DC Collins

DC Collins ASN

ED

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All Content by DC Collins

  1. Immediate bedding

    DC Collins replied to emtb2rn's topic in Emergency

    Are you kidding? The whole point of this system is to get pts back to the room instantly to improve the door-to-doc times. They will never do that. Just two years ago charge nurses were leaving 1-2...

  2. Immediate bedding

    DC Collins replied to emtb2rn's topic in Emergency

    Even if pts are trickling in it doesn't always work. If I am gone, off to the floor with another pt, for 10+ minutes, that STEMI that we don't yet know is a STEMI that someone walks back waits that...

  3. Nurse/Patient ratio in the ED?

    DC Collins replied to jlan79's topic in Emergency

    Agreed, though in our case, our 3:1 (sometimes 4:1) as I just described is baseline. Someplace to start. We get a STEMI or CVA or respiratory distress or something and others jump in to help until...

  4. Medication tidbits an ER nurse should always know

    DC Collins replied to RNstdntSVSU's topic in Emergency

    Nitro in any form. Have the IV in place first. Have a bag of NS hanging ready. I have seen it drop systolic BP 40+ points. DC

  5. Central line protocols

    DC Collins replied to brainkandy87's topic in Emergency

    I wish it was always that simple. In our hospital, the ED docs do the central lines. On the night shift, sometimes the *one* ED doc has a pile of patients, some of them critical, and they don't have...

  6. Central line protocols

    DC Collins replied to brainkandy87's topic in Emergency

    We don't have that protocol at our hospital to my knowledge. At least I haven't heard of it and have never had a pt denied for it. For that matter, I have never heard of our ICU refusing a pt at all....

  7. Nurse/Patient ratio in the ED?

    DC Collins replied to jlan79's topic in Emergency

    Three to one 'regular' pts is our norm. Quite often we have a fourth mental health pt that doesn't require much of us once initial eval is done. We often get a fourth if an ambulance comes in when we...

  8. Recieving a patient from ER

    DC Collins replied to jkr2020788's topic in Emergency

    We are not going to electronic med ordering until next year. It is still on paper. Add to that, in emergencies, sometimes verbal med orders are necessary. To accommodate those issues, our Pyxis gives...

  9. Immediate bedding

    DC Collins replied to emtb2rn's topic in Emergency

    We are doing it too. Only for a few months now. It is great for the door-to-doc time, if being roomed is considered the doc time. But I too worry that someone has not been triaged and I am just...

  10. Verbal er orders...help me understand this

    DC Collins replied to tiltgirl's topic in Emergency

    I will gladly give meds, even narcotics, on a verbal order, *if*: 1) I have a great, trusting working relationship with the provider, and, 2) timing is very important (doc is doing a procedure or...

  11. Just a question to understand the ER better

    DC Collins replied to sheilahdee's topic in Emergency

    I won't call you crazy, but I will say that there are MANY times in my ED where there just isn't a monitor available. Every room is taken and every hallway bed as well so there is no place to move...

  12. ED support

    DC Collins replied to ERnurse1983Ontario's topic in Emergency

    We have 1:3 ratio as standard, but if things get nuts sometimes it reaches 1:4, and it often reaches 1:4 if we get drunks, suicides/other mental health evals. (Fast Track is another matter entirely)...

  13. Calling Code Blue in ED

    DC Collins replied to becca001's topic in Emergency

    Hear, hear. In our hospitals, ICU will call a code because there isn't an intensivist there. So an ED doc does run down there. And ED nurse goes as well just in case the ICU is nuts and more RN hands...

  14. How can we make the process of report from ER to floor better?

    DC Collins replied to nrsang97's topic in Emergency

    We use the report form that the floor (various departments) use to give shift reports. We fill in the stuff that we can answer on those forms and then have them in hand when we give report. That way...

  15. Med surg nurse breaking into specialty

    DC Collins replied to Silvergem800's topic in Emergency

    Do you work 12's? If so, you might want to try applying for per diem work in the ED at another hospital (12's giving you time to do so). If they need per diems badly enough, they will give you the...

  16. shots to peds

    DC Collins replied to rebels25player's topic in Emergency

    Thank you mariebailey, I have been an ED nurse for two years and didn't know that (I would always ask first anyway since we don't get peds that often in our ED, but its good to know!) DC

  17. I feel so dumb... I got flustered - about a patient in respiratory distress

    DC Collins replied to LalaJJB's topic in Emergency

    Additional thought inspired by what someone wrote above. Yes, nursing is about knowing your stuff. That comes with time. But IMHO even more important about nursing is knowing what you *don't* know....

  18. I feel so dumb... I got flustered - about a patient in respiratory distress

    DC Collins replied to LalaJJB's topic in Emergency

    Communication is key! Tell your charge nurse if your coworkers aren't available. The CN can eval the situation and make that pt a priority so that another nurse can come help you. Plus most ED CNs are...

  19. New to ER

    DC Collins replied to Emilynn09's topic in Emergency

    That whole post was one of the best I have seen. It lays it out clearly. There are only a handful of types of true emergencies and you get to know those protocols FAST, automatically. The best part is...

  20. Introverted nurse+ ER nursing?

    DC Collins replied to born2circulateRN's topic in Emergency

    I'm introverted. Very. Well, I was. School forced me to get over it a bit, finally being able in the end to be able to speak in front of others without sweating enough to fill a bath tub. But...

  21. call backs

    DC Collins replied to pm2rn's topic in Emergency

    We did them in our ED for many months. We all hated them. Especially since there was a script and, of course, it was hokey. I think it ended because we all slowly just started doing less and less of...

  22. How to get into a specialty area like ER w/o experience?

    DC Collins replied to TCrozierRN's topic in Emergency

    Just apply anyway, and emphasize your teamwork qualities. I went directly from school to the ED. It is possible. DC

  23. Considering ER but not good at starting IV's

    DC Collins replied to srleslie's topic in Emergency

    We are *all* bad at IV starts when we start out. If you have a decent facility, even though you have a year of experience as a nurse, they will preceptor you for a time in the ED. Work with your...

  24. Cooler weather and homeless "patients"

    DC Collins replied to NurseOnAMotorcycle's topic in Emergency

    I don't know about most other EDs but we contract our ED docs. They don't get paid unless they see patients. None of ours would let someone like this just hang out *unless* it isn't taking up...

  25. nurses and EMT's

    DC Collins replied to phieud's topic in Emergency

    I am sorry for how you have been treated. In my regular experience with our EMTs and Paramedics, there are a couple I think of as 'just taxi drivers'. But that's because there are some under...