back2bRN

You may in fact have a "crap cart", the Broselow I am familiar with does have two of all sort of tubes on it in each drawer(and no issues opening it up). However our peds iv supplies and our io supplies are both in different and distinct portable caddies. The other system that I have seen work well is the Broselow duffel bag with each color a velcro attached to the main bag which contained the supplies used for all peds. Ie scope/blades,ect. That also worked well.

We use the Broselow Cart where I am, ours is fairly streamlined so don't often have things fall out the back and get stuck. However, our blades and scope are in the first drawer(pink/red). Maybe you need to re-evaluate the quantities and supplies in each drawer? Are your iv supplies in each drawer/fluids?

They are both easier than they were in years gone by...they are still both challenging if you DON'T prepare!!! So yes they can be simple but do the book work, walk through the scenarios and you will be well prepared.

I have similar reactions to the soap and hand sanitizers provided at the hosp. I bring my own, yes both and use them exclusively. I also moisturize with my own supply of hand butter. Of course you may want to speak with your OH&S in regards to being able to use your own supplies. Supporting your argument with the importance of frequent hand washing as infection control measures... As far as using my own, I have it at a central location and carry a small purse size sanitizer around if needed.

It's exactly as said by the above posters. The positions filled are the ones they want to fill or are pressured to fill. I have recently changed positions (new one to start in 2 wks), and my current one is posted but... there was a vacant position unfilled for over 2 months. My advice, keep applying, get your foot in the door somewhere, look at the "preferred" wish lists on the positions, see how you can add to your experiences by education.

At one of the tertiary centers they have an RN "greeter", from my understanding they(the Rn) gather the cc and do a very basic assessment then determine if they get a number and wait in line or go and be assessed immediately by one of the triage nurses. The idea of a clerk with limited experience and education doing what experienced triage nurses should be doing is terrifying and should make you extremely uncomfortable.

I completed the basic audit last year...it wasn't too bad, but yes it was airy-fairy and quite subjective. But yes you had better have documentation or it can be really bad for you. Always dot the i's and cross the t's. As jan said above, there are still impediments to positions here, budgetary from what I can gather. Two of our positions have gone unfilled from sept and nov of last year. One isn't even posted. And we are chronically working short....

Does not have a policy to DO this, however there have been instances (rarely and long ago) where a foley was placed in npo pts to expedite an U/S and assess viability of the pregnancy....had VB ect. So have done it,not routinely and would definitely question the practice as protocol.

Calm, focused steady people who use their brains, thinking about things not just acting but knowing when to act and when to think. Those who listen, as well as those able to kick it into high gear when needed. Flexibility, caring, firm. Being able to admit when you don't know and communicate concisely. Yes be assertive, but you don't need to be aggressive. Be self directed, independent and interdependent(at the same time). The ones who really don't work: Aggressive ones, those who always have to be right and can't deal when they aren't, those who can't be told anything...(you all know one!),the "cowboys". The ones who escalate any situation. The meek/quiet/slow ones that get walked all over.

I find the ones who are dramatic are going to be dramatic regardless of what is done or not done. I point out that they have had x,y,z for a,b,c and there is simply nothing more to be done but wait. Of course in a firm (yet caring) voice. They are the ones behaving poorly, my reaction does not have to engage that. I am not supposed to control my pts, but educate them.

I give my seat to anyone who may need it more than me....courtesy, not because of the MD behind their names. I've had docs and other co-workers give their seat to me when I needed it as well. Although sometimes my contrary nature takes over and if they expect it or feel entitled just because they are a doc, well I find it way more difficult to be nice! And shockingly enough sometimes I'm not courteous!

Tattle, no, especially after only one night of working with "Janet". You said that you were basically calling it a bad night until you HEARD what the other nurses were saying....... be forewarned but make your own opinion.You will likely work with her again and then you keep your wits about you, as well as being diligent with your patient load. You do have to establish a pattern, and you should talk to her directly. This isn't high school and you are a professional.

Bacteria is why not to wear polish or fake nails. Seen the infections come in from some salons who don't keep things hygienic. Buffing nails is wonderful. I have recently began to do that and wouldn't consider clear polish at all. My nails were also brittle and thin, peeling too. I keep them fairy short. I would steer clear of polish if at all possible.

It is subjective with some experienced nurses(which I find frustrating), but per the guidelines I work with when on the unit(brought back from front) it is a minimum of hourly and prn in that time frame.IE: After meds there can be specific intervals, pt condition changes , following procedures ect. What I find happening is that inexperienced staff begin modeling their habits after the more seasoned nurses, but minus the experience. So there has been some horrible situations and poor outcomes occur. But what exactly do you mean when you say "re-class"is that the same as reassess?

The only thing I find worse than checking off the boxes without actually checking things( don't get me wrong that is abhorrent) is complaining about how poorly organized the crash cart/room is......those same complainers have never checked it. Really how do you expect to find anything if you don't familiarize yourself with YOUR equipment!Some people are simply breathtaking in their complaints!!!

Thanks for the replies, it was prior to DI(which subsequently all our computer/server systems had a failure arghhh) First, yes it was ordered,I ensured the MD knew all the U/A results, second yes I offered alt of MS, declined by MD d/t "I don't want him to be drowsy" yet in anticipation of transfer I asked for antiemetic and got an order for gravol?!? Usual s/e drowsiness!! My other team member was from Trauma/surgery unit and she questioned the order as well. Initial CBC WNL except WBC which was double normal (underlying dental infection, teeth were awful-I wondered about meth mouth)Hgb,Hct platelets were fine,not even near lower levels of normal, nor indicating dehydration.I don't know what subsequent ones were though. Doc was made aware of urine issues and in fact didn't even want to have a cath put in. This pt was sent to the tertiary care center, ASAP BTW there is SIGNIFICANT hx b/w this MD & I, she loves her toradol.....ordered it for a first &worst H/A in a pt on Plavix....again I didn't give it and although I find it to be very effective, it can have some significant effects. Wanted to reduce a shoulder that wasn't out in a pt with bone mets, wouldn't call the rad on that one.(i went around her, the xray tech called the rad oncall to get them to read the xray) My days working with her involve me trying not to antagonize the situation by picking the hill to die on!!!

Sooo, here's the question.... do/would you give toradol to a trauma pt. Fall >25 ft thru many obstacles (wood ect) with +3 blood & +3 protein in urine and decreased output ? VS WNL. A&O x4. Pain mid thoracic. FYI, I didn't b/c of potential for increased bleeding, impaired kidney function, potential for surgery ect.

Days like that...wow They show us what nursing is REALLY about. You all made a difference in their lives and did what you could to ease the suffering. Great Job! Thanks for the reminder.

I was told...no news is good news. So if you are not being hauled into your managers' office, you are in fact doing a good job! Believe me, you would hear about it if you weren't doing well. Sucks I know, but do your job so you can look at yourself in the mirror and you won't need a managers "thata girl"

" I don't blame nurses who face it every day in the ER for getting somewhat cynical. Hopefully they don't show it, but I think maybe we lack some compassion if we trounce on nurses who come here to vent. " Hmmm food for thought.. why so fast to defend patients and so quick to judge colleagues ? It IS hard to deal with the entitlement that many people show when being admitted to the ER, " Yes I know you are sore"... sometimes it is merely that way! (My magic wand is in the shop!) I do try to have compassion for those around me, but it gets REALLY hard when the ONLY thing that will help with your pain extra Percocet/Tyl#3/Dilaudid/fentanyl/ect. which has been given less than on hour ago, within the limits recommended...and you are texting a mad flurry, while drinking your coke, eating your doritos and asking if you can have your cigarette! While declining other nonnarcotic forms of analgesia... Just sayin'

Give your "baby-brain" some time to re habituate to work... we've all been there, even the ones who adamantly deny it. At least you are aware of things. Good luck!

Depends on where you are from. In Alberta,Canada GN's are responsible for their own pt care. There are some limitations placed on them, but as said earlier, it really depends on your province/state. Ask your registration body.

Be honest, treat the employer with integrity and they will treat you in kind. Isn't there something in our code of ethics that speaks to this dilemma? IMO an employee that is honest, but potentially short term is way better than the one who is longterm but untrustworthy and tells me what I want to hear.

Answer to both is it can be, but isn't always. You will need to analyze things and be prepared to stretch in ways that aren't comfortable.

I echo what petethecanuck has said. I graduated in the 90's when there were no jobs(just layoffs and bumping), I took what job I could and was realistic about it. Be ready to have a plan B and take a job that gets your foot in the door.Try to get an undergrad position where ever they are offered. Honestly this past year has not been as bad as it was (in my recollection) back then. Good Luck