soapaddictOH

My dad has been in the hospital a lot recently, and tells EVERYONE I am a nurse. I usually just sit back and watch everything going on, I don't say a word. I hate the nurse family members that act like they know everything, and comment about how things are being done "differently than at their hospital." I had a patient this week that had a foley in for an US, and her sister kept going on and on about catheters, and she would rather put them in than clean up ****, and blahblahblah... Guess what? She's a nursing student!

To the patient who has been in the ER weekly for "overdosing" on pills.... next time don't call a squad. To the patient who is drug seeking and lying about it... "Oh you were here 3 days ago and got a prescription for Vicodin from one of the other ER docs? Guess what!!! We can look up your record online, it's called an OARRS report!" "No, it's not a Teckmus shot. You aren't allergic to Sulfur. The medicine that starts with 'D...di...de...' is called Dilaudid. I'm making damn sure the doctor doesn't order it for your toothache you have had for 2 months." I'm pretending like Sodium Chloride is a new wonder drug, and I'm calling it Nackle and giving it to you as a big bolus while I tell you that it's stronger than Dilaudid.

You have ever been coding a patient and the family member of the patient next door walks over with an empty cup and says, " Excuse me, but Stella needs some more water."

When I work in ER 3-4 and sometimes 1-2 hallway patients. When I work in SICU 1-2.

I left ER and went to SICU recently. I also don't think a glucose of 212 is something to freak out about. I am still stuck in the ER mindset of blood pressures. I hate calling the floors and giving report- God forbid the patient has a blood pressure of 179/85. "Was the blood pressure addressed?" No. "That patient needs to be medicated for his blood pressure before he comes to the floor." Really? The nurses/docs are like that in the unit too. I have written up other nurses a handful of times in 10 years. Sending a patient to surgery with a K+ drip on straight tubing running wide open was one of the write ups.

Being an ER nurse, I can tell you that whay might help is having a pump ready if you know the pt is on a Levo drip. We call report to the unit before we take a pt up. The nurse receiving report know all about any drips the patient is on. Or when the ED chartS they gave Vanco at a certain time, but when I mull it over a little later, when I get my bearings, and I realize that Vanco should have been still hanging when they arrived, and then I call pharmacy, and they tell me Vanco was NEVER dispensed for this patient. In our ER the meds are done completely different than the floor meds. We don't fax orders down, and Vanco is a standard med in our Pyxis. How long are you giving them to run Vanco in? I always chart meds, fluids, etc that I give a patient. Why wouldn't someone do that? I am making the transition from ER nurse (9 years) to SICU nurse in a few weeks. Maybe I'll see the difference once I start working in SICU, but for the most part I think our ER does an awesome job. I hate taking a pt to the unit, and everyone is talking at the desk, and we are transferring the patient ourselves (2 people), hooking them to the monitor and waiting for the nurse or anyone to come into the room.

I'm leaving ER after 9 years and going to SICU. Nervous but really excited as well.

I used to make soap, and it was quite addicting. I have a lot of soap waiting to be used!!

I did burn nursing first, then ER. I did a little inservice for my er peeps on burn care a few years ago, and I have to say my fellow ER nurses don't listen! Triage will 99.9% of the time put ice on a burn. I will immediately take it away and throw it down the sink. Then families get upset and I have to explain to them to never put ice on a burn. It's even in our discharge instructions to put ice on a burn! Other nurses will cover a pt head to toe in saline dressings if they are flying out. Or slather Silvadene all over. Nooo! Dry sterile dressings! That's all the pt needs, because once they get to the burn unit they are going to the spray table.

http://http://www.youtube.com/watch?v=GW1q5vevwO8 hehehe... sorry I had to post this! :redpinkhe ER nursing vs floor nursing will always have it's debates. I do know that I love having my docs around, and that we can start protocols for patients when they roll in the door. Having lab results, and the patient being pain and nausea free by the time the doc sees them is nice. I get so frustrated calling report to the floor and being told that they can't accept a pt with a BP of 175/86 because it's too high. The ER docs don't generally treat a pressure like that, especially if the pt is hypertensive and missed a dose of meds. Or that a glucose of 260 needs insulin before the pt can come up. Ugh! I think that in floor vs ER there are different priorities. Most of the patients on a regular floor are stable once they are admitted, not so in the ER. I can have 4 patients with very high acuities and have to do everything myself, if the unit is slammin' busy. Not that the floors aren't busy, but their busy is a different kind of busy. I can never refuse a patient, and I don't understand why the floors can. I also started working part time at a LTC facility and that is another whole ball of wax... I like it, it's more laid back and not so stressful.

Mouth/teeth things gross me out. Sputum, when patients are hawking it up. Doesn't bother me to suction it out of an intubated patient. And lastly, ear irrigations. Ginormous balls of ear wax are not normal, and should not be in someone's ear.

I am also going to be working in LTC- part time, every other weekend.I'll be working days. I will still be working my 40 hour shift in the ER. Not quite ready to leave yet! I've been in the ER for 8 years. I'm used to the docs being right there, we also have protocols that we can start when patients come in and are triaged. I think that will be the hardest thing to get used to. I function as a charge nurse when needed, and must do a good job because they keep letting me do it. So I'm used to dealing with irate patients, families, etc. I am going to get 2 days of orientation, which makes me a little nervous. I would like to have more, but I am starting January 8th. We will have to keep in touch, make sure you update your post as far as how you are doing! Maureen

I worked in holding and would assist with all kinds of blocks. I gave the boluses with anesthesia standing right there watching. Most of the time it's anesthesia securing the catheter, I have the bupivicaine in hand already from injecting during the procedure. Same with femoral blocks.

None of those things happen in the PACU I worked at. Nurses will avoid patients rolling out from OR. If I had a stable patient, even though 1/2 hour VS weren't done yet I would take a 2nd patient. It was a big deal for a lot of the nurses to have more than one patient, the drama about it would last for a week. That's part of why I left PACU!

I can only tolerate triage in minute doses. I hate being screamed at..."Someone could die out here before they get taken care of!" while I'm holding pressure on an arterial bleed, trying to manuver the wheelchair to the back with my other hand and left big toe. "Okay, ma'am, what are you here for?" "A toothache." Puhhhlease!! I'm sure I managed an eye roll that was too obvious. I get in trouble in triage too much. I don't like it. I used to get stuck there every weekend because I did a 9a-9p shift. I would do 9-3 in triage and then come to the back and get stuck in code for 6 hours. :scrm: