kmoonshine

kmoonshine RN

Emergency

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All Content by kmoonshine

  1. Lpn's working ER

    kmoonshine replied to Arky's topic in General Nursing

    Now, this isn't a personal statement on what I think LPN's should/shouldn't do -this is just from a legal standpoint. But don't most states require an RN to be triaging patients? This could be a huge...

  2. Paralytic Question

    kmoonshine replied to Nurseboy1's topic in Certified Registered Nurse Anesthetist, CRNA

    Agree with the above; succinylcholine raises (which is why many docs wont use it for patients with renal

  3. Are these procedures so bad?

    kmoonshine replied to shelikesmorningglori's topic in General Nursing

    Versed is a benzo that has amnesiac/sedative properties. We use it for short procedures that may cause patient discomfort (and therefore complicating the procedure). Splinting a grossly-deformed...

  4. Are these procedures so bad?

    kmoonshine replied to shelikesmorningglori's topic in General Nursing

    I've helped with lumbar punctures - and they're not that bad. My role has primarily been one of support. I'll give IV meds (either versed or ativan), and remind the patient to keep still. I'll...

  5. Zofran

    kmoonshine replied to scoopyjosh's topic in Patient Medications

    IMO, zofran is one of the safest medications out there. Safe for elderly patients and patients with kidney disease, and no dose adjustment required. Its also safe in patients with liver failure...

  6. Zofran

    kmoonshine replied to scoopyjosh's topic in Patient Medications

    I've never had a problem with Zofran - whether it be pushing it quickly, or slowly; pushing it through IVF, or just giving the med alone. However, the only med that I push "fast" is adenosine. I...

  7. Left ED job due to unsafe staffing...

    kmoonshine replied to kmoonshine's topic in Emergency

    Just a quick update: I've been offered a job position in another ED (3 RN's and 1 EDT for 8 rooms :nuke:). Oh yeah, the pay is $5.00 an hour more too! They also have a 24/7 on-site cardiac cath lab,...

  8. Question/Concern about pt and Dilaudid IVP

    kmoonshine replied to Christy1019's topic in Emergency

    The highest dose of dilaudid that I have given was 8mg IVP (patient had sickle-cell disease and had home pain medication management abuse issues). She begged me to "just push it all in". Yeah, sure...

  9. Help me stop obsessing over my shortcomings

    kmoonshine replied to RNcDreams's topic in General Nursing

    No one can remember everything. Good nurses are the ones who realize that they are unsure about something, and therefore look up the answer or ask someone for help. I'm also in the ED, and there are...

  10. A rant: sick time use and policies

    kmoonshine replied to andre's topic in General Nursing

    Totally agree - if you're sick, you're sick! How are we supposed to take care of others if we can't even take care of ourselves? Where I used to work, 1 sick day was an "occurrence". Seriously. And...

  11. Dilaudid and Psych patient

    kmoonshine replied to tampaflrn6's topic in General Nursing

    Where I work, dilaudid comes in both 2mg/ml and 4mg/ml bottles. Just thought I'd ask if the dosing was correct, since higher doses may need more narcan (and perhaps this is why the 0.4mg administered...

  12. Dilaudid and Psych patient

    kmoonshine replied to tampaflrn6's topic in General Nursing

    Is it possible that the dose was incorrect (perhaps 4mg was administered

  13. have you used chemical restraint?

    kmoonshine replied to diamondmeadows's topic in General Nursing

    "Chemical Restraint: a psychopharmacologic drug that is used for discipline, to control behavior, or for convenience and is not required to treat medical symptoms." I am in emergency nursing, so I...

  14. charting"incident report filled" in nurse's notes

    kmoonshine replied to NICURN04's topic in General Nursing

    Miss Mab: If there is concern that IR's are disappearing, why would one continue to work at that facility? Our nursing license is with the state, not the hospital where we work. If things are that...

  15. charting"incident report filled" in nurse's notes

    kmoonshine replied to NICURN04's topic in General Nursing

    As others have mentioned, do not chart that an incident report was filed (allows access for lawyers). Incident reports are internal reports and are to examine what happened, how it happened, and how...

  16. what is the best way to deal with belligerent patient?

    kmoonshine replied to Ms.RN's topic in Geriatric, LTC

    Depending on the situation (and if the patient is decisional), I usually tell verbally abusive patients something along the lines of "your behavior is unacceptable and if you continue such behavior,...

  17. removing tegaderm

    kmoonshine replied to godbless-yute's topic in General Nursing

    Use your dominant hand to "stretch" the tegaderm out and pull up, while stabalizing the hub of the IV catheter with your non-dominant hand. Don't peel the tegaderm; stretch

  18. Left ED job due to unsafe staffing...

    kmoonshine replied to kmoonshine's topic in Emergency

    Thanks for all the support - I appreciate it!

  19. For Trauma / ER nurses.. difficult topic..

    kmoonshine replied to ICor9:24's topic in General Nursing

    I'm so sorry for your loss. I would suggest calling the ED director/manager, and see if you can ask these questions to the nursing staff or MD that was taking care of your mother. Perhaps they would...

  20. Left ED job due to unsafe staffing...

    kmoonshine replied to kmoonshine's topic in Emergency

    PNB=Pulseless,

  21. Death bed visions

    kmoonshine replied to legend0710's topic in General Nursing

    You should read the book "Final Gifts: Understanding the Special Awareness, Needs, and Communications of the

  22. ED protocols that include zofran?

    kmoonshine posted a topic in Emergency

    Does anyone have standing orders/protocols for nausea and vomiting that includes giving zofran ODT? Our ED has been swamped with nausea/vomiting patients; and I didn't know if there was anyone out...

  23. ED protocols that include zofran?

    kmoonshine replied to kmoonshine's topic in Emergency

    Oh yeah, one dose of zofran 4mg ODT is safe for men, women, patients with liver disease, and patients with renal failure. Same dose for all, no adjusting needed (peds dosing is different

  24. ED protocols that include zofran?

    kmoonshine replied to kmoonshine's topic in Emergency

    Depending on how your facility charges, ondansetron ODT (generic) breaks down to roughly $20 $25 bucks a pill. I'm sure that is cheaper than the charge for placing an IV and getting reglan or...

  25. It's MY License....Made Report to Adult Protective Services

    kmoonshine replied to tencat's topic in General Nursing

    This was your patient and you had every right to advocate for them. We need more nurses like you - and I am sorry you are getting slack. I believe that you acted apporpriately, considering our RN...