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  1. imanedrn

    Nurses at Disney

    This. Is. My. Dream. JOB! :hpygrp:
  2. imanedrn

    Having trouble with IV's! Can't get them to thread...

    IBPG = International Best Practice Guidelines. Following those isn't considered "blind" -- at least in most circles, these days. Also, I wasn't advocating that you simply d/c the line and do nothing for an indefinite period of time, until you can get another one. Reread my post. And stop taking this as a personal attack. That wasn't my initial intent.
  3. imanedrn

    Having trouble with IV's! Can't get them to thread...

    We ER nurses don't understand what that means
  4. I call all of my male nurse friends Murses. They often do the same to themselves. I think it's awesome that so many men are entering nursing. Diversity, hooray! I also prefer working with murses, esp in the ER. They're so much less catty, direct, to the point -- in general.
  5. imanedrn

    How long can IV push meds stay in a syringe?

    Don't get in that habit. As nurses, we do a lot of things that we just shouldn't because it's easier. Even though I "know" what meds I'm giving to my patient, even it's just one, I try always to bring the MAR with me to the Pyxis and bedside. Get in the habit of doing that, and it will become so second nature, that it will become one less thing for you to worry about. It sounds like you're just frustrated with being new. Take a few deep breaths and pat yourself on the back. You're open to suggestion, and that's one of the best things you can do as a nurse -- experience, intermediate, and new, alike!
  6. imanedrn

    ER's Turn Non-Emergencies Away?

    Young guy in his 30s in HTN crisis. Said he couldn't afford his BP meds. Had high end watch, clothes, shoes, gold teeth How do we better educate lay-people?...
  7. imanedrn

    ER's Turn Non-Emergencies Away?

    It's on their face sheet. I hear docs ask it all the time r/t which physician can/will admit them. After they've been medically screened, it's acceptable to ask about payment. There is no EMTALA violation then.
  8. imanedrn

    ER's Turn Non-Emergencies Away?

    We live in a Fast Food Nation. What else can we expect?
  9. imanedrn

    ER's Turn Non-Emergencies Away?

    I like this question a lot! "Who's your PMD?" "I don't have one. I can't afford one." "So how do you intend to pay your ER bill? Which directly affects whether or not I get paid? You don't want me to work for free, do you? Because, I volunteer at a free clinic, which I'm cool with, but I need this job to pay me, so I can continue to pay my bills, so I can pay my dr's visit bills." :nuke: I'm so flippin' jaded, it ain't even cool!
  10. imanedrn

    ER's Turn Non-Emergencies Away?

    It really is an education issue. EDs are not viewed as "emergency" depts anymore. It is perfectly reasonable to come in for tooth ache x1 month at 0500 for pain meds because my dentist can't get me in for another month Recently, there was a pt in the hallway who had "I'm doubled-over, moaning out loud" abd pain. A breather came in. RA sats 75%. 90% on 15L NRB. The pt saw me get the dr while her chart was waiting to be picked up, and she had the nerve to yell at me! I was at work, sick, and she hit the wrong flippin' nerve! So I yelled back at her! (Not my proudest moment...) "This person can't breathe! They're more important than you!" She yelled back, "But I've been in pain for a week!" Why are you here NOW then?! Or what about the family in the room next to the code room who needs a warm blanket NOW for dad who's cold?... People running in and out. Everything is loud. We're really not ignoring you! How do we compete when the lay public doesn't even comprehend what a true emergency is?...
  11. imanedrn

    ER's Turn Non-Emergencies Away?

    I LOVE THIS! The ER in which I work now does not MSO/MSE ANYONE! The one from which I came, where 1/2 of our pts were self-pay/medicaid, we MSO/MSE'd many. Of course, it's purely a financial decision. But this is smart move on the part of the hospital. He was right... the majority of ER visits are for non-emergent matters. It is a shame that these people can't afford primary care doctors. This pulls at my heart-strings (esp. as a tree-hugging liberal!). But I am out of a job if my employer gives everyone free health care to every person who can't afford care. Ultimately, this underscores a MAJOR problem with my GOVERNMENT, and it is not one that my employer should have to fix.
  12. imanedrn

    CEN's and experienced ED nurses I need your help!

    I love when the oncoming nursing home sends a patient for AMS. Then the family arrives and asks why the pt's here. "Because they're confused, right?" I ask. Family, "No..." Baseline is SO important!
  13. imanedrn

    Having trouble with IV's! Can't get them to thread...

    When infection is in question, what "we" are concerned with should not be our primary concern. True for children, I had no idea: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5110a1.htm "Replace peripheral venous catheters at least every 72--96 hours in adults to prevent phlebitis (128). Leave peripheral venous catheters in place in children until IV therapy is completed, unless complications (e.g., phlebitis and infiltration) occur." I have no problems telling a physician their patient will NOT have IV access unless they order a central line or PICC. If you want to extend those 72-96 hrs for "a few" until you can get another site, ok... but I have issue with bending rules indefinitely when my patient's safety is in question. Those guidelines aren't in place to make our lives more difficult. How do we expect nursing to be elevated as a profession if we don't follow IBPG?
  14. imanedrn

    Reapply a Fentanyl Patch?

    But why wake a physician for some basic critical thinking? I'm ALL FOR waking physicians when they need to get involved, but you don't need a new order for some tape. As a previous poster said, these patches are pretty fickle. Sometimes it's best to save the trouble and add tegaderm on top of every brand new patch.
  15. imanedrn

    HATE my job!!!

    I echo your sentiments. I know it's hard to stay positive when you do so many amazing things then get treated like nothing more than a waitress. Esp if you came from a challenge career field. I did the same as well. But remember why you did it. Remember the big picture. I'm convinced we'll always be frustrated simply because nursing pulls us in so many directions. Sounds like you have a lot to be thankful for and proud of. Also sounds like you work in an ER. And possibly need a good, long, well-deserved vacation. I'm on one right now! My unit is short-staffed (like they are every shift of every day). But I'm taking every minute of it for myself, so I can return in good health (emotionally, mentally, and physically). Don't become a burn-out victim! If all else fails, look to another unit? Or another area in nursing entirely. Good luck, OP!