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.

Wow you guys carry a lot of stuff! When I hit the floor I grab pens, alcohol swabs and flushes. I have a small tote bag with other misc stuff like crit care and emergency references, extra hair tires, gum, phone charger etc, but I just throw that under the desk when I get to work. Never needed my own trauma shears or stuff like that in my pockets or even my bag. The less junk you have to carry the better!

I went through several until I settled on the Master Cardiology. I can actually hear stuff through it now! The Cardio III is probably similar, however the Master Cardiology doesn't have a bell and diaphragm, just one side. You can still hear everything by pressing harder or lighter depending on what you're listening for.

Yup, this is exactly what I would have posted. 11-23 is my favorite also! Home in time to sleep for the night and you don't have to get up early. Plus the shifts go by so fast! Love it :)

Omg that was great! Looks like so much fun!

I've seen it once. 34 beds. And it lasted a couple of hours!! It was a weird morning!

This is the single simplest and useful piece of advice new grads can take from this forum. Obviously we do a lot more than just keep patients breathing, but at the end of the day, and you're feeling frazzled, just look back and say "at least they're all alive!" Like another poster above, I also used a to-do list while I worked med/surg. I had struggled for a while with getting all of my morning tasks completed before dayshift arrived. Eventually I started sitting down in that really still part of the night around 4-4:30am and making my list. I would divide up a scrap paper into however many rooms I had and put down everything I expected to do in those rooms from now til I leave. For example, scheduled meds would go in, accu checks would go in, foley empties, drain empties, anticipated pain medications, placing people in CPM's, pulling drains etc. A to-do list serves several purposes. First, if you have a list of things to do, and a patient calls out to go to the bathroom at 5:15 am, you can refer to your list and see what else needs to be done with this patient on your shift. Why not take their meds, pain pills, ice packs, ice water, etc etc with you. This will prevent you going in the room three other times to do all of these things as you remember them. Another excellent reason to make a to do list: Lets say someone codes on your floor and its 5:45 in the morning. Not the best time, but nevertheless that's when they usually go. Anyway, so you're scrambling around working on this patient, eventually they get them off to another floor or whatnot. Then what? Your adrenaline is pumping and you're probably going to have a hard time focusing. Hey, what's that in your pocket? A handy list of all the tasks you need to do this morning! Just start checking them off! Same scenario as above, but the patient coding is your patient. So you're in the room with the code team and then transferring them to ICU, leaving all of your patients with no nurse. One of your coworkers can use your to do list to make sure your patients are all taken care of. This exact situation happened to me many times, where I'd be behind for one reason or another and my wonderful coworkers would come find my list on my COW and start checking things off for me. And finally, my home run point for why to-do lists are good for floor nurses.... Once you've crossed all your stuff off, you can go home and sleep easy, knowing that you haven't forgotten anything, that all your stuff was charted and that everyone was taken care of! I used to use just a brain sheet and would often get confused with the massive amount of numbers and letters and stuff scratched all over the page. When I started supplementing my notes with a to-do list (typically just for really busy times - like the end of night shift was when I used it most), I noticed that I was much more relaxed, much more efficient and was able to easier anticipate my patients needs. Win-win for everyone!

Saw a guy with facial fractures being repaired in the OR. They peeled his face right down to his nose to get to the bones. Unforgettable.

Yep, you'd be crazy to pass it up. If ER is what you want to do, then you should jump on this opportunity. The chances that you'll find another ER job that's day shift is probably close to zero. You're a new grad, you'll almost certainly have to do a few years on nights. I've been a nurse for 4 years and I'm on the "waitlist" for dayshift still.

What a great explanation! Thanks hodgieRN!

Great sources, thank you! I'm switching to ED in the next couple of weeks, so I'm sure these references will come in handy at some point.