Annisme

1. Trust your gut instinct. Even if it is wrong, you will learn something. 2. If you don't know, say so and get help. Trying to bluff your way through might kill your patient. 3. Don't take it personally. 4. Appreciate the techs and those who help you, and tell them you do. 5. Check meds the pharmacy sends you with the orders. 6. Ask questions and listen to the answers. 7. Working in the ED means you education is about to begin. Learn all you can from everyone you can. 8. The hoofbeats are usually horses, but the zebras in the herd will get you if you don't watch for and recognize them. 9. It's okay to cry with your patients and fellow nurses. We are caring human beings, no matter what the other floors think. 10. Don't bring home to work, or work to home. 11. Find someone safe to vent to. 12. Be kind to yourself. Ann

An extern's scope of practice depends on the school and the hospital...possibly the state, too. As far as being an extern goes...you cannot buy the experience you get as an extern. If you have the opportunity, DO IT even if it means going to a unit that is not your first choice. Every minute of experience you get builds your practice! Good luck!

? I was under the impression that it is mandatory to report all abuse and/or assaults, even when the victim does not want to cooperate. I know that I have reported several domestic abuse/assault cases to the authorities.

Lord, let my hands be Your hands, my heart be Your heart and may the words that come out of my mouth be what You would have me say instead of what I want to say!

Gayle, I'm sorry you've had a terrible experience with ER nurses. I have worked Med/Surg and now ER so I see both sides. Have you ever worked in the ER? I have invited several floor nurses to work a day with us and, so far, none have taken the offer. The usual response I get is :eek:"No Way!!" I'll let you in on a little secret... The hip fx patient you just got that is hypertensive; While you are on the phone with her physician getting Vasotec, the ER nurse that sent him/her up may have an ICU patient they are holding because the ICU is full, 2 peds patients, one waiting for transfer to a Children's hospital and a 40 year old with a STEMI they just put in the room vacated by your new patient. I'm sorry you didn't get the report and the orders you want prior to the patient arriving. Your new patient had a room assignment prior to the admissions orders being written and the doctor that wrote them put them on the chart and left. I understand that you don't have time to take report. We don't have time to call with it, but we have to find the time. If you haven't already, please walk the proverbial mile (really more like 10 miles) in our shoes. I think we should do the same.

I was assisting a doc with a procedure when his scribe passed out cold. Said scribe is now in medical school. Be sure to eat and breath...you'll be fine!

I give 12.5 mg MAX iv, diluted in 10 ml NS, IV not in the hand or wrist, and with a NS bolus running, per our facility policy. I still push it v-e-r-y slowly.

Hmmm, I'm in my 50's and if the girl referred to comes "waltzing into my ER", I hope she is ready for the knowledge and experience she will gain, but she has to keep up with me to get it. Being "hot and young" doesn't threaten me a bit and it doesn't mean anything when it comes to learning. I will happily mentor anyone who wants to learn, but they will need to be ready to receive it or get left in the dust. This gorgeous grandma can set the pace for the rest. Come to think of it, I know quite a few beautiful, "hot" old hags:D

Yes. I let the doc know if wanted an NG tube in a patient with a deviated septum he would need to find someone else to do it as I was not comfortable with it. He was a little miffed and decided to do it himself. He just wanted a sample of gastric contents. Patient vomited as soon as he started. Problem solved

Doc...I have a BSN...you have a PhD in things that matter to keep us all well, safe and to save our behinds. You are welcome in "my" ED anytime. I have a lot to learn from you. Thank you for all you have done and continue to do. Blessings, Ann

It is posted on the Board website. My results were posted in less than a week, but not everyone has that result

This doctor's behavior is unprofessional and unacceptable. Would I put up with it? No, not for a minute...but then I work in the ER and our docs treat us with respect and as part of the team. When other doctors come into "our house", they do the same. I don't think any of our staff would stand for someone screaming at them like that. Just my

You are doing what you were charged with doing. Some people will not be taught. That said. Document, document, document. If it comes back to you, you will have covered yourself.

Wheels, I agree with the above posts. I work in the ER and see a lot of folks over and over. Some really need to be here and I am happy these people know they can rely on us to help them. As for having and "Ativan push already ordered"...it sound like these nurses know and understand your anxiety at having to come in and are anticipating your needs. The nurses I know (even the ER nurses...LOL) have soft and caring hearts for their patients.

Our ER chest pain protocol: 2LNC, 325 mg asa, notify doc for nitro and morphine orders (MONA). Aspirin is not given if there is a contra-indication (GI bleed, allergy, etc.)

BRN = Board of Registered Nursing. Yes, I had to take oral and written communications classes..they were required to receive my BSN in California. Hope that helps!

Yes, you did the right thing. If someone leaves our ER w/an IV in place, we call PD to bring them back or assure it has been DC'd. If someone leaves after they have been medicated, they are "under the influence" and we are again required to call PD. We insist that patient's have someone to drive them and ask for names and to see the person. However, some of them lie. Someone was recently arrested for DUI after lying to a nurse and driving. Tried to blame the nurse, but great documentation had been done.

Personally, I have worked 10 in a row, 12 hr. nights in the ER. Didn't feel unsafe... I do have that extremely supportive husband (cooks, washes scrubs...Mr. Perfect:redbeathe) and have no problem sleeping during the day. I would have a hard time working that many day shifts.

You know what patient is in triage just by the wailing.

I felt the same way about my OB rotation. I sat and cried, telling my husband "I don't wanna do OB!!!" The calm, wise soul that he is put it simply..."if you know you are supposed to be a nurse, you have to do OB to finish nursing school." He knows me so well. It is hard, it is a lot of work and...IT IS WORTH IT!!!! Take a deep breath, know that you are not alone and keep putting one foot in front of the other. It is how you got this far...besides, NOT going in to OB when you pass the NCLEX is a great reward! Blessings to you.

I am still a relatively new nurse (6 mos) and, hence, new to the ED. We have a wonderful charge nurses who makes sure I get difficult patients and can learn in every situation. They remain available to me as resources and keep me on the right track. They answer my thousand questions and give me hands on help when needed. We also have techs who are worth their weight in gold. So, the answer to your questions is...I don't know. We have so much to learn, but having supportive, knowledgeable, experienced people around who will help you will get you there.

Not all California nurses are unionized, but we all have staffing ratios...

K=8.7 Pt alert and oriented

I have the Sketchers and I love them! :loveya: I bought a second pair. They don't feel heavy to me, the bottoms are "squishy" enough to absorb shock and my legs and back feel great! I bought them for comfort, not for toning, so I haven't paid any attention to that aspect.

I worked very hard for my BSN and I would be very upset to see someone using the credential who has not earned it. That said, you could mail one of the business cards to your facility (anonymously). You would have to check with your BON to see if it should be reported. Thanks for looking out for the integrity of our profession!