ERbunny

Where oh where do y'all work that you can get that pt "in the back " right away ?? Lucky, lucky. I know we are all struggling with packed ED's and often triage is full of waiting patients who really should be on monitors, etc. We have 3 beds, 3 recliners and 5 "chairs", plus running an obstacle course around the wheel chairs. We do everything we can to get these pts ' care started, always keeping in mind that the complaint they sign in with may be totally benign compared to what is really going on, and we don't want to be that hospital in the news with someone dying the lobby. A bit off track, but it does speak to the OP a bit: you don't just need those BASIC cardiac skills--experience and "gut " help too... Good times !!

I was a new grad so long ago, my preceptor's first name was Florence. All kidding aside, my first job as an RN was CCU in 1968. I was incredibly fortunate in that the staff took me under their wings and treated me with care and respect. Critical care was very exciting as we kept inventing the wheel. When I made the change to ED after 12 years I was again treated with tremendous respect as I went through that challenging process. You know, lose the ICU mentality and get REAL. I have been in this ED 25 years and was recently honored with an award for excellence in education, I guess because I have precepted just about everyone, including my current manager. We have a 16 week residency for our new grads and most of them start out just fine. I am so proud to be associated with them, and what a pleasure to see them progress in their careers. God bless the new grads...someday we are all going to need them to take care of us !!

It was brought up that perhaps the toradol and phenergan were given too close together and came in contact. When Toradol first came out, I was working in a very small rural facility with 1 other RN and an always half-asleep doctor. We decided to "play" and see if the two drugs were compatible in a syringe. A most impressive result !! I try to dilute every IV med I give, if allowed by the literature...saves veins, saves pain.

I hope the original poster will return and let us know how her experience turned out. I have had several subpoenas, have only had to testify twice. Once my testimony helped convict a man who kidnapped and murdered a woman and her three year old daughter. Your careful documentation will stand you in good stead, especially as the events may be "ancient history" by the time it comes to trial. The DA will help put some of your questions to ease. Good luck.

Once more...I do have some experience: 40 years in critical care and ED. New grads, who I love working with, have requested me to be their preceptor. Yes, I do remember being new. I was very lucky to have winderful preceptors both as a new CCU nurse, and when I changed to ER nursing. This is one reason why I think it is important to start people off on the right foot. My point was that there are always at least 2 sides to the story, and the OP's charge nurse may not be guilty as charged. The OP mentioned her previous experience in a different specialty. If she comes from critical care, sometimes it takes a while to adjust to the pace and rapidly changing conditons of the ER. "been there, done that", and have tried to help many make that transition.

Oh great...another thread where the less experienced nurse is complaining about the more experienced ones in her department. Could it be possible that your charge nurse and the other nurses are right ? Instead of complaining about your mangaement, perhaps you should be grateful that they have extended your orientation, so that you will be a safe practitioner in the ER. Remember, as an orientee you are considered "non-productive" budget -wise (yes it IS a horrible term when you are probably working very hard). Yes, do keep a log of the interactions you are concerned about. Are the comments derogatory, or are they trying to guide you ? The ER is very fast-paced, and sometimes nurses don't use the TLC to their peers they would use with their patients. I sincerely hope you succeed, as does your management, or they wouldn't have extended your orientation. I do hope you realize that those experienced ED nurses are not basing their "judgement' of you on personal dislike. They probably do know more than you, and the really good ones will admit they are still learning also. PLease try to concentrate on your organizational skills and time mangagement, not worrying about cliques. I hope I have not come across as terribly cold, but this site is loaded with threads griping about older nurses and their attitudes and abilities. I sincerely wish you well.

Kizzy, you express yourself beautifully, here and on your other postings. Dear colleagues --the reason this turned into a discussion of age is the inflammatory phrase "past their prime". The obvious conclusion from so many readings of this and other threads is that bad attitiudes occur in all age groups, the challenge for managers is how to deal with them. Good luck.

This 17 year old sounds like a perfect candidate for the "medical necessity" screening by the MD....More of the hospitals in our area are going this way and perhps when word get around some of the abuse of the ER will diminish ( I know better than to think it will stop. LOL)

I am so very disappointed by the ageism displayed by some of the younger RNs on this board. There are several other posts and threads where ageism is rearing its ugly head. It is also showing up in my workplace where some of the very young techs seem to think they have to tell me things I have known since before they were born. Here are some facts: In 3 three weeks I will celebrate both 40 years as an rn, working all but 3 of those years full time in ERs and ICUs, and I will also turn 60 . I am still being asked to precept both new grads, and new hires, and I absolutely love it. Some of them have even requested me. It is fabulous to take part in their professional growth, and perhaps feel a little responsible for it. I work an average of 48 hrs/week on 7p-7a, am very prodective and get good evals from my supervisor and peers--all of them younger !! Aside from the divisive and mean attitudes expressed here, I have a sincere concern that these angry young nurses are giving poor care to their elder patients. Unless they spend their entire careers in Peds or OB they will be encountering an aging population over the foreseeable future. I used to joke about who would take care of us when we need it, now I wonder if they will even want to. Best wishes to all.

I am very impressed by the care and concern expressed here, and it brought back memeories of my nervous student days. However, you have descrbed fears that go beyond the nervousness many posters have described here, and I think it only fair to yourself, and your patients if you have a counselling session with faculty. Be as open with them as you are here, perhaps even share this forum with them. There are so very many ways to help others without being an RN, perhaps you should explore them, maybe with a pastor if you are a church member. As an afterthought, I am wondering about the hundreds of injections you gave. Was it nder a doctor's license? I think once you complete a pharm course you will understand my amazement that this goes on. I guess an unlicensed person doesn't have as much to lose, but still scary to me.

Whew...In a few short weeks I will celebrate being 60 years old and an RN for 40 years, all critical care and ED. Of course this does not mean I know more than the OP, but it does mean there are several things I do know. One of them is that I am a better and smarter person than I was was 10, 15, 20 years ago, and have really learned a lot since I was 38. A day without learning something is sad in its way. Some of our nurse residents have requested me to be their preceptor, a very touching honor, so I guess I still have something to offer. I don't think I could do CPR for 6 hours even when I was 20, and I don't think even our youngest and fittest techs could either..and some of them are also firemen. I work an average of 48 hours/week, and am very productive in my output. Perhaps the staff the OP is concerned about have strengths to offer the pt besides the physical. Life experience is a wonderful thing to have, even though it may be acquired through adversity. I am old fashioned enough to believe there is still a place for TLC, even inthe ED. It is extremely unlikely I will be reading these boards when the OP reaches this advanced age, but I sincerely hope they will remember with a light heart the exchanges here. Best wishes to all.

WELL......I think the OP said it in first post, that these people may have been mean even when younger. Please do not attribute their attitudes to age alone. You seem to be a thoughtful person and supervisor, so I hope you are not really guilty of ageism. I will celebrate/mourn (LOL) 40 years of nursing this summer. I work full time 7p-7a in one of the busiest EDs in my state, and yes I do indeed keep up, and often outwork, my younger peers. Precepting and oienting have been one of the most rewarding aspects of this long career. Our department has had an internship program for many years, after management realized we would have to "grow our own" ED nurses. Over the years I have worked with many nurses as they advance from secretary or tech to RN. One is now a shift supervisor, one is my clinician. If I can take even a small amount of credit , I am amply rewarded. I must also say, gray hair does NOT generate respect--I run across several people who seem to think they have to tell me things I have known forever. I have been blessed with wonderful health , and am far from my dotage. Best wishes y'all.

Please accept my condolences on your losses. I commend your courage in sharing this heartbreak with your students. Many years ago I worked with a woman whose son was brought in to the ED as a traumatic arrest while she was on duty. She was a very private person , and this wound only lightly healed , even many years later. I had so much respect for her ability to cope. Yet sometimes people can be so cruel. She and I attended a seminar on death and dying and the leader (cruelly, I think) , asked if any of us had lost someone close to us. (Haven't we all, how stupid to ask). My friend, usually calm and stoic, started to sob and had to leave the room, no comfort offered by the leader, who was supposedly the know-all of death and dying support. I think your boss's poor response is typical of how uncomfortable people are when faced with losses such as yours. They would just rather not hear about it, because facing such pain in our own family is so impossible to accept. Thank you for sharing your experience with us and your students, they are lucky to have you.

Here is what happens in the ED when no one will take report at 0700. Exhausted night nurse has to either give report to day nurse , who really should n't have to bother with a pt she will not be taking care of, she then has to give a report on a pt she barely knows. O r exhausted night nurse has to stay over and wait on floor nurse to get report, get coffee, chat with friends, etc, wants to assess her pts, etc, etc. Exhausted night nurse now wondering if she will be able to stay awake driving home having stayed late to give report. The ED is also now starting to back up, as the drive time trauma is now sucking up resources and the am bus has let off its load in triage. Bottom line : SOMEBODY on that floor can take report and pass it on. And yes I have been on the other side, having worked ICU the first 12 years of my 40 year career. We were NEVER allowed to refuse report unless we were personally involved in a code situation.

How interesting that this older thread is still relevant to us .and sad. We try as hard as we can to expedite employees when they show up as patients in our facility...professional coutesy, ya know. And I know they often expect it, or actually think they have the right to come down and get free advice, scripts, etc, from our docs. I can just just imagine how they would feel if they had to wait hours and hours in our lobby, and partly because the floor nurse wanted us to hold the pt. I try to be understanding when I know they have just had a code on their floor, or other crisis, but as said before, EMS just can't wait... One of my colleagues last month told me one of the unit nurses thought we only had 1 pt each........They are only allowed 2 patients, yet with our staffing one RN may have 3 fresh 1:1 pts ...... I loved the comment that we are all just one ED, with all the same problems, makes me feel less alone inthe world Best wishes all.