Gampopa

HI: New to working in the ER at a small community hospital but I've been an RN in various rolls for 20 yrs. While I "like" working in the ER I'm finding it difficult working with another RN - surprise! This RN has been in the ER for several years but now almost always does triage and that's it. Between triages this RN stands around chatting, joking and ***ing about how other department staff is so lazy. Meanwhile there are pt's to DC, meds to give, pt calls to attend to and this RN just continues to complain how shitty the patients are. And it's not just me other RNs know they will have more work to do when this RN is on. I know I can't control or change this RNs attitude but I'm having difficulty changing mine and find I really dislike and and avoid interacting with them. Any suggestions how I can adapt? Going to the ER manager I don't think would effect things.

OK. I think it is the floor the position is located on.

I've been seeing adds for Surgical D9s RNs. What is this position?

Yup. That's Meditech. You should get quicker at searching for basic information but it is a step back. And the system also doesn't share information well with other areas of the hospital. At least that has been my experience.

OMG get rid of the guilt. Hospital mngt will use that guilt to drain your life force energy until you want to leave nursing entirely. Are you thinking ICU will be less stressful? Maybe but with all the COVID pts in ICUs right now it may be much more stressful with the critically vented pt and their families. But you certainly will learn a lot. Good luck.

Like others have stated our ER has been really quiet and census is low. Our hospital has been financially marginal for the past 2 years and there is deep concern COVID19 will bankrupt us. No elective surgeries or outpatient procedures and the extra cost of COVID is making things really tenuous. We've had 2 deaths and several rule outs. We're making all kinds of plans for when the wave hits and hoping that the Federal economic package will have some money to keep us afloat.

Here's another link to a good research backed article on spread of COVID19 and use of PPE: http://www.cidrap.umn.edu/news-perspective/2020/03/commentary-covid-19-transmission-messages-should-hinge-science

Watch How the Coronavirus Spread Across the United States

I don't know if we can post company info but there is AYA Healthcare staffing. Our hospital uses them and they don't seem to be a fly by night organization.

We are told to adhere to the CDC recommendation of N95 for aerosolizing procedures covered by a procedure mask and just a procedure mask for all other pt interactions with r/o COVID pts. I hear repeatedly from my manager that is all you need and since CNAs do not do these procedures they shouldn't even get N95s. Coughing does not qualify as aerosolizing since the CDC doesn't include it in their list. I fail to comprehend how coughing is not aerosolizing and I disagree with hospital policy. I understand that we're rationing the remaining stock of N95s for when we get hit with pts but we're already taking care of r/o pts who may or may not be positive. I ask myself would I go into a r/o COVID pt room w/o an N95 and my answer is no way so how can I insist that other staff do so? Perhaps it's time to resign from my position.

At our facility, to ration masks, we are going by WHO recommendations for using N95 only when aerosolization is likely. However, staff is using N95s with any suspected COVID19 pt even for routine care. My managers are adamant that N95s get passed out only to staff that need them d/t the very limited supply which I understand. But I also understand staff wanting to protect themselves and their families so as the House sup I look the other way.

Isn't a pt who is actively coughing producing aerosolized droplets? I would want to be wearing an N95 into a COVID 19 room regardless of what procedure I'm performing.

The CDC recommends for healthcare providers to use glove, gown, N95 and eye protection in an AIIR room for COVID19 patients. Yet, in nearly all photos of anyone dealing with COVID19 they are in full body isolation suits with shoe and head coverings. I'm having some cognitive dissonance between what the DCD says to do and what other countries are doing. What am I missing?

Does your facility use an IV Tube organizer at bedside for pts that have multiple IV lines to keep tubing off the floor and in one place? I am thinking about something other than a wooden tongue blade taped to the bed rail.

Was passing off a pt who came into the hospital d/t a fall at home. The oncoming nurse was adamant that I tell her if the pt had fallen in the bathroom or in the living room at home and was upset that I wasn't able to tell her.