans. 5. If you come to the ED with any complaint pertaining to your lady parts ex: itchy, discharge, rash, lumps, bleeding etc, or c/o abd pain PLEASE FOR GOD'S SAKE WASH THAT THING! Is it to much to ask to put a little soap on a wash cloth and clean down there! 6. If when I ask you in my primary nursing exam "any illicit drug use"? Be honest. Because if you tell me "no" and your UDS lights up like a christmas tree I am going to be really Pi&&ed. Just be honest. I will find out the truth anyhow. 7. If when I ask you "do you take any medications?" or "did you take anything for pain?" and you reply "No" and the UDS comes back positive for oxycodone and or opiates, I am going to be pi$$ed you lied to me. Just tell me. 8. Please for the sake of everyone around you, get a shower! I understand we all don't feel like dressing up in our Sunday's best when we are sick but for goodness sake when the bottoms of your feet are so crusty black from DIRT and there is lice the size of cotton balls jumping around in your hair and I am sure your skin hasn't had contact with a bar of soap in MONTHS make me want to barf. 9. If your motives are clearly to score narcotics for the simple fact to get high, at least be smart about it. If you are going to prick your finger with a safety pin to drip blood in your ua to make it positive for blood to help your kidney stone act, please at least make sure your finger is done bleeding before you hand me the cup with your tampered specimen. 10. Please don't lie to me when I ask you if you drove before medicating you with narcotics. Then when you lie to me and say "my friend dropped me off" don't get mad when I call the police and have them sit in your driveway and wait for you after you pulled your iv out and sneaked out of the er, into your car and leave after you got what you were looking for. I was outside smoking and saw you. And I got your license plate number. Ok, thanks for letting me vent. I feel better. :)

Your right, clearly I "didn't get it". Sorry for my two cents in the earlier post. Hope you find what it is your looking for.