allstudentnurses

They'll change their tunes when they start getting sued.

I would also recommend this book very highly: Amazon.com: Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell (9780826105219): Jennifer Buettner RN CEN: Books

I have had patients tell me they came to my hospital because they had been waiting at Grady for 18 hours, not sure if that's true, but I have seen Grady have 80 or more patients in triage at a time.

Congratulations, now be ready to learn a whole new way or nursing. :)

I have to agree with Runner, I don't feel like I'm restricted in my E.D., I order a lot of things based on my nursing judgment and that is why I love the E.D. and will never work anywhere else unless I'm unable. E.D. is completely different from any other dept. in the hospital. I moved from med/surg to the E.D. as a tech and it took me a while to catch on with how things "worked" down there, but once I understood how things worked, I was hooked. Now that I'm a R.N. now, I love it even more. The E.D. is very stressful, you have to be able to keep your cool and manage stress well, otherwise you will not last. I admit, I get crabby at times when at work, but outside of work I'm usually extremely happy because compared to E.D. life, regular life is relatively stress-free. :-)

Okay, I think I have the best one yet. Two days ago, a man came in via ambulance, chief complaint was he ran out of his prescription medications. Seriously, he wasted a 911 call on THAT. Why he didn't call his physician is beyond me.

We use the GEM ring cutter system, works great for us. http://www.ringcutter.com/Index.asp

I work in the Metro Atlanta Area, have worked in downtown Atlanta and can give you lots of information about all the hospitals and pay around here, message me privately and I'll help you out.

BWAHAHAHAHA!!! That's sooo NASTYYYY

That's why when I hand out pills, I ALWAYS tell them to hold their hand out, palm up and I drop the pill in their hand. If they drop it, they feel it's their fault and they find it themselves, has always worked for me

Triage checks the temperature and unless they've been running a fever we don't re-check it as routine.

@ DeadHeadRN, you're lucky. I rarely get any paperwork from the Nursing Homes at all.

Had one the other night, had a "injury" to his arm, he came in via ambulance. It was a very minor bruise. He was triaged and discharged in all of about 15 minutes.

I personally make an effort not to care if the diagnosis is valid or not, if someone comes in and says they are having pain, no matter where it is, I do everything within my nursing power to resolve the situation. I try really hard to leave the determination of valid or invalid diagnosis / drug seeker or not a drug seeker up to the physician. There have been times where the patient was an obvious drug seeker and so I told the physician that I felt they were seeking, but that's usually only in obvious cases. But... We, as humans, still know very little about the human body (especially the brain) and for some to say fibromyalgia is a crap diagnosis boggles my mind. How can you give a definitive opinion about something when you don't fully understand what you're giving an opinion about? It would be different if "you thought" you fully understood something and gave an opinion on something based on what you "thought" to be factual, but everyone knows we don't understand the human brain and it's a great mystery at this point in humanity, I think it's very presumptuous to say Fibromyalgia is a crap diagnosis, how do you really know? Especially since the brain is where all pain in interpreted and relayed. I hope I haven't offended anyone with this post, but I felt the need to say it.

Interesting responses, I've recently brought this up in my dept.; they're response was to submerge the bag in warm water until the bag is warm. We have a level one fluid infuser, but I was told not to use it as it will infuse the fluids too quickly? What is everyone's opinion on using the Level 1 rapid infuser / warmer with patients who are not hypovolemic, but are hypothermic?

People who are angry / cause trouble for other people have their own problems / demons that they don't know how to deal with so they project / cause problems for others, that doesn't make them saints, but understanding that has helped me to deal with those people. Also... If you have a good management team (which is usually NOT true) they will not have knee jerk reactions to accusations and such, they will investigate, take their time and observe to see the truth and then deal with the problem person accordingly. Hope this situation gets better for you :)

I have had MD's give antibiotics without drawing cultures many times, do I agree with it? Of course not, other hospitals I've worked at drew cultures on just about anyone getting antibiotics, but it was explained to me (by one of "those" physicians that routinely don't order cultures before antibiotics) that he doesn't order cultures because then they are "required" to follow a certain pathway because cultures have been done; take from that what you will.

You could start having laboratory put something on the patients wristband (like a green dot) indicating cultures have been drawn, giving you the "green light" to give the antibiotics, just a thought.

I will typically give Toradol 30mg/1cc in the gluteal area, but I also give in the deltoid, but 60mg/2cc is too much fluid for the deltoid and may cause muscle damage. When you are giving a deltoid injection, you are putting fluid in the middle of the muscle, therefore, separating the power and causing it to tear; if you put too much liquid in the deltoid, it will cause irreversible damage and will cause excessive pain, which is why it's recommended that no more than 1.5 cc's be pushed into the deltoid, anything more than 1.5 cc's must go into a large muscle, likes the glutes.

Honestly, I've got most of the books on E.D. out there and there are a few that are my favorites because they do a great job of giving you the "meat and potatoes" of daily E.D. work. They are: 1. Fast Facts for the ER Nurse by Jennifer Buettner (My personal favorite) 2. Quick reference to triage by Valerie G.A. Grossman These books do not cover trauma, they simply cover what you will see the most of in an E.D. setting. If you want a book on trauma I suggest you take the TNCC course, that book, from the ENA, (in my opinion) is the best book on trauma. Good luck in your E.D. journey. Chris

Disclaimer: I completely HATE working in triage...okay, had to get that out LOL... Based on your description I would say 4, but there are so many variables when triaging a patient such as what they say, how they act, body language, how the site looks, and on and on...

18G is what is desired in my hospital, but they take what they get because there have been a few times we could only get a 22G. 18G is my go to guy, occasionally a 20G and rarely a 22G. The only time I use 24G is on peds

It's normal to feel dumb, slow, and inept... Over time you'll get better, faster, and (in my case) my memory improved.

I was going to say mosquito bite, because "it hurt", but I think pregnancy test beats that LOL