flychick08

just a side note to the excellent explantation that flightnurse2b gave....the patient may develop respiratory alkalosis (i think) because they are very tachypniec in an effort to compensate for the collapsed lung (pain causes tachypnea,too). i'd suspect that the alkalosis won't last very long with a pneumothorax or tension pneumo. they can't compensate that long and will flip over to respiratory acidosis despite the tachypnea. one more thing about tension pneumo's.....flightnurse2b is correct! tracheal deviation is a late sign...typically these pts. will also present hypotensive and will have a moi that may lead you to suspect a tension pneumo. good luck to9 you:up:

hmmm...where to go after er nursing?!good question!!! i've been doing er nursing for 5 years and am starting to feel the "burn-out". i just started flight nursing and it seems like a very natural transition. ems stuff-100 mph with your hair on fire (the stuff we all like), but without the whiners that come in that have had left great toe pain for 6 months and now it's an emergency, or the "my doctor is out of town, but before he left he said you guys would fill my script for 100 80 mg oxycontin tabs that i take for my fibromyalgia" type of nonsense that makes er nursing so exasperating. it's critically ill pts, load-and-go....stabilization....drop off and report......minimal bedpan duty:yeah:

glad to see nurses so interested in flight nursing! it's a tough field to crack. for those of you just starting out in nursing, i would suggest you do the following: 1)3-5 years of icu experience. know your swan-ganz, art lines,vents,etc inside out and backwards. once you start feeling really comfortable there, then..... 2)3-5 years er experience. now you get to use all that icu knowledge in a warp-speed setting. plus, you get very familiar with what the prehospital folks are doing (not as easy as it looks!!!) and you get to work with the docs side by side and learn what they expect. good stuff to learn, as they probably will end up being your medical command in one shape or another if you fly. 3)get all the alphabet stuff out of the way...and keep it current!!! (acls,pals,itls,nrp,tncc,emt,etc,etc...) you won't even get through the door to interview if you dont have those letters after your name. 4) schedule some ride-alongs with a local flight service. you'll see if this is something you really want, plus it gets your name in people's heads. strive to make the best impression possible. 5)stay (or get) really physically fit. i mean....less than 220#, lots of strength and endurance. you'll need it. i know all this seems daunting and it is!!! but the tenacity required to get all of this to apply is what separates the groupies from the rock-stars!!! don't try to cut corners!!! i've seen people try to cut corners and they get eaten alive once they are up in the air. you'll put your patients at risk and really irritate the crap out of your partner-neither is a good outcome. i've been a nurse for 17 years (icu,er,telemetry) and just got the opportunity of a lifetime to fly with statmedevac in the pittsburgh,pa area. it's worth the work. good luck!!!!

Nice. My first phone call would have been to the nursing supervisor or unit director. Second call would've been to the police. THE NERVE!!! People NEVER cease to amaze me with their stupidity. It was child abandonment...no matter what kind of spin this twit put on it.

I am so sorry this happened to you. The fact is....this didn't happen because of the fact that you drank. You were taken advantage of. People know when someone is too altered to consent to something, including this. This was absolutely not your fault and I'm sorry for the pain you are going through right now. I am a sexual assault nurse examiner and I have to say that unfortunately, your husband's reaction is not unusual-as a husband or as a police officer. Remember that he was hurt by this too. It's very hard for men to realize that they can't keep bad things from happening to their family (harder yet for police officers). You guys probably need some professional counseling. My thoughts and prayers are with you. You will come out of this a stronger, better woman. Just hang in there.

I had an 18 year old once who needed an IV. He had tatoos and piercings EVERYWHERE and freaked out when I told him I needed to put an INT in him. I asked him why he was scared when obviously he'd been exposed to needles multiple times in the past. He said that was different. I said (probably shouldn't have) yes, this time would be different....My needles were sterile and this time he was sober. He quieted down pretty quick after that:smackingf

Yep....I feel your pain!!! Our hospital is building a new tower-6stories. The ER has seen the most growth as far as sheer pt. volume in the past several years and the ER is NOT going to be in the new building!! The nurse to pt. ratio is horrendous every day, given the acuity. So...we have to take care of very sick pts, work around the construction of the new tower, of which we won't be a part, and being told by management that what we need to make things safe, efficient, and more comfortable for everyone isn't in the budget. Yes-I am burned out too. I'd be less burned out if the administration wasn't making life so difficult.

you are right about agency nurses getting( and taking) the blame for all the ills of a hospital, floor,unit,etc. i just joined an agency this week. i figured if i'm going to get abused anyways, i might as well get paid better to take the nonsense from the administration! flychick08...my handle.....means that in 2008, i hope, i'll be doing flight nursing! pts, nurses and even docs at pick-up facilities are usually very happy to see the flight crew arrive. if they're sick enough to fly, the above mentioned groups almost never complain.....

Geez.....I thought that was just my hospital that was in bed with their union. Union representation on the state level was a laugh.....they are indeed in bed together. Union reps in the unit (fellow nurses) were great, but their hands were tied.

I am so sorry you are going through this. I have been subjected to a very similar experience within the past month. I am(was) an RN in a community hospital ED with a total of 17 years as a nurse under my belt. I'd been in the ED over 3 years. I got along great with most of the nurses, and have received accolades from all the ED docs on my work. I had a patient one night that physically attacked me and threatened to rape me. Administration handled the situation terribly, and when they discovered that they might ACTUALLY be at fault for having such poor security in place, they decided to come after me instead. They told me it was my fault and that I didn't know how to properly handle the situation. They told me they were going to suspend and then fire me. I told them to keep their job, I quit. They spent 2 weeks "investigating" the situation; not to improve how nurses and docs and other pts. can be safer, but how they can keep from being sued by staff or other patients. I spent 2 weeks crying and scared. I couldn't believe that my manager and her manager were so out of touch with what the nurses were going through in the ED or what we needed to do our job safely. Most of the other nurses in the unit have been very supportive; a number of nurses and paramedics are either taking other jobs or looking since this incident. Ironically, this particular facility is named "One of the best places to work" in my state. HA!!! I have learned to watch my back much more carefully. I hope that you have better luck in the future. I understand you wanting to get out of nursing all together......I have felt the same way. I'm going to keep on plugging along for now. Good luck to you and you are in my prayers:nuke:

It's too bad that happened. Most of the EMT's and Paramedics I work with are professional and pleasant. The problem described in your second scenario is this.....if an ambulance crew is called to a nsg home for a resp./cardiac arrest or distress, they are doing what they are supposed to do by performing CPR. Why call an ambulance if nothing was to be done for the distress? It is inherently against a paramedics nature and his/her job description to kick back and watch while someone codes in front of them. If you called them, then they more than likely are thinking that someone along the whole messed-up advanced directive BS line decided something SHOULD be done. Here's something else....if they get to the ER with a resp./cardiac arrest and haven't done ACLS protocol, they're butts are going to get chewed up by their medical command physician and the nsg staff at the ED. Plus, if the ER isn't supposed to perform ACLS, exactly what ARE they supposed to do? 9 times out of 10, the family will come in to the ED and completely turn over an advanced directive out of panic. So in the end, I think the overall view of EMS is to do CPR until directed by the POA or medical command to stop.

Hey....I don't know where you work, but I work in a large city ED and you have multiple pts. and sometimes 50-60% of them are high acuity. And we are a well-staffed ED in comparison to most. We have a very low turnover because our director absolutely WILL NOT hire new grads into the dept. It's unfair to them and to the rest of the staff that has to make up for it. You MUST be able to handle high acuity pts. efficiently and then you can begin to think about being able to handle lesser acuities on top of that as well.

Sorry....let me try to clarify that last statement. I mean that you very well may feel like you are in over head as far as pt. acuity, the demands of the pt.,the demands of the docs and your co-workers. They all aren't TRYING to make things hard...they all need everything done quickly and correctly. I think alot of grads (God Bless Them!) come out of school and have a overly-rosey picture of what nursing is in general. ER medicine is tough....physically,emotionally and mentally. I'm not saying you can't do it. In fact, if you are sure....please give it a whirl!!! I just want you to be happy in the field after the first year or two and not wish you had gone into accounting instead.

Ok...I'm ashamed to admit it, but I initially went into nsg.school because I was madly in "love" with a gorgeous Italian med. student. Our plan was to graduate college and travel the world saving people. Yeah, it's goofy!What do you want?! We were 20 yrs. old and full of dreams and hormones!! It turned out I did the right thing for the wrong reasons....never have regretted it either.

Actually, float pool is a VERY good idea! That way you can get an idea of what might be a good fit for you. Don't get me wrong.... I love being in the ED, but I would have been eaten alive if I hadn't had ICU experience first. If you really want to do it, by all means do it! But you can get some good experience behind you first:balloons: