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Emergency Department Nursing
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dortizjr1 has 10 years experience and specializes in Emergency Department Nursing.

dortizjr1's Latest Activity

  1. dortizjr1

    best practices

    Hello, I have a question for Operating Circulating nurses, (or any nurse that can point me to articles), the OR I work in has the practice of having OR RN's pull local anesthetic from a pyxis in our core and then we leave that local anesthetic in the preop area with syringes and needles for another RN to monitor and for the surgeon to administer. I worked as an ED nurse for 12 years prior to transferring to the OR and I never left any medication out of my sight so I'm uncomfortable with this practice. Is there a best practice recommendation or even an AORN recommendation in regards to this? The nurses in my preop area have a pyxis and are capable of pulling out any medication required preop and I haven't received an answer from my organization as to why I'm pulling and effectively abandoning a med at bedside, other than "that's the way we've always done it".
  2. dortizjr1

    Racist surgeon?

    True More or less what my parents taught me, though I'm not Jewish.
  3. dortizjr1

    Disturbing Conversation on Overweight Healthcare Workers

    I've been very interested in this topic, mainly because my hospital adopted a no hiring smoker/tabacco users policy several years ago. The policy actually states that new employees will be nicotine free - verified by a blood test and... our health insurance makes existing nicotine users pay a higher premium than other employees. Basically I wonder when health insurance is going to say, BMI above "magical level" you must now pay more or do without or loose weight to get to "magically acceptable level".
  4. dortizjr1

    Racist surgeon?

    I happen to work in an ED in a community hospital in eastern Pennsylvania. I'm not too far from Philadelphia and not too close. I've had very similar experiences to what OP relates. It's not just a southern thing.
  5. dortizjr1

    Project Management

    Some employers may require it, the same as some employers require a BSN to be hired as a staff RN. Some employers will allow substitution of relevant work experience.
  6. dortizjr1

    Project Management

    After moving into nursing informatics I became exposed to project management and have become interested in this process. Has anyone here moved from Nursing Informatics strictly into project management?
  7. dortizjr1

    We can't go on divert!

    The hospital I work at is 30 minutes from 2 level 2 trauma centers and 1 level 1 trauma center. These three organizations are substantially bigger than the hospital where I work and they routinely go on divert. Actually it's gotten so bad that all of the hospital in the region will go on divert and we, the smallest place will finally divert when it's just impossible to take anymore people. By that time though the environment in the ED starts turning into a people are going to start dying in the lobby and hallways environment. I really hate that administration lets this happen over and over. We also have a problem that when we do go on divert, our medics, yes our own medics tell people and families that if they insist on coming to our Ed that we can't refuse them. They show up, drop them off, give us dirty looks then leave. It really sucks at times.
  8. dortizjr1

    Help me find the positive in this

    At the risk of sounding very ignorant, what is and ER tech. I have a nurse aids in my ED and they do nurse aid tasks. An ED tech sounds like a person who does more than nurse aid tasks.
  9. dortizjr1

    Help, ER getting swamped.

    Yeah but what happens when the hospital is full? I work in a small rural hospital. We total at 150 beds and we've ended up holding patients in the ED for three days. The ED i work in has 20 beds total. We resort to moving regular hospital beds out of storage into our treatment rooms and then half the ED gets turned into a medsurg/ICU ward. In the mean time we've still got ambulances coming in, and the front doors are still open to the public. I mean the 4 hour rule is nice but what would happen in the UK in this circumstance?
  10. dortizjr1

    "IM doesn't work for me"

    Ah... me too.
  11. dortizjr1

    who does your casting and splinting?

    Almost the same where I work. We dont' have ED techs though. The nurses do all routine splints (metal or ortho glass), the ED Docs may do more complex fractures or just punt those to the orthopedic surgeons. This week I've actually splinted several ulnar-radial fractures, (not routine) but I do ankles, wrists, forearms, finger and shins every night. I love the ortho glass splinting material.
  12. dortizjr1

    Stupidest reason to go to ER

    How about nursing homes sending people who are hospice patients AND total DNR's to the ED because they are.... dying.
  13. dortizjr1

    Who me, a techy? A whole new world-nursing informatics!

    I'm new to the Nursing profession but not to the Information technology profession. My boss told me she hired me as a new grad 7 months ago partly because of my IT background and she was looking for someone to be a liaison for the department when we go through our conversion to meditech. It's good to see that a melding of the two fields is happening.
  14. dortizjr1

    Allowing infected staff to work--your thoughts please!

    I'm not trying to be smart here I honestly want to see what opinion is. How about an RN or an LPN that is infected with HIV? It's against federal law to ask people if they have it, but we have to submit proof of immunization against other diseases. I know you can't aquire HIV like measels, mumps or chicken pox, but still it's an Infection and falls under above's "happy little bugs".
  15. dortizjr1

    Allowing suicide vs. not allowing suicide????

    I work in a busy ED and we don't call an ethics committee. I have patients routinely leave the ED AMA or at least sign a voluntary limiting of treatment agreement. This past week I had several people go through entire cardiac workups to reveal life threatening conditions and in the end each one left AMA. I wondered about a persons right to die. Well i guess it isn't a right to die is it? A person can drink themselves into oblivion, shoot heroin, smoke crack, or do what ever drug of choice and destroy themselves and slowly destroy every one attached to them and they come into the ED via ambulance when they've been found by a loved one. Then once they are sober, or out of the influence they can simple insist to the Behavioral health people that they aren't trying to kill themselves and that is the end of the story. They walk out. I had a young person being brought into the ED frequently for OD'ing. I tried to 302 this person but the county crisis person denied my petition because he felt there wasn't sufficient evidence for it. I coiuldn't get the physician to back it up either. However. I 302'd a person last week because she said she wanted to kill herself while she was being triaged and that involuntary commitment passed with no problem. so I'm left with... ??? ...
  16. Hey Glamgal, A lot of hospitals seem to start recruiting in earnest between april and may. Well thats how it's been in my area for the last three or four years. I'm in Berks county, but I found hospitals in Lebanon, Montgomery, bucks, chester and some of the mainline health system hospitals where the same.

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