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ER, education, mgmt
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cookienay has 18 years experience and specializes in ER, education, mgmt.

cookienay's Latest Activity

  1. cookienay

    Geriatrics in ED

    Sitcom- As an ED nurse please allow me to say thank you for the above information. We completely let these things slide and it SHOULD NOT BE SO. Seeing the visit from the perspective of the elderly LTC patient has been beneficial to me and I will share it with my colleagues. God bless you for your work with the geriatric population, not just any nurse could do that! Cookienay PS- I have no idea what NICHE or GENE is.
  2. cookienay

    Coding visitors?

    I can tell you one thing not to do. That is call 911. What are the medics going to do? Put them on a stretcher and take them 2 floors down to the ED? Plus, EMS may want to take them to another facility and that would be a big no-no for you. Actually, per EMTALA guidelines (and all hospital personnel are required to abide by them, not just ED) emergency and stabilizing treatment must be provided. This includes anywhere within 250 yards (yes, yards) of the medical center (with some exceptions). And this standard holds regardless of the size or capabilities of your facility.
  3. cookienay

    Criticized by the media...(long)

    Big woo! No pillows. I don't remember that being a standard of care. Sometimes rooms aren't spotless. Should they be? yes, but alas reality prevails. Our society has been deceived! We believe we should never have to wait, never experience anxiety or pain, every complaint is legitimate, bad outcomes always means someone dropped the ball, and people are as sick as they think they are. And the media is partly to blame for this crap. OP- you are doing just fine. I believe you realize that it is not about us. We can't always be Suzy Sunshine. Frankly I would rather have Nurse Ratchet and Dr. Mean who know their stuff than than Nurse Perfect Personality who is an idiot. Do your best, and right in the middle of a crisis situation when it dawns on you that you are making a difference in whether this patient lives or dies- remember THAT is why you go to work. Best wishes! BTW...I just read what I wrote and it is soooo obvious to me that the past two days at work have been wretched.
  4. cookienay

    Athletes heart rate

    Healthstar- many athletes know their resting HR and their target HR. They can tell you if their HR is too high or low. Also, a good way to know is to look at them. Are they symptomatic with this low HR? While there is not a different "scale" for them per se, but bradycardia is definitely their norm in most cases. Hope this helps with your question.
  5. cookienay

    ER nurse to patient ratio

    We have 4:1 ratio in our 45 bed ER (with a 10 bed overflow area that we open PRN). While not a trauma center, we are a regionally recognized center for cardiac care and the busiest ER in our state (as far as volume goes). To me 4:1 with techs AND medics sounds sorta dreamy. Good luck!
  6. cookienay

    help!training a superior for my job

    Ditto to what the other posters replied. You know how to do this. You can't teach someone something if they already know it, anyway. *rolling eyes* Ahhhh, I remember the "special person pass". I tried to get one once, but it did not work out too well.
  7. cookienay


    Were you gone for more than the 12 weeks? Is this an exceptionally small facility?Is this standard practice?? If they have allowed others to remain in their identical position while you were not, a case could be made that you are being punished for taking your leave. Would not hurt to consult an attorney. Best wishes. As a working mom it is so hard when they mess with your schedule!! Dont they know how hard it is to find good childcare??
  8. cookienay

    Just interviewed a nurse who *loves* her job

    I love my job. Even when I deal with the drug seekers, drama, blood, customer service BS, whiny nurses, and cranky docs at the end of the day I love that I made someone feel better. Perhaps even played a small part in saving a life. What a tremendous privilege I have been given!
  9. cookienay

    Do RN's need special training to read PPD tests?

    In my facility, any RN may administer/read a Mantoux. The ER nurses are frequently the ones to do this because of course we are here 24/7. My favorite thing to see is someone hold up their arm and the nurse says, "Yep, it's negative" and sign their form. AAARRGGHH! If you did not touch them, you did not read it! I think that you should have to be trained and validated yearly to read them. But that is just me...
  10. cookienay

    Beta-blocker administraion error?

    Granted I work ED, not ICU but here is my thought... The meds were ordered, there were no contraindications at the time of administration. So, you followed the MD order and administered the meds. Sounds to me like you were acting as a prudent nurse and your doc is being a little passive-aggressive and looking for someone to blame. The physician should be familiar with standard med times at your facility and if he/she wanted them administered differently it should have been noted. Yes, you are responsible for safe med administration but the physician is responsible for the meds ordered. you did fine, IMHO.
  11. cookienay

    AAS-LPN/ Confused!

    I have never heard of an associate degree LPN. But it does not mean that it does not exist. Yes, an LPN has a lesser scope of practice and generally makes less money. I would have to wonder why someone would want to take two years to obtain a degree for LPN when you can get an RN in the same amount of time and make more money. But that is just me.
  12. Drug half life is not affected by PVD. Half life is what it is regardless of how the body distributes it. If drug ABCD has a half life of XX time then just because the body's circulatory system is compromised does not mean the half life changes. Does that make sense? Or did I completely misunderstand your post....been way too long since I have been in school.
  13. cookienay

    Escorting patients to labor

    Why is an Admitting Department making decisions regarding patient care? Serious question, btw...
  14. cookienay

    humerous, yet a little scary story

    What??? Grey's Anatomy is not real?? *gasp* :) Code 99 is mass casualty where I work. Or "get the heck out of dodge".
  15. cookienay

    ER nursing and pregnancy...

    Babypoo- I am sorry you are going through this. It must be tough not being able to work. However, you are employed as an RN under a specified job description. If you are unable to meet the criteria under your job description, under OSHA guidelines, your employer cannot allow you to work. They are not required to find a light duty assignment for you unless it is a WC issue (which hopefully this pregnancy is not ). It is not the employer's responsibility to find a job for those who find themselves in these positions. Sucks, I know. But if an RN job description reads.."must be able to lift xx pounds" and you can't- then well- you can't. I have this same conversation with almost every pregnant nurse I work with who thinks if their doc writes them for restrictions they will get a "light duty" assignment, when all they find is that they are sent home. (I do NOT think that is what you are trying to do BTW...) Not trying to sound preachy- just trying to shed some light on why they won't let you work. Best wishes for you.
  16. cookienay

    Feeling like a "bad" nurse

    Seriously, this should not be affecting your life. You provided the necessary assessments. You followed the standard of care. You responded appropriately when his condition changed. You are assigning too much responsibility on yourself. What would you have done differently? nothing. Allow me to gently say- move on. this is not worth your time or worry.