Virgo_RN BSN, RN

...and spend hours cleaning up the mess left behind by the previous nurse, find several orders that were not addressed, causing delays in diagnostics, medications, labwork, etc., do you write an Incident Report? When I was on the floor, I would have...

I forgot about IV infiltrations. We're supposed to IR those too. And skin tears.

I've known CNAs to do agency work, but it's usually local/regional, and for shift fill-in, not extended assignments.

Sorry, off topic.... Once, when I was quite young, I was waiting at a hospital pharmacy to pick up my script. The person behind the window called out my name, and the name of the medication and what it was for, in front of a full waiting room. :mad...

When I go to get a patient from the lobby, I call their first name only.

People can be hostile and uncooperative for a variety of reasons ranging from basic personality traits to disease process. For me, I have found the most effective way to gain trust and get around this barrier is to brush off the rudeness, do not tak...

Again, the fact that none of the nurses were doing complete assessments raises questions in my mind about that facility. Why is it that virtually the entire nursing staff feels comfortable taking this kind of shortcut? While we are all responsible ...

Although I have never had 10 patients, let alone 7, I can say that I have had shifts like this, and I know how it feels. Even so, assessments are a priority. Patients may have to wait for a Sierra Mist, warm blanket, or even to be helped to the bat...

A diltiazem drip on a patient with new onset A-Fib, not started for two hours after the doctor wrote the order IS an incident, IMO. So is a CXR on a septic patient that was never ordered, and not discovered until 3 hours into the patient's ED stay. ...

Sorry. I had just gotten home from work, and when I'm tired, I tent to keep my posts brief. What I was wondering was, were there not any orders in place for the previous nurse? It sounds like there were. Even in the absence of orders, it would ha...

Does your facility not have some sort of insulin protocol for diabetic patients?

I dunno...I've seen actual procedural changes implemented as a result of IRs, and I've never seen anyone disciplined/fired over one. We are reminded that the IR system is for the purpose of process improvement, yet the mentality that it is "writing ...

I worked for 2 years on an inpatient unit and never really felt competent at IVs since ours only needed to be changed Q72 hours or when site condition warranted. I was able to get them on nice plump veins, but the little spidery ones always eluded m...

I agree that there is a general lack of accountability for personal health behaviors, but I think there is also a tremendous lack of knowledge as well. Counseling a 30 something man on bland diet (for N/V): "Scrambled eggs have protein?" Counseling a...

Sometimes it needs to be more rigid to go through the LES.

Q1hr narrative note, Q2hr vitals on stable patients.

Again, such posts admonishing ED RNs to reserve judgment do not add perspective to the discussion. I almost chose "you don't have a horse in this race", but went with the dog analogy. It's a figure of speech, not to be taken literally. In an att...

Interesting.

No, you didn't. You posted a "poor me, they thought I was a drug seeker" story, the type of which we have seen ad nauseum any time the topic of drug seekers in the ED comes up. These types of posts contribute nothing of value to the discussion, IMO...

Unfortunately, the subjective nature of pain makes it especially tricky to treat appropriately at times. We cannot just snow every person who comes in with pain with narcotics. And, when it comes to kidney pain, if that's what the docs were suspect...

No. It's because in the context of this discussion, it is a red herring.

tewdles, I am sorry about the unfortunate experience of your patient with metastatic cancer. Blaming is a part of dealing with such a devastating diagnosis, and I have no doubts that he blames health care providers. The thing that many people seem t...

The thing is, any nurse with half a brain knows this. These types of "reminders" are patronizing.

I'm sorry that was your experience, but you are also making an assumption that those of us who have an opinion on the very real issue of inappropriate use of the ED behave in a less than professional way with any of our patients. These types of fing...

How *dare* you question my compassion? Ask the patient who is dying of cancer and in my ED for pain control. Ask the little boy with acute appendicitis. Ask the little old lady with the broken hip. Ask the man who fell off the ladder who has a fr...