kathypbib

there is a way to palpate a systolic and a diastolic and it's pretty darn accurate. Place your fingers on the pulse near the A.C. (right where you'd place the bell of your stethoscope), feel the pulse, pump up the cuff about 20-30 mm past where you loose the pulse. Release slowly. The first time you feel a pulse will be the systolic, when you feel the "change" in the pulse, that is your diastolic. Exactly like you'd take it with your stethoscope, only you're using your finger tips. Practice it a couple of times before you rely on it. It's a great skill to have when you're in a noisy place and can't hear a pulse.

I've been a paramedic for 11 years and am graduating from nursing school in December. They have offered me a job in the ER as an RN(17 beds serving 100-140 pts/day). On one hand I am a new grad, on another I have 11 years of patient care experience. What advice can you give me as I make this transition?

I've been a paramedic for 11 years and am now graduating from nursing school. The flight service based here runs RN/Medic. Some of the paramedic staff have 2nd jobs on the helicopter. According to them it's a great mix because the medics have their "comfort zone" on scene flights and the nurses specialty comes from critical inpatient transfers. Both staff members are cross trained, or in other words, critical care providers. I think it's a wonderful mix, especially having a foot in both arenas. Sometimes you have to think like a paramedic and sometimes you have to think like a nurse. Nurses and paramedics are coming from two very different perspectives with the same goal in mind.