kmoonshine

kmoonshine RN

Emergency

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All Content by kmoonshine

  1. My daughter's experience today in a Phoenix Emergency Room

    Please don't take offense by what I'm about to say... Your daughter went in with multiple complaints; some docs say "pick one". The solution to "nausea" was get a preg test at the dollar store. Now,...
  2. Darvocet vs Percocet

    Usually it involves the severity of pain and the pts history. Darvocet is a C-IV, usually used for mild-moderate pain. Vicodin is a C-III, usually used for moderate pain. Percocet is a C-II, usually...
  3. ? for ER nurses

    When I'm triaging and something like this arises, I follow my A-B-C's. Now, who knows what was going on exactly with everyone else waiting to be triaged; perhaps the pt having the "migraine" stated it...
  4. What can I do to get into an ED?

    Join the ENA (Emergency Nurses Association). It looks good on a resume and they have lots of good journal articles. You may need to transfer to a hospital and work med-surg - and after a certain...
  5. Grand Rounds?

    It could also be a lecture-format presentation, where a specific pt history is discussed. I held a grand rounds presentation on a pt that I cared for who had lupus. She was in her 60's, and I was...
  6. Someone told me something that upset me today.

    And this behavior makes all those employees with a few tardies look bad. "Nurse Jane has a perfect attendance record, even during those blizzards we had in December...but you, Nurse Mary, were tardy...
  7. No one is going out of their way to ruin this person's career, and mistakes do happen. But, the mistake that happened was when the wrong medication was given to the wrong patient. This mistake was...
  8. Simply Dehydration

    http://www.mcc.ca/objectives_online/objectives.pl?lang=english&loc=obj&id=99-1-E http://www.medcalc.com/sodium.html http://clinicalcases.org/2004/05/hypernatremia-due-to-dehydration-in.html...
  9. Simply Dehydration

    Ok, I'm going to take a stab at this one... Pts that are hypernatremic can't receive rapid IV fluid therapy to try to correct the imbalance (it must be done slowly). Quickly adding IV fluids (which...
  10. The returned medication should have been given directly to the pharmacist. When narc pills are dispensed, they are double-counted, initialed by the person who counted the pills, and verified by the...
  11. Vicodin and Percocet

    It is not appropriate to have both vicodin and percocet ordered concurrently. It would be appropriate for orders to give tylenol every 6 hrs for mild pain, OR vicodin every 6 hrs for moderate pain, OR...
  12. Vital signs

    I hope that you repeated a manual BP (we once had a student reporting that a pt was hypotensive; turns out that the student was taking the pts blood pressure with her arm up in the air, rather than...
  13. Holding each other accountable..

    Next time you get report from this nurse, ask them for 2 minutes of their time to pop into each room with you for a quick "bedside" report. That way, you can address these issues right away....
  14. ER nursing and pregnancy...

    I don't have any personal experience to share, just some advice. I'd be uncomfortable at triage if I was pregnant, just because you don't know squat about the patients who come to the desk. What if...
  15. how do you expect me to pay for this???

    I consider this to be a part of my responsibility when discharging a pt. Just yesterday I had a little kid with strep throat and he was actively vomiting. The doc wrote a prescription for an...
  16. Malpractice Insurance?

    Get it - afterall, your license is with the state, not with the hospital. Do you really expect a hospital to cover you if you were sued? No way! The hospital is out to protect themselves and minimize...
  17. IM Administration of Immune Globulin

    Yeah, he got at least 8 shots. But like I said, it wasnt immune globulin (it was fosphenytoin - the guy had a seizure prior to ED arrival, was noncompliant with medications, and was combative and had...
  18. IM Administration of Immune Globulin

    I have not given this IM, but I once had to give a total volume of 20mL IM. Another nurse helped me give the shots (2-for-1 special). We divided the volume between the DG, VL, VG, and deltiod sites....
  19. Frustrated and let down.

    Sorry to hear about your troubles. However, any reputable employer will send you a letter in the mail that outlines a basic job offer. It usually is a "welcome aboard" letter which would include...
  20. How can I work specifically with GLBT patients?

    You probably wouldn't be able to find work caring specifically for GLBT pts. There isn't "GLBT-specific" hospitals, just like there isn't "caucasian-specific" hospitals. Depending on the area you...
  21. Explain the different trauma level designations to me please.

    You can look through the definitions here: http://www.facs.org/trauma/verifivisitoutcomes.html I think that the biggie for level 1 facilities is to have neurosurgery available 24/7 (but I'm not...
  22. Was anyone poor before becoming a nurse?

    I was poor before I graduated and I'm poor now (well, I feel like it anyways). However, being "poor" totally depends on your lifestyle. I've also noticed that it seems like earning more money earns...
  23. I cannot do this job anymore!

    As others have said, have you considered traveling or working prn/pool hours? Right now I work pool and I LOVE it. I pick my own hours (I've been favoring 4hr shifts lately) and I have to work one...
  24. Diprivan: push or not to push

    Some state BON's will not allow propofol to be used by nurses, unless the med is being used for sedation on a pt who is intubated. Propofol induces general anesthesia and many interpret that to mean...
  25. Admit orders