Wolfe24

I always did until I started working in a military hospital. My logic might be flawed, but it just doesn't seem necessary right now. If I go back to a civilian hospital, I will get a new policy then.

I messaged you just now :)

I work for MedTrust at NMCP. Feel free to direct message me with any questions. My department isn't staffed by Loyal Source (I think they used to be), but I assume they are pretty similar in how they handle things.

I've been looking in to Navy Nurse Reserves and I've been told only your years as a BSN nurse count toward your rank. I'm not 100% sure as I haven't yet talked to a recruiter, but I was told this by someone who recently commissioned into the reserves.

In almost 9 years of nursing, I've never attempted to aspirate blood prior to administering medications. I didn't learn to do that in school nor has it ever been a part of policy at any of the hospitals I've worked at. On that note, I have never seen my coworkers ever attempt to get blood return either (obviously not including PICCs or central lines, etc). Its quite easy to assess the patency of a line and getting blood return isn't necessary. I like to put my finger a few inches above the vein I'm flushing and you can feel the fluid flushing through easily. If the site isn't swollen, cool, painful, etc, and you can feel the flush going through, you're almost guaranteed to be good. Also, if someone has little tiny veins and all you can get is a 22g in them, it's going to be hard to get blood back sometimes, even on the initial stick.

Monitor tech who is a paramedic answers the calls and figures out which room they'll go to. Nurse or doc can technically do it, but the tech is always right there, so it's easiest.

I think it totally depends on the hospital as to what it means. Some places it's a float pool. Others you can even float between hospitals. I am in a labor pool spot right now and it literally only means that I am prn in my dept. I don't float anywhere, I am last to be scheduled, but I don't have to take call or give availability or anything. I think it's a rather unusual use of the term labor pool, but my point is that it could mean any number of things.

Let me get this straight - you're basing your entire opinion of all night shift nurses not off of any actual experience, but off of one complaint from one patient? Does that not seem a bit unreasonable? Then don't "do nothing." You'll have plenty to do to avoid being labeled. Once you work two hours on a night shift you'll realize just how much there is to do. You're the only one with this perception. Throw all of your misguided, preconceived notions out the window and wait until you have actual experience on nights before judging us all as lazy and incompetent. If you go in to your clinicals with this holier-than-thou attitude, I guarantee you, your experience will live up to your expectations.

I've skimmed through a lot of the responses here and I just want to say one thing: To the OP - You are right, it is NOT ok to scan meds that you are not giving at that time. I'm completely shocked that so many nurses with experience are advocating for this practice. Never ever ever say you've given a med if you haven't actually given it or started the drip. It is NOT ok. Its the same as charting ahead of time. You never chart your assessment before you do it, right? What if something changes? Its the opposite of "if you don't chart it, it didn't happen." What if you do chart it and it doesn't happen? HUGE liability. DON'T DO IT. EVER. I won't address the rest of it as it seems that you've gotten adequate responses there :) Good luck on your new adventure, you seem to have the foundation to become a great nurse - make sure you soak up what you're learning and seeing, but *always* question what you're seeing if you don't think its right. If you don't question something, you may develop habits from someone that aren't right. I've been at this for 7 years now, and I still ask questions if I see something new or something I'm unfamiliar with.

She will undoubtedly be exposed to male anatomy in her clinical training and later in practice. One of the skills nurses learn is how to do catheters on both sexes. Men can often get out of doing it on females, but I've never seen a female nurse not cath a male patient because she was uncomfortable with it. If she can get through her training somehow, perhaps L&D or mother baby would be good places for her?

I'm going to have to come to the defense of the OP here. I think many of you are not really reading what she's saying. She never said that verbal report shouldn't be given. Obviously there are times when a thorough report is necessary, but the point that seems to be missed here is that IF the floor nurse can peruse the chart prior to the admit being received, then the verbal report would be much more efficient and less time consuming. There will always be some instances when the floor nurse is swamped and/or can't get to a computer, but in general and when the floors have access to the ED chart it should be standard practice to read the highlights of the chart. If you don't have access to the same charting system, then the original post doesn't apply to you. At the hospital I'm at now, it is standard practice for the charge nurse to send up an SBAR to floors (mostly just med surg and intermediate floors) and then call to make sure it was received. There is no verbal report in these situations. The ED nurse is usually busy with other patients and may not even know one of their patient's has a bed assigned that is ready. Often on floors that do get verbal report, its the charge calling or another nurse who is floating who is attempting to get the patients upstairs. Obviously it is ideal for the nurse who is taking care of the patient to call, but sometimes that just isn't feasible. As the OP suggests, and I agree with, its easier for the floor nurse to look in the chart for answers than it is for the ED nurse who doesn't know the patient to look in the chart and then read the answers to them. I'll mention again though, that I do understand that sometimes the floor nurse won't have had time, in which this case, there does need to be a certain amount of understanding and respect between the nurses. If I am able to call report, it is insanely frustrating to get asked non-pertinent questions. I understand that floor nurses of any specialty have a different focus than ED nurses (I spent 4 years on the floor), but there are just some things we don't ask. For example when I get a 40 year old guy with chest pain through the doors, I don't ask him when he last pooped or look at his rear for breakdown. I've had these questions asked many times and I often get the feeling that the nurse asking them is just looking for questions that they know I won't be able to answer. I wish I could answer ALL of your questions, but there simply isn't time in the 1-2 hours that I take care of a patient to get down to that kind of detail. As far as things not being charted being the reason for not looking at the chart, personally I keep my charts as up to date as I can. If I don't chart a line relatively soon after I start it, I probably never will. Two plus hours later, I can't remember where I put that line on my fourth chest pain of the afternoon. I would like to think that most ED charts are up to date, but besides codes or STEMIs I can't imagine not keeping up with it. Hopefully you guys don't rake me over the coals with my response - but basically I think that if you can look over the chart, then you should, simply to save time on both ends. If you can't, then verbal report would definitely need to be more detailed.

1100-2300 is my favorite shift in the ER! You don't have to get up early and you don't have to stay up all night. I also like being busy because it makes the day go faster. At my job we would open 2 more pods at 1100 and then close them at 2300 so that's usually where the 11-11ers would go. It was nice because you could start fresh with your own patient load. At another facility, I would usually end up floating from 11-15 or fast track or something until a more "standard" shift change time (1500). I thought it was a great shift, but I'm not a morning or overnight person. You won't know til you try it!

I read through Jeff Solheim's pocket pearls, then went to a live course of his, and then did practice tests in the ENA book. I'd HIGHLY recommend Jeff Solheim, I think that review course was what ensured that I passed the exam. Good luck!

I did the RN to EMT-B course a Creighton and it was fantastic. The staff there are wonderful; very knowledgeable, helpful, and nice. I really wanted to do their paramedic program but its expensive and my state offers RN reciprocity. One of my co-workers did the paramedic program and loved it. If anyone is interested in the Creighton programs, I highly recommend them. The paramedic program has more requirements - like crit care experience and you have to be an RN or MD/DO.

Being more contagious later in the disease process actually makes a lot of sense. If you think about how this disease works and how people begin sweating with fevers and bleeding from all orifices, the opportunities for coming into contact with infected bodily fluids is much higher as the person gets sicker. Prior to becoming really ill with ebola, people aren't usually going around vomiting, bleeding and sweating on everything, so it would make sense that it would be less likely to contract it at this point.