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Is anybody using an ultrasound machine (like the Sonosite) for finding/starting peripheral IV's. I did my first one the other night, deep brachial in a man who had bilateral forearm trauma and marked edema from overzealous crystalloids (when he had a...

Graduated 1991. Took CEN 1992. Passed. Take it every 4 years. Celebrating 20 years.

Does anybody else in the ER/ED do this? If a patient is using foul language directed at staff (calling us names, every other word is F**K or Motherf****r, etc) I chart, in quotes, exactly what the patient is saying. I do this so that if later, the pa...

We are re-designing our ED. It has been suggested to put TV's in the patient rooms. I am against the idea as our ED is disrupted enough and feel that TV's will encourage more visitors at bedside (always a problem) and loudness issues. Does anybody ...

The new (6th edition) TNCC which rolls out this year does dedicate a lecture and skill station to airway management and is up to date with ETT position verification. Problem with ANY course is that it is often outdated, in at least some respect, as ...

I have always had a dream of creating a common trauma course, one that was taken from hospital to hospital so that the teams that worked together in the smaller community ED's would take the course together. medics, EMT's, ER nurses and doctors and s...

Yes, it is called medical school.

Agreed. However, administration (in my experiences) rarely sees that nurses have limitations. Often there is a feeling that "a nurse is a nurse is a nurse" and there is no difference in capability, experience or competence. That is when it gets to be...

I am an acute care NP and all of my preceptors ere physicians. My choice. I have never fully subscribed to the nursing model and nursing Dx, even as an RN. Do what you want to do, there will be a job.

I just graduated from University of Southern Indiana (Evansville) ACNP program. ONline with clinicals set up locally (and approved by professors). Very good preogram. High pass rate and high certification rate. 2,3 or 4 year tracts depending on your...

I do not need a scheduled break. I have repeatedly gone a 12 hour shift with none, not even toilet break. But the common 8+:1 and sometimes 12:1 ratio got old and I felt the level of care by MD's and nursing was not (and still is not) safe.

That is one of the reasons why I left where I had worked for over 24 years. Too unsafe and administration did not care. Now they have temporary docs and agency nurses and so things are even worse. A friend still works there and he has had 20:1 ratios...

Ridiculous? YES! [EVIL]Dangerous? YES!![/EVIL] Uncommon? Increasingly NO. Where I used to work we were so poorly staffed and so very busy that if a critical patient came in that needed 1:1, the other staff might have 10 or 12:1 ratio and some of them...

Nope, I researched post rape options for a paper for my MSN. Many Catholic hospitals allow for post sexual assault counseling including providing medication to prevent pregnancy. SSFHS opted to go to the extreme, citing "working in concert with the d...

Striict adherence to Catholic dogma (no tubal ligations, no plan B for rape victims, etc) poor insurance plans, poor management, blinders to what is going on in the real world, poor management again. Left a facility I had worked at for 20 years becau...

Also hair tourniquets on fingers, toes and penis

Marfan's Syndrome

If you have read the book, worked in an ER x 5 years (that sees a fair amount of trauma, pay attention during presentations and practice all that you can during the skill sessions I can almost guarantee that you will do well. Good luck and have fun!

I have had 12:1 before, and no, that is not fast track. Real ER with real sick patients.

No. In fact, the fact that I am a paramedic also (23 years) in addition to an ER nurse (15 years) means absolutley nothing to nursing administration (even though my paramedic skills has saved the doc and the patient on more than one occasion). I als...

It must not be total crap if a couple of well known anesthesiologists subscribe to it. I agree that this is new ground but I think it is physiologically reasonable ground. I am not advocating a slug of a drug and walk away, but give the medication, ...

Some quotes from a critical care listserv regarding sedation: In most sedation situations, obstruction leading to lack of ventilation rather than total apnea is more common, although certainly apnea can occur. In most of the "rescue" situations to wh...

We use propofol a great deal for our CS procedures (as well as for our vented pts in ED). Works great, doctor is at bedside at time of administration, all equipment set up to manage any airway issue (none yet except very infrequent and brief bag/mask...

I was just at an ATCN course in St. Louis and was taught by many Illinois nurses who wore "TNS" on their badges. TNS is indeed a class but it ends with a very difficult written and practical trauma exam. IF you earned the TNS show off the TNS!